scholarly journals A comparative study of MRI versus arthroscopic findings in ACL and meniscal injuries of the knee

2018 ◽  
Vol 4 (2) ◽  
pp. 198 ◽  
Author(s):  
Omkar P. Kulkarni ◽  
Ganesh N. Pundkar ◽  
Satish B. Sonar
Keyword(s):  
Sensitivity And Specificity ◽  
Clinical Examination ◽  
Knee Injury ◽  
Statistical Tests ◽  
Knee Injuries ◽  
High Sensitivity ◽  
Therapeutic Modality ◽  
Mri Findings ◽  
Acl Injuries ◽  
Diagnostic Arthroscopy

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">This study was conducted to compare accuracy of MRI findings taking arthroscopy as standard in knee injuries.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">All patients attending our hospital with knee injury underwent clinical examination. Out of them 100 patients with knee injury were subjected to clinical examination, MRI and then Arthroscopy. The results were compared and analyzed using various statistical tests. The accuracy, sensitivity and specificity were calculated based on these arthroscopic and MRI findings</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The accuracy of clinical diagnosis in our study was 88% for ACL tears and 85% for meniscal tears. Our study proved high sensitivity and specificity and almost high accuracy for ACL injuries of knee joint in comparison to arthroscopy. MRI is an excellent screening tool for therapeutic arthroscopy. We can avoid diagnostic arthroscopy in patients with knee injuries having equivocal clinical and MRI examination and go on for therapeutic modality. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">For the assessment of ligamentous and meniscal injuries magnetic resonance imaging (MRI) is accurate and noninvasive modality. It can be used as a first line investigation but arthroscopy still remains gold standard in diagnosing ACL and meniscal injuries.</span></p><p class="abstract"> </p>

scholarly journals The Role of Clinical Examination in Predicting Relevant MRI Findings in Acute Knee Injuries: A Retrospective Study

2018 ◽  
Vol 32 (03) ◽  
pp. 280-283
Author(s):  
Daoud Makki ◽  
Daniel Ness ◽  
Raghuram Thonse ◽  
Saleem Mastan
Keyword(s):  
Clinical Examination ◽  
Knee Injury ◽  
Knee Injuries ◽  
Joint Effusion ◽  
Range Of Movement ◽  
Mri Findings ◽  
Mri Scan ◽  
Time Period ◽  
Acute Knee ◽  
Acute Knee Injury

AbstractThe objective of this study was to delineate the usefulness of clinical examination and magnetic resonance imaging (MRI) in acute knee injuries. We aim to establish whether the time period post acute knee injury is related to the diagnostic accuracy of clinical examination and to investigate the strength of specific clinical examination findings in predicting a clinically relevant MRI abnormality. Seventy patients were referred to fracture clinic with an acute knee injury who subsequently went on to be investigated with MRI over 12 months. These patients were retrospectively analyzed looking at the time period they were reviewed, the components that were assessed at physical examination, and the results of their eventual MRI scan looking for any correlation. A greater proportion of patients who were examined at 2 weeks had relevant positive findings on MRI scan, p = 0.03. Range of movement and lateral joint line tenderness were not associated with a positive MRI scan at any period after injury. The presence of a moderate to large effusion was not associated with an MRI abnormality if the examination was within 2 weeks of injury but was if present 2 weeks after injury, p = 0.0001. Range of movement should not form part of the decision making on whether an injury should be investigated with MRI. Joint effusion in isolation within 2 weeks after injury should not be an indication for MRI but a repeat clinical examination in 2 weeks, where if still present, should be investigated with MRI.

scholarly journals Performance of PROMIS Computer Adaptive Testing As Compared With Established Instruments for Multiple-Ligament Knee Injuries

2019 ◽  
Vol 7 (9) ◽  
pp. 232596711986741 ◽  
Author(s):  
Nicholas A. Trasolini ◽  
Shane Korber ◽  
Aaron Gipsman ◽  
Austin E. San ◽  
Alexander E. Weber ◽  
...  
Keyword(s):  
Physical Function ◽  
Knee Injury ◽  
Knee Injuries ◽  
Patient Reported Outcome ◽  
Activity Limitations ◽  
Acl Injuries ◽  
Multiligament Knee Injury ◽  
Patient Reported ◽  
Ceiling Effects ◽  
Multiligament Knee Injuries

Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive testing (CAT) is a patient-reported outcome metric that has been validated for anterior cruciate ligament (ACL) injuries, ACL reconstructions, and meniscal injuries. Thus far, the system has not been validated for multiligament knee injuries. The Multiligament Quality of Life (MLQOL) questionnaire is a validated, disease-specific patient-reported outcome instrument for this population that can serve as a gold standard for validation of the newer PROMIS. Purpose/Hypothesis: The purpose of this study was to further validate the PROMIS CAT for multiligament knee reconstruction. We hypothesized that the PROMIS CAT modules would correlate with the Lysholm knee score (Lysholm), Tegner activity scale (Tegner), and MLQOL for postoperative multiligamentous knee injury patients and that the PROMIS CAT would use fewer question items than the Lysholm, Tegner, and MLQOL while still avoiding floor and ceiling effects. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 30 patients meeting the inclusion criteria were retrospectively identified and agreed to participate (87% male; mean ± SD age, 36.3 ± 13.5 years). Consenting patients were administered the Lysholm, Tegner, MLQOL, and PROMIS CAT for Physical Function, Mobility, and Pain Interference. Spearman correlations were used to test agreement across survey instruments. Floor and ceiling effects were assessed for all instruments. Results: PROMIS Pain Interference had excellent correlation with MLQOL Activity Limitations ( r = 0.71, P < .0001). Excellent-good correlations were detected between PROMIS Physical Function and MLQOL Activity Limitations ( r = –0.63, P = .0002) and PROMIS Mobility and MLQOL Activity Limitations ( r = –0.62, P < .0002). Good correlations were found between the Lysholm and the PROMIS Physical Function and PROMIS Mobility (for each, r = 0.50, P = .005). Additional correlations were present with other subsections. There were no floor or ceiling effects for the PROMIS CAT instrument in any category. Conclusion: The PROMIS CAT correlates well with existing outcome measures for multiligament knee injury patients without floor or ceiling effects. The PROMIS CAT is a concise adjunct to the validated injury-specific outcome tool for multiligament knee injury. Surgeons should consider implementing the PROMIS CAT because of its broad validity, including ACL injuries, meniscal tears, and now multiligament knee injuries.

Overuse of Previsit Ultrasound in Patients Referred for Treatment of Inguinal Hernias

2019 ◽  
Vol 85 (3) ◽  
pp. 261-265
Author(s):  
Bryce French ◽  
Caleb Van Essen ◽  
Christopher Mcdonald ◽  
Andrew Ting
Keyword(s):  
Health Care ◽  
Inguinal Hernia ◽  
Physical Examination ◽  
Sensitivity And Specificity ◽  
Clinical Examination ◽  
Medical Records ◽  
High Sensitivity ◽  
Patient Demographics ◽  
Inguinal Hernias ◽  
Case Outcome

Inguinal ultrasound (US) has a high sensitivity and specificity for the diagnosis of inguinal hernias but is often performed unnecessarily, adding cost and time to treatment. The aim of our study was to assess the rate and necessity of US before clinical examination by a hernia surgeon. Medical records of patients referred for an inguinal hernia from April through July 2017 were reviewed. These cases were analyzed for patient demographics, physical examination (PE) findings, previsit imaging, health-care system of surgeon, and case outcome. Twenty-nine per cent of patients had an inguinal US before visiting a surgeon. Sixty-three per cent of patients who underwent an US had a palpable hernia on PE, and 76 per cent had a positive PE by the surgeon. Patients without a hernia on referring provider's PE underwent US 59 per cent of the time. Inguinal USs are being ordered unnecessarily by referring providers. Physical examination by referring providers and surgeons should be the primary tool for diagnosis of an inguinal hernia.

scholarly journals Pattern of Menisci and Cruciate Ligaments Injury of Knee Joint in MRI and Arthroscopy

