MRI versus US in diagnosis of meniscal injury in the knee joint

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Nourhan Nasery Demian Saad MBChB ◽  
Hana Hamdy Nassef ◽  
Mennatallah Hatem Shalaby
Keyword(s):  
Knee Joint ◽  
Gold Standard ◽  
Meniscal Tear ◽  
Common Type ◽  
Radiology Department ◽  
Meniscal Injury ◽  
The Us

Abstract Background Meniscal injuries are the most common type of knee injuries.MRI is the gold standard in the diagnosis of meniscal injuries. Aim of the work:- The aim of this study is to compare between the accuracy of ultrasound and MRI in diagnosis of meniscal injury. Patients and Methods:- This study was carried out at the Radiology Department, AinShams University Hospitals.Twenty patients with proven MRI meniscal tear underwent ultrasound(US) examination. Results :- The overall sensitivity of the US to diagnose meniscal injuries reached (85.0%), specificity (100%) and accuracy (92%),

Incidence of Cerebral Hemorrhage in Traumatic Patients using Computed Tomography in Tabuk City, Saudi Arabia

2020 ◽  
Vol 5 (10) ◽  
pp. 460-463
Author(s):  
Amna Mohamed Ahmed ◽  
Towmader Awad ◽  
Hajer Yousif ◽  
Reem Nahari ◽  
Omnia Abdelrhman ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Saudi Arabia ◽  
Head Trauma ◽  
Subdural Hematoma ◽  
Cerebral Hemorrhage ◽  
Imaging Modality ◽  
Common Type ◽  
Radiology Department ◽  
Age Group ◽  
Ct Finding

Computed Tomography (CT) is the most commonly used imaging modality in the evaluation of cerebral hemorrhage in the head trauma patients. Objective: To study the incidence of a cerebral hemorrhage in traumatic patients using computed tomography. Method: This retrospective study was conducted at King Khalid hospital in Tabuk city, Saudi Arabia, in the radiology department, in the period from September 2018 to April 2020. The study was done by collecting 471 CT reports of patients all of them were exposed to head trauma with deferent reasons. The data were analyzed by Statistical Package for the Social Sciences (SPSS) program (ver. 20) and presented in tables and graphs according to the checklist which includes: patient age, gender, type of trauma, CT finding, and type of hemorrhage. Results: The most age group suffered from head trauma was less than 20 years percentage (55%), The male patients more exposed to head trauma than female patients with percentage (84.5%), the road traffic accident (RTA) is the most common type of trauma by percentage (63.5%), according to the CT finding; the cerebral hemorrhage represented (15.5%) with the highest percentage in a subdural hematoma (31.2%), the fracture represented (2.8%) while the normal appearance represented (81.7%) as the highest percentage. Conclusion: Most of the traumatic brain injury in patients caused cerebral hemorrhage and the CT scan reports show that: the common type of cerebral hemorrhage is subdural hematoma and it is common in males which exposed to (RTA) in the age group (21 - 40) years old.

scholarly journals POS1143 GOUT AND JOINT REPLACEMENTS IN THE US

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 851.1-851
Author(s):  
G. Singh ◽  
M. Sehgal ◽  
A. Mithal
Keyword(s):  
Knee Joint ◽  
Confidence Intervals ◽  
Knee Replacement ◽  
Joint Replacement ◽  
Economic Burden ◽  
Hip Replacement ◽  
Average Charge ◽  
Joint Replacements ◽  
Increased Risk ◽  
The Us

