Radiographic Predictors for Adverse Outcomes Following Surgical Correction of Hammertoe Deformity

Category: Lesser Toes Introduction/Purpose: Hammertoe deformities are common, often painful deformities of the lesser foot and are known to severely affect physical function. When patients seek surgical management, x-ray imagining is utilized for diagnosis, evaluation for surgical candidacy, and selection of the operative technique. Postoperatively, radiographs are retaken to assess bone health, healing status, and alignment. Despite their frequent use, no previous data support particular X-ray findings as being indicative of clinical presentation nor surgical outcomes. The aim of this study is to identify specific radiographic parameters that are predictive of pain and function outcomes after surgical correction of hammertoe deformity. Methods: Prospectively collected data was reviewed on 116 patients who underwent hammertoe correctional surgery. Patient demographics, comorbidities, and postsurgical complications were recorded from their electronic medical records. Clinical outcomes were assessed utilizing preoperative and postoperative pain Visual Analogue Scale (VAS) and Short Form Health Survey Physical Component (SF-36 PCS) scores with 1-year follow-up. Radiographs were scored by a foot & ankle fellowship-trained orthopaedic surgeon to assess preoperative severity, postoperative joint fusion, and both pre- and postoperative joint instability. Data was examined using chi-squared, t-test, and ANOVA analyses. Results: Preoperatively, 14.7% of patients had a deformity classified radiographically as mild, 37.1% as moderate, and 48.3% as severe. X-rays prior to surgery showed that 65.5% had MTP joint instability, 9.5% had joint dislocation, and 18.1% had joint arthritis. Postoperatively, 78.5% had PIP joint fusion, 38.8% had MTP joint arthritis, and 17.2% had MTP joint instability. A significant association was found between postoperative MTP joint instability and a lower 1-year SF-36 PCS (p=0.0032). There were no associations found between the other radiographic findings and postoperative outcomes, and no parameters were associated with pain VAS scores. Conclusion: After undergoing surgical correction of hammertoe deformity, the postoperative radiographic finding of MTP joint instability was determined to be predictive of physical function. However, neither metatarsophalangeal joint arthritis nor PIP fusion were predictive of outcomes. This work informs foot and ankle specialists that proper joint alignment and stabilization is critical to ensuring success in hammertoe surgery.

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Radiographic predictors for improved outcomes after hammertoe correction surgery

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00329 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0032

Author(s):

Samuel Maidman ◽

Jason Bariteau ◽

Stephanie Boden ◽

Allison Boden ◽

Shay Tenenbaum

Keyword(s):

Joint Instability ◽

Short Form ◽

Multivariable Analysis ◽

Surgical Correction ◽

X Rays ◽

Radiographic Parameters ◽

Joint Fusion ◽

Sf 36 ◽

Pip Joint ◽

Joint Arthritis

Category: Lesser Toes Introduction/Purpose: Hammertoe deformities are common, often painful deformities of the lesser foot and are known to severely affect daily activities. When patients seek surgical management, x-rays are utilized for diagnosis, evaluation for surgical candidacy, and selection of the operative technique. Postoperatively, radiographs are retaken to assess bone health, healing status, and alignment. Despite the frequent use of radiographs pre- and post-operatively, radiographic results are not necessarily indicative of clinical presentation or surgical outcomes. The aim of this study is to identify specific radiographic parameters that are predictive of improved pain and function after surgical correction of hammertoe deformity. Methods: Prospectively collected data was reviewed on 51 consecutive patients who underwent operative correction of hammertoe deformity. Patient demographics, comorbidities, and post-surgical complications were recorded from their electronic medical records. Clinical outcomes were assessed utilizing preoperative and postoperative Visual Analogue Scale (VAS) and Short Form Health Survey Physical Component (SF-36 PCS) scores with a minimum of six-month follow-up. Radiographs were scored by a foot & ankle fellowship-trained orthopaedic surgeon to assess preoperative severity, postoperative joint fusion, and both pre- and postoperative joint instability and arthritis. Data was examined using a multivariable analysis. Results: Preoperatively, 15.7% (8/51) of patients had a deformity classified radiographically as mild, 37.3% (19/51) as moderate, and 47.1% (24/51) as severe. Additionally, 60.8% (31/51) had joint instability, 17.7% (9/51) had joint dislocation, and 7.8% (4/51) had joint arthritis. Postoperatively, 74.5% had PIP joint fusion, 35.3% (18/51) had joint arthritis, and 9.8% (5/51) had joint instability. A significant association was found between PIP joint fusion and improved SF-36 PCS scores (p=.004). Preoperative anticoagulant therapy was associated with reduced rates of PIP joint fusion (p=0.02). There was no association found between the other demographic or radiographic parameters, and no parameters were associated with improvement in VAS scores. Conclusion: After undergoing surgical correction of hammertoe deformity, postoperative PIP joint fusion was the only variable determined to be indicative of improved physical function. However, pre- and postoperative metatarsophalangeal joint arthritis nor instability was predictive of outcomes. This work informs foot & ankle specialists that healing of the PIP joint is critical to successful hammertoe surgery.

