scholarly journals GRADING SCALE OF LUMBAR DEGENERATIVE DISEASE IN FULL SPINE X-RAY

2019 ◽  
Vol 18 (1) ◽  
pp. 32-36
Author(s):  
Iúri Tomaz de Vasconcelos ◽  
Daniel Arnoni Sant’Anna ◽  
Carlos Eduardo Algaves Soares de Oliveira ◽  
Carlos Fernando P. S. Herrero ◽  
Raphael de Rezende Pratali
Keyword(s):  
Age Groups ◽  
Kappa Coefficient ◽  
Degenerative Disease ◽  
Degree Zero ◽  
Diagnostic Study ◽  
X Rays ◽  
Level Of Evidence ◽  
Lumbar Degenerative Disease ◽  
Intraobserver Reproducibility ◽  
Grading Scale

ABSTRACT Objective: To present a new lumbar degenerative disease grading scale considering full spine radiography and to evaluate its inter- and intraobserver reproducibility. Methods: A total of 132 full spine radiographies in the anterior and lateral views were analyzed. The cases were independently graded by two examiners. The radiographic parameters observed were osteophytosis, loss of disc height, sclerosis and subchondral cysts, number of affected segments, deformities, and signs of instability. The grading scale was proposed as follows: Degree zero corresponded to the absence of signs of degenerative disease in the lumbar spine; Grade I – presence of signs of degenerative disease up to two segments; Grade II – involvement of three or more segments; Grade III – associated deformity or signs of instability. The intra- and interobserver reproducibility was determined by the Kappa coefficient (κ) in general and according to the age group. Results: Kappa coefficient obtained for interobserver and intraobserver analysis showed excellent overall correlation (0.855 and 0.902, respectively). When analyzed according to age, results obtained in intraobserver correlation remained excellent (κ >0.8) in all age groups. The interobserver correlation remained excellent, except in the age range of 40-59 years (κ = 0.773), although maintaining a substantial reproducibility. Conclusion: The grading scale of lumbar degenerative disease observed in full spine x-rays showed excellent inter- and intraobserver reproducibility. Level of Evidence I; Diagnostic study.

scholarly journals COMPARATIVE ANALYSIS OF ADHERENCE TO THE MEDITERRANEAN DIET AMONG GIRLS AND ADOLESCENTS WHO PERFORM RHYTHMIC GYMNASTICS

2019 ◽  
Vol 25 (4) ◽  
pp. 280-284
Author(s):  
Mercedes Vernetta Santana ◽  
Isabel Montosa Mirón ◽  
Leopoldo Ariza Vargas ◽  
Jesús López Bedoya
Keyword(s):  
Waist Circumference ◽  
Mediterranean Diet ◽  
Eating Habits ◽  
Age Groups ◽  
Total Sample ◽  
Diagnostic Study ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Rhythmic Gymnastics ◽  
The Mediterranean

ABSTRACT Introduction: Eating habits are one of the underlying aspects in rhythmic gymnastics as a sport with an aesthetic component. Objective: To evaluate adherence to the Mediterranean diet (MD) in girls and adolescents who perform rhythmic gymnastics, and the relationship of this adherence with Body Mass Index (BMI) and waist circumference. Methods: A prospective, descriptive comparative cross-sectional study with the participation of 221 gymnasts aged between 7 and 17 years. Adherence to the Mediterranean diet was analyzed using the KIDMED test. The waist circumference, height and weight of each gymnast were measured and the BMI calculated. Results: 41.63%, 52.94% and 5.43% of the total sample exhibited high, medium and low adherence, respectively, to the Mediterranean diet. The Mann-Whitney U test indicated significant differences in the rate of adherence to the Mediterranean diet between the two age groups, U = 5007.0, p = .016, r = .162. The adolescent gymnasts had greater adherence than the younger gymnasts. The total sample showed a positive correlation of the rate of adherence with weight (Rho = .143, p = .034), BMI (Rho = .152, p = .024) and waist circumference (Rho = .180, p = .007). Conclusions: The eating habits of adolescent gymnasts with regard to the Mediterranean diet are healthier than those of the younger gymnasts. All participants had normal BMI values. The KIDMED values of the total sample were related to weight and BMI. The high percentages of younger gymnasts with mean adherence to the MD evidenced the need to approximate their eating habits with Mediterranean standards. Level of evidence II; Comparative diagnostic study.

