Patella dislocation: an overview

2021 ◽  
pp. 1-10
Author(s):  
Kwaku Baryeh ◽  
Fanuelle Getachew
Keyword(s):  
Soft Tissue ◽  
Operative Treatment ◽  
Knee Injuries ◽  
Recurrent Dislocation ◽  
Patella Dislocation ◽  
Osteochondral Defects ◽  
Cross Sectional ◽  
Acute Setting ◽  
Cross Sectional Imaging ◽  
Acute Knee

Patella dislocation is one of the most common knee injuries, accounting for 3% of acute knee injuries. Despite its prevalence, patella dislocation is often missed, with a haemarthrosis often the only sign, albeit a non-specific one. A thorough history and examination are necessary to identify patella dislocation and its potential causes. Investigations should include cross-sectional imaging to evaluate both osseous and soft tissue structures in order to guide management. Management in the acute setting is normally non-operative, but damage to structural supports, osteochondral defects or recurrent dislocation should prompt consideration of operative treatment. Operative treatment should address the soft tissue stabilisers and/or osseus deformities that predispose to, or occur secondary to, patella dislocation.

Soft Tissue Infections

2019 ◽  
pp. 102-108
Author(s):  
Sumer N. Shikhare ◽  
Wilfred C. G. Peh
Keyword(s):  
Soft Tissue ◽  
Early Diagnosis ◽  
Disease Process ◽  
Conventional Radiography ◽  
Diagnostic Value ◽  
Soft Tissue Infections ◽  
Cross Sectional ◽  
Clinical Presentations ◽  
Cross Sectional Imaging ◽  
Diagnostic Capabilities

Chapter 88 outlines the key radiologic features of soft tissue infections and the diagnostic value of the different imaging modalities such as conventional radiography, US, CT, and MRI. Soft tissue infections present in various forms that involve varying depths from skin to deeper tissues. Early diagnosis may be challenging because of nonspecific clinical presentations, resulting in delay in management. The advent of cross-sectional imaging has improved diagnostic capabilities dramatically, with US, CT, and particularly MRI being the pillars of evaluation. Prompt and appropriate imaging workup of the various MSK soft tissue infections aids early diagnosis and in demonstrating the extent of the disease process, as treatment delay significantly reduces the cure rate and increases the risk of complications.

scholarly journals Elastofibroma dorsi: The clunking tumour that need not cause alarm

2016 ◽  
Vol 98 (03) ◽  
pp. 208-211 ◽  
Author(s):  
HG Smith ◽  
JAF Hannay ◽  
K Thway ◽  
C Messiou ◽  
MJF Smith ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcomas ◽  
Percutaneous Biopsy ◽  
Surgical Excision ◽  
Electronic Patient Records ◽  
Cross Sectional ◽  
Female Ratio ◽  
Cross Sectional Imaging ◽  
Soft Tissue Masses ◽  
Pathology Reports

Introduction Elastofibromas are rare, pseudo-tumours arising at the inferior pole of the scapula that have a characteristic presentation. Due to their tissue of origin and size, they may often be mistaken for soft tissue sarcomas. We present the management of patients diagnosed with elastofibroma at a single institution. Methods Patients diagnosed with elastofibroma between January 1995 and January 2015 were identified from a prospectively maintained histopathology database. Electronic patient records, imaging and pathology reports were retrieved and reviewed. Results Thirty seven patients were identified, with a median age of 66 years and a male-to-female ratio of 1:1.6. All tumours occurred in the characteristic subscapular location. The median maximum tumour diameter was 8.2cm. A synchronous contralateral lesion (15.8%) was found in six patients. Cross-sectional imaging was performed in 29 patients, with magnetic resonance imaging the most common modality (59.5%). Diagnosis was confirmed with percutaneous biopsy in all but one patient, who proceeded directly to surgery. Eighteen patients were managed non-operatively; 19 opted for surgical excision due to significant symptoms. Excision was performed in a marginal fashion and, at a median follow-up of 5 months, no functional impairment or local recurrences were observed. Conclusions Soft tissue masses greater than 5cm in diameter should prompt the clinician to exclude soft tissue sarcoma. The diagnosis of elastofibroma may be alluded to by its typical presentation and can be confirmed by percutaneous biopsy. After excluding malignancy, these lesions can be safely managed non-operatively, with surgery reserved for symptomatic patients.

scholarly journals Imaging review of the anterior skull base

2018 ◽  
Vol 7 (5) ◽  
pp. 205846011877648 ◽  
Author(s):  
Olivia Francies ◽  
Levan Makalanda ◽  
Dimitris Paraskevopolous ◽  
Ashok Adams
Keyword(s):  
Soft Tissue ◽  
Nasal Cavity ◽  
Skull Base ◽  
Paranasal Sinuses ◽  
Anterior Skull Base ◽  
Normal Anatomy ◽  
Radiological Findings ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

The anterior skull base (ASB) is intimately associated with the unique soft tissue subtypes of the nasal cavity, paranasal sinuses, orbits, and intracranial compartment. Pathology involving the ASB is rare but the causes are manifold and can be broadly subdivided into those intrinsic to the skull base and processes extending from below or above. Sinonasal pathology is the most commonly encountered and poses significant management challenges that rely heavily on accurate interpretation of the radiological findings. We illustrate the normal anatomy of the ASB and present a cross-sectional imaging review of the pathological entities that may be encountered, focusing on the specific features that will impact on clinical and surgical management.