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The association between pain catastrophizing, physical function and pain in a cohort of patients undergoing knee arthroplasty

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-2787-6 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 3

Author(s):

Sara Birch ◽

Maiken Stilling ◽

Inger Mechlenburg ◽

Torben Bæk Hansen

Keyword(s):

Physical Function ◽

Knee Arthroplasty ◽

General Health ◽

Pain Catastrophizing ◽

Short Form ◽

Oxford Knee Score ◽

Preoperative Pain ◽

Sf 36 ◽

Before And After ◽

One Year

Abstract Background Pain catastrophizing contributes to acute and long-term pain after knee arthroplasty (KA), but the association between pain catastrophizing and physical function is not clear. We examined the association between preoperative pain catastrophizing and physical function one year after surgery, as well as differences in physical function, pain and general health in two groups of patients with high and low preoperative pain catastrophizing score. Methods We included 615 patients scheduled for KA between March 2011 and December 2013. Patients completed The Pain Catastrophizing Scale (PCS) prior to surgery. The Oxford Knee Score (OKS), Short Form-36 (SF-36) and the EuroQol-5D (EQ-5D) were completed prior to surgery, and 4 and 12 months after the surgery. Results Of the 615 patients, 442 underwent total knee arthroplasty (TKA) and 173 unicompartmental knee arthroplasty (UKA). Mean age was 67.3 (SD: 9.7) and 53.2% were females. Patients with PCS > 21 had statistically significantly larger improvement in mean OKS for both TKA and UKA than patients with PCS < 11; 3.2 (95% CI: 1.0, 5.4) and 5.4 (95% CI: 2.2, 8.6), respectively. Furthermore, patients with preoperative PCS > 21 had statistically significantly lower OKS, SF-36 and EQ-5D and higher pain score than patients with PCS < 11 both preoperatively and 4 and 12 months postoperatively. Conclusions Patients with high levels of preoperative pain catastrophizing have lower physical function, more pain and poorer general health both before and after KA than patients without elevated pain catastrophizing.

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Quality of Life After Pulmonary Rehabilitation: Assessing Change Using Quantitative and Qualitative Methods

Physical Therapy ◽

10.1093/ptj/80.10.986 ◽

2000 ◽

Vol 80 (10) ◽

pp. 986-995 ◽

Cited By ~ 23

Author(s):

Pat G Camp ◽

Jessica Appleton ◽

W Darlene Reid

Keyword(s):

