scholarly journals Moragas Manouver Correlation Clinically Arthroscopy, in the Diagnosis of Lateral Meniscal Injury

2014 ◽  
Vol 2 (12_suppl4) ◽  
pp. 2325967114S0024
Author(s):  
Juan Pablo Estévez Ballas

Purpose: The aim of this study is to access the correlation of Moragas manouver and arthroscopic findings, in the diagnosis of lateral meniscal injury, and to know the imagenologic findings and comparison with arthroscopic results. Methods: 474 arthroscopic procedures were performed with meniscal injuries between 2005-2013. 142 are lateral meniscus lesions (male=94, female=58) by clinical evaluation, average age= 34.4 years old (15-58). MRI was performed in 73 cases, what allowed correlate findings clinical imaging. All clinical tests were realized by the same clinician. Results: Of the 142 patients, 136 were pure external meniscus injuries, (95.77%), 3 were colateral ligament lesions, 1 was a parameniscal cyst, 1 was popliteus tendinosis and 1 was normal. Of 73 cases with MRI evaluation, 68 were a pure lateral meniscal lesions (93.15%), 2 were partial colateral ligament lesions, 1 was popliteus tendinosis, 1 was iliotibial band friction syndrome and 1was lateral condyle avascular necrosis. The comparison between MRI findings and arthroscopic procedure they had no statistical significance. p< 0.0025 Conclusion: The Moragas manouver has a high sensitivity diagnosed for lateral meniscal injury, and the imagenologic correlation with arthroscopic findings was minor in this study (95.77% v/s 93.15%). Discussion: A correct clinic examination and semiologic tests are still important to clinical diagnosis in orthopedics.

2008 ◽  
Vol 21 (04) ◽  
pp. 365-366 ◽  
Author(s):  
D. Hulse ◽  
S. C. Kerwin ◽  
L. E. Peycke ◽  
J. B. Case

Summary Objective: To describe clinical signs, arthroscopic findings, and outcome in a group of dogs undergoing second look arthroscopy for the treatment of meniscal tears following original surgery to correct a CCL deficient stifle joint. Methods: The medical records of 26 dogs from the Veterinary Teaching Hospital at Texas A&M University and the Veterinary Orthopedic Center (Round Rock, Texas) that had second look arthroscopy for lameness following an original surgical procedure were reviewed. Pre-operative clinical findings, 2nd look arthroscopic findings and owner assessed outcome were documented. Results: Postliminary bucket handle tears of the medial meniscus were detected in 22 (75.9%) cases. Other postliminary meniscal injuries included frayed caudal horn tears of the medial meniscus 6 (20.7%), and longitudinal tears of the lateral meniscus 1 (3.4%). An audible or palpable click was present in 27.6% of cases. An improvement or resolution of lameness was reported in 96.5% of cases reported. In conclusion, tears of the medial meniscus are a significant cause of lameness in dogs subsequent to surgery for cranial crucial ligament ruptures. Increased lameness or acute onset of lameness after surgery for cranial crucial rupture is a consistent finding. In rare cases, a palpable or audible click will be appreciated. Arthroscopic evaluation and partial meniscectomy improve or resolve lameness in the majority of cases. Clinical significance: Sudden or increased lameness in dogs with historical CCL stabilization surgery should be evaluated and treated arthroscopically for postliminary meniscal injury if another cause for lameness can not be determined.


2021 ◽  
Vol 2 ◽  
pp. 34-40
Author(s):  
Prateek Gupta ◽  
Shakti Swaroop ◽  
Rakesh Arya