Background:Irreversible joint damage in gout has been linked to a possible increase in knee and hip joint replacements1. In addition, the strong association between gout and osteoarthritis2,3 could also lead to an increased risk of joint replacements in patients with gout. Population-based data from the UK and Taiwan have shown hazard rates of 1.14 and 1.16 respectively for knee replacements in patients with gout compared to age and gender matched controls1. However, there is little national data in the US on clinical and economic burden of joint replacements in patients with gout.Objectives:To evaluate total or partial hip and knee joint replacements in patients with gout in the US and to estimate their economic impactMethods:The Nationwide Inpatient Sample (NIS) is a stratified random sample of all US community hospitals. It is the only US national hospital database with information on all patients, regardless of payer, including persons covered by Medicare, Medicaid, private insurance, and the uninsured. Detailed information including clinical and nonclinical data elements on each hospital stay including International Classification of Diseases (ICD)10 diagnosis and procedure codes, age, gender, length of stay, payer, charges, comorbidities etc. is available. We examined hospitalizations in patients with gout with hip and knee joint replacements in NIS 2018, the most recent year of data.Results:In 2018, there were 914,510 hospitalizations with primary or secondary diagnosis of gout in the US. Of these 43,615 were for joint replacement surgeries (knee (24,840) and hip (18,755)). Patients with knee replacement were on an average 68.5 years old (95% confidence intervals 68.2 years -68.8 years). Patients with hip replacement were slightly older (mean age 70.3 years, 95% confidence intervals 69.8 years -70.7 years). Unlike general population statistics, men formed a majority of these joint replacements (68% for the knee and 72% for the hip). The average charge per hospitalization was $69,279 and $72,944 for knee and hip replacement respectively. The total annual national cost estimate was $3.09 billion, with government insurances (Medicare and Medicaid) responsible for 67% of knee replacement and 70% of hip replacement costs.Conclusion:Joint replacements in gout patients have a large clinical and economic burden in the US. This calls for an increased awareness and management of associated hip and knee arthritis in patients with gout.References:[1]Kuo CF, Chou IJ, See LC, et al. Urate-lowering treatment and risk of total joint replacement in patients with gout. Rheumatology. Dec 1 2018;57(12):2129-2139.[2]Howard RG, Samuels J, Gyftopoulos S, et al. Presence of gout is associated with increased prevalence and severity of knee osteoarthritis among older men: results of a pilot study. Journal of clinical rheumatology: practical reports on rheumatic & musculoskeletal diseases. Mar 2015;21(2):63-71.[3]Roddy E, Zhang W, Doherty M. Are joints affected by gout also affected by osteoarthritis? Annals of the rheumatic diseases. Oct 2007;66(10):1374-1377.Disclosure of Interests:Gurkirpal Singh Shareholder of: Pfizer, Merck, Sanofi, Grant/research support from: Horizon, Maanek Sehgal: None declared, Alka Mithal: None declared.

scholarly journals DELAY TO ACL RECONSTRUCTION IN PEDIATRIC AND ADOLESCENT PATIENTS IS ASSOCIATED WITH A LINEAR INCREASE IN THE RISK OF MEDIAL MENISCAL TEARS

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0004
Author(s):  
David A. Kolin ◽  
Brody Dawkins ◽  
Joshua Park ◽  
Peter D. Fabricant ◽  
Allison Gilmore ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Meniscal Tear ◽  
Lateral Meniscus ◽  
Linear Increase ◽  
Meniscal Injury ◽  
Meniscal Tears ◽  
Increased Risk ◽  
Text Figure ◽  
Time From Injury