scholarly journals Bohler Angle and the Crucial Angle of Gissane in Paediatric Population

2019 ◽  
Vol 12 ◽  
pp. 117954411983522
Author(s):  
Bruno Pombo ◽  
Ana Cristina Ferreira ◽  
Luís Costa
Keyword(s):  
Young Children ◽  
Age Groups ◽  
Paediatric Population ◽  
Mean Difference ◽  
Adult Patients ◽  
Control Group ◽  
Diagnostic Study ◽  
Age Group ◽  
Level Of Evidence ◽  
Calcaneus Fractures

Bohler angle and the crucial angle of Gissane are used on the evaluation of calcaneus fractures. However, few authors have described the variation of the angles when the calcaneus is growing. In this study, Bohler angle and the crucial angle of Gissane in paediatric population were measured using lateral foot radiographs of 429 patients, from 0 to 16 years of age. The control group was composed of 70 adult patients. The sample had a mean Bohler angle of 35.4° ± 5.9° and a mean crucial angle of Gissane of 110.5° ± 7.4°. The greater mean difference was identified for Bohler angle (8°) in the age group of 5 to 8 years (39.6° ± 5.7°) and for the crucial angle of Gissane (5°-6°) in the age group of 0 to 4 years (115.8° ± 7.3) ( P < .05). The influence of the ossification centres on the geometry of the calcaneus across age groups makes Bohler angle and the crucial angle of Gissane higher in young children. The increase in Bohler angle points out the relative development of the posterior facet in young children and the importance of the reconstruction of the posterior facet height in the intra-articular calcaneus fractures. Level of Evidence: Diagnostic study; Level III.

Reporting on acromion morphology: classifications demonstrate significant correlation

2020 ◽  
Vol 5 (2) ◽  
pp. 83-87 ◽  
Author(s):  
Antonio Klasan ◽  
Dominik Malcherczyk ◽  
Thomas Neri ◽  
Jascha Saul ◽  
Markus Dietmar Schofer ◽  
...  
Keyword(s):  
Pearson Correlation ◽  
Diagnostic Study ◽  
X Rays ◽  
Level Of Evidence ◽  
Patient Gender ◽  
Secondary Purpose ◽  
Initial Cohort ◽  
Average Patient ◽  
And Gender ◽  
Acromion Index

ObjectivesVarious classifications of acromion morphology exist in the literature. Only a few studies have compared these classifications and their results vary substantially. The primary purpose of this study was to determine a correlation between different classifications of acromial morphology on a large cohort. The secondary purpose was to establish if there is a difference between age, sides and gender.MethodsA retrospective analysis of 1853 subjects’ shoulder CTs has been performed. A total of 350 CT scans of polytraumatised patients have been selected out of the initial cohort, after exclusion of fractures and technically insufficient scans. Acromial slope, type, lateral acromion angle (LAA) and acromion index were measured and gender, age and side differences were analysed. Correlations between the different classifications were analysed using the Pearson correlation coefficient.ResultsThe average patient age of this cohort was 48 (range 16–90). There were 232 men and 118 women. There was a significant correlation between all classifications. Excellent correlations have been shown for left-right comparison of all measurements. Gender showed no correlation to any of the measurements. Age was correlated to LAA and acromial type.ConclusionThere is a significant correlation between all investigated acromion classifications, demonstrated with the CT. This may aid the clinician in choosing a classification to use when reporting on a patient, depending on the pathology even when plain X-rays are obtained. Age is correlated to LAA and acromial type. There is a strong bilateral correlation within each patient. Gender is not correlated to the acromial shape in any classification.Level of evidenceLevel III diagnostic study.