Quality Of Life ◽

Qualitative Research ◽

Qualitative Methods ◽

Physical Function ◽

Pulmonary Rehabilitation ◽

Short Form ◽

Well Being ◽

Sf 36 ◽

Quantitative And Qualitative Methods

Abstract Background and Purpose. The purpose of this study was to use quantitative and qualitative research methods to evaluate quality-of-life (QOL) changes in patients with chronic obstructive pulmonary disease (COPD) after pulmonary rehabilitation. Subjects. Twenty-nine individuals with COPD (18 women and 11 men), with a mean age of 69 years (SD=8.6, range=53–92), participated. Methods. Subjects were assessed before and after a 5-week control phase and after a 5-week rehabilitation phase using the Chronic Respiratory Questionnaire (CRQ), the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and spirometry. Our qualitative research was based on a subsample of 7 subjects who were interviewed after pulmonary rehabilitation. Results. Pulmonary rehabilitation improved QOL, as demonstrated by increases of 22% and 14% in the physical function categories of the CRQ and the SF-36, respectively, and by an increase of 10% in the CRQ's emotional function category. The qualitative data indicated how pulmonary rehabilitation influenced QOL. Conclusion and Discussion. The use of both quantitative and qualitative methods illustrated the nature of improvement in QOL after pulmonary rehabilitation. Improved physical function, less dyspnea, and a heightened sense of control over the subjects' COPD resulted in increased confidence and improved emotional well-being.

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Determinants of Function After Total Knee Arthroplasty

Physical Therapy ◽

10.1093/ptj/83.8.696 ◽

2003 ◽

Vol 83 (8) ◽

pp. 696-706 ◽

Cited By ~ 172

Author(s):

C Allyson Jones ◽

Donald C Voaklander ◽

Maria E Suarez-Almazor

Keyword(s):

Functional Status ◽

Physical Function ◽

Short Form ◽

Study Data ◽

Walking Distance ◽

Comorbid Conditions ◽

Function Score ◽

Sf 36 ◽

Physical Function Score ◽

Total Knee

Abstract Background and Purpose. Decreasing hospital stays for patients with total knee arthroplasties (TKAs) have a direct effect on rehabilitation. The identification of modifiable determinants of postsurgical functional status would help physical therapists plan for discharge from hospitals. The purpose of this study was to identify preoperative determinants of functional status after a TKA. Participants. Using a community-based, prospective cohort study, data were collected from 276 patients who received a primary TKA in a Canadian health care region. Data were collected in the month before surgery and 6 months after surgery. Methods. Function was measured using the function subscale of a disease-specific measure—the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index—and a generic health status measure—the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Independent variables examined included demographic variables (eg, age, sex), medical variables (eg, diagnosis, number of comorbid conditions, ambulatory status), surgical variables (eg, type of implant, number of complications), and knee range of motion. Results. At 6 months after surgery, the average WOMAC physical function score was 70.5 (SD=18.2) and the average SF-36 physical function score was 44.8 (SD=25.3). Using multiple regression analyses, baseline function, walking device, walking distance, and comorbid conditions predicted 6-month function (WOMAC: R2=.20; SF-36 physical function: R2=.27). Discussion and Conclusion. Patients who have lower preoperative function may require more intensive physical therapy intervention because they are less likely to achieve functional outcomes similar to those of patients who have less preoperative dysfunction.

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RELATIONSHIP BETWEEN DISABILITY AND RADIOGRAPHIC FINDINGS OF LUMBAR DISK DEGENERATION IN SAMPLE OF IRAQI PATIENTS WITH MECHANICAL LOW BACKACHE

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2021.v14i2.40166 ◽

2021 ◽

pp. 83-88

Author(s):

KHUDAIR AL-BEDRI ◽

RIYAM ALI ◽

ZAINAB A. MAHMOOD

Keyword(s):

Back Pain ◽

X Rays ◽

Radiographic Findings ◽

X Ray ◽

Disk Space ◽

Lumbar Disk ◽

Disk Degeneration ◽

Lumbar Disk Degeneration ◽

Severity Of Disability ◽

Disk Space Narrowing

Objectives: Disability related to chronic low back pain (LBP) is a complex and multidimensional phenomenon all over the world. The prevalence of backache in middle age and elderly is up to 84%. This study aims to evaluate the associations of X-ray features of lumbar disk degeneration with severity of disability among patients with mechanical LBP. Patients and Methods: A cross-sectional study was conducted on a total of 300 patients with chronic mechanical LBP. Severity of disability was measured using Modified Oswestry Disability Index and intensity of backache was assessed using numeric rating scale (0–10). X-ray features of lumbar disc degeneration according to Lane classification and spondylolisthesis were assessed in lateral recumbent lumbar X-rays. Results: The mean age of our sample was 52.45±7.87 and 71.7% of involved patients were women. Most patients were recorded as overweight or obese. The findings of disk space narrowing were mild in 65.7%, moderate in 28.7%, and severe in 5.6%, where the presence of osteophytes were small in 76.9%, moderate in 20.5%, and large in 2.6%. Regarding disability, two-third of cases were focused on minimal disability, followed by moderate, severe, and crippled as (26%), (6%), and (2%), respectively. There was highly significant association between women and pain radiation to legs (p=0.004). Obesity and overweight had meaningless effects on all markers. Conclusions: The severity of disability was significantly more in women, high intensity of lower back pain, presence of pain radiating to legs, moderate/severe disk space narrowing on X-ray, and disk degenerative disease score on X-ray, while age, presence of osteophytes and spondylolisthesis, body mass index, and pain duration were not associated with severity of disability.

