Assessment of scapholunate instability with dynamic computed tomography

2019 ◽  
Vol 45 (4) ◽  
pp. 375-382 ◽  
Author(s):  
Lionel Athlani ◽  
Kamel Rouizi ◽  
Jonathan Granero ◽  
Gabriela Hossu ◽  
Alain Blum ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Prospective Study ◽  
Gap Size ◽  
Dynamic Computed Tomography ◽  
Level Of Evidence ◽  
Plain Radiographs ◽  
Scapholunate Instability ◽  
The Mean ◽  
A Prospective Study

We performed a prospective study to evaluate the values of dynamic four-dimensional computed tomography in assessing suspected chronic scapholunate instability. Forty patients were evaluated with radiographs, arthrography, and four-dimensional computed tomography. On plain radiographs and computed tomography, we found 16 patients with definite scapholunate instability, five with questionable scapholunate instability, and 19 with absence of scapholunate instability. We used four-dimensional computed tomography to evaluate the size of the scapholunate gap during radioulnar deviation. The mean and maximal values of the gap size were lowest in the patients with absence of scapholunate instability and highest in those with definite scapholunate instability. When comparing the scapholunate gap sizes of the patients with absent and questionable scapholunate instability, the range of the gap sizes was significantly higher in the patients with questionable scapholunate instability. We conclude that four-dimensional computed tomography aids assessment of chronic scapholunate instability, which allows the differentiation between patients without and those with definite or questionable scapholunate instability. Level of evidence: II

Dual mobility trapeziometacarpal prosthesis: a prospective study of 107 cases with a follow-up of more than 3 years

2021 ◽  
pp. 175319342110245
Author(s):  
Bruno Lussiez ◽  
Cyril Falaise ◽  
Pascal Ledoux
Keyword(s):  
Prospective Study ◽  
Functional Outcomes ◽  
Pinch Strength ◽  
Level Of Evidence ◽  
Dual Mobility ◽  
The Mean ◽  
The Stability ◽  
A Prospective Study ◽  
Score Index

We report the results of a prospective study using a dual mobility trapeziometacarpal prosthesis (Touch®) in 107 patients with a minimum follow-up of 3 years. One-hundred and two patients (95%) were very satisfied or satisfied with the functional outcomes and the mean pain intensity in visual analogue scale decreased from 7.4 to 0.8 ( p < 0.001). Thumb opposition (Kapandji score) index increased from an average of 8.0 to 9.4, while the mean QuickDASH score improved from 38 preoperatively to 20 at follow-up ( p < 0.01). Key-pinch strength improved from 3.5 kg (range 0.5–9.5) to 5.5 kg (range 3.0–11.5). There was a 4.6% rate of complications, including cup loosening and wear of polyethylene, which required revision, but no cases of prosthetic dislocation were seen. Applying the dual mobility principle to trapeziometacarpal arthroplasty may significatively improve the stability of these prostheses. Radiolucent zones around the components of the prostheses are not systematic predictors of future loosening. Level of evidence: IV

Rapid-bolus contrast-enhanced dynamic computed tomography in acute pancreatitis: A prospective study

1991 ◽  
Vol 78 (12) ◽  
pp. 1452-1456 ◽  
Author(s):  
N. J. M. London ◽  
T. Leese ◽  
D. F. L. Watkin ◽  
D. P. Fossard ◽  
J. M. Lavelle ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Prospective Study ◽  
Dynamic Computed Tomography ◽  
Contrast Enhanced ◽  
A Prospective Study ◽  
Rapid Bolus

scholarly journals Jones Fractures Identified at the National Football League Scouting Combine: Assessment of Prognostic Factors, Computed Tomography Findings, and Initial Career Performance

2018 ◽  
Vol 6 (8) ◽  
pp. 232596711879074 ◽  
Author(s):  
Robert C. Spang ◽  
Daniel B. Haber ◽  
Brendin R. Beaulieu-Jones ◽  
Kristen L. Stupay ◽  
George Sanchez ◽  
...  
Keyword(s):  
Computed Tomography ◽  
National Football League ◽  
Treatment Method ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Specific Performance ◽  
Incomplete Healing ◽  
Bony Healing ◽  
The Mean ◽  
Career Performance