Background: Anterior cruciate ligament (ACL) tears are frequently associated with meniscal tears. Previous studies have shown that secondary meniscal tears—occurring after the initial ACL injury—are associated with greater delays from injury to ACL reconstruction (ACLR), but frequently use dichotomous categories of acute versus delayed ACLR. Purpose: As meniscal damage is likely accrued constantly over time, we investigated the variability of concurrent meniscal injuries as a function of time from injury to ACLR in a pediatric and adolescent population. Methods: We performed a retrospective review of all patients ≤18 years who underwent an ACLR between 2014 and 2018 at one of two tertiary academic hospitals. Outliers were excluded if time from injury to ACLR was greater than 78 weeks. Records were reviewed to assess patients’ dates of injury and surgery. The prevalence of concurrent medial and/or lateral meniscal injury was evaluated at the time of surgery for each patient. Adjusted relative risks (ARRs) of meniscal injury were calculated using Poisson regression models adjusted for age, sex, and body-mass index. Logistic regression was used to model the predicted probability of medial meniscal tears. Results: 546 patients met inclusion criteria. The mean age of participants was 15.3 years (S.D., 1.6), and 277 (50.7%) patients were male. Overall, 344 (63.0%) patients had a meniscal tear. 169 (49.1%) tears occurred at the medial meniscus, and 257 (74.7%) occurred at the lateral meniscus (Table 1). Compared to females, males had a greater risk of lateral meniscal injury (ARR, 1.46; 95% CI, 1.20-1.77) but not medial meniscal injury (ARR, 1.01; 95% CI, 0.77-1.31) (Figure 1). When considering all meniscal tears, time from injury to ACLR was not associated with increased risk of a tear (ARR, 1.01; 95% CI, 1.00-1.01). However, for medial meniscal tears, there was a significant association between time from injury to ACLR, in weeks, and meniscal tears (ARR, 1.02; 95% CI, 1.01-1.03, P = 0.003). A ten-week delay was associated with a 20% increased risk of medial meniscal injury (Figure 2). Conclusion: In pediatric and adolescent ACLR patients, the risk of any meniscal injury was not associated with delay from injury to surgery. However, the risk of medial meniscal injury increased by 2% each week from injury to surgery. [Table: see text][Figure: see text][Figure: see text]

Diagnostic Accuracy of HRCT Chest in Detection of Covid-19 Infection Taking PCR as Gold Standard

2021 ◽  
Vol 15 (6) ◽  
pp. 1679-1681
Author(s):  
Afaque Ali ◽  
Majid Shaikh ◽  
Ahsanullah . ◽  
Adeel Ahmed ◽  
Abid Ali Sahito ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Gold Standard ◽  
Cross Sectional Study ◽  
Radiology Department ◽  
High Resolution Computed Tomography ◽  
Cross Sectional ◽  
Head Of Department

Objective: To determine the diagnostic accuracy of High-resolution computed tomography (HRCT) chest in detection of covid-19 infection taking PCR as gold standard. Study Design: Cross-sectional study Setting: Radiology department of Tabba Hospital, Karachi. Duration: From March 2019 to September 2020 Material and Methods: All the clinically suspected patients of covid-19, of any age, both genders and those referred to radiology for High-resolution computed tomography (HRCT) chest to detect the covid-19 infection were included. After two days, patients’ PCR reports were collected from the ward, after taking informed consent and permission from head of department. The diagnostic accuracy of HRCT was established with respect to sensitivity, PPV, NPV, and specificity by taking PCR as gold standard. All the information was collected via study proforma. Results: Total 70 patients suspected for COVID-19 were studied, and the patients’ mean age was 58.23±9.52 years. Males were in majority 54(77.1%). As per HRCT findings, COVID-19 infection was positive in 46 patients, however, 48 patients were detected positive for COVID-19 infection as per PCR findings. In the detection of COVID-19 infection, HRCT chest showed sensitivity of 91%, specificity of 90%, PPV of 83%, NPV of 84% and diagnostic accuracy of 94%; by taking PCR as gold standard. Conclusion: High-resolution computed tomography (HRCT) is a reliable diagnostic approach in promptly detecting the COVID-19; with 91% sensitivity, 90% specificity, 83% positive predictive value, 84% negative predictive value and 94% diagnostic accuracy. Keywords: Accuracy, HRCT, COVID-19

Accuracy of Computed Tomography for Detection of COVID-19 among Suspected Patients

2021 ◽  
Vol 15 (9) ◽  
pp. 2474-2476
Author(s):  
Maham Munir Awan ◽  
Afshan Noreen ◽  
Farah Kalsoom ◽  
Muhammad Tahir ◽  
Umaima Majeed ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Predictive Value ◽  
Gold Standard ◽  
Radiology Department ◽  
True Positive ◽  
Test Results ◽  
Rt Pcr ◽  
Radiological Society ◽  
Medical University ◽  
Pcr Test

