scholarly journals Sonographic Evaluation of the Degree of Medial