Background: Jones fractures result in subsequent dysfunction and remain an issue for athletes. Purpose: To (1) describe the epidemiology, treatment, and impact of Jones fractures identified at the National Football League (NFL) Scouting Combine on players’ early careers and (2) establish the value of computed tomography (CT) to determine bony healing after a fracture in prospective players. Study Design: Cohort study; Level of evidence, 3. Methods: All players who attended the combine between 2009 and 2015 were retrospectively reviewed to identify their history of Jones fractures. The playing position, treatment method, and number of missed collegiate games were recorded. The mean overall draft pick number, number of games started and played, snap percentage, and position-specific performance scores (fantasy score) over the first 2 years in the NFL were compared between players with fractures and controls. An imaging classification system was applied based on grading of each quadrant of the fifth metatarsal (plantar, dorsal, medial, lateral), with a score of 0 for not healed or 1 for healed. Results: Overall, the number of Jones fractures identified was 72 in 2285 athletes (3.2%), with all treated via intramedullary screw fixation. The mean overall draft pick number for players with fractures was 111.2 ± 67.9 compared with 99.0 ± 65.9 for controls ( P = .12). Performance scores for players with fractures were lower than those for controls across all positions, with a significant difference in running backs (2.6 vs 4.0, respectively; P < .001) and defensive linemen (1.4 vs 2.3, respectively; P = .02). The mean CT score was 2.5 ± 1.3. Of the 32 athletes who underwent imaging, 16 Jones fractures (50.0%) were healed or nearly healed, 12 (37.5%) were partially healed, and 4 (12.5%) showed little or no healing. The plantar cortex demonstrated the least healing (18/32; 56.3%), followed by the lateral cortex (15/32; 46.9%). Players with a mean score <1 were found to have fewer games started (2.7 ± 2.5) than those with 1 to 3 cortices healed (17.4 ± 10.4) or all cortices healed (8.7 ± 11.2). Conclusion: Based on CT, 50% of all players with a previous Jones fracture demonstrated incomplete healing. Moreover, position-specific performance scores over the first 2 years of a player’s career were lower across all positions for those with fractures compared with controls. Players with CT scores <1 were found to start fewer games and were drafted later than controls.

scholarly journals Computed tomography scan findings in eclampsia: a prospective study

2018 ◽  
Vol 7 (11) ◽  
pp. 4432
Author(s):  
K. S. Raja Rajeswari ◽  
R. Niranjana
Keyword(s):  
Computed Tomography ◽  
Prospective Study ◽  
Ct Scan ◽  
Brain Infarction ◽  
Cortical Blindness ◽  
Obstetrics And Gynaecology ◽  
A Prospective Study ◽  
Ct Finding ◽  
Brain Haemorrhage ◽  
Tomography Scan

Background: Eclampsia is a leading cause of maternal death, with classical neurological symptoms that include headache, nausea, vomiting, cortical blindness, coma and convulsions. Computed tomography (CT) scan helps in diagnosing and management of eclampsia in pregnant women. The present study was done with the objective to analyse the findings of CT scan of brain in eclampsia, to identify the prevalence of neurovascular complications in these cases and to determine if these findings can be of value in determining the prognosis of this disorder.Methods: This was a prospective study done on 100 patients with eclampsia. All of the 100 patients were screened with CT scan brain at Institute of Obstetrics and Gynaecology, Egmore, Chennai during the period from August 2008 to August 2009. All the data were analyzed and compared between the groups of positive CT scan and negative CT scan observations.Results: Out of 100 patients, positive CT scan findings were noticed in 15 patients. Of them, 7 patients expired, and 8 patients survived after treatment. Of the expired patients (7), 5 of them expired due to brain haemorrhage, and 1 patient died with cerebral oedema and 1 with brain infarction. Cerebral odema (46%) was the most common positive CT finding.  Parietal region of brain was the most common (40%) affected area.Conclusions: CT scan of brain provides valuable information in determining the prognosis and the prevalence of neurovascular complications in Eclampsia.

scholarly journals Acute benign myositis of childhood: Results of a prospective study performed in a pediatric emergency department

2020 ◽  
Vol 10 (3) ◽  
Author(s):  
Vanuza Rosa ◽  
Gabriela Kuzma ◽  
Luana Hornung ◽  
Márcia Bandeira
Keyword(s):  
Emergency Department ◽  
Prospective Study ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Care Providers ◽  
Study Objective ◽  
Gait Abnormality ◽  
The Mean ◽  
A Prospective Study ◽  
Musculoskeletal Involvement

OBJECTIVE: Benign acute childhood myositis is characterized by acute musculoskeletal involvement leading to transient limitations on deambulation followed by a viral illness. Our study objective to evaluate clinical and laboratory features of patients in a pediatric emergency department. METHODOS: We conducted a prospective study in patients with symptoms and laboratory findings compatible with viral myositis in the period of August 2017 to August 2018. RESULTS: We assessed 20 patients in the period of twelve months. The mean age was 8,25 years. Of these, 83,3% had infectious symptoms in the week before the musculoskeletal involvement. By the time of the diagnosis, the symptoms were: calf pain, reluctance to walk, gait abnormality, diffuse myalgia and calf weakness. The most relevant laboratory finding was the elevation of CPK (mean 3359,556U/L) level, followed by AST (mean 131U/L) and ALT (mean 64,66U/L) elevation. The mean time for symptom relief was 3 days and in 7 days all exams were normal. CONCLUSION: Though the exact incidence of this condition remains undetermined, the lower extremity pain and the gait abnormality is of concern of both parents and health care providers. We emphasize the importance of knowing this condition to avoid unnecessary exams and the delay in the diagnosis of severe conditions.

