Radiographic and MRI Assessment of the Thrower’s Elbow

Abstract Purpose of Review Throwing athletes are vulnerable to elbow injuries, especially in the medial elbow, related to high stress and valgus load in both acute and chronic settings as a result of this complex biomechanical action. This current review details the relevant anatomy and imaging features of common elbow pathology identified with radiographs and MRI in throwing athletes. Recent Findings Although elbow pathology in throwing athletes is well documented, advances in imaging technology and technique, particularly with MRI, have allowed for more detailed and accurate imaging description and diagnosis. Summary Pathology of thrower’s elbow occurs in predictable patterns and can be reliably identified radiologically. Clinical history and physical examination should guide radiologic evaluation initially with radiographs and followed by an MRI optimized to the clinical question. Constellation of clinical, physical, and radiologic assessments should be used to guide management.

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Imaging Review of Skeletal Tumors of the Pelvis—Part I: Benign Tumors of the Pelvis

The Scientific World JOURNAL ◽

10.1100/2012/290930 ◽

2012 ◽

Vol 2012 ◽

pp. 1-10 ◽

Cited By ~ 3

Author(s):

Gandikota Girish ◽

Karen Finlay ◽

Yoav Morag ◽

Catherine Brandon ◽

Jon Jacobson ◽

...

Keyword(s):

Plain Film ◽

Clinical History ◽

Benign Tumors ◽

Resonance Imaging ◽

Advantages And Disadvantages ◽

Radiologic Evaluation ◽

Imaging Characteristics ◽

The Common ◽

Magnetic Resonance Imaging Mri ◽

Pelvic Lesions

The osseous pelvis is a well-recognized site of origin of numerous primary and secondary musculoskeletal tumors. The radiologic evaluation of a pelvic lesion often begins with the plain film and proceeds to computed tomography (CT), or magnetic resonance imaging (MRI) and possibly biopsy. Each of these modalities, with inherent advantages and disadvantages, has a role in the workup of pelvic osseous masses. Clinical history and imaging characteristics can significantly narrow the broad differential diagnosis for osseous pelvic lesions. The purpose of this review is to familiarize the radiologist with the presentation and appearance of some of the common benign neoplasms of the osseous pelvis and share our experience and approach in diagnosing these lesions.

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Clinical history-taking and physical examination in medical practice in Africa: still relevant?

Croatian Medical Journal ◽

10.3325/cmj.2016.57.605 ◽

2016 ◽

Vol 57 (6) ◽

pp. 605-607 ◽

Cited By ~ 3

Author(s):

Ayo Oyedokun ◽

Davies Adeloye ◽

Olanrewaju Balogun

Keyword(s):

Physical Examination ◽

Medical Practice ◽

Clinical History ◽

History Taking

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Midthoracic Punctate Midline Myelotomy for Treatment of Chronic, Intractable, Nonmalignant, Abdominal Visceral Pain: 2-Dimensional Operative Video

Operative Neurosurgery ◽

10.1093/ons/opaa034 ◽

2020 ◽

Vol 19 (2) ◽

pp. E183-E183 ◽

Cited By ~ 1

Author(s):

Tyler Ball ◽

Zaid Aljuboori ◽

Haring Nauta

Keyword(s):

