Diagnostic Benefit of MRI for Exclusion of Ligamentous Injury in Patients with Lateral Atlantodental Interval Asymmetry at Initial Trauma CT

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, defines a motion segment as “two adjacent vertebrae, the intervertebral disk, the apophyseal or facet joints, and ligamentous structures between the vertebrae.” The range of motion from segment to segment varies, and loss of motion segment integrity is defined as “an anteroposterior motion of one vertebra over another that is greater than 3.5 mm in the cervical spine, greater than 2.5 mm in the thoracic spine, and greater than 4.5 mm in the lumbar spine.” Multiple etiologies are associated with increased motion in the cervical spine; some are physiologic or compensatory and others are pathologic. The standard radiographic evaluation of instability and ligamentous injury in the cervical spine consists of lateral flexion and extension x-ray views, but no single pattern of injury is identified in whiplash injuries. Fluoroscopy or cineradiographic techniques may be more sensitive than other methods for evaluating subtle abnormal motion in the cervical spine. The increased motion thus detected then must be evaluated to determine whether it represents normal physiologic motion, normal compensatory motion, motion related to underlying degenerative disk and/or facet disease, or increased motion related to ligamentous injury. Imaging studies should be performed and interpreted as instructed in the AMA Guides.

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DNA Testing Proves of Diagnostic Benefit in Genodermatoses

Family Practice News ◽

10.1016/s0300-7073(05)71322-0 ◽

2005 ◽

Vol 35 (3) ◽

pp. 40

Author(s):

BETSY BATES

Keyword(s):

Dna Testing ◽

Diagnostic Benefit

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Schädel-Hirn-Trauma – CT-Scans rasch durchführen

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren ◽

10.1055/s-0031-1295621 ◽

2011 ◽

Vol 183 (12) ◽

pp. 1098-1098

Keyword(s):

Ct Scans ◽

Trauma Ct

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[18F]Fluoride PET Indicates Reduced Bone Formation in Severe Glucocorticoid-induced Osteoporosis

Nuklearmedizin ◽

10.1055/s-0038-1629797 ◽

1998 ◽

Vol 37 (02) ◽

pp. 76-79 ◽

Cited By ~ 8

Author(s):

T. D. Kirchhoff ◽

W. Burchert ◽

J. v. d. Hoff ◽

H. Zeidler ◽

H. Hundeshagen ◽

...

Keyword(s):

Bone Formation ◽

Multiple Organ ◽

High Dose ◽

Multiple Fractures ◽

Glucocorticoid Treatment ◽

Organ Manifestations ◽

Diagnostic Benefit ◽

Sharp Syndrome ◽

18F Fluoride

SummaryA 61-year-old female patient presenting with mixed connective tissue disease (Sharp syndrome), underwent a long-term high dose glucocorticoid treatment because of multiple organ manifestations. Under steroid therapy she developed severe osteoporosis resulting in multiple fractures. A dynamic [18F]fluoride PET study in this patient revealed reduced fluoride influx in non-fractured vertebrae. This finding corresponds to pathogenetic concepts which propose an inhibition of bone formation as major cause of glucocorticoid-induced osteoporosis. In the light of the presented case it seems to be promising to evaluate the diagnostic benefit of [18F]fluoride PET in osteoporosis.

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Circulating IL-10 is compromised in patients predisposed to developing and in patients with severe knee osteoarthritis

Scientific Reports ◽

10.1038/s41598-021-81382-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Tyler Barker ◽

Victoria E. Rogers ◽

Vanessa T. Henriksen ◽

Roy H. Trawick ◽

Nathan G. Momberger ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Cruciate Ligament ◽

Ligamentous Injury ◽

Radiographic Evidence ◽

X Ray ◽

Tnf Α ◽

Total Knee ◽

Anterior Cruciate ◽

Anterior Cruciate Ligament Surgery ◽

Necrosis Factor

AbstractThe purpose of this investigation was to identify if serum interleukin (IL)-10 and tumor necrosis factor (TNF)-α concentrations and their ratio (IL-10/TNF-α) are altered in subjects predisposed to developing knee osteoarthritis following ligamentous injury and in those with severe knee osteoarthritis. Serum IL-10 and TNF-α concentrations were measured in four groups of subjects (n = 218): (1) reportedly-healthy and non-injured control subjects (CON; n = 92), (2) subjects scheduled to undergo anterior cruciate ligament surgery (ACL; n = 42), (3) non-surgical subjects with knee osteoarthritis (OA; n = 60), and (4) subjects with knee osteoarthritis scheduled to undergo total knee arthroplasty (TKA; n = 24). X-ray images were used to grade the severity of knee osteoarthritis. Serum IL-10 and the serum IL-10/TNF-α ratio were significantly lower while serum TNF-α was not significantly perturbed with severe compared to moderate knee osteoarthritis (i.e., Kellgren-Lawrence grade 4 vs. 3, respectively). Serum IL-10 was significantly lower in the absence of serum TNF-α alterations in the ACL group. We conclude that serum IL-10 concentrations are compromised in subjects predisposed to developing knee osteoarthritis following ligamentous trauma and in subjects with radiographic evidence of severe knee osteoarthritis.