scholarly journals Computed Tomography Evaluation of Acute Pancreatitis and Its Complications – A Prospective Study at a Tertiary Referral Center

2021 ◽  
Vol 8 (11) ◽  
pp. 643-647
Author(s):  
Rama Krishna Narra ◽  
Manjeera Boddepalli ◽  
Narasimhachary Munjuwanpalli ◽  
Bhimeswarao Pasupaleti
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Prospective Study ◽  
Pancreatic Necrosis ◽  
Contrast Enhanced ◽  
Necrotising Pancreatitis ◽  
Enhanced Computed Tomography ◽  
A Prospective Study ◽  
Contrast Enhanced Computed Tomography ◽  
Score Index

BACKGROUND Acute pancreatitis (AP) is described as acute inflammation of the pancreas with or without peripancreatic abnormalities. The present study describes the role of computed tomography in the evaluation and grading of acute pancreatitis. Acute pancreatitis is a dynamic disease having biphasic mortality peaks due to two overlapping phases, which include early and late due to increased obesity, ageing of population, alcohol abuse, increased gall stone incidence, the worldwide AP incidence is increasing. Most important causes of AP in developing countries such as India include increased alcohol consumption. Contrast enhanced computed tomography plays an important role in diagnosis of the disease and helps in determining the prognosis of the disease. Modified CT severity index scoring system is the most commonly used scoring system for assessment of the severity of the disease. METHODS The present study is a prospective study of patients presenting with signs and symptoms of acute pancreatitis referred to the Department of Radio Diagnosis at Katuri medical college. This study comprised of 50 patients with clinical suspicion / diagnosis of acute pancreatitis, raised pancreatic biochemical parameters like serum amylase and serum lipase. Contrast enhanced computed tomography was performed in these patients, findings reported, and the disease was classified using modified CT scoring index system (MCTSI). RESULTS The mean age of the patients in the present study was 42.3 ± 12.28 years. Most of the patients presented with abdominal epigastric pain, abdominal distension. Acute pancreatitis was divided into acute oedematous pancreatitis and necrotising pancreatitis, the former being common. Complications included, ascites, pleural effusions, splenic vein thrombosis, portal venous thrombosis, and haemorrhages. CONCLUSIONS Contrast enhanced CT is useful to differentiate between oedematous and necrotising types of pancreatitis. The MCTSI helps in better evaluation of pancreatic necrosis grading. The modified computed tomography score index correlation with the development of local and systemic complications in acute pancreatitis is well established. Ideally, conducting contrast enhanced computed tomography (CECT) after 48 - 72 hours of acute attack, increases the probability of identifying necrotising pancreatitis. CT in particular has an overall accuracy of about 87 % and sensitivity and specificity of 100 % in the recognition of pancreatic necrosis. KEYWORDS Computed Tomography, Acute Pancreatitis, Pseudocyst, Modified CT Score Index

Comparison of Self-Hypnosis and Propranolol in the Treatment of Juvenile Classic Migraine

PEDIATRICS ◽  
1987 ◽  
Vol 79 (4) ◽  
pp. 593-597
Author(s):  
Karen Olness ◽  
John T. MacDonald ◽  
Donald L. Uden
Keyword(s):  
Statistical Analysis ◽  
Prospective Study ◽  
Specific Treatment ◽  
The Self ◽  
Objective Measures ◽  
Headache Frequency ◽  
Entire Study ◽  
Headache Severity ◽  
The Mean ◽  
A Prospective Study

In a prospective study we compared propranolol, placebo, and self-hypnosis in the treatment of juvenile classic migraine. Children aged 6 to 12 years with classic migraine who had no previous specific treatment were randomized into propranolol (at 3 mg/kg/d) or placebo groups for a 3-month period and then crossed over for 3 months. After this 6-month period, each child was taught self-hypnosis and used it for 3 months. Twenty-eight patients completed the entire study. The mean number of headaches per child for 3 months during the placebo period was 13.3 compared with 14.9 during the propranolol period and 5.8 during the self-hypnosis period. Statistical analysis showed a significant association between decrease in headache frequency and self-hypnosis training (P = .045). There was no significant change in subjective or objective measures of headache severity with either therapy.

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