scholarly journals Diagnostic performance of high-resolution ultrasound in pre- and postoperative evaluation of the hand tendons injuries

Author(s):  
Ahmed Abdelrahman Mohamed Baz ◽  
Aya Bahaa Hussien ◽  
Hesham Mostafa Abdel Samad ◽  
Hatem Mohamed Said El-Azizi

Abstract Background Hand tendon injuries are recognized clinical entities that are frequently seen. Clinical examinations usually warrant radiological correlative studies for confirmation and as a postoperative screening test. Here is a prospective observational cohort study enrolling 30 patients who were diagnosed clinically to have hand tendon injuries either pre- or postoperative; their ages were ranging from 5 to 64 years with a mean ± SD of 31.43 ± 12.19 years; 23 male patients (76.7%) and 7 female patients (23.3%) were evaluated by high-resolution ultrasound examination and a correlative evaluation was done by either intra-operative assessment or MRI study as gold standards. Results High-resolution ultrasound (HRUS) findings were binned into seventeen cases (56%) that had tendon tears, of which 10 cases (33.3%) had a complete tear and 7 cases (23.3%) had a partial tear. Postoperative tendon integrity was present in 13 cases (43.3%), a tendon callus was found in 2 cases (6.66%), and a postoperative abnormal motion on the dynamic study was present in 15 cases (50%). Intra-tendinous foreign bodies were detected in two cases (6.66%), a gap between the torn ends was found in 10 cases (33.3%), and re-tear (rupture) of the repaired tendons was present in four cases (13.3%). Coexistent nerve injuries were seen in two cases (6.66%); for the forementioned findings, HRUS had gained high accuracy measures as correlated to the gold standards (100% sensitivity and 100% specificity). Conclusion High-resolution ultrasound serves as a highly accurate potential diagnostic modality for preoperative evaluation of hand tendon injuries and the postoperative follow-up.

Author(s):  
Doria Mohammed Gad ◽  
Mostafa Thabet Hussein ◽  
Nagham Nabil Mahmoud Omar ◽  
Mohamed Mostafa Kotb ◽  
Mohamed Abdel-Tawab ◽  
...  

Abstract Background Brachial plexus injury occurs following birth trauma or adult trauma as well, surgical repair is important to regain upper limb function, and preoperative evaluation with MRI is important and considered the accurate and safe imaging modality. Thirty-seven patients with clinically suspected obstetric (15 patients) or adult traumatic (22 patients) brachial plexus injury were included in our study; all of them underwent MRI examination including T1WI, T2WI, STIR, DWIBS, 3D STIR SPACE, and MR myelography sequences. Results In obstetric cases, MRI sensitivity, specificity, and accuracy for preganglionic injury were 63%, 89%, and 82%, respectively, while for postganglionic lesions, MRI sensitivity, specificity, and accuracy were 60%, 99%, and 95%, respectively. In adult cases, MRI sensitivity, specificity, and accuracy for preganglionic injury were 96%, 95%, and 95% respectively, while for postganglionic injury, MRI sensitivity, specificity, and accuracy were 60%, 100%, and 99%, respectively. Conclusion MRI represents a safe, non-invasive, diagnostic modality having the multiplanar capability and better soft tissue characterization.


Neurosurgery ◽  
1984 ◽  
Vol 14 (3) ◽  
pp. 350-352 ◽  
Author(s):  
J. C. Angtuaco Edgardo ◽  
C. Holder John ◽  
C. Boop Warren ◽  
F. Binet Eugene

Abstract Thin section, high resolution computed tomographic (CT) scans of the lumbar spine produce images that can show herniated intervertebral discs without intravenous or intrathecal contrast enhancement. With this technique, the diagnosis of posterolateral and midline herniation has been greatly facilitated. This communication reports the use of CT discography in the preoperative evaluation of two patients who were shown at discography and proven at operation to have extreme lateral disc herniations.


Diagnostics ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 324
Author(s):  
Po-Cheng Hsu ◽  
Ke-Vin Chang ◽  
Kamal Mezian ◽  
Ondřej Naňka ◽  
Wei-Ting Wu ◽  
...  

The brachial plexus (BP) is a complicated neural network, which may be affected by trauma, irradiation, neoplasm, infection, and autoimmune inflammatory diseases. Magnetic Resonance Imaging is the preferred diagnostic modality; however, it has the limitations of high cost and lack of portability. High-resolution ultrasound has recently emerged as an unparalleled diagnostic tool for diagnosing postganglionic lesions of the BP. Existing literature describes the technical skills needed for prompt ultrasound imaging and guided injections for the BP. However, it remains particularly challenging for beginners to navigate easily while scanning its different parts. To address this, we share several “clinical pearls” for the sonographic examination of the BP as well as its common pathologies.