Impairment Tutorial: Rating Tears of the Acetabular Labrum

2006 ◽  
Vol 11 (6) ◽  
pp. 4-7
Author(s):  
Charles N. Brooks ◽  
Richard E. Strain ◽  
James B. Talmage
Keyword(s):  
Magnetic Resonance ◽  
Hip Arthroscopy ◽  
Age Groups ◽  
Limited Range ◽  
Labral Repair ◽  
X Rays ◽  
Joint Stability ◽  
Acetabular Labrum ◽  
Complete Excision ◽  
Limited Range Of Motion

Abstract The primary function of the acetabular labrum, like that of the glenoid, is to deepen the socket and improve joint stability. Tears of the acetabular labrum are common in older adults but occur in all age groups and with equal frequency in males and females. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, is silent about rating tears, partial or complete excision, or repair of the acetabular labrum. Provocative tests to detect acetabular labrum tears involve hip flexion and rotation; all rely on production of pain in the groin (typically), clicking, and/or locking with passive or active hip motions. Diagnostic tests or procedures rely on x-rays, conventional arthrography, computerized tomography, magnetic resonance imaging (MRI), magnetic resonance arthrography (MRA), and hip arthroscopy. Hip arthroscopy is the gold standard for diagnosis but is the most invasive and most likely to result in complications, and MRA is about three times more sensitive and accurate in detecting acetabular labral tears than MRI alone. Surgical treatment for acetabular labrum tears usually consists of arthroscopic debridement; results tend to be better in younger patients. In general, an acetabular labral tear, partial labrectomy, or labral repair warrants a rating of 2% lower extremity impairment. Evaluators should avoid double dipping (eg, using both a Diagnosis-related estimates and limited range-of-motion tests).

Evaluation of Potential Segmental Instability with Lumbar Degenerative Disease

2019 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
ahmed sweilam ◽  
Magdy Rashed ◽  
Mahmoud Taha ◽  
Magdy Elsheikh
Keyword(s):  
Degenerative Disease ◽  
Lumbar Degenerative Disease ◽  
Segmental Instability

scholarly journals Deferring Routine Wrist Radiography Does Not Affect Management of de Quervain Tendinopathy Patients

2017 ◽  
Vol 07 (02) ◽  
pp. 115-120 ◽  
Author(s):  
Tiffany Liu ◽  
Chia Wu ◽  
David Steinberg ◽  
David Bozentka ◽  
L. Levin ◽  
...  
Keyword(s):  
Physical Examination ◽  
Medical Center ◽  
Academic Medical Center ◽  
Diagnostic Study ◽  
Level Of Evidence ◽  
Radiographic Findings ◽  
Academic Medical ◽  
De Quervain ◽  
Clinical Records ◽  
Surgical Release

Background Obtaining wrist radiographs prior to surgeon evaluation may be wasteful for patients ultimately diagnosed with de Quervain tendinopathy (DQT). Questions/Purpose Our primary question was whether radiographs directly influence treatment of patients presenting with DQT. A secondary question was whether radiographs influence the frequency of injection and surgical release between cohorts with and without radiographs evaluated within the same practice. Patients and Methods Patients diagnosed with DQT by fellowship-trained hand surgeons at an urban academic medical center were identified retrospectively. Basic demographics and radiographic findings were tabulated. Clinical records were studied to determine whether radiographic findings corroborated history or physical examination findings, and whether management was directly influenced by radiographic findings. Frequencies of treatment with injection and surgery were separately tabulated and compared between cohorts with and without radiographs. Results We included 181 patients (189 wrists), with no differences in demographics between the 58% (110 wrists) with and 42% (79 wrists) without radiographs. Fifty (45%) of imaged wrists demonstrated one or more abnormalities; however, even for the 13 (12%) with corroborating history and physical examination findings, wrist radiography did not directly influence a change in management for any patient in this series. No difference was observed in rates of injection or surgical release either upon initial presentation, or at most recent documented follow-up, between those with and without radiographs. No differences in frequency, types, or total number of additional simultaneous surgical procedures were observed for those treated surgically. Conclusion Wrist radiography does not influence management of patients presenting DQT. Level of Evidence This is a level III, diagnostic study.

Drop Foot Due to Lumbar Degenerative Disease: Painless Drop Foot is Difficult to Recover

2021 ◽  
pp. 106696
Author(s):  
Jun Tanaka ◽  
Yoshihiro Takamori ◽  
Teruaki Shiokawa ◽  
Ryo Shibata ◽  
Shinri Nobutou ◽  
...  
Keyword(s):  
Degenerative Disease ◽  
Drop Foot ◽  
Lumbar Degenerative Disease

scholarly journals The change of coagulation profile in two-staged arthroplasty for periprosthetic joint infection patients: a retrospective cohort study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Hao Li ◽  
Rui Li ◽  
L. L. Li ◽  
Wei Chai ◽  
Chi Xu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Periprosthetic Joint Infection ◽  
Retrospective Cohort Study ◽  
Persistent Infection ◽  
Retrospective Cohort ◽  
Joint Infection ◽  
Diagnostic Study ◽  
Level Of Evidence ◽  
Coagulation Profile ◽  
Significant Difference