Objective: To determine the accuracy of CT chest in diagnosis of COVID-19 taking RT-PCR-testing as gold standard. Materials and Methods: A total of 150 patients of suspicion of COVID-19 who were referred for CT Chest in Radiology Department of Nishtar Medical University Multan from June-2020 to May-2021 were included. In all patients, two RT-PCR test results were obtained with 7 days of admission in hospital. Presence of any of these positive was labelled as COVID-19 infection. CT chest was performed in all patients within 2 days of admission in hospital using 128 slices CT scan machine. The diagnosis of COVID-19 infection was made according to the recommendations by Radiological Society of North America (RSNA) protocol. Results: Mean age was 51.3±14.7 years. 78 (52%) patients were male and 72 (48%) patients were female. RTPCR test was positive in 89 (59.3%) patients. While the CT chest findings were suggestive of COVID-19 infection in 130 (86.7%) patients. The sensitivity of CT chest was 95.5%, specificity 26.2%, PPV wad 65.4% and NPV was 80.0%. Conclusion: CT chest has a very good sensitivity for detection of COVID-19, it can be used as a rapid diagnostic tool especially in areas of pandemic. However, the specificity of CT chest is low, that can limit its use in low COVID-19 affected areas. Keywords: COVID-19, Computed tomography, False Positive, True Positive, Positive Predictive Value, Negative Predictive Value.

scholarly journals Injuries related to respiratory masks in the US are very rare

2021 ◽  
Author(s):  
Philip N. Cohen
Keyword(s):  
Census Data ◽  
Incidence Rates ◽  
Common Type ◽  
Respiratory Protection ◽  
Risk Of Falling ◽  
Injury Surveillance System ◽  
Household Products ◽  
The Us ◽  
Protection Devices ◽  
Almost All

Background. Protective facemasks are important for preventing the spread of COVID-19, and almost all Americans have worn them at least some of the time during the pandemic. There are reasonable concerns about some ill effects of mask-wearing, especially for people who wear masks for extended periods, and for the risk of falling as a result of visual obstruction. But there are also unsupported fears and objections stemming from misinformation and fueled by political disputes. Methods. The study analyzed the Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS) for 2020, using the product code for Respiratory Protection Devices, and calculated population incidence rates using Census data. Results. The NEISS included 128 cases, representing an estimated 5122 reported injuries in the population (95% CI 3322, 6922). The overall rate of injury reports was 1.54 per 100,000 U.S. residents (95% CI 1.00, 2.08). People over age 75 had higher rates than the population overall, with 5.27 injuries per 100,000 (95% CI 2.17, 8.37). The most common type of incidents involved facial injuries, rashes, falls, and those that might be considered anxiety-related. Conclusion. Wearing protective face masks is extremely safe, especially in comparison with other common household products, and in light of their protective benefits with regard to prevent the spread of COVID-19. This information may be useful for public health messaging, and for practitioners trying to increase compliance with mask-wearing guidance.

scholarly journals Still tied by golden fetters: the global response to the US recession of 1937–1938

2012 ◽  
Vol 19 (1) ◽  
pp. 21-48 ◽  
Author(s):  
Scott Urban ◽  
Tobias Straumann
Keyword(s):  
Exchange Rate ◽  
Gold Standard ◽  
Exchange Rate Regime ◽  
Central Banking ◽  
Eastern European ◽  
Standard View ◽  
Global Response ◽  
Policy Regime ◽  
The Us ◽  
Eastern European Countries

The US recession of 1937–8 is one of the deepest on record. Yet it did not produce a global depression – quite unlike 1930. According to the standard view, this reflected an unfettering of central banking after the collapse of the international gold standard circa 1931. We challenge this view. While Germany and a couple of Central and Eastern European countries were sheltered by binding exchange controls, most countries were still constrained by their golden fetters, as our new exchange rate regime classification suggests. The underlying policy regime was surprisingly similar to that of the 1929–30 downturn. What mattered was a quick reversal in US policy in 1938 and, for many countries, a more plentiful stock of international reserves.