Radiography and ultrasound of the equine neck

UK-Vet Equine ◽  
2021 ◽  
Vol 5 (4) ◽  
pp. 142-149
Author(s):  
Jonathon J Dixon ◽  
Lucy Meehan
Keyword(s):  
Computed Tomography ◽  
Soft Tissue ◽  
Ultrasound Examination ◽  
Imaging Modality ◽  
Three Dimensional ◽  
Cross Sectional ◽  
Articular Process ◽  
Planar Images ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Diagnostic imaging of the equine neck is undertaken for a wide variety of conditions. In many cases, radiography is the principal imaging modality, often complemented by ultrasound examination. Common conditions encountered include osteoarthritis, articular process joint osteochondral fragmentation, cervical vertebral malformation (‘wobbler’), fractures and numerous soft tissue lesions. The complex three-dimensional anatomy of the region limits interpretation of planar images and, in some cases, cross-sectional imaging (such as computed tomography) may be required. However, careful use of radiography and ultrasound can help clinicians to achieve a diagnosis in many cases, often from combining conventional and lesion-orientated projections with a thorough clinical examination.

Spinal Fixation Hardware

2019 ◽  
pp. 224-230
Author(s):  
Kevin B. Hoover ◽  
Tim B. Hunter
Keyword(s):  
Soft Tissue ◽  
Human Body ◽  
Spinal Canal ◽  
Spinal Fixation ◽  
Disc Space ◽  
Cross Sectional ◽  
Structural Support ◽  
Cross Sectional Imaging ◽  
Sectional Imaging ◽  
The Stability

Chapter 49 discusses spinal fixation hardware. The spine is the primary structural support of the human body. Traumatic, neoplastic, infectious, or degenerative disruption of the 3 columns of the spine causing pain and instability are the primary indications for spine surgery. Implanted hardware is used to provide short-term stability while osseous fusion of bone graft develops. Radiographs are routinely used for pre- and postoperative evaluation. Spinal fusion is used to restore and maintain disc space height, to decompress the spinal canal and neural foramina, to maintain normal lordosis, and to increase the stability of involved segments. Cross-sectional imaging is important for identified hardware and soft tissue complications.

scholarly journals Cross-sectional imaging of thoracic traumatic aortic injury

VASA ◽  
2019 ◽  
Vol 48 (1) ◽  
pp. 6-16
Author(s):  
Lewis D. Hahn ◽  
Anand M. Prabhakar ◽  
Evan J. Zucker
Keyword(s):  
Thoracic Trauma ◽  
Aortic Injury ◽  
Rapid Diagnosis ◽  
Major Contributor ◽  
Cross Sectional ◽  
Acute Setting ◽  
Thoracic Aortic Injury ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Abstract. Aortic injury remains a major contributor to morbidity and mortality from acute thoracic trauma. While such injuries were once nearly uniformly fatal, the advent of cross-sectional imaging in recent years has facilitated rapid diagnosis and triage, greatly improving outcomes. In fact, cross-sectional imaging is now the diagnostic test of choice for traumatic aortic injury (TAI), specifically computed tomography angiography (CTA) in the acute setting and CTA or magnetic resonance angiography (MRA) in follow-up. In this review, we present an up-to-date discussion of acute traumatic thoracic aortic injury with a focus on optimal and emerging CT/MR techniques, imaging findings of TAI, and potential pitfalls.

scholarly journals P60 Impact of Acute Knee Clinic in the West of Scotland

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Saud Alfadhel ◽  
Laith Sinan ◽  
Simon Spencer ◽  
Saud Alfadhel
Keyword(s):  
Soft Tissue ◽  
Clinical Outcomes ◽  
Waiting Time ◽  
Cruciate Ligament ◽  
Adult Population ◽  
Knee Injuries ◽  
Definitive Treatment ◽  
The West ◽  
The Impact ◽  
Acute Knee

