The Phenomenon of the Apparent (Double) Femoral Head in Infant Hip Sonography According to Graf-Description, Incidence and Clinical Relevance

2019 ◽  
Vol 158 (05) ◽  
pp. 462-465
Author(s):  
Charlotte Struwe ◽  
Rahel Bornemann ◽  
Sebastian Gottfried Walter ◽  
Sebastian Koob ◽  
Richard Placzek
Keyword(s):  
Femoral Head ◽  
Clinical Findings ◽  
Coxa Vara ◽  
Trochanter Major ◽  
Ultrasound Findings ◽  
Neonatal Hip ◽  
Definition Of ◽  
Hip Flexion ◽  
Hip Rotation ◽  
Double Head

Abstract Purpose Hip screening sonography according to Graf in rare cases yields the appearance of a double femoral head, aptly named the Double-Head-Sign. The goal of this retrospective study is to offer a definition of this rare sign, evaluate its incidence of occurrence and compare the sonographic findings with the clinical findings. Materials and Methods This Double-Head-Sign is caused by the overlap of the trochanter major with the actual head of the femur in cases of coxa vara. This was observed in 13 of 2800 neonates we screened as part of our sonographical neonatal hip screening. Results 13 neonates presented themselves with ultrasound findings in accordance with our description, yielding an incidence of 0,46% in our patient cohort. In correlation, these neonates also exhibited increased external and decreased internal rotation of the hip. Two had an underlying condition (achondroplasia). Conclusion In these rare cases, clinical examination of hip rotation in 90° hip flexion has proved helpful and further interdisciplinary examination of such infants to distinguish a possible underlying primary condition is recommended

Legal Update: North Dakota Supreme Court: Third Edition of Guides is “Most Current”

1999 ◽  
Vol 4 (1) ◽  
pp. 6-7
Author(s):  
James J. Mangraviti
Keyword(s):  
Internal Rotation ◽  
External Rotation ◽  
Measurement Techniques ◽  
Fourth Edition ◽  
Hip Motion ◽  
The Difference ◽  
The Right ◽  
Hip Flexion ◽  
Hip Rotation ◽  
Hip Extension

Abstract The accurate measurement of hip motion is critical when one rates impairments of this joint, makes an initial diagnosis, assesses progression over time, and evaluates treatment outcome. The hip permits all motions typical of a ball-and-socket joint. The hip sacrifices some motion but gains stability and strength. Figures 52 to 54 in AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, illustrate techniques for measuring hip flexion, loss of extension, abduction, adduction, and external and internal rotation. Figure 53 in the AMA Guides, Fourth Edition, illustrates neutral, abducted, and adducted positions of the hip and proper alignment of the goniometer arms, and Figure 52 illustrates use of a goniometer to measure flexion of the right hip. In terms of impairment rating, hip extension (at least any beyond neutral) is irrelevant, and the AMA Guides contains no figures describing its measurement. Figure 54, Measuring Internal and External Hip Rotation, demonstrates proper positioning and measurement techniques for rotary movements of this joint. The difference between measured and actual hip rotation probably is minimal and is irrelevant for impairment rating. The normal internal rotation varies from 30° to 40°, and the external rotation ranges from 40° to 60°.

Dreifachosteotomie des proximalen Femurendes bei Coxa vara mit Hochstand des Trochanter major und Beinverkürzung

1992 ◽  
Vol 4 (1) ◽  
pp. 50-62 ◽  
Author(s):  
Reinhard Graf ◽  
Christian Tschauner ◽  
Wolfgang Klapsch
Keyword(s):  
Coxa Vara ◽  
Trochanter Major

scholarly journals How to evaluate the clinical outcome of joint-preserving treatment for osteonecrosis of the femoral head: development of a core outcome set

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Zhipeng Xue ◽  
Jigao Sun ◽  
Taixian Li ◽  
Zeqing Huang ◽  
Weiheng Chen
Keyword(s):  
Femoral Head ◽  
Core Outcome Set ◽  
Consensus Meeting ◽  
Walking Distance ◽  
Core Outcome ◽  
Outcome Indicators ◽  
X Ray ◽  
Outcome Set ◽  
Core Outcomes ◽  
Hip Flexion

