Can Elastosonography Be Useful in Improving Diagnosis and Prognosis of Acute Muscle Injuries?

Purpose The objective of this study was to investigate the ability of elastosonography (USE) in the identification of different grades of muscular injuries, comparing its effectiveness with traditional ultrasound (US) survey and by relating the results to the clinical classification of muscular pain. Methods In the period between August 2014 and May 2016, we conducted a prospective cohort study on a population of 34 young male professional athletes belonging to the same under-17 football club (Ancona 1905). Injuries were recorded according to location, type, mechanism, recurrence, and whether they occurred with or without contact. Muscle pain was classified, after a physical examination, according to the classification of Mueller-Wohlfahrt et al. All athletes were evaluated by musculoskeletal US and USE in hours following the trauma/onset of pain. Results Seventy injuries were documented among 19 players. Muscle/tendon injuries were the most common type of injury (49%). USE showed areas of edema in nine lesions that were negative at the US examination and previously classified as fatigue-induced muscle disorders. These nine players took more time to return to physical activity compared with others with injuries classified into the same group, but negative at USE evaluation. Conclusion USE is a valuable aid in the diagnosis and prognostic evaluation of muscle injury, as it detects pathologic changes that are not visible with the B-mode US. Level of Evidence This is a Level III, observational cohort study.

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PREVALENCE OF INJURIES IN BRAZILIAN RECREATIONAL STREET RUNNERS: META-ANALYSIS

Revista Brasileira de Medicina do Esporte ◽

10.1590/1517-869220192502214466 ◽

2019 ◽

Vol 25 (2) ◽

pp. 161-167 ◽

Cited By ~ 3

Author(s):

Wyngrid Porfirio Borel ◽

José Elias Filho ◽

Juliano Bergamaschine Mata Diz ◽

Poliana Fernandes Moreira ◽

Priscila Monteiro Veras ◽

...

Keyword(s):

Associated Factors ◽

Low Cost ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Knee Injuries ◽

Muscle Injuries ◽

Level Of Evidence ◽

Meta Regression Analysis ◽

Type Of Injury

ABSTRACT Street running is an accessible, low-cost form of exercise. However, the occurrence of musculoskeletal injuries may hinder regular practice. This study aimed at estimating the prevalence of injuries in Brazilian street runners and the associated factors. A meta-analysis of Brazilian studies was performed to investigate the prevalence and risk factors of injuries in male and female recreational street runners aged ≥18 years. We excluded systematic review studies, research conducted on professional athletes or triathletes, and duplicate articles. The following databases were used: SciELO, LILACS, PubMed, Web of Science, and Google Scholar. Keywords such as “prevalence,” “injury,” “recreational street runners,” and “Brazil” were used. Prevalence analysis was performed using the random effect model, and a funnel plot was used to assess publication bias. Then the Begg-Mazumdar and Egger tests were applied to quantify the graph results. The Prevalence Critical Appraisal Instrument was used to evaluate the methodological quality of the studies. Associated factors were analyzed with meta-regression analysis. Twenty-three studies with 3,786 runners were included in the review. The prevalence of injury was 36.5% (95% confidence interval [CI] 30.8-42.5%), and a running distance per week greater than 20 km was a predictive variable of injuries. A higher prevalence of injuries was observed in men than in women (28.3%, 95% CI 22.5-35.0%), the knee was the most affected site of injury (32.9%, 95% CI 26.7-39.6%), and muscle injuries were the most frequent type of injury (27.9%, 95% CI 18.2-40.1%). This is the first national meta-analysis conducted to investigate the prevalence of injuries in recreational street runners. Although the prevalence of injuries was moderate, caution is required in terms of the weekly duration of running. Male runners are more susceptible, and muscle and knee injuries are the most common. Level of evidence II, Systematic reviewb of Level II Studies.

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Interpretation of the QuickDASH score after open carpal tunnel decompression: threshold values associated with patient satisfaction

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193415622341 ◽

2016 ◽

Vol 41 (6) ◽

pp. 624-631 ◽

Cited By ~ 20

Author(s):

N. D. Clement ◽

A. D. Duckworth ◽

P. J. Jenkins ◽

J. E. McEachan

Keyword(s):

