Hip Arthrography

2019 ◽  
pp. 156-157
Author(s):  
Matthew DelGiudice
Keyword(s):  
Clinical Practice ◽  
Femoral Nerve ◽  
Routine Clinical Practice ◽  
Imaging Findings ◽  
Younger Patients ◽  
Steroid Injections ◽  
Suspected Infection ◽  
Hip Arthrography ◽  
Femoral Nerve Injury ◽  
Labral Injury

Chapter 101 describes the indications, technique, and imaging findings of hip arthrography. Hip arthrography is selectively performed in routine clinical practice for MRA, typically in younger patients. Indications include hip pain thought to be caused by acetabular labral injury, femoroacetabular impingement syndromes, as well as therapeutic steroid injections. Contrast should easily inject and disperse throughout the joint away from the needle, opacifying the femoral head and neck recesses and outlining the zona orbicularis. The technique can also be used for arthrocentesis with suspected infection, but contrast should not be injected. Contrast extension into the acetabular labral substance may be occasionally depicted on the standard arthrography images. However, it is nowadays evaluated by MRA or sometimes CTA. Complications include infection, bleeding (especially if arterial puncture), and femoral nerve injury.

Knee Arthrography

2019 ◽  
pp. 158-159
Author(s):  
Matthew DelGiudice
Keyword(s):  
Clinical Practice ◽  
Hyaline Cartilage ◽  
Cruciate Ligament ◽  
Cartilage Defects ◽  
Osteochondral Lesions ◽  
Imaging Findings ◽  
Younger Patients ◽  
Osteochondral Injuries ◽  
Knee Arthrography

Chapter 102 describes indications, technique, and imaging findings of knee arthrography. Knee arthrography is selectively performed in clinical practice for MRA, typically in younger patients. Indications include evaluation for meniscal re-tear after prior repair, osteochondral injuries, and therapeutic injections (most commonly steroid). Extension of intraarticular contrast into the meniscal substance indicates a tear or re-tear. Abnormal course of the cruciate ligament fibers indicates a tear. Contrast undermines unstable osteochondral lesions and extends into the hyaline cartilage defects. Complications are rare but include infection and bleeding.

scholarly journals Tapentadol Prolonged Release for Severe Chronic Osteoarthritis Pain in the Elderly—A Subgroup Analysis of Routine Clinical Practice Data

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Andreas Schwittay ◽  
Melanie Sohns ◽  
Birgit Heckes ◽  
Christian Elling
Keyword(s):  
Quality Of Life ◽  
Clinical Practice ◽  
Elderly Patients ◽  
Subgroup Analysis ◽  
The Elderly ◽  
Routine Clinical Practice ◽  
Prolonged Release ◽  
Younger Patients ◽  
Quality Of Life Measures

Background. Tapentadol prolonged release (PR) has been shown effective and generally well tolerated in a broad range of chronic pain conditions. This subgroup analysis investigated its benefits for elderly patients with severe chronic osteoarthritis (OA) pain in routine clinical practice. Patients and Methods. Data of all patients with chronic OA pain were extracted from the database of a prospective, 3-month noninterventional tapentadol PR trial. The data of elderly OA patients (>65 years of age; n = 752) were compared with the data of younger OA patients (≤65 years; n = 282). Results. Almost all patients (elderly 98.7% and younger patients 99.3%) had received long-term analgesic medication prior to the start of tapentadol PR treatment but presented with severe pain accompanied by considerable impairments in sleep quality and quality of life measures. Tapentadol PR provided effective pain relief in both patient groups, with slightly better outcomes in younger patients. However, the mean baseline pain intensity of 7.1 (SD 1.5) was reduced by 3.8 points (p≤0.001), and sleep and quality of life measures had also markedly improved in the elderly: quality of sleep by 3 points, quality of life by 3.4 points, social activities by 3 points, and independence by 2.7 points (p≤0.001 for all measures; 11-point scale). At the end of observation, 68% of the elderly had clinically relevant pain reductions of at least 50% (vs baseline), and 87.9% attained either their intended pain reduction target and/or an additional individual treatment target (both predefined during baseline examination). Only 8.4% of the elderly experienced adverse drug reactions, most frequently nausea (2.7% of patients) and dizziness (1.5%). Conclusion. Tapentadol PR provided effective and well-tolerated treatment of severe chronic OA pain for elderly patients in routine clinical practice. The favorable tolerability profile in particular suggests tapentadol PR as a treatment option before classical strong opioids are considered.