Abstract Aims Periprosthetic joint infection (PJI) is a serious complication of total joint arthroplasty. We performed a retrospective cohort study to evaluate (1) the change of coagulation profile in two-staged arthroplasty patients and (2) the relationship between coagulation profile and the outcomes of reimplantation. Method Between January 2011 and December 2018, a total of 202 PJI patients who were operated on with two-staged arthroplasty were included in this study initially. This study continued for 2 years and the corresponding medical records were scrutinized to establish the diagnosis of PJI based on the 2014 MSIS criteria. The coagulation profile was recorded at two designed points, (1) preresection and (2) preimplantation. The difference of coagulation profile between preresection and preimplantation was evaluated. Receiver operating characteristic curves (ROC) were used to evaluate the diagnostic efficiency of the coagulation profile and change of coagulation profile for predicting persistent infection before reimplantation. Results The levels of APTT, INR, platelet count, PT, TT, and plasma fibrinogen before spacer implantation were significantly higher than before reimplantation. No significant difference was detected in the levels of D-dimer, ACT, and AT3 between the two groups. The AUC of the combined coagulation profile and the change of combined coagulation profile for predicting persistent infection before reimplantation was 0.667 (95% CI 0.511, 0.823) and 0.667 (95% CI 0.526, 0.808), respectively. Conclusion The coagulation profile before preresection is different from before preimplantation in two-staged arthroplasty and the coagulation markers may play a role in predicting infection eradication before reimplantation when two-stage arthroplasty is performed. Level of evidence Level III, diagnostic study.

scholarly journals Novel Radiographic Indexes for Elbow Stability Assessment: Part B—Preliminary Clinical Study

2021 ◽  
Author(s):  
Francesco Luceri ◽  
Davide Cucchi ◽  
Enrico Rosagrata ◽  
Carlo Eugenio Zaolino ◽  
Alessandra Menon ◽  
...  
Keyword(s):  
Case Series ◽  
Radiographic Evaluation ◽  
Healthy Population ◽  
X Rays ◽  
The Novel ◽  
Level Of Evidence ◽  
Orthopaedic Surgeons ◽  
Joint Congruency ◽  
Radiological Parameters ◽  
The Mean

Abstract Introduction The coronoid process plays a key-role in preserving elbow stability. Currently, there are no radiographic indexes conceived to assess the intrinsic elbow stability and the joint congruency. The aim of this study is to present new radiological parameters, which will help assess the intrinsic stability of the ulnohumeral joint and to define normal values of these indexes in a normal, healthy population. Methods Four independent observers (two orthopaedic surgeons and two radiologists) selected lateral view X-rays of subjects with no history of upper limb disease or surgery. The following radiographic indexes were defined: trochlear depth index (TDI); anterior coverage index (ACI); posterior coverage index (PCI); olecranon–coronoid angle (OCA); radiographic coverage angle (RCA). Inter-observer and intra-observer reproducibility were assessed for each index. Results 126 subjects were included. Standardized lateral elbow radiographs (62 left and 64 right elbows) were obtained and analysed. The mean TDI was 0.46 ± 0.06 (0.3–1.6), the mean ACI was 2.0 ± 0.2 (1.6–3.1) and the mean PCI was 1.3 ± 0.1 (1.0–1.9). The mean RCA was 179.6 ± 8.3° (normalized RCA: 49.9 ± 2.3%) and the mean OCA was 24.6 ± 3.7°. The indexes had a high-grade of inter-observer and intra-observer reliability for each of the four observers. Significantly higher values were found for males for TDI, ACI, PCI and RCA. Conclusion The novel radiological parameters described are simple, reliable and easily reproducible. These features make them a promising tool for radiographic evaluation both for orthopaedic surgeons and for radiologists in the emergency department setting or during outpatient services. Level of evidence Basic Science Study (Case Series). Clinical relevance The novel radiological parameters described are reliable, easily reproducible and become handy for orthopaedic surgeons as well as radiologists in daily clinical practice.

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