Cohort Study ◽

Patient Satisfaction ◽

Carpal Tunnel ◽

Outcome Data ◽

Observational Cohort Study ◽

Baseline Score ◽

Threshold Values ◽

Level Of Evidence ◽

Future Studies ◽

Observational Cohort

We studied the correlation between change in the QuickDASH score and the absolute post-operative QuickDASH score with patient satisfaction after open carpal tunnel decompression. Threshold values in the QuickDASH score, the point at which the sensitivity and specificity are maximal in predicting patient satisfaction, were identified. During the study period, outcome data were compiled for 937 carpal tunnel decompressions, which included 219 (23%) male and 718 (77%) female patients with a mean age of 58 years (standard deviation (SD) 14). There was a significant improvement (mean difference 32, 95% confidence interval (CI) 30 to 34) in the QuickDASH from a mean of 54 (SD 20) to 22 (SD 23) at 1 year after surgery. There were 808 (86%) patients who defined their outcome as satisfactory at 1 year. The identified threshold values for the post-operative QuickDASH score (⩽34 points) and the change (⩾20 points) in the score were highly predictive of patient satisfaction. However, these threshold values varied significantly according to the baseline pre-operative score. The threshold values identified in the QuickDASH can be used to interpret the score. However, the influence of the pre-operative baseline score should be taken into account when comparing different cohorts of patients or using the values to power future studies. Level of Evidence IV: Prognosis, observational cohort study

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PROSPECTIVE STUDY OF INJURIES OCCURRED DURING BRAZILIAN FOOTBALL CHAMPIONSHIP IN 2019

Acta Ortopédica Brasileira ◽

10.1590/1413-785220212904241563 ◽

2021 ◽

Vol 29 (4) ◽

pp. 207-210

Author(s):

GUSTAVO GONÇALVES ARLIANI ◽

PAULO HENRIQUE SCHMIDT LARA ◽

GABRIEL FURLAN MARGATO ◽

DIOGO CRISTIANO NETTO ◽

MOISÉS COHEN ◽

...

Keyword(s):

Risk Factors ◽

Prospective Study ◽

Gold Standard ◽

Common Type ◽

Muscle Strain ◽

Muscle Injuries ◽

Level Of Evidence ◽

Mapping System ◽

A Prospective Study ◽

Type Of Injury

ABSTRACT Objective: To determine the incidence and risk factors for injuries that occurred during the matches of the Brazilian Football Championship. Methods: A prospective study was carried out with the collection of data referring to injuries that occurred during the 2019 Brazilian Football Championship. The injuries were recorded by the responsible physician of each team, through an online injury mapping system. Results: Among the 645 athletes who were included in the study, 214 (33.2%) of the players had at least one injury during the tournament. In total, 257 injuries were recorded during the Brazilian Championship, with an average of 0.68 injuries per game. 59.1% of the injured athletes were over 26 years old. The most common type of injury was muscle strain (37.7%) and forwards were the most affected (33.6%). Conclusion: Muscle injuries were the most frequent in the tournament, with the thigh muscles being the most affected. Most of the affected players were over 26 years old, there were 20.5 injuries for every 1000 hours of play and the incidence of injuries was approximately 33%, with attackers being the most affected (33.6%). Level of Evidence III, Study of nonconsecutive patients; without consistently applied reference “gold” standard.

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Multirater Agreement of Arthroscopic Grading of Knee Articular Cartilage

The American Journal of Sports Medicine ◽

10.1177/0363546505275129 ◽

2005 ◽

Vol 33 (11) ◽

pp. 1654-1657 ◽

Cited By ~ 77

Author(s):

Robert G. Marx ◽

Jason Connor ◽

Stephen Lyman ◽

Annunziato Amendola ◽

Jack T. Andrish ◽

...

Keyword(s):

Cohort Study ◽

Articular Cartilage ◽

Multicenter Studies ◽

Level Of Evidence ◽

Arthroscopic Knee Surgery ◽

Cartilage Lesions ◽

Grade 3 ◽

Arthroscopic Knee ◽

Articular Cartilage Lesions

Background Acute and chronic cartilage injury of the knee has an important impact on prognosis. The validity of the classification of such injuries is critical for prospective multicenter studies. The agreement among multiple surgeons at different institutions for articular cartilage lesions has not been established. Hypothesis Arthroscopic classification of articular cartilage lesions is reliable and reproducible and can be used for multicenter studies involving multiple surgeons. Study Design Cohort study (diagnosis); Level of evidence, 1. Methods A total of 6 surgeons from 5 centers reviewed 31 videos of articular cartilage lesions. With grade 2 and grade 3 combined for the analysis, observed agreement ranged from 81% to 94%, and kappa ranged from 0.34 to 0.87. An additional 22 videos comprising grade 2 and grade 3 lesions were analyzed, and the observed agreement was 80%, with an overall kappa of 0.47. Conclusion Arthroscopic grading of articular cartilage lesions is reproducible among surgeons at different centers. Clinical Relevance Articular cartilage lesions can be reliably classified among surgeons at different sites. Such reliability is important for multicenter clinical research studies involving arthroscopic knee surgery.

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Subphenotyping and Classification of Cleft Lip and Alveolus in Adult Unoperated Patients

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665618767106 ◽

2018 ◽

Vol 55 (9) ◽

pp. 1267-1276 ◽

Cited By ~ 2

Author(s):

Christl Vermeij-Keers ◽

Anna M. Rozendaal ◽

Antonius J. M. Luijsterburg ◽

Benny S. Latief ◽

Costas Lekkas ◽

...