Abstract Background This study aimed to develop a core outcome set (COS) for clinical trials of joint-preserving treatment for osteonecrosis of the femoral head (ONFH), that is, to define a minimal set of outcomes that should be reported in such trials. Methods A mixed research method was adopted in this study. First, clinical trials of hip preservation therapy were systematically researched and analyzed. Second, a three-round Delphi survey involving both doctors and patients was carried out to obtain the core outcome indicators. Round 1 was a modified Delphi questionnaire for doctors and patients to determine which outcomes are important to these stakeholders, round 2 determined what clinical evaluation core outcomes should be included for the joint-preserving treatment of ONFH, and round 3 determined how core outcomes should be measured. Finally, a consensus meeting was held to discuss and vote on the established COS. Results The results of the systematic review showed that 42 outcome indicators were classified according to common signs and symptoms, quality of life, long-term outcomes, radiological evaluation, blood biochemistry, and indexes of safety. The three rounds of Delphi surveys completed the selection of indicators for the COS and the determination of the corresponding measurements. A total of 73 orthopedic doctors and 103 patients participated in round 1, and the top 10 indicators selected were basically the same. In round 2, 32 experts identified the following indicators: pain, range of motion (ROM) of hip flexion, walking distance, and stable rating of X-ray images. In round 3, 35 experts defined the measurement of each indicator. Finally, the consensus meeting identified the four indicators aforementioned that constituted the COS. The scores for pain, ROM of hip flexion, and walking distance are from 0 to 10; 0 represents the best scores, while 10 represents the most serious impairment. The stable rating of X-ray images is determined by the morphology of the femoral head and the change in the density of the necrotic area. Conclusions We established a COS for hip-preserving treatment of ONFH that includes four indicators: pain, ROM of hip flexion, walking distance, and stable rating of X-ray images.

Diffusion Tensor Imaging in Patients With Adult Chronic Idiopathic Hydrocephalus

Neurosurgery ◽  
2010 ◽  
Vol 66 (5) ◽  
pp. 917-924 ◽  
Author(s):  
Elke Hattingen ◽  
Alina Jurcoane ◽  
Julia Melber ◽  
Stella Blasel ◽  
Friedhelm E. Zanella ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Normal Pressure ◽  
Clinical Findings ◽  
Control Group ◽  
Microstructural Changes ◽  
Automated Method ◽  
Definition Of ◽  
Lumbar Cerebrospinal Fluid

Abstract OBJECTIVE Diffusion tensor imaging (DTI) parameters were investigated in patients with chronic idiopathic hydrocephalus to evaluate microstructural changes of brain tissue caused by chronic ventricular dilatation. METHODS Eleven patients fulfilling the criteria for possible or probable idiopathic normal pressure hydrocephalus and 10 healthy control subjects underwent MRI at 3 Tesla, including DTI with 12 gradient directions. Patients were scanned before lumbar cerebrospinal fluid (CSF) withdrawal tests. Differences in fractional anisotropy (FA) and mean diffusivity (MD) between patients and controls were assessed using 2 different methods: manual definition of regions of interest and a fully automated method, TBSS (Tract-Based Spatial Statistics). DTI parameters were correlated with clinical findings. RESULTS Compared with the control group, patients with chronic idiopathic hydrocephalus had significantly higher MD values in both the periventricular corticospinal tract (CST) and the corpus callosum (CC), whereas FA values were significantly higher in the CST but lower in the CC. DTI parameters of the CST correlated with the severity of gait disturbances. CONCLUSION Microstructural changes in periventricular functionally relevant white matter structures (CSF, CC) in chronic idiopathic hydrocephalus can be visualized using DTI. Further studies should investigate the change of DTI parameters after CSF shunting and its relation to neurologic outcome.

scholarly journals Isokinetic Strength of Rotators, Flexors and Hip Extensors is Strongly Related to Front Kick Dynamics in Military Professionals

2019 ◽  
Vol 68 (1) ◽  
pp. 145-155
Author(s):  
Michal Vagner ◽  
Jan Malecek ◽  
Luboš Tomšovský ◽  
Petr Kubový ◽  
Andrea Levitova ◽  
...  
Keyword(s):  
Lower Limb ◽  
Impact Force ◽  
Isokinetic Dynamometry ◽  
Main Condition ◽  
Impact Forces ◽  
Hip Flexion ◽  
Limb Flexion ◽  
Hip Rotation ◽  
Kicking Performance ◽  
Flexion And Extension

AbstractAchieving the maximum possible impact force of the front kick can be related to the isokinetic lower limb muscle strength. Therefore, we aimed to determine the regression model between kicking performance and the isokinetic peak net moment of hip rotators, flexors, and hip extensors and flexors at various speeds of contraction. Twenty-five male soldiers (27.7 ± 7.2 yrs, 83.8 ± 6.1 kg, 180.5 ± 6.5 cm) performed six barefoot front kicks, where impact forces (N) and kick velocity (m∙s-1) were measured. The 3D kinematics and isokinetic dynamometry were used to estimate the kick velocity, isokinetic moment of kicking lower limb hip flexors and extensors (60, 120, 240, 300°∙s-1), and stance lower limb hip internal and external rotators (30, 90°∙s-1). Multiple regression showed that a separate component of the peak moment concentric hip flexion and extension of the kicking lower limb at 90°∙s-1 can explain 54% of the peak kicking impact force variance (R2 = 0.54; p < 0.001). When adding the other 3 components of eccentric and concentric hip internal and external rotations at 30°∙s-1, the internal and external hip rotation ratios at 30°∙s-1 on the stance limb and the concentric ratio of kicking limb flexion and extension at 300°∙s-1 that explained the variance of impact force were 75% (p = 0.003). The explosive strength of kicking limb hip flexors and extensors is the main condition constraint for kicking performance. The maximum strength of stance limb internal and external rotators and speed strength of kicking limb hip flexors and extensors are important constraints of kicking performance that should be considered to improve the front kick efficiency.