Objectives: Anterior cruciate ligament (ACL) injury of the knee is commonly associated with meniscal and chondral lesions. This study was performed to assess the relative risk factors as well as the extent of the meniscal and chondral pathology at the time of arthroscopic ACL reconstruction. Materials and Methods: In this prospective study, patients undergoing ACL reconstruction were enrolled. Association of meniscal and chondral lesions was analyzed with age, sex, body mass index (BMI), mechanism of injury (sports-related or not), time gap between injury and surgery (<3 month and >3 months), and instability episodes. Logistic regression and Pearson Chi-square test were applied for evaluating the association. Results: A total of 55 patients (mean age 30 years [19–50 years]; 45 male:10 female) underwent arthroscopic ACL reconstruction, out of which 20 (36.3%) had isolated lateral meniscus tear, 14 (25.4%) had isolated medial meniscus tear, and 3 (5.4%) had both lateral and medial meniscus tear. BMI (P = 0.031) and instability episodes (P = 0.033) were predictor for meniscal lesions. Male sex was associated with significantly higher medial (P = 0.049) and lateral meniscal (P = 0.008) lesions. The older age group (>30 years) was associated with medial meniscus lesions (P = 0.047), while the younger age group (<30 years) had significantly higher lateral meniscal lesions (P = 0.008). Chronic ACL injuries (>3 months) had a significantly higher risk of medial meniscus lesions (P = 0.006). Age (>30 years) (P = 0.002) and obesity (BMI >30 kg/m2) (P = 0.043) were predictors of chondral lesions. Conclusion: Significant association is observed between age (>30 years), male gender, obesity, and chronicity with medial meniscal injuries in patients with an ACL injury, while younger patients (<30 years) and patient operated within 3 months had a higher incidence of lateral meniscus lesions. Age and BMI (>30 kg/m2) were predictors of chondral lesions in ACL injury.


2020 ◽  
Vol 7 (3) ◽  
pp. 35-40
Author(s):  
Bidur Gyawali ◽  
Amit Joshi ◽  
Nirab Kayastha

Introduction: Knee injuries are common among active adults. Achieving a correct clinical diagnosis is often difficult in acute presentations. Knee arthroscopy is considered the gold standard in diagnosing post-traumatic intra-articular lesions, but it is an invasive procedure requiring a certain degree of expertise. Magnetic Resonance Imaging (MRI) is a non-invasive, sensitive diagnostic tool for knee injuries. This study aims to correlate the findings of MRI with arthroscopy of the knee. Method: This Prospective Observational Study was done at Shree Birendra Hospital, Kathmandu, Nepal from 13 Feb 2016 to 13 Jun 2016. The sensitivity, specificity, and accuracy of MRI findings in ligamentous, meniscal, and osteochondral injuries of the knee were analyzed using arthroscopic findings as standard. Result: Fifty-two patients (35 male and 17 female), mean age 35.4 years were included in the study. The accuracy of MRI for anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial meniscus, lateral meniscus, and chondral lesions of the knee were 94%, 100%, 92%,86%, and 86% respectively. Conclusion: The MRI is accurate  (86-94%) in diagnosing Meniscal and Ligamentous injuries of the knee. It has poor sensitivity (22%) for chondral lesions.


2016 ◽  
pp. 120-127
Author(s):  
Dinh Toan Nguyen

Background: Dementia after stroke, particularly subacute period is often overlooked. Today the quality of human life is increasingly high, finding scales that have high value for detection of dementia in patients with stroke is increasingly interested. MoCA test is high sensitivity with mild dementia and identify more abnormalities of awareness caused by vascular, but MoCA have not been studied much in Vietnam. Objective: Assessing MoCA test in subacute stroke patients and compare MoCA versus MMSE in these patients. Subjects: 90 patients with subacute stroke period, these people are being treated at Department of cardiovascular internal medicine at Hue Central Hospital, from 7/2014 - 7/2015. Methods: cross-sectional description and analysis. Results: The mean age is 65.57 ± 13.38, accounting for 54.4% male and 45.6% female. Age, duration of illness has weak correlation with MoCA. The risk factors: hypertension, stroke ischemic transient, alcoholism, smoking, heart disease, diabetes, dyslipidemia related no statistical significance with MoCA. The proportion of dementia in subacute stroke according MoCA is 82.2%. The concordance between MoCA and MMSE was good (kappa = 0.684). Using DSM-IV criteria as the gold standard we found MoCA more valuable in the dementia diagnosis than MMSE (AUC 0.864 versus 0.774, p <0.05). Conclusion: The rate of dementia in stroke subacute period according MoCA is quite high. MoCA is valuable than MMSE in detecting dementia in patients with stroke subacute period, this scale is short, easy to implement so should put into using widely in clinical practice. Key words: MoCA test, subacute stroke, dementia


2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0004
Author(s):  
David A. Kolin ◽  
Brody Dawkins ◽  
Joshua Park ◽  
Peter D. Fabricant ◽  
Allison Gilmore ◽  
...  