The Modern Politics of Sexual Assault Prosecution

2020 ◽  
pp. 13-18
Author(s):  
Matthew Barry Johnson
Keyword(s):  
Sexual Assault ◽  
Acquaintance Rape ◽  
Common Type ◽  
Reform Movement ◽  
Law Reform ◽  
Legal Process ◽  
Rape Law ◽  
Modern Politics ◽  
Rape Law Reform ◽  
The Us

This chapter presents and discusses the “rape law reform” movement that emerged in the 1970s. The movement sought reforms designed to encourage victims to make official reports and facilitate the successful prosecution of rape and sexual assault. The movement achieved legislative and practice reform, but there was no discernible increase in sexual assault convictions. The rape law reform movement solidified an alliance of concern that strengthened vigorous prosecution of “stranger rapes” but had little impact on the more common type of rape, “acquaintance rape.” Rape law reform advocacy produced dramatic and rapid legislative change, change that was clearly warranted not only for victims of sexual assault, but also reform that contributed to the integrity of the US legal process.

scholarly journals Barriers to implementation of guidelines for the diagnosis and management of undescended testis

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 326 ◽  
Author(s):  
Shawn C. Smith ◽  
Hiep T. Nguyen
Keyword(s):  
Early Detection ◽  
Gold Standard ◽  
Undescended Testis ◽  
Surgical Correction ◽  
International Studies ◽  
American Urologic Association ◽  
Diagnosis And Management ◽  
The Us ◽  
Barriers To Implementation ◽  
Common Barriers

Cryptorchidism or undescended testis (UDT) is one of the most common genital disorders identified at birth. The gold standard for treatment in the US is to surgically bring the UDT into the scrotal sac. In 2014, the American Urologic Association (AUA) presented a guideline for evaluation and treatment of cryptorchidism. We reviewed some of the most recent domestic and international studies examining the results of implementing the AUA and similar guidelines for the diagnosis and management of UDT. In addition, we reviewed some of the more common barriers to the implementation of the AUA guidelines and offered recommendations on how to increase the rate of early detection of UDT, thereby increasing the rate of surgical correction at the appropriate age.

scholarly journals Printability Optimization of Gelatin-Alginate Bioinks by Cellulose Nanofiber Modification for Potential Meniscus Bioprinting

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Wenbin Luo ◽  
Zhengyi Song ◽  
Zhonghan Wang ◽  
Zhenguo Wang ◽  
Zuhao Li ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Knee Joint ◽  
Cellulose Nanofiber ◽  
Cellular Viability ◽  
Meniscal Injury ◽  
Biological Tests ◽  
Biological Environment ◽  
Matrix Accumulation

Meniscal injury is more likely to cause a permanent alteration of the biomechanical and biological environment of the knee joint, mainly due to the morphological mismatch and substantial loss of meniscal tissues. Herein, to overcome this challenge, we developed an improved bioink with enhanced printability, while maintaining the biocompatibility of major cellular component of the meniscus, namely fibrochondrocytes. Firstly, cellulose nanofiber (CNF) was mixed with gelatin-alginate thermal-responsive bioinks to improve the printability. Afterward, individual-specific meniscal prototypes based on the 3D reconstruction of MRI data were bioprinted using our bioink. The rheological and printability properties of the bioinks were characterized to select proper bioink content and bioprinting parameters. And then, a series of biological characterizations of the bioprinted samples, such as cell viability, metabolic activity, and extracellular matrix accumulation, were carried out in vitro. The results indicated that superior rheological performance and printability of CNF-modified bioink were achieved, ensuring high-precision bioprinting of specific-designed meniscal prototype when compared with the non-CNF-containing counterparts. Meanwhile, biological tests indicated that fibrochondrocytes encapsulated within the CNF-modified bioink maintained long-term cellular viability as well as acceptable extracellular matrix accumulation. This study demonstrates that the CNF-modified bioink is in favor of the printing fidelity of specific meniscus by improved rheological properties, minimizing the mismatch between artificial meniscal implants and native knee joint tissues, thereby permitting the evolution of clinical therapeutic methods of meniscal reconstruction.

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