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Analysis of Sagittal Thoracic Inlet Measures in Relation to Anterior Access to the Cervicothoracic Junction

Global Spine Journal ◽

10.1177/21925682211005730 ◽

2021 ◽

pp. 219256822110057

Author(s):

Joseph F. Baker

Keyword(s):

Vertebral Body ◽

Cervicothoracic Junction ◽

Thoracic Inlet ◽

Mean Values ◽

Anterior Access ◽

Projection Angle ◽

The Mean ◽

T1 And T2 ◽

Trauma Ct ◽

Inlet Angle

Study Design: Retrospective radiographic study. Objective: The aim of this study was to define the association between thoracic inlet measures in relation to anterior access to the cervicothoracic junction. Methods: Trauma CT scans in patients >16 years were analyzed. The projection angle (PA), defined as the angle subtended by a line along the superior endplate of the vertebral body and the line from the anterosuperior corner of the vertebral body to the manubrium, was measured at C7, T1 and T2; angles were positive if the projection was above the manubrium. Thoracic inlet angle (TIA), thoracic inlet distance (TID) and pelvic incidence (PI) were measured. Results: 65 scans were assessed (33 males; mean age 47.7 years (s.d. 8.7)). The mean TIA 79.9° (s.d. 13.4°; range 52.6° – 112.2°), mean TID 66.1 mm (s.d. 6.6 mm) and mean PI was 50.5° (s.d. 10.2°). Mean values for the projection angles at C7, T1 and T2 were 24.2°, 7.6° and −8.3° respectively. PA were positive in 95% at C7, 73% at T1 and 30% at T2. PA at each level correlated significantly with age (mean r=−0.371; P = .015) and TIA (mean r=−0.916; P < .001) but neither TID nor PI. TIA correlated with age (r = 0.328; P = .008). Conclusions: The projection angles of the CTJ vertebrae are influenced by thoracic inlet angle and a lesser degree age. Understanding sagittal spinal parameters in the CTJ can aid in planning surgical strategy and approach.

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Consultation between forensic and clinical pathologists for histopathology examination after forensic autopsy

Medicine Science and the Law ◽

10.1177/0025802420965763 ◽

2021 ◽

Vol 61 (1_suppl) ◽

pp. 25-35

Author(s):

Vito Cirielli ◽

Federica Bortolotti ◽

Luca Cima ◽

Zeno De Battisti ◽

Giovanna Del Balzo ◽

...

Keyword(s):

Bone Marrow ◽

Cause Of Death ◽

Molecular Analysis ◽

Real World ◽

Routine Practice ◽

Working Relationships ◽

Post Mortem ◽

Macroscopic Findings ◽

Diagnostic Benefit ◽

Histopathology Examination

The magnitude of the diagnostic benefit conferred by performing histopathological examinations after medico-legal/forensic autopsies remains debatable. We have tried to address this issue by reviewing a series of histopathology referrals concerning medico-legal autopsies in real-world routine practice. We present an audit of the consultations provided to forensics by clinical pathologists at our institute between 2015 and 2018. Over this period, 493 post-mortem examinations were performed by forensic pathologists. Of these cases, 52 (11%) were referred for histopathology. Gross assessment was requested in 22/52 (42%) cases. Histopathology examination was performed on single organs in 15/52 (29%) cases, primarily on the lung and heart, whereas parenchymatous multi-organ analysis was carried out in 14/52 (27%) cases. Bone-marrow sampling was studied in 4/52 (8%) cases. Immunohistochemistry was needed in 16/52 (31%) cases, special stains in 9/52 (21%) cases and molecular analysis in 4/52 (8%) cases. Focusing on technical processes, standard methodology on pre-analytical procedures was changed in 10/52 (19%) cases in order to answer specific diagnostic questions. We showed that although most of the time the diagnosis is clear by the end of dissection on the basis of the macroscopic findings, histopathology can provide, modify or confirm the cause of death in many medico-legal/forensic cases. Therefore, it is desirable that forensic pathologists and clinical pathologists establish robust working relationships in a cooperative environment. We conclude that it is important to implement guidelines based on real-world routine practice in order to identify cases where histopathology can provide useful contributions, which in our experience applied to 11% of forensic cases.

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