scholarly journals 1189. COVID 19 Infection in Children in Colombia, Experience from a Nationwide Network (CORONARED)

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S686-S686
Author(s):  
Juan Gonzalo Mesa-Monsalve ◽  
Ivan Felipe Gutiérrez Tobar ◽  
Alejandro Diaz Diaz ◽  
Juan Pablo Calle-Giraldo ◽  
Yamile K Chaucanez-Bastidas ◽  
...  
Keyword(s):  
Age Groups ◽  
Panel Member ◽  
Clinical Findings ◽  
Age Group ◽  
Local Data ◽  
Material Support ◽  
Gi Symptoms ◽  
Bacterial Coinfection ◽  
Definition Of ◽  
Prolonged Hospital

Abstract Background Worldwide SARS-CoV-2 infections increase every day. Despite the infection is less severe in children, it can be severe and associated with complications. However, local data remain scarce. We sought to describe epidemiological and clinical characteristics of COVID-19 infection in this population across different age groups. Methods Observational, multicenter study across 23 Colombian hospitals from 22 different territories. We included all patients from 0 months to 17 years with confirmed SARS-CoV-2 infection by either antigen or RT-PCR testing. Results From March 1, 2020, to October 31, 2021, we identified 1,186 patients: neonates (88), 1 to 3 months (130), 4 to 23 months (306), 2 to 4 years (169), 5 to 11 years (229) and 12 to 18 years (226) with confirmed COVID-19 infection. Of those,77(6.2%) were asymptomatic, 631(53.2%) hospitalized, 132(11.2%) required PICU. 58 cases met WHO definition of MIS-C. Patients less than 24 months of age were characterized by fever (74%) and more respiratory distress (30.1%) compared to other groups. Patients &gt;5yo seemed to have a more severe presentation. They had more gastrointestinal (GI) symptoms (31% vs 37.8%), had more need for ICU care given presentation with shock increased with age ( &gt;5yo 9.5%; 5-12yo 10.6%; 12-18yo 11.5%). Lab markers including thrombocytopenia and Lymphopenia were more common on this age group. Antibiotic treatment was common (%%) especially in neonates (40.9%), despite bacterial coinfection was rare (8.7%), length of hospitalization was longer in older than 2-year-old groups. 23(1.9%) patients died, similar across different age groups. Heat map by age group Conclusion COVID-19 infection in Colombian children presented differently across different age groups. Children older than 5 years had a more severe clinical course and prolonged hospital stays. Clinical findings according to age groups could help clinicians in characterizing and identifying COVID 19 infections in Children. Disclosures Ivan Felipe Gutiérrez Tobar, n/a, Pfizer and MSD (Advisor or Review Panel member, Research Grant or Support, Speaker’s Bureau, Has received support from Pfizer and MSD for participation in congresses and has received conference payments from Pfizer)Pfizer and MSD (Speaker’s Bureau, Other Financial or Material Support, Has received support from Pfizer for participation in congresses) Juan P. Rojas -Hernandez, Candidate for doctorate in Public Health, Pfizer (Other Financial or Material Support, Has received support from Pfizer for participation in congresses) Eduardo López Medina, n/a, Pfizer (Other Financial or Material Support, Has received support from Pfizer for participation in congresses)

scholarly journals Classification of Intervertebral Disc Disease

2020 ◽  
Vol 7 ◽  
Author(s):  
Joe Fenn ◽  
Natasha J. Olby ◽  
Keyword(s):  
Intervertebral Disc ◽  
Intervertebral Disc Degeneration ◽  
Clinical Findings ◽  
Intervertebral Disc Disease ◽  
Disc Disease ◽  
Clinical Presentations ◽  
Disc Material ◽  
Definition Of ◽  
Current Systems

Intervertebral disc disease (IVDD) has been recognized in dogs since the 1800s, when the first descriptions of extruded disc material within the vertebral canal were published. In the intervening time our understanding of intervertebral disc pathology in dogs and cats has increased dramatically, with many variations of IVDD described. Whilst the volume of literature and collective understanding of IVDD has expanded, there has also been scope for confusion as the definition of intervertebral disc disease, with its myriad different manifestations, becomes more complicated. A large volume of literature has aimed to combine the use of histopathology, diagnostic imaging and clinical findings to better understand the various ways in which IVDD can be classified. Much of this research has focused on the classification of mechanisms of intervertebral disc degeneration, centering around the differences between, and overlaps in, IVDD in chondrodystrophic and non-chondrodystrophic dog breeds. However, with the increasing availability of advanced imaging modalities allowing more accurate antemortem diagnosis, the concept of IVDD has expanded to include other clinical presentations that may not fit into traditional models of classification of IVDD. This review aims to provide an up to date overview of both historical and current systems of IVDD classification, highlighting the important findings and controversies underpinning them.

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