2019 ◽  
Vol 2 (1) ◽  
pp. 15-20
Author(s):  
Santosh Joshi ◽  
Swayam Prakash Pandit ◽  
Binod Sherchan
Keyword(s):  
Knee Joint ◽  
Diagnostic Tool ◽  
Predictive Value ◽  
Knee Injury ◽  
False Negative ◽  
Knee Injuries ◽  
Left Knee ◽  
Gold Standard Method ◽  
Diagnostic Arthroscopy ◽  
One Year

Introduction: The traumatic or internal derangement of the knee requires certain investigations for the establishment of diagnosis. With advances in technology and because of high resolution and accuracy a MRI scan is now a standard for evaluating the knee injuries before a subsequent arthroscopy. When used properly after a thorough clinical examination, an MRI can prove to be an efficient and non-invasive diagnostic tool in the management of knee injuries. On the other hand, arthroscopy is considered as the gold standard method for the diagnosis of such injuries.  Methods: The prospective hospital based study was conducted on fifty one symptomatic patients with knee injuries over a period of one year. All the patients underwent MRI of the knee joint on Philips Achieva 1.5 Tesla MRI Machine in Bir Hospital, NAMS and they were evaluated and cross checked by faculty members. After proper evaluation, diagnostic arthroscopy was done, if needed therapeutic intervention was also performed. The sensitivity, the specificity, the positive predictive value and the negative predictive value of MRI for MM, LM, ACL and PCL were calculated. Results: A total of 51 patients were included with a mean age of 30.92 years. Left knee was predominantly involved in 56.1% of the cases with 43.9% involvement of right knee. Overall, MRI showed a total of 32 medial menisci tears and 8 lateral menisci tears. There were 5 false negative cases for MMT. MRI revealed tears of ACL in 44 patients and no patient with PCL tear. Arthroscopy revealed ACL tears in 44 cases and confirmed no patient with PCL tear. Conclusions: MRI is a noninvasive, useful and reliable diagnostic tool for evaluating knee injury and it can be used as a first line of investigation in patients with knee injury.

Detector-C: A Blood-based IVD with High Sensitivity and Specificity for Early Detection and Screening of Colorectal Cancer

2010 ◽  
Vol 48 (08) ◽  
Author(s):  
A Rosenthal ◽  
H Köppen ◽  
R Musikowski ◽  
R Schwanitz ◽  
J Behrendt ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Early Detection ◽  
Sensitivity And Specificity ◽  
High Sensitivity

Trends in Diagnosis for Active Tuberculosis Using Nanomaterials

2019 ◽  
Vol 26 (11) ◽  
pp. 1946-1959 ◽  
Author(s):  
Le Minh Tu Phan ◽  
Lemma Teshome Tufa ◽  
Hwa-Jung Kim ◽  
Jaebeom Lee ◽  
Tae Jung Park
Keyword(s):  
Sensitivity And Specificity ◽  
High Efficiency ◽  
Point Of Care ◽  
High Sensitivity ◽  
Signs And Symptoms ◽  
Diagnostic Methods ◽  
Advantages And Disadvantages ◽  
Treatment And Prevention ◽  
Clinical Tools ◽  
Diagnostic Applications

Background:Tuberculosis (TB), one of the leading causes of death worldwide, is difficult to diagnose based only on signs and symptoms. Methods for TB detection are continuously being researched to design novel effective clinical tools for the diagnosis of TB.Objective:This article reviews the methods to diagnose TB at the latent and active stages and to recognize prospective TB diagnostic methods based on nanomaterials.Methods:The current methods for TB diagnosis were reviewed by evaluating their advantages and disadvantages. Furthermore, the trends in TB detection using nanomaterials were discussed regarding their performance capacity for clinical diagnostic applications.Results:Current methods such as microscopy, culture, and tuberculin skin test are still being employed to diagnose TB, however, a highly sensitive point of care tool without false results is still needed. The utilization of nanomaterials to detect the specific TB biomarkers with high sensitivity and specificity can provide a possible strategy to rapidly diagnose TB. Although it is challenging for nanodiagnostic platforms to be assessed in clinical trials, active TB diagnosis using nanomaterials is highly expected to achieve clinical significance for regular application. In addition, aspects and future directions in developing the high-efficiency tools to diagnose active TB using advanced nanomaterials are expounded.Conclusion:This review suggests that nanomaterials have high potential as rapid, costeffective tools to enhance the diagnostic sensitivity and specificity for the accurate diagnosis, treatment, and prevention of TB. Hence, portable nanobiosensors can be alternative effective tests to be exploited globally after clinical trial execution.