Abstract Introduction Soft tissue knee injuries are a common presentation among the young and adult population, thus, we have performed this audit to investigate the impact of introducing a new acute knee clinic in the West of Scotland with regards to delay in treatment of such injuries and potential clinical outcomes. Methods We have collected data from over 100 random patients with anterior cruciate ligament (ACL) injuries pre and post- the introduction of acute knee clinic in the West of Scotland and calculated the median time taken for them to see a knee specialist following their initial injury. The data was collected using a standardised proforma and analysed using Microsoft Excel. All patients included were 18-years-old and above. Results The introduction of an acute knee clinic has led to over 65% reduction in waiting time to see a knee specialist following a knee injury. In addition, soft tissue co-injuries such as meniscal tears were more likely to occur in patients who waited longer to be treated and thus the introduction of the knee clinic had also led to a reduction in waiting time for a definitive treatment (i.e. surgery) of patients and subsequent reduction in associated co-injuries. Conclusion Acute knee clinics are effective in reducing patient waiting time to be seen by a knee specialist following an ACL tear. This is particularly important as the earlier intervention is more likely to prevent subsequent meniscal and chondral injuries which in turn can provide patients with better clinical outcomes and quality of life.

scholarly journals The impact of an Acute Knee Clinic

2010 ◽  
Vol 92 (8) ◽  
pp. 685-688 ◽  
Author(s):  
Simon Ball ◽  
Fares S Haddad
Keyword(s):  
Soft Tissue ◽  
Open Access ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Economic Cost ◽  
Total Delay ◽  
Simple Method ◽  
Time To Diagnosis ◽  
The Impact ◽  
Acute Knee

INTRODUCTION The aim of this audit was to analyse the impact of an open access clinic for the treatment of soft tissue knee injuries with regard to delay to treatment. PATIENTS AND METHODS Data from 100 consecutive patients seen in our sports clinic in 2000 were collected. Following this audit, an Acute Knee Clinic was introduced and took place once per week. In 2006, the audit loop was closed and data from 100 consecutive patients seen in the Acute Knee Clinic were collected. RESULTS The time from injury to the first review by a specialist is referred to as the time to diagnosis. The introduction of the Acute Knee Clinic led to an 89% reduction in the time to diagnosis for accident and emergency referrals and a 32% reduction for general practitioner referrals. The average number of visits of any sort made by the patient prior to review by a specialist in 2000 was five as opposed to one in 2006. CONCLUSIONS An Acute Knee Clinic with open access is a simple method of dramatically reducing the delay to diagnosis. This decreases the total delay to treatment which is of particular importance in patients requiring anterior cruciate ligament (ACL) reconstruction due to the risk of secondary meniscal and chondral injuries. Decreasing the delay to diagnosis and appropriate treatment reduces the recovery time. This not only reduces the socio-economic cost of soft tissue knee injuries but may also decrease the psychosocial consequences for the patient. By reducing the number of times a patient is seen by medical practitioners prior to review by a specialist has the potential to decrease the total cost of treatment. The socio-economic impact and potential actual cost savings of treatment are particularly important with the current economic climate.

scholarly journals Validity of Ottawa Knee Rules at a Teaching Hospital of Eastern Nepal

2021 ◽  
Vol 6 (2) ◽  
pp. 1471-1475
Author(s):  
Bibhuti Nath Mishra ◽  
Santosh Nepal ◽  
Surya Bahadur Parajuli
Keyword(s):  
Teaching Hospital ◽  
Subjective Evaluation ◽  
Knee Injuries ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Fisher Exact Test ◽  
X Rays ◽  
Cross Sectional ◽  
Exact Test ◽  
Acute Knee

Introduction: Knee injuries are encountered frequently in Orthopedic emergency and Outpatient departments. Radiographs are routinely ordered in them, but not all of them demonstrate clear fractures. The decision for radiography based on subjective evaluation can help to reduce cost, decrease waiting time, and unnecessary radiation exposure. We lack this information in our context. Objective: The objective of this study was to find the validity of the Ottawa knee rule (OKR) in patients presenting with acute knee injuries at a teaching hospital in eastern Nepal. Methodology: A cross-sectional study was conducted from March 2018 to February 2019 including 210 cases of acute knee injuries. The patients were evaluated as per OKR and their X-rays were evaluated too. Collected data were entered in MS Excel and analyzed by SPSS for validity.   Results: Out of the total of 210 eligible patients (122 males and 88 females) with a mean age of 43.97 years, the radiography rate was 100% but the yield rate was only 10.5%. Overall 69% of patients presented to the hospital within 24 hours of the injury and direct hit/trauma was the commonest mode of injury. Patella fractures were commonest followed by proximal tibia fractures. There was a high sensitivity of 100% and a specificity of 42.02%.  The rule yielded a Positive and Negative Predictive value of 16.79% and 100%, respectively. The OKR, if applied correctly, could result in radiography rate reduction by 37.61%. The Fisher exact test result was significant at p<0.05. Conclusion: OKRs is a valid tool to predict fractures in patients who has a history of acute knee injuries without chances of missing fractures. This rule can reduce unnecessary radiography in our setup as well.

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