Abdominal Pain ◽

Physical Examination ◽

Surgical Procedure ◽

Visceral Pain ◽

Lower Abdominal Pain ◽

Clinical History ◽

Dorsal Column ◽

Complete Relief ◽

Patient Reported

Abstract Punctate midline myelotomy (PMM) is a surgical procedure that damages the ascending fibers of the postsynaptic dorsal column (PSDC) pathway to interrupt visceral pain transmission.1-3 It can offer relief to patients with chronic visceral pain conditions that are refractory to other treatments. Here, we present a surgical video of midthoracic PMM in a patient with chronic, intractable, nonmalignant visceral abdominal pain that failed over a decade of medical treatment. We choose T7-8 as the level for laminectomy in patients with pelvic or lower abdominal pain, because the postsynaptic pain fibers transmitting visceral pain sensation from the lower abdominal organs will invariably be caudal to this level. The patient developed immediate and complete relief of her visceral pain after the procedure, which was sustained through the 11-wk follow-up period to date and was able to be weaned off narcotics. Postoperatively, she remained full strength and had no impairment of light touch or proprioception of her lower extremities. Detailed physical examination showed a reduced vibratory sensation on the glabrous skin of her great toes. Regarding patient-reported sensory changes (not detected on physical examination), she reported some numbness on the insides of her feet that had resolved by 11-wk follow-up. She also reported some numbness of the vulva, but not of the vagina. However, by 11-wk follow-up, she reported this had resolved and she had normal sexual function. The only persistent sensation at 11-wk follow-up was slight tingling in her toes that was not bothersome to her.4 The patient presented in the following video consented to both the surgical procedure and the publication of her clinical history and operative video.

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Tibial Neuropathy—Tarsal Tunnel Syndrome

10.1093/med/9780190617127.003.0010 ◽

2018 ◽

Author(s):

Daniel A. Lyons ◽

David L. Brown

Keyword(s):

Physical Examination ◽

Surgical Intervention ◽

Tibial Nerve ◽

Clinical History ◽

Surgical Decompression ◽

Tarsal Tunnel ◽

Success Rates ◽

Tarsal Tunnel Syndrome ◽

Tunnel Syndrome ◽

Space Occupying Lesion

Tarsal tunnel syndrome (TTS) is caused by compression of the tibial nerve and its branches within the tarsal tunnel at the ankle. The diagnosis of TTS is often made clinically, but imaging and electrodiagnostic studies should be considered when the diagnosis cannot be ascertained from the clinical history and physical examination. Surgical decompression of the tarsal tunnels should be pursued only after conservative measures have failed or when a space-occupying lesion or point of tibial nerve compression has been identified. Surgical intervention requires complete release of the flexor retinaculum at the medial ankle, as well as release of the three distinct tunnels enveloping the medial and lateral plantar nerves and the calcaneal branch. Success rates for tibial nerve decompression vary widely in the literature, ranging from 44% to 96%.

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Clinical reasoning in feline spinal disease: which combination of clinical information is useful?

Journal of Feline Medicine and Surgery ◽

10.1177/1098612x19858447 ◽

2019 ◽

Vol 22 (6) ◽

pp. 521-530 ◽

Cited By ~ 2

Author(s):

Stephanie L Mella ◽

Thomas JA Cardy ◽

Holger A Volk ◽

Steven De Decker

Keyword(s):

Logistic Regression ◽

Physical Examination ◽

Clinical History ◽

Spinal Disease ◽

Multivariate Logistic Regression ◽

Intervertebral Disc Disease ◽

Disc Disease ◽

Feline Infectious Peritonitis ◽

General Physical Examination ◽

General Physical

Objectives The aim of this study was to evaluate if a combination of discrete clinical characteristics can be used to identify the most likely differential diagnoses in cats with spinal disease. Methods Two hundred and twenty-one cats referred for further evaluation of spinal disease were included and categorised as follows: non-lymphoid neoplasia (n = 44); intervertebral disc disease (n = 42); fracture/luxation (n = 34); ischaemic myelopathy (n = 22); feline infectious peritonitis virus myelitis (n = 18); lymphoma (n = 16); thoracic vertebral canal stenosis (n = 11); acute non-compressive nucleus pulposus extrusion (n = 11); traumatic spinal cord contusion (n = 8); spinal arachnoid diverticula (n = 7); lumbosacral stenosis (n = 5); and spinal empyema (n = 3). Information retrieved from the medical records included signalment, clinical history and clinical presentation. Univariate analyses of variables (clinical history, breed, age, sex, general physical examination findings, onset, progression, spinal hyperaesthesia, asymmetry, ambulatory status and neuroanatomical location) were performed, and variables were retained in a multivariate logistic regression model if P <0.05. Results Multivariate logistic regression revealed that intervertebral disc disease most often occurred in middle-aged, purebred cats with a normal general physical examination and an acute onset of painful and progressive clinical signs. Ischaemic myelopathy occurred most often in older cats with a stable or improving, non-painful, lateralising, C6–T2 myelopathy. Spinal fracture/luxation occurred most often in younger cats and resulted most often in a peracute onset, painful, non-ambulatory neurological status. Concurrent systemic abnormalities or abnormal findings detected on general physical examination were significantly associated with feline infectious peritonitis virus myelitis, spinal lymphoma or spinal empyema. Conclusions and relevance This study suggests that using easily identifiable characteristics from the history and clinical examination can assist in obtaining a preliminary differential diagnosis when evaluating cats with spinal disease. This information could aid veterinary practitioners in clinical decision-making.