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Evaluation of Chinese People Quality of Life Who Suffer From Hematologic Diseases

Blood ◽

10.1182/blood.v118.21.4776.4776 ◽

2011 ◽

Vol 118 (21) ◽

pp. 4776-4776

Author(s):

Rong Hu ◽

Ying Yang ◽

Bin Wu ◽

Ke Zhu ◽

Miao Miao ◽

...

Keyword(s):

Quality Of Life ◽

Physical Function ◽

Educational Level ◽

Short Form ◽

Social Model ◽

Chinese People ◽

Hematologic Diseases ◽

Sf 36 ◽

Linear Regressions

Abstract Abstract 4776 Objective Now the medical model is transformed from simple biomedicine model to biomedical- psychological-social model and the clinical work also should pay more attention to the patients quality of life(QOL). To study physical function and health-related quality of life in Chinese people with hematologic diseases, we interviewed 64 patients in hematological department of Shengjing hospital. We used medical outcomes study 36-item short-form health survey(SF□ 36) to investigate hematologic patients' QOL and the influencing factors. Method All the data was collected between November 2009 to March 2010, after informed consent was obtained from all participants. We selected 64 patients who were interviewed face to face. They all over 14 years old, 39 males(60.9%) with a mean(SD) age of 43.23(16.71) years. They all suffer from hematologic disease and we listed 14 complications: fatigue, palpitation, insomnia, frequent micturition, anorexia, osteoporosis, night sweat, pain, diarrhea, nausea, constipation, cough, dyspnea and hemoptysis. The SF-36 consists of 36 items which were divided into eight different dimensions of health: physical function(PF), role limitations related to physical problems(RP), role limitations related to emotional problems (RE), social functioning (SF), mental health (MH), vitality (VT), bodily pain(BP) and general health (GH). The health concepts are described by scores ranging from 0 to 100, with higher scores indicating better health. Physical component (PCS) and mental component summary (MCS) scores are calculated from the 8 domains. Physical function was assessed querying limitations in 6 ADL including bathing, dressing, eating, transferring to and from chair, walking, and using the toilet. Each ADL limitation was categorized as any versus no limitation (dichotomous), and total ADL limitations ranging 0–6, categorized into “no”: 0 ADL, “moderate”: 1–2ADL, or “severe limitations”: ≥ 3ADL. As the total ADL can be divide into three degrees: first level is normal fuction: <16; second level is moderate limitations: 16–22; severe limitations of function: >or=22. Result The quality of life is remarkably lower than the normal people in all the aspects in China. The single factor analysis shows age, employment, education, complications and ADL degree have great effect on patients' quality of life. To exclude the interaction of these factors, further multivariable linear regressions indicate the main factors are age, education, complications and ADL degree. That means the above four factors are the independent factors which influence the hematologic patients in China. Conclusion This study found the QOL among hematologic patients was much lower than that among the Chinese general population in every dimension. Therefore, hematologic patients should be given more help to improve their QOL. We also try to find the factors such as gender, age, education, diseases, act influence the QOL. We hope to find a way to improve the QOL of hematologic patients. QOL is people's goal, expectation, standard and the life experiences; it is synthetic indictors to evaluate the burden of diseases. In this study we found age was inversely associated with PF. Educational level had different influence in patients social function and body pain. The patients who had lower educational level is better in SF and BP dimensions. Job status was found to be influence factor for RP. This may be because the patients who at work suffer much more pressure in daily life. Disease is also an important thing which can influence the patients' QOL. Through our investigation we found that activity of daily living is one of the important factors to influence the hematologic patients' QOL. On multivariable linear regressions analysis age, education, complications and ADL all retained an independent association with overall QOL. The hematologic diseases damage their QOL much stronger than others. All above status tell us that hematologic diseases have strong influence to patients' life quality. We should consider about the above four factors and pay more attention to them in order to improve patients' QOL. Disclosures: No relevant conflicts of interest to declare.