Value of Coronary Calcium Scoring in Symptomatic and Asymptomatic Coronary Artery Disease Patients

2020 ◽  
Vol 16 ◽  
Author(s):  
Hala T. Salem ◽  
Eman A.S. Sabek
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Sensitivity And Specificity ◽  
High Sensitivity ◽  
Coronary Calcium ◽  
Risk Estimate ◽  
Calcium Scoring ◽  
Coronary Calcium Scoring ◽  
Framingham Risk ◽  
Artery Disease

Aim and Objective: To estimate the relationship between Coronary Calcium Scoring (CCS)and presence of different degrees of obstructive coronary artery disease (CAD) to avoid unnecessary examinations and hence unnecessary radiation exposure and contrast injection. Background: Coronary Calcium Scoring (CCS) is a test uses x-ray equipment to produce pictures of the coronary arteries to determine the degree of its narrowing by the build-up of calcified plaques. Despite the lack of definitive data linking ionizing radiation with cancer, the American Heart Association supports widely that practitioners of Computed tomography Coronary Angiography (CTCA) should keep “patient radiation doses as low as reasonably achievable but consistent with obtaining the desired medical information”. Methods: Data obtained from 275 CTCA examinations were reviewed. Radiation effective doses were estimated for both CCS and CTCA, measures to keep it as low as possible were presented, CCS and Framingham risk estimate were compared to the final results of CTCA to detect sensitivity and specificity of each one in detecting obstructive lesions. Results: CCS is a strong discriminator for obstructive CAD and can with high sensitivity and specificity and correlates well with the degree of obstruction even more than Framingham risk estimate which has high sensitivity and low specificity. Conclusion: CCS helps reducing the effective radiation dose if properly evaluated to skip unnecessary CTCA if obstructive lesions was unlikely, and as a test does not use contrast material, harmful effect on the kidney will be avoided as most of coronary atherosclerotic patients have renal problems.

scholarly journals An Investigation of Knee Injury Profiles among Iranian Elite Karatekas: Observations from a Cross-Sectional Study

2021 ◽  
Vol 18 (13) ◽  
pp. 6888
Author(s):  
Hamidreza Naserpour ◽  
Julien S. Baker ◽  
Amir Letafatkar ◽  
Giacomo Rossettini ◽  
Frédéric Dutheil
Keyword(s):  
Knee Injury ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Cross Sectional Study ◽  
Lower Extremity Injury ◽  
Sectional Study ◽  
Positive Health ◽  
Sports Activity ◽  
Cross Sectional ◽  
National Team

Karate training, despite the many positive health benefits, carries a risk of injury for participants. The current cross-sectional study aimed to investigate knee injury profiles among Iranian elite karatekas. Participants who attended the national team qualifiers, which included 390 male Kumite karatekas (age 24 ± 3 years old and weight 63 ± 12 kg), participated in this study. Information on knee injuries (injury history, type of injury mechanisms, and effects of knee symptoms on the ability to perform daily activities and recreational activities) were obtained using the Knee Outcome Survey (KOS). Using Pearson’s correlation coefficient, the study examined the relationships between different variables, including KOS subscales and levels of self-reported knee joint function. Our findings indicated that 287 karatekas (73.6%) experienced knee injuries. The anterior cruciate ligament (ACL) rupture (6.9%), articular cartilage (5.4%), and meniscus damage (3.8%) were the main typology of injury. In addition, there were no differences in knee injuries between the non-dominant and dominant legs. Most injuries occurred during the preparatory period (n = 162, 50%), especially during training periods. The KOS subscales scores (Mean ± Sd) for activities of daily living (ADL) and sports activity (SAS) were, respectively, 89 ± 11 and 91 ± 9. The self-reported scores for both the ADL and SAS subscales were, respectively, 89 ± 11 and 90 ± 10. Pearson coefficients of ADL and SAS subscales with their self-reported score were r = 0.761 (p < 0.0001) and r = 0.782 and (p < 0.0001), respectively. The profile of knee injuries in the current investigation is similar to previous surveys that reported lower extremity injury patterns. The findings of this study could be adopted to inform practice aimed at planning interventions for the reduction and prevention of knee injuries among karatekas.