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Lipolymphedema Associated with Idiopathic Cyclic Edema: A Therapeutic Approach

Case Reports in Vascular Medicine ◽

10.1155/2017/5470909 ◽

2017 ◽

Vol 2017 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Jose Maria Pereira de Godoy ◽

Henrique Jose Pereira de Godoy ◽

Aline Aparecida de Sene Souza ◽

Ricardo Budtinger Filho ◽

Maria de Fatima Guerreiro Godoy

Keyword(s):

Body Weight ◽

Physical Examination ◽

Female Patient ◽

Therapeutic Approach ◽

Clinical History ◽

Calcium Dobesilate ◽

Intracellular Fluid ◽

Total Reduction ◽

Clinical Control ◽

Patient Reported

Idiopathic cyclic edema is a type of generalized edema that mainly affects women. Diagnosis is made by the patient’s clinical history and an evaluation of the accumulation of weight during the day. The objective of this study is to report the clinical control of lymphedema associated with idiopathic cyclic edema using calcium dobesilate. A 55-year-old female patient reported generalized edema for years in that she woke up in the morning with her legs swollen and the edema worsened during the day. The physical examination revealed generalized edema. After four days of treatment with calcium dobesilate, the patient returned to the Clínica Godoy, Brazil, with less edema and reductions in body weight and the amount of extracellular and intracellular fluid. With further treatment, there was a total reduction of the edema. It is concluded that calcium dobesilate helps to control lymphedema secondary to idiopathic cyclic edema.

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Diagnosis of Appendicitis in Patients with Abnormal Position of the Appendix due to Mobile Caecum

Case Reports in Surgery ◽

10.1155/2012/921382 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Huseyin Toprak ◽

Mehmet Bilgin ◽

Musa Atay ◽

Ercan Kocakoc

Keyword(s):

Acute Appendicitis ◽

Physical Examination ◽

Clinical Symptoms ◽

Clinical History ◽

Abnormal Position ◽

Ct Findings

Acute appendicitis is usually diagnosed on the basis of signs, symptoms, clinical history, physical examination, and results of laboratory tests.The position of the appendix can vary considerably, both in relation to the caecum and because of the inconsistent position of the caecum itself, and may cause variable clinical symptoms. We present the CT findings of surgically proven acute appendicitis associated with atypically located caecum in two patients.

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Clinical predictors of vestibulo-ocular dysfunction in pediatric sports-related concussion

Journal of Neurosurgery Pediatrics ◽

10.3171/2016.7.peds16310 ◽

2017 ◽

Vol 19 (1) ◽

pp. 38-45 ◽

Cited By ~ 44

Author(s):

Michael J. Ellis ◽

Dean M. Cordingley ◽

Sara Vis ◽

Karen M. Reimer ◽

Jeff Leiter ◽

...

Keyword(s):

