Description of pain provocation tests used for the diagnosis of sports-related chronic groin pain: relationship of tests to defined clinical (pain and tenderness) and MRI (pubic bone marrow oedema) criteria

2005 ◽  
Vol 15 (1) ◽  
pp. 36-42 ◽  
Author(s):  
Geoffrey M. Verrall ◽  
John P. Slavotinek ◽  
Peter G. Barnes ◽  
Gerald T. Fon
Keyword(s):  
Bone Marrow ◽  
Groin Pain ◽  
Bone Marrow Oedema ◽  
Pubic Bone ◽  
Chronic Groin Pain ◽  
Provocation Tests ◽  
Clinical Pain ◽  
Pain Provocation ◽  
Relationship Of

Groin Pain in Footballers

2005 ◽  
Vol 33 (6) ◽  
pp. 894-899 ◽  
Author(s):  
John Paul Slavotinek ◽  
Geoffrey Mark Verrall ◽  
Gerald Tau Fon ◽  
Michael Radford Sage
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Bone Marrow Edema ◽  
Groin Pain ◽  
Pubic Bone ◽  
Resonance Imaging ◽  
Training Capacity ◽  
T2 Hyperintensity ◽  
Marrow Edema

Background Groin pain and tenderness are common in athletes from a variety of codes of football, but little attention has been directed to the influence of magnetic resonance imaging and such clinical findings on athlete participation. Hypothesis Preseason groin pain, tenderness, and magnetic resonance imaging findings such as pubic bone marrow edema are associated with restricted training capacity and missed games. Study Design Cohort study; Level of evidence, 2. Methods Fifty-two Australian footballers in the national competition were recruited. Preseason groin pain and focal tenderness were recorded, and magnetic resonance imaging of the groin was performed within 1 week of examination. Training restriction and games missed owing to groin pain were documented during the subsequent season. Results Magnetic resonance imaging showed pubic bone marrow edema in 19 of 52 (37%) footballers and linear parasymphyseal T2 hyperintensity in 16 of 52 (31%) footballers. Groin pain restricted training during the season in 22 of 52 (42%) footballers, and 9 of 52 (17%) footballers missed at least 1 game. Preseason pain (P =. 0004), pubic bone tenderness (P =. 02), and linear parasymphyseal T2 hyperintensity (P =. 01) were associated with restricted training capacity during the subsequent season. Preseason groin pain (P =. 03) was associated with missed games, but magnetic resonance imaging findings were not. Conclusion Preseason pubic bone marrow edema, groin pain, and linear parasymphyseal T2 hyperintensity were associated with training restriction, but only preseason groin pain was associated with missed games.

scholarly journals 950 Experience of Inguinal Mesh Hernioplasty Under Local Anaesthesia: A 3-Year Experience in A Teaching Hospital

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
Z Hashmi ◽  
R Ahmed ◽  
T Zafar ◽  
M Ahmed ◽  
N Yousaf ◽  
...  
Keyword(s):  
Local Anaesthesia ◽  
Groin Pain ◽  
Clinical Judgement ◽  
Chronic Groin Pain ◽  
Day Case ◽  
Post Operative Pain ◽  
The Mean ◽  
Mesh Hernioplasty ◽  
Operating Surgeon

Abstract Objective To prove Inguinal mesh hernioplasty under L/A is safe and acceptable. Helps with post-operative pain and enables rapid recovery as a day case. Method All patients who underwent inguinal hernia repair under local anaesthesia were retrospectively analysed in our hospital between July 2014- July 2017. Clinical judgement was used for inclusion and exclusion parameters. Results From July 2014- July 2017, 260 patients were included in study who underwent Inguinal mesh hernioplasty under L/A. ASA grade for all patients ranged between I-III. The mean age was 37 (20-65). Intraoperatively (9.1) 3.5% patients had problems such as pain, hypotension or sweating. About (86.3%) 224 patients were discharged home the same day and remaining stayed overnight for less than 24 hours. Hematoma was seen in 5 (1.92%) patients, Urinary retention in 2 (0.7%) patients, Wound infection seen in 24(9.2%) patients, Readmission in 10 (3.8%) patients. Chronic groin pain was seen in 10 (3.9%) patients and no recurrence on 6 months follow up. Conclusions Our results showed that this procedure is feasible under L/A and can be performed safely. It showed satisfactory acceptance by the operating surgeon and patient, without significant perioperative issues. It is reliable and showed shorter hospital stay.