scholarly journals Validation and verification of predictive salivary biomarkers for oral health

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nagihan Bostanci ◽  
Konstantinos Mitsakakis ◽  
Beral Afacan ◽  
Kai Bao ◽  
Benita Johannsen ◽  
...  
Keyword(s):  
Oral Health ◽  
Predictive Accuracy ◽  
Statistical Tests ◽  
Area Under The Curve ◽  
Regression Tree ◽  
High Sensitivity ◽  
Oral Health Status ◽  
Classification And Regression Tree ◽  
Cart Analysis ◽  
Salivary Biomarkers

AbstractOral health is important not only due to the diseases emerging in the oral cavity but also due to the direct relation to systemic health. Thus, early and accurate characterization of the oral health status is of utmost importance. There are several salivary biomarkers as candidates for gingivitis and periodontitis, which are major oral health threats, affecting the gums. These need to be verified and validated for their potential use as differentiators of health, gingivitis and periodontitis status, before they are translated to chair-side for diagnostics and personalized monitoring. We aimed to measure 10 candidates using high sensitivity ELISAs in a well-controlled cohort of 127 individuals from three groups: periodontitis (60), gingivitis (31) and healthy (36). The statistical approaches included univariate statistical tests, receiver operating characteristic curves (ROC) with the corresponding Area Under the Curve (AUC) and Classification and Regression Tree (CART) analysis. The main outcomes were that the combination of multiple biomarker assays, rather than the use of single ones, can offer a predictive accuracy of > 90% for gingivitis versus health groups; and 100% for periodontitis versus health and periodontitis versus gingivitis groups. Furthermore, ratios of biomarkers MMP-8, MMP-9 and TIMP-1 were also proven to be powerful differentiating values compared to the single biomarkers.

scholarly journals Blood-Based Detection of Colorectal Cancer Using Cancer-Specific DNA Methylation Markers

Diagnostics ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 51
Author(s):  
Nam-Yun Cho ◽  
Ji-Won Park ◽  
Xianyu Wen ◽  
Yun-Joo Shin ◽  
Jun-Kyu Kang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Dna Methylation ◽  
Sensitivity And Specificity ◽  
Stage Iv ◽  
High Sensitivity ◽  
Liquid Biopsies ◽  
Blood Leukocytes ◽  
Marker Panel ◽  
A Genome ◽  
Methylight Assay

Cancer tissues have characteristic DNA methylation profiles compared with their corresponding normal tissues that can be utilized for cancer diagnosis with liquid biopsy. Using a genome-scale DNA methylation approach, we sought to identify a panel of DNA methylation markers specific for cell-free DNA (cfDNA) from patients with colorectal cancer (CRC). By comparing DNA methylomes between CRC and normal mucosal tissues or blood leukocytes, we identified eight cancer-specific methylated loci (ADGRB1, ANKRD13, FAM123A, GLI3, PCDHG, PPP1R16B, SLIT3, and TMEM90B) and developed a five-marker panel (FAM123A, GLI3, PPP1R16B, SLIT3, and TMEM90B) that detected CRC in liquid biopsies with a high sensitivity and specificity with a droplet digital MethyLight assay. In a set of cfDNA samples from CRC patients (n = 117) and healthy volunteers (n = 60), a panel of five markers on the platform of the droplet digital MethyLight assay detected stages I–III and stage IV CRCs with sensitivities of 45.9% and 95.7%, respectively, and a specificity of 95.0%. The number of detected markers was correlated with the cancer stage, perineural invasion, lymphatic emboli, and venous invasion. Our five-marker panel with the droplet digital MethyLight assay showed a high sensitivity and specificity for the detection of CRC with cfDNA samples from patients with metastatic CRC.

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