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Study of Clinical and Biochemical Parameters of Type 2 Diabetic Subjects with Pulmonary Tuberculosis

BIRDEM Medical Journal ◽

10.3329/birdem.v4i1.18545 ◽

2014 ◽

Vol 4 (1) ◽

pp. 5-8

Author(s):

F Afsana ◽

SNAA Jamil ◽

ZA Latif

Keyword(s):

Pulmonary Tuberculosis ◽

Biochemical Parameters ◽

Complete Blood Count ◽

Radiological Finding ◽

X Rays ◽

Radiographic Findings ◽

Bacteriological Culture ◽

X Ray ◽

Chest X Ray

Aims: Type 2 DM is a global epidemic and recognized as a threat to pulmonary tuberculosis (PTB) control worldwide especially in developing countries. When tuberculosis is diagnosed in diabetic subjects both can be affected in term of clinical presentation and course of disease. The aim of the study was to evaluate the demographic, clinical and biochemical parameters of newly detected PTB patients with type 2 diabetes. Methods: Seventy two diabetic subjects with newly detected PTB attending outpatient department, BIRDEM were studied. Patients with fever, cough, hemoptysis and/or weight loss were interviewed by a structured questionnaire. After thorough clinical examination, blood sugar, complete blood count (CBC), ESR, sputum for bacteriological culture and acid fast bacilli (AFB) (3 samples), X-ray chest were done. The diagnosis of PTB was based on a positive sputum AFB test, a suggestive CBC report or typical radiographic findings with high clinical probability. Diagnosed PTB cases were included in the study. All patients were followed up at least at1st, 3rd and 6th month of antitubercular therapy. Result: Mean age of study subjects was 46(19-75) years. The study subjects do not have past history of tuberculosis. Most of the study subjects (98.6%) were on insulin for treatment of diabetes. Mean body mass index (BMI) was 19.9kg/m². Mean ESR (mm in 1st hour) was 94.5 with 60% subjects having ESR >100. Sputum for bacteriological culture revealed no growth in 77.3% patients. Chest X-ray revealed cavity in 47.2%, opacity in 40.3%, both opacity and cavity in 5.6 %, pleural effusion in 5.6% and 5.5% had no detectable lesion. All patients were sputum AFB positive and among them 73.6% (n=53) had AFB positive in all 3 samples. Most of the patients (n=62, 86.6%) become sputum AFB negative after one month of treatment initiation. Rest 10 subjects (13.4%) become sputum negative in 2 months follow up and all of these patients had cavitary lesions in chest X-rays. A good number of the patients (98%) with positive x-ray finding showed radiological improvement after 2 months of antitubercular treatment. All the patients completed their therapy without any interruption for 6 months. Conclusion: Pulmonary cavity and opacity is the commonest radiological finding among study subjects. Sputum positivity for AFB is a good diagnostic tool for PTB in diabetic subjects. Subjects with cavitary lesion in chest X-ray become sputum negative than others. DOI: http://dx.doi.org/10.3329/birdem.v4i1.18545 Birdem Med J 2014; 4(1): 5-8

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Cross-Cultural Adaptation, Translation, and Validation of the Toronto Extremity Salvage Score for Extremity Bone and Soft Tissue Tumor Patients in Netherlands

Sarcoma ◽

10.1155/2017/6197525 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Julie J. Willeumier ◽

C. W. P. G. van der Wal ◽

Robert J. P. van der Wal ◽

P. D. S. Dijkstra ◽

Thea P. M. Vliet Vlieland ◽

...