Keyword(s):

Cohort Study ◽

Outcome Measures ◽

Cleft Lip ◽

Observational Cohort Study ◽

Adult Patients ◽

Oral Clefts ◽

Developmental Mechanisms ◽

Primary Palate ◽

Observational Cohort

Objective: Previously, a new embryological classification was introduced subdividing oral clefts into fusion and/or differentiation defects. This subdivision was used to classify all subphenotypes of cleft lip with or without alveolus (CL±A). Subsequently, it was investigated whether further morphological grading of incomplete CLs is clinically relevant, and which alveolar part is deficient in fusion/differentiation defects. Design: Observational cohort study. Setting: Three hundred fifty adult unoperated Indonesian cleft patients presented themselves for operation. Cephalograms, dental casts, and intraoral and extraoral photographs—eligible for the present study—were used to determine morphological severity of CL±A. Patients: Patients with unilateral or bilateral clefts of the primary palate only were included. Main Outcome Measures: Clefts were classified—according to developmental mechanisms and timing in embryogenesis—as fusion and/or differentiation defects. Grades of incomplete CLs were related to the severity of alveolar clefts (CAs) and hypoplasia, and permanent dentition was used to investigate which alveolar part is deficient in fusion/differentiation defects. Results: One hundred eight adult patients were included. All subphenotypes—96 unilateral and 12 bilateral clefts—could be classified into differentiation (79%), fusion (17%), fusion-differentiation (2%), or fusion and differentiation (2%) defects. The various grades of incomplete CLs were related to associated CAs and hypoplasia, and all alveolar deformities were located in the premaxillae. Conclusions: This study showed that all CL±A including the Simonart bands can be classified, that further morphological grading of incomplete CLs is clinically relevant, and that the premaxilla forms the deficient part in alveolar deformities.

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Validation of a modified Birmingham Eye Trauma Terminology classification for mechanical eye injuries

Trauma ◽

10.1177/1460408617715488 ◽

2017 ◽

Vol 20 (3) ◽

pp. 217-220 ◽

Cited By ~ 1

Author(s):

Mehul Shah ◽

Shreya Shah ◽

Rupesh Agrawal ◽

Kashyap Patel

Keyword(s):

Cohort Study ◽

Foreign Body ◽

Ocular Trauma ◽

Eye Injuries ◽

Eye Trauma ◽

Globe Rupture ◽

Wide Range ◽

The World ◽

Type Of Injury

Introduction Criticisms have been levelled at the widely accepted Birmingham Eye Trauma Terminology (BETT) classification of mechanical ocular trauma, as it is not specific enough. Alternative modifications to the BETT have been proposed and this study aimed to assess these newer classifications. Methods A prospective cohort study of all patients presenting to the outpatient department between January 2005 and December 2014, who were examined and categorised based on the BETT. Cases which did not comply with the BETT system were placed in additional categories, and documented for each type of injury. Results A total of 4721 eyes suffered mechanical injuries and 1060 (22.4%) could not be classified with BETT, including 368 globe injuries (7%) associated with orbital/ocular adnexa injury; 692 eyes (14.6%) with ocular surface foreign body (OSFB) or ocular wall foreign body (IWFB). There were 77 eyes (1.6%) with contusion, 9 eyes (0.19%) with lamellar laceration-associated OSFB or OWFB, 29 eyes (0.6%) with globe rupture-associated OSFB, OWFB or intraocular foreign body (IOFB) and 60 eyes (1.4%) with laceration-associated OSFB or OWFB. Conclusion The BETT needs modification to be fully applicable to the wide range of ocular trauma seen across the world.

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Evidence-based Treatment of Muscle Injuries

Swiss Sports & Exercise Medicine ◽

10.34045/ssem/2018/2 ◽

2018 ◽

Vol 66 (1) ◽

Keyword(s):

Treatment Approach ◽

Early Mobilization ◽

Medical Professional ◽

Moderate Activity ◽

Team Physician ◽

Muscle Injuries ◽

Evidence Based Treatment ◽

Exertional Compartment Syndrome ◽

Type Of Injury

Injuries to skeletal muscle can pose a severe challenge for any team physician or medical professional. They account for up to one third of all sports-related injuries and can result in weeks of recovery and absence from play. Crucial in the successful treatment is the accurate classification of the type of injury, be it fatigue, structural or chronic. The PRICE protocol is a well known first step in the initial treatment, but its shortcomings should be recognized and considered. Currently, a more active treatment approach with early mobilization and moderate activity is being advocated. Chronic muscle problems, such as chronic exertional compartment syndrome (CECS), are among the very few indications for surgical treatment.

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