scholarly journals THU0492 MAGNETIC RESONANCE IMAGING OF THE SACROILIAC JOINTS IN PATIENTS WITH HYPERMOBILITY: A RETROSPECTIVE COHORT STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 482.4-483
Author(s):  
A. Jones ◽  
C. Ciurtin ◽  
H. Kazkaz ◽  
M. Hall-Craggs
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Back Pain ◽  
Lumbar Spine ◽  
Magnetic Resonance ◽  
Bone Marrow Oedema ◽  
Resonance Imaging ◽  
Sacroiliac Joints ◽  
Fatty Change ◽  
Subchondral Sclerosis

Background:The incidence of inflammatory and structural lesions on magnetic resonance imaging of sacroiliac joints (MRI SIJs) in patients with hypermobility related disorders has not been fully investigated. Hypermobile patients are more susceptible to pelvic instability and biomechanical stress of the SIJs, leading to MRI SIJ changes similar to those occurring in spondyloarthritis (SpA). Patients with hypermobility and suspected SpA pose a unique challenge owing to the high prevalence of back pain in the hypermobility cohort and the absence of spinal restriction on clinical examination.Objectives:In this study, we aim to investigate the incidence of MRI SIJ lesions in patients with hypermobility.Methods:We performed a retrospective study of all patients with a confirmed diagnosis of hypermobility related disorders (including hypermobility syndrome, hypermobility spectrum disorders and Ehlers-Danlos Syndromes) referred for an MRI lumbar spine and SIJ between 2011 and 2019 to investigate long-standing back pain. MRIs were examined by a musculoskeletal (MSK) radiologist with more than 25 years of experience, who was blinded to the clinical outcome of the patients. MRI SIJs were assessed for the presence of bone marrow oedema, subchondral sclerosis, erosion, fatty change, enthesitis, ankylosis, joint fluid and capsulitis.Results:51 patients with confirmed hypermobility related disorders were referred for MRI SIJ and lumbar spine between 2011 and 2019. 3 patients demonstrated clinical features in keeping with a diagnosis of SpA and were excluded from the study. 15/48 (31.3%) of patients with hypermobility and back pain (but no clinical picture of SpA) were found to have inflammatory and/or structural lesions on MRI SIJ. The most frequent lesions were small foci of bone marrow oedema (16.6%) followed by subchondral sclerosis (12.5%) and fatty change (10.4%). The incidence of erosions was 4.2%.Conclusion:There is a relatively high incidence of inflammatory and structural lesions on MRI SIJ of patients with hypermobility. The presence of hypermobility should be taken into consideration when interpreting MRI changes in patients with suspected SpA. Further research into long-term outcomes of MRI SIJs in patients with hypermobility and back pain is required to establish the clinical significance of these findings.Disclosure of Interests: :Alexis Jones: None declared, Coziana Ciurtin Grant/research support from: Pfizer, Consultant of: Roche, Modern Biosciences, Hanadi Kazkaz: None declared, Margaret Hall-Craggs: None declared

scholarly journals Proplatelets and stress platelets

Blood ◽  
1987 ◽  
Vol 69 (2) ◽  
pp. 522-528 ◽  
Author(s):  
M Tong ◽  
P Seth ◽  
DG Penington
Keyword(s):  
Bone Marrow ◽  
Platelet Rich Plasma ◽  
Early Period ◽  
Platelet Volume ◽  
Plasma Exposure ◽  
Functional Characteristics ◽  
Platelet Production ◽  
Relationship Of ◽  
The Relationship ◽  
Platelet Formation

Abstract The process of platelet formation by the fragmentation of megakaryocyte pseudopodia, termed proplatelets, demonstrable in the marrow sinusoids is poorly understood. “Stress” platelets produced under conditions of stimulated platelet production differ from normal circulating platelets with respect to volume and a number of functional characteristics. To clarify the relationship of stress platelets to proplatelets, rats were injected with heterologous platelet antiserum. Nondiscoid platelet forms, some characteristically beaded in appearance, strongly resembling bone marrow proplatelets, can be recovered in the circulation of normal rats. During the early period of recovery from acute thrombocytopenia, there was a substantial increase in the proportion of these elongated platelets in the citrated platelet rich plasma. Exposure to EDTA rendered them spherical. Circulating proplatelets may contribute significantly to the prompt increase in platelet volume during recovery from acute thrombocytopenia at a time prior to significant increase in megakaryocyte size and ploidy.