2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S305-S306
Author(s):  
Valentin Skriabin ◽  
Maria Vinnikova

Abstract Background Cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC) are the two principal ingredients of natural cannabis with counteracting functions. Synthetic cannabinoids (SCs) are much more potent than natural cannabis, since they act as a more potent full agonist at the cannabinoid subtype 1 receptor than THC, and they also lack cannabinoids such as CBD that may otherwise counteract psychoactive properties of THC. Therefore, SCs may induce a more severe clinical presentation than natural cannabis does: the use of SCs may be associated with agitation, anxiety, tachycardia, hallucinations, irritability, memory and cognitive impairment, violent behavior, unresponsiveness, and psychosis. Clinical characteristics, specificity of the disease course and patient profile of the SC-induced psychoses are still poorly characterized in the scientific literature. The present study was therefore designed to evaluate the psychotic disorders in patients with synthetic cannabinoid use disorder in terms of patient profile and clinical characteristics with reference to their follow-up. Methods A total of 60 male patients (n=60; mean (standard deviation [SD]) age: 23.6 (3.5) years) diagnosed with psychotic disorder induced by the SC use who were hospitalized at the intensive care unit or emergency department of the Moscow Research and Practical Centre on Addictions of the Moscow Department of Healthcare were included in this single-centre, longitudinal, observational cohort study. The catamnestic follow-up period was up to 2 years. Results We evaluated different clinical cases of SC-induced psychoses and identified four clinical types of them on the ground of leading psychopathological syndrome during the patient’s entire length of hospitalization: Then we performed a catamnestic follow-up of patients to reveal the possible schizophrenic process manifestation in patients who use SC. Catamnestic follow-up revealed that manifestation of the schizophrenic process was present in 8 patients (13% of cases). Discussion Our results revealed that SC-induced psychoses affect young adults primarily. Consistent with the statement that the majority of first-time SC users are experienced marijuana smokers, SC was used following other transitional substances rather than as the first substance in the majority of our patients, with cannabis being the most popular antecedent substance. SC was not the first substance used in the majority of our patients, and it had been preceded by use of other transitional substances, such as cannabis in most cases. Despite the exogenous nature, structurally such psychoses are often endoformic. For instance, even the delirium is atypical and includes the elements of Kandinsky-Clerambault’s syndrome. Psychopathologically hallucinations and delusions dominate in the clinical presentation of the psychoses (with predominant hallucinatory symptoms or affective paranoid symptoms). Development of substance-induced psychoses is often associated with the manifestation of the schizophrenic process (in our study it was revealed in 13% of cases). It is extremely difficult to create a differential diagnosis between such psychotic disorders and a primary endogenous psychotic episode. In such cases the appearance of deficit symptoms specific for schizophrenia becomes crucial.


2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Hirotaka Yamamoto ◽  
Atsushi Fujita ◽  
Taichiro Imahori ◽  
Takashi Sasayama ◽  
Kohkichi Hosoda ◽  
...  

Cartilage ◽  
2020 ◽  
pp. 194760352093118
Author(s):  
Scott Fernquest ◽  
Antony Palmer ◽  
Claudio Pereira ◽  
Calum Arnold ◽  
Emma Hirons ◽  
...  

Objective The aim of this study was to determine the effects of activity and cam morphology on cartilage composition during adolescence and investigate the development of cartilage composition with age. Design Cross-sectional observational cohort study of individuals from football club academies and an age-matched control population, aged 9 to 18 years. Assessments included questionnaires and T2-mapping of hips. Primary imaging outcome measures were T2 relaxation time of acetabular and femoral cartilage, average alpha angle, and lateral epiphyseal extension. Results The cohort consisted of 109 elite male footballers, 49 male controls, and 51 female controls. Elite male footballers had an acetabular cartilage T2 value 4.85 ms greater than male controls ( P < 0.001). A significant positive correlation existed between Physical Activity Questionnaire Score and acetabular cartilage T2 value (coefficient 1.07, P < 0.001) and femoral cartilage T2 value (coefficient 0.66, P = 0.032). Individuals with a closed physis had an acetabular cartilage T2 value 7.86 ms less than individuals with an open physis. Acetabular cartilage T2 values decreased with age in elite footballers. No correlation existed between alpha angle and anterosuperior acetabular cartilage T2 value and no difference in T2 value existed between individuals with and without cam morphology. Conclusions This study demonstrates that high activity levels may significantly affect acetabular cartilage composition during adolescence, but cam morphology may not detrimentally affect cartilage composition until after adolescence.


2020 ◽  
Vol 31 (2) ◽  
pp. 136-141 ◽  
Author(s):  
VY Skryabin ◽  
EA Bryun ◽  
LJ Maier

The present study was designed to investigate the phenomenon of chemsex among Moscow men who have sex with men (MSM) patients who were hospitalized due to various addictive disorders. It was an observational cohort study which included a total of 30 male patients who underwent inpatient treatment at the Moscow Research and Practical Centre on Addictions of the Moscow Department of Healthcare due to various addictive disorders. Data on sociodemographic, sexuality-, sexually transmitted infection- (STI-), and drug use-related characteristics obtained in face-to-face interviews were recorded in all patients. Mean (SD) age of the patients was 24.3 (3.5) years. Mephedrone was the drug most commonly reported as being used for chemsex (over half of cases); it was consumed by 16 patients. Gamma-hydroxybutyric acid/gamma-butyrolactone use was reported by 6.7% of patients; 16.7% of patients preferred cocaine; ketamine use was present only in one patient. Five participants (16.7%) reported the use of other stimulants. Overall, 20% of patients reported their HIV serostatus as positive. Self-reported other STI status was positive in 12 patients (40.0%). Our findings revealed that practicing chemsex among MSM can be considered a trend in Moscow. Our study emphasizes the role of collaborative work of sexologists and addictologists in order to develop and evaluate the interventions.


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