Ankle Arthrography

2019 ◽  
pp. 160-162
Author(s):  
Matthew DelGiudice
Keyword(s):  
Clinical Practice ◽  
Nerve Injury ◽  
Joint Capsule ◽  
Osteochondral Lesions ◽  
Imaging Findings ◽  
Talar Dome ◽  
Younger Patients ◽  
Main Indication

Chapter 103 describes the indications, technique, and imaging findings of ankle arthrography. Ankle arthrography is selectively performed in clinical practice for MRA. It is typically performed in younger patients. The main indication is the evaluation of the talar dome for stability of osteochondral lesions. Contrast undermines the unstable osteochondral lesions. Extravasation of the contrast through the lateral or medial joint capsule is consistent with ligamentous tear. Filling defects within the intraarticular contrast relate to joint bodies or synovitis. Complications are rare but can include infection, bleeding, and nerve injury.

Short stripping of the incompetent great saphenous vein by InvisiGrip® vein stripper

Phlebologie ◽  
2010 ◽  
Vol 39 (02) ◽  
pp. 77-81 ◽  
Author(s):  
A. G. Krasznai ◽  
E. C. M. Bollen ◽  
J. C. van der Kley ◽  
R. J. Th. J. Welten ◽  
G. M. J. M. Welten
Keyword(s):  
Success Rate ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Femoral Nerve ◽  
Preoperative Selection ◽  
Superficial Wound ◽  
Good Cosmetic ◽  
Surgical Device ◽  
Femoral Nerve Injury ◽  
Selection Of

SummaryOur aim is to describe the results of a new short stripping technique for the treatment of the incompetent great saphenous vein (GSV) using a new developed surgical device. Patients, methods: 397 patients (498 legs) were treated with the InvisiGrip® Vein Stripper, which removes the GSV through a single groin incision, endovascular cutting and antegrade stripping by inversion. We reported the surgical success rate and postprocedural complications. Results: The mean age was 51 years, 74% were women. The success rate for removal of the GSV was 95%. The 23 failures were half patient related, half device related. In 82% of the strippings, one or two attempts were needed to successfully remove the GSV, which was done by invagination in 80%. Age, gender, BMI ≥30 kg/m2 and male GSV diameter were not associated with the number of attempts. Superficial wound infection, haematoma and temporary saphenous and femoral nerve injury occurred in 6 (1.6%), 0, 3 (0.8%) and 7 (1.9%) patients, respectively. Conclusion: The InvisiGrip® is highly successful for the removal of the GSV using short inverting stripping. Furthermore, it is simple, safe, associated with good cosmetic results and no preoperative selection of patients is necessary.

Diagnosis and Management of Cardiomyopathies – A Focus on Genetics, Cardiac Magnetic Resonance and Clinical Features

2011 ◽  
Vol 7 (3) ◽  
pp. 225
Author(s):  
Gianfranco Sinagra ◽  
Michele Moretti ◽  
Giancarlo Vitrella ◽  
Marco Merlo ◽  
Rossana Bussani ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Imaging Techniques ◽  
Molecular Genetic ◽  
Molecular Genetic Analysis ◽  
Routine Clinical Practice ◽  
Clinical Approach ◽  
Diagnosis And Management ◽  
Made In

In recent years, outstanding progress has been made in the diagnosis and treatment of cardiomyopathies. Genetics is emerging as a primary point in the diagnosis and management of these diseases. However, molecular genetic analyses are not yet included in routine clinical practice, mainly because of their elevated costs and execution time. A patient-based and patient-oriented clinical approach, coupled with new imaging techniques such as cardiac magnetic resonance, can be of great help in selecting patients for molecular genetic analysis and is crucial for a better characterisation of these diseases. This article will specifically address clinical, magnetic resonance and genetic aspects of the diagnosis and management of cardiomyopathies.

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