Grading scale of radiographic findings in the public bone and symphysis in athletes

2003 ◽  
Vol 44 (1) ◽  
pp. 79-83
Author(s):  
J. Besjakov ◽  
C. von Scheele ◽  
O. Ekberg ◽  
C. F. Gentz ◽  
N. E. Westlin
Keyword(s):  
Groin Pain ◽  
Pelvic Ring ◽  
Age Groups ◽  
Pubic Bone ◽  
Control Group ◽  
Male Athletes ◽  
Radiographic Findings ◽  
Bone Changes ◽  
Grading Scale ◽  
Group 2

Purpose: Radiographic abnormalities in the pubic bone and symphysis are often seen in athletes with groin pain. The aim was to create a grading scale of such radiologic changes. Material and Methods: Plain radiography of the pelvic ring including the pubic bone and the symphysis was performed in 20 male athletes, age 19–35, with long-standing uni- or bilateral groin pain. We used two control groups: Control group 1: 20 healthy age-matched men who had undergone radiologic examination of the pelvis due to trauma. Control group 2: 120 adults (66 men and 54 women) in 9 age groups between 15 and 90 years of age. These examinations were also evaluated for interobserver variance. Results and Conclusion: The grading scale was based on the type and the amount of the different changes, which were classified as follows: No bone changes (grade 0), slight bone changes (grade 1), intermediate changes (grade 2), and advanced changes (grade 3). The grading scale is easy to interpret and an otherwise troublesome communication between the radiologist and the physician was avoided. There was a high interobserver agreement with a high kappa value (0.8707). Male athletes with long-standing groin pain had abnormal bone changes in the symphysis significantly more frequently and more severely ( p>0.001) than their age-matched references. In asymptomatic individuals such abnormalities increased in frequency with age both in men and women.

Is active sacroiliitis on MRI associated with radiographic damage in axial spondyloarthritis? Real-life data from the ASAS and DESIR cohorts

Rheumatology ◽  
2018 ◽  
Vol 58 (5) ◽  
pp. 798-802 ◽  
Author(s):  
Alexandre Sepriano ◽  
Sofia Ramiro ◽  
Robert Landewé ◽  
Maxime Dougados ◽  
Désirée van der Heijde ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Odds Ratio ◽  
Structural Damage ◽  
Axial Spondyloarthritis ◽  
Multivariable Analysis ◽  
Real Life ◽  
Daily Practice ◽  
Bone Marrow Oedema ◽  
Number Of Patients ◽  
Structural Progression

Abstract Objective To assess any association between bone marrow oedema on MRI of the sacroiliac joints (MRI-SIJ) according to local readings in daily practice and the development of structural damage on radiographs of the SIJ (X-SIJ) in axial spondyloarthritis (axSpA). Methods Patients with axSpA from the Assessment of the SpondyloArthritis international Society (ASAS) and DEvenir des Spondylarthopathies Indifférenciées Récentes (DESIR) multicentre cohorts were included. MRI-SIJ and X-SIJ were obtained at baseline, and X-SIJ at follow-up after a mean 4.6 years (ASAS) and 5.1 years (DESIR). All images were scored by local readers. Structural damage in the X-SIJ was defined according to the modified New York criteria. The percentage of structural net progression (number of ‘progressors’ minus the number of ‘regressors’ divided by the total number of patients) was assessed and the effect of bone marrow oedema on MRI-SIJ on X-SIJ damage evaluated by multivariable logistic regression. Results In total, 125 (ASAS-cohort) and 415 (DESIR-cohort) patients had baseline MRI-SIJ and complete X-SIJ data available. According to local readings, progression and ‘improvement’ in X-SIJ was seen in both the ASAS- and DESIR-cohort, yielding a net progression that was higher in the former than in the latter (19.2% and 6.3%). In multivariable analysis, baseline bone marrow oedema on MRI-SIJ was strongly associated with X-SIJ structural progression in both ASAS (odds ratio = 3.2 [95% CI: 1.3; 7.9]), and DESIR (odds ratio = 7.6 [95% CI: 4.3; 13.2]). Conclusion Inflammation on MRI-SIJ is associated with future radiographic progression according to local readings despite an expected increased imprecision invoked by local readings.

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