Physical Examination ◽

Clinical History ◽

International Classification Of Diseases ◽

Initial Assessment ◽

Clinical Predictors ◽

Blurred Vision ◽

Posttraumatic Amnesia ◽

Potential Risk Factors ◽

History Of ◽

History Of Depression

OBJECTIVE There were 2 objectives of this study. The first objective was to identify clinical variables associated with vestibulo-ocular dysfunction (VOD) detected at initial consultation among pediatric patients with acute sports-related concussion (SRC) and postconcussion syndrome (PCS). The second objective was to reexamine the prevalence of VOD in this clinical cohort and evaluate the effect of VOD on length of recovery and the development of PCS. METHODS A retrospective review was conducted for all patients with acute SRC and PCS who were evaluated at a pediatric multidisciplinary concussion program from September 2013 to May 2015. Acute SRS was defined as presenting < 30 days postinjury, and PCS was defined according to the International Classification of Diseases, 10th Revision criteria and included being symptomatic 30 days or longer postinjury. The initial assessment included clinical history and physical examination performed by 1 neurosurgeon. Patients were assessed for VOD, defined as the presence of more than 1 subjective vestibular and oculomotor complaint (dizziness, diplopia, blurred vision, etc.) and more than 1 objective physical examination finding (abnormal near point of convergence, smooth pursuits, saccades, or vestibulo-ocular reflex testing). Poisson regression analysis was used to identify factors that increased the risk of VOD at initial presentation and the development of PCS. RESULTS Three hundred ninety-nine children, including 306 patients with acute SRC and 93 with PCS, were included. Of these patients, 30.1% of those with acute SRC (65.0% male, mean age 13.9 years) and 43.0% of those with PCS (41.9% male, mean age 15.4 years) met the criteria for VOD at initial consultation. Independent predictors of VOD at initial consultation included female sex, preinjury history of depression, posttraumatic amnesia, and presence of dizziness, blurred vision, or difficulty focusing at the time of injury. Independent predictors of PCS among patients with acute SRC included the presence of VOD at initial consultation, preinjury history of depression, and posttraumatic amnesia at the time of injury. CONCLUSIONS This study identified important potential risk factors for the development of VOD following pediatric SRC. These results provide confirmatory evidence that VOD at initial consultation is associated with prolonged recovery and is an independent predictor for the development of PCS. Future studies examining clinical prediction rules in pediatric concussion should include VOD. Additional research is needed to elucidate the natural history of VOD following SRC and establish evidence-based indications for targeted vestibular rehabilitation.

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Clinical Diagnosis and the Order of Information

Medical Decision Making ◽

10.1177/0272989x9801800409 ◽

1998 ◽

Vol 18 (4) ◽

pp. 412-417 ◽

Cited By ~ 32

Author(s):

George R. Bergus ◽

Gretchen B. Chapman ◽

Barcey T. Levy ◽

John W. Ely ◽

Robert A. Oppliger

Keyword(s):

Urinary Tract ◽

Physical Examination ◽

Clinical Decision Making ◽

Laboratory Data ◽

Clinical Information ◽

Clinical History ◽

Clinical Decision ◽

Background Information ◽

Likelihood Ratios ◽

Patient’S History

Background. Information order can influence judgment. However, it remains unclear whether the order of clinical data affects physicians' interpretations of these data when they are engaged in familiar diagnostic tasks. Methods. Of 400 randomly selected family physicians who were given a questionnaire involving a brief written scenario about a young woman with acute dysuria, 315 (79%) returned usable responses. The physicians had been randomized into two groups, and both groups had received the same clinical information but in different orders. After learning the patient's chief com plaint, physicians received either the patient's history and physical examination results followed by the laboratory data (the H&P-first group) or the laboratory data followed by the history and physical examination results (the H&P-last group). The results of the history and physical examination were supportive of the diagnosis of UTI, while the laboratory data were not. All physicians judged the probability of a urinary tract infection (UTI) after each piece of information. Results. The two groups had similar mean estimates of the probability of a UTI after learning the chief complaint (67.4% vs 67.8%, p = 0.85). At the end of the scenario, the H&P-first group judged UTI to be less likely than did the H&P-last group (50.9% vs 59.1 %, p = 0.03) despite having identical information. Comparison of the mean likelihood ratios attributed to the clinical information showed that the H&P-first group gave less weight to the history and phys ical than did the H&P-last group (p = 0.04). Conclusions. The order in which clinical information was presented influenced physicians' estimates of the probability of dis ease. The clinical history and physical examination were given more weight by phy sicians who received this information last. Key words: diagnosis; urinary tract infec tions ; judgment; primary care; clinical decision making. (Med Decis Making 1998;18: 412-417)

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