Keyword(s):

Soft Tissue ◽

Physical Function ◽

Short Form ◽

Intraclass Correlation ◽

Retest Reliability ◽

Sf 36 ◽

Toronto Extremity Salvage Score ◽

Patient Reported ◽

Test Retest Reliability ◽

Extremity Salvage

Purpose. The aim of this study was to translate and culturally adapt the Toronto Extremity Salvage Score (TESS) to Dutch and to validate the translated version. Methods. The TESS lower and upper extremity versions (LE and UE) were translated to Dutch according to international guidelines. The translated version was validated in 98 patients with surgically treated bone or soft tissue tumors of the LE or UE. To assess test-retest reliability, participants were asked to fill in a second questionnaire after one week. Construct validity was determined by computing Spearman rank correlations with the Short Form- (SF-) 36. Results. The internal consistency (0.957 and 0.938 for LE and UE, resp.) and test-retest reliability (intraclass correlation coefficients 0.963 and 0.969 for LE and UE, resp.) were good for both questionnaires. The Dutch LE and UE TESS versions correlated most strongly with the SF-36 physical function dimension (r=0.737 for LE, 0.726 for UE) and the physical component summary score (r=0.811 and 0.797 for LE and UE). Interpretation. The Dutch TESS questionnaire for lower and upper extremities is a consistent, reliable, and valid instrument to measure patient-reported physical function in surgically treated patients with a soft tissue or bone tumor.

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FRI0491 IS THERE A RELATIONSHIP BETWEEN VOGT-KOYANAGI-HARADA AND INFLAMMATORY RHEUMATOLOGICAL DISEASES

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.3872 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 844.2-844

Author(s):

S. B. Kocaer ◽

M. Kaya ◽

S. Guven ◽

Z. Ayhan ◽

A. O. Saatci ◽

...

Keyword(s):

Connective Tissue Diseases ◽

X Rays ◽

Radiographic Findings ◽

X Ray ◽

Normal Ranges ◽

Pathergy Test ◽

The Mean ◽

Sicca Symptoms ◽

Rheumatological Diseases ◽

Rheumatological Manifestations

Background:Vogt-Koyanagi-Harada Disease (VKHD) is a systemic autoimmune disease characterized by bilateral granulomatous panuveitis associated with systemic symptoms, including neurological, dermatological and audiovestibular systems. Due to its systemic nature, it may accompany with other autoimmune conditions. However, there is a considerably limited number of reports on the association of VKHD and rheumatologic diseases.Objectives:To investigate the relationship between VKHD and inflammatory rheumatological diseases.Methods:Patients who had bilateral granulomatous uveitis and fulfilled the 2001 revised diagnostic criteria for VKHD were included in our study. All patients were systematically reviewed in terms of the presence of any rheumatological manifestations including connective tissue diseases, spondyloarthritis (SpA), vasculitis, Behcet’s disease and sarcoidosis.Results:Demographic findings: There were fifteen patients in the study (86,7%,female), the mean age at diagnosis was 31,2 ± 11,1 years.Comorbidities: Six patients (4 hashimoto thyroiditis, 2 diabetes mellitus) had comorbid diseases.Rheumatological findings: Mechanical back pain in 4 patients, 1 patient had morning stiffness without any other SpA related features; 2 patients had inflammatory arthralgias in small joints, 4 patients had sicca symptoms, 1 patient had arthritis in knee joint, 3 patients had oral aphthae and 1 patient had photosensitivity.Laboratory tests and autoantibodies: The acute phase reactants were within normal ranges. The mean CRP value at the time of diagnosis was 2,7 ± 3,2 mg/L and ESR was 14,4 ± 9,2 mm/h. Two (15,3%) out of 13 patients had high serum ACE levels. RF, anti-CCP and anti-dsDNA were negative in all patients. ANA was positive (>1/160 titers) in 4 patients (28,6%) and 3 patients had a titer above 1/320. Anti-ENA profile was positive in 2 patients with anti-SS-B and anti-histone components. MPO-ANCA was positive in one patient.HLA test: HLA-B27 was negative in all patients. HLA-B51 and B18 were positive in 2 patients.Radiographic findings: One patient had heel enthesitis on X-ray, 4 patients had bilateral grade 1 and one patient had unilateral grade 2 sacroiliitis. None of them fulfilled the Modified New York criteria for radiographic sacroiliitis. Hand X-rays of all patients were normal. One patient had reticular density on chest X-ray.Pathergy: The pathergy test was negative in all patients.Capilleroscopy: Four patients had pathological capilleroscopy findings (3 patient tortuous loops, 1 patient tortuous loops and microhemorrhages).Conclusion:This study suggests that; 1) inflammatory arthralgias and sicca symptoms were the most common rheumatological findings, 2) the frequency of SpA related features were not increased in VKHD, 3) increased autoantibody frequency, particularly in high titers of ANA could be seen in VKHD possibly reflecting the autoimmune nature of the disease, 4) even though there were signs of rheumatic diseases, none of the patients were grouped into any rheumatologic diagnostic classification.Demographic findings and rheumatological manifestations in VKHD patientsVKHD patients (n=15)Females,n (%)13 (86,7)Age,yrs (mean ± std)34,6 ± 12,6Age of diagnosis, yrs (mean±std)31,2 ± 11,1CRP baseline (mean±std)2,7 ± 3,2 mg/LESR baseline (mean±std)14,4 ± 9,2 mm/HHigh ACE levels,n(%)2/13 (15,3)RF positivity,n(%)0/14 (0)Anti-CCP positivity,n (%)0/6 (0)ANA positivity,n(%)4/14 (28,6)ANA pattern,(n)Homogeneous (2)Nuclear (1)Homogeneous speckled (1)Anti-dsDNA positivity,n(%)0/11 (0)Anti-ENA profile positivity,n(%)2/14 (14,2)ANCA positivity,n(%)1/12 (8,3)Pelvis X-Ray abnormality,n(%)Sacroiliitis (n)5/12 (41,7)Bilateral grade 1 (4)Unilateral grade 2 (1)Capilleroscopy abnormality,n(%)4/9 (44,5)Pathergy,n (%)0/12 (0)Disclosure of Interests:None declared