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]


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Seiya Ota ◽  
Eiji Sasaki ◽  
Shizuka Sasaki ◽  
Daisuke Chiba ◽  
Yuka Kimura ◽  
...  

AbstractWe investigated the prevalence of magnetic resonance imaging (MRI) findings and their relationship with knee symptoms in women without radiographic evidence of knee osteoarthritis (KOA). This cross-sectional cohort study included 359 Japanese women without radiographic evidence of KOA (Kellgren‒Lawrence grade < 2). All participants underwent T2-weighted fat-suppressed MRI of their knees. Structural abnormalities (cartilage damage, bone marrow lesions [BMLs], subchondral cysts, bone attrition, osteophytes, meniscal lesions, and synovitis) were scored according to the whole-organ MRI score method. Knee symptoms were evaluated using the Knee Injury and Osteoarthritis Outcome Score. Participants were divided into early and non-KOA groups based on early KOA classification criteria. Logistic regression analysis was performed to evaluate the relationship between MRI abnormalities and knee symptoms. Cartilage damage was the most common abnormality (43.5%). The prevalences of cartilage damage, BMLs, subchondral cysts, bone attrition, meniscal lesions, and synovitis were higher in patients with early KOA than in those without. Synovitis (odds ratio [OR] 2.254, P = 0.002) and meniscal lesions (OR 1.479, P = 0.031) were positively associated with the presence of early KOA. Synovitis was most strongly associated with knee pain and might be a therapeutic target in patients with early KOA.


2021 ◽  
Vol 12 (02) ◽  
pp. 281-289
Author(s):  
Pranjal Phukan ◽  
Kalyan Sarma ◽  
Barun Kumar Sharma ◽  
Deb K. Boruah ◽  
Bidyut Bikash Gogoi ◽  
...  

Abstract Objective Japanese encephalitis (JE) is an arthropod-borne flavivirus infection having high mortality and morbidity. This study was performed to evaluate the conventional magnetic resonance imaging (MRI) findings in JE and to find out any difference between pediatric and adult JE. Materials and Methods This retrospective study was performed on serologically positive 54 JE patients presented to a tertiary care hospital with acute encephalitic symptoms between April 2016 and October 2019. Relevant neurological examination, cerebrospinal fluid analysis, and MRI scan of the brain were performed. Results Fifty-four JE patients (n = 31 males and n = 23 females) having 32 pediatric and 22 adult JE were included in the study sample. Group 1 JE (n = 16) patients had encephalitic symptoms with duration less than 15 days up to the day of MRI scan and group 2 JE (n = 38) had symptoms more than 15 days. Group 1 JE had mean apparent diffusion coefficient (ADC) value of 0.563 ± 0.109 (standard deviation [SD]) × 10–3 mm2/sec and group 2 JE had 1.095 ± 0.206 (SD) × 10–3 mm2/sec. The mean ADC value of pediatric JE was 0.907 ± 0.336 (SD) × 10–3 mm2/sec and adult JE was 0.982 ± 0.253 (SD) × 10–3 mm2/sec. Conclusion The majority of the JE patient shows abnormal signal alterations in bilateral thalami and substantia nigra. Diffusion-weighted imaging with ADC mapping helps in evaluating the stage of the JE. No statistical significance of the various conventional MRI findings was found between the pediatric JE and adult JE.


Neurology ◽  
1998 ◽  
Vol 51 (2) ◽  
pp. 570-573 ◽  
Author(s):  
Vincent I.H. Kwa ◽  
Laura H. Zaal ◽  
Bernard Verbeeten ◽  
Jan Stam ◽  

Objective: To examine the clinical relevance of isolated pontine hyperintense lesions(PHLs) on MRI in patients with atherosclerosis.Methods: Seventeen atherosclerotic patients with isolated PHL on MRI were compared with 17 patients without PHL and were matched for age, sex, and initial manifestation of atherosclerosis. Subjects and observer were blinded to the MRI findings. We assessed symptoms, impairment, and disability with a structured interview and neurologic examination as well as disability scales.Results: On all items, patients with PHL scored worse that did their controls. We found the largest differences in frequencies of symptoms of disequilibrium, difficulties with speech or swallowing, the Timed Walking Test, and the body care and movement subscale of the Sickness Impact Profile. Except for disequilibrium (p = 0.04), these differences did not reach statistical significance. Abnormal tandem-walking tests were more frequent in patients than they were in controls. Pyramidal signs were equally distributed.Conclusions: We propose PHL as a cause of symptoms of disequilibrium in patients with atherosclerosis. Symptoms are probably elicited by dysfunction of the corticopontine fibers, the pontocerebellar fibers, or the pontine nuclei.


2005 ◽  
Vol 93 (03) ◽  
pp. 488-493 ◽  
Author(s):  
Rainer Vormittag ◽  
Thomas Vukovich ◽  
Verena Schönauer ◽  
Stephan Lehr ◽  
Erich Minar ◽  
...  

SummaryThe role of C-reactive protein (CRP) in venous thromboembolism (VTE) is still under discussion because of controversial results in the literature. Conflicting data may have partly been due to bias by exogenous factors altering CRP levels. We investigated CRP concentrations in patients with spontaneous VTE applying a study design that allowed the measurement of basal high sensitivity (hs)-CRP levels. Patients with a history of deep vein thrombosis (DVT, n=117) and pulmonary embolism (PE, n=97) were compared to healthy individuals (n=104). Hs-CRP levels (mg/dl) were significantly higher in patients (n=214, median/interquartile range: 0.171/0.082–0.366) than in controls (0.099/0.053–0.245, p=0.001). The unadjusted odds ratio (OR) for VTE per 1 mg/dl increase of CRP was 2.8 [95% confidence interval (CI): 1.1–6.8, p=0.03]. This association remained significant after adjustment for factor V Leiden, prothrombin G20210A and factor VIII activity above 230% (OR = 2.9, 95% CI [1.1–7.5]), but became remarkably attenuated and lost its statistical significance after adjustment for BMI alone (OR = 1.7 [0.7–4.0]). CRP was also not independently associated with VTE in subgroups of patients (those with DVT without symptomatic PE, those with PE and patients without established risk factor) in multiple regression analysis. In summary, we observed significantly higher basal hs-CRP levels in patients with spontaneous VTE compared to healthy controls. This association was independent of hereditary and laboratory risk factors for VTE, but lost its significance after adjustment for BMI. Increased basal CRP levels do not appear to represent an independent risk factor for VTE.


2010 ◽  
Vol 63 (9-10) ◽  
pp. 607-610 ◽  
Author(s):  
Goran Malenkovic ◽  
Tihomir Dugandzija ◽  
Aljosa Mandic ◽  
Marija Velaga ◽  
Olivera Tesic ◽  
...  

Introduction. Ovarian cancer is one of the leading health problems, as it is the underlying cause of disease and deaths of a large number of women around the world. Postmenopausal female population, in whom ovarian carcinoma is most often diagnosed in advanced stages of the disease, is primarily affected. Material and methods. We used data from Hospital Registry for Malignant Neoplasms at Oncology Institute of Vojvodina, for the period from 2001 to 2008, according to which 422 cases of ovarian carcinoma were reported. The obtained data were classified into three groups according to FIGO classification of ovarian malignant neoplasms. The statistical assessment of data employed the method of linear trend and tests of statistical significance (t-test). Results. The results of our study showed that most cases of diagnosed disease were advanced forms of ovarian cancer, FIGO stages II and IV. The linear trend of the reported cases in stage I for the period 2001/2008 showed a descending trend. According to the processed data, in the same period of time, stage II showed an ascending trend, while stages III and IV described together showed a moderate ascending linear trend. Conclusion. A vast majority of cases of ovarian cancer are detected in advanced stages of the disease, which is at the same time the group with the worst prognosis. Special attention should be paid to the group of patients with positive family history, as well as the presence of BRCA1 and BRCA 2 genetic mutations. Currently existing diagnostic procedures have not given good results individually in terms of high sensitivity for diagnosis of early stages.


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