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Chest X-Ray Findings and Temporal Lung Changes in Patients with COVID-19 Pneumonia

10.21203/rs.3.rs-45829/v1 ◽

2020 ◽

Author(s):

Liqa A Rousan ◽

Eyhab Elobeid ◽

Musaab Karrar ◽

Yousef Khader

Keyword(s):

Ct Scan ◽

Chest Ct ◽

Common Finding ◽

X Rays ◽

Radiographic Findings ◽

X Ray ◽

Abnormal Chest ◽

Chest X Ray ◽

Chest Ct Scan

Abstract Background: Chest CT scan and chest x-rays show characteristic radiographic findings in patients with COVID-19 pneumonia. Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia. The study aims at describing the chest x-ray findings and temporal radiographic changes in COVID-19 patients.Methods: From March 15 to April 20, 2020 patients with positive reverse transcription polymerase chain reaction (RT-PCR) for COVID-19 were retrospectively studied. Patients’ demographics, clinical characteristics, and chest x-ray findings were reported. Radiographic findings were correlated with the course of the illness and patients’ symptoms.Results: A total of 88 patients (50 (56.8%) females and 38 (43.2%) males) were admitted to the hospital with confirmed COVID-19 pneumonia. Their age ranged from 3-80 years (35.2 ±18.2 years). 48/88 (45%) were symptomatic, only 13/88 (45.5%) showed abnormal chest x-ray findings. A total of 190 chest x-rays were obtained for the 88 patients with a total of 59/190 (31%) abnormal chest x-rays. The most common finding on chest x-rays was peripheral ground glass opacities (GGO) affecting the lower lobes. In the course of illness, the GGO progressed into consolidations peaking around 6-11 days (GGO 70%, consolidations 30%). The consolidations regressed into GGO towards the later phase of the illness at 12-17 days (GGO 80%, consolidations 10%). There was increase in the frequency of normal chest x-rays from 9% at days 6- 11 up to 33% after 18 days indicating a healing phase. The majority (12/13, 92.3%) of patients with abnormal chest x-rays were symptomatic (P=0.005).Conclusion: The chest x-ray findings were similar to those reported on chest CT scan in patients with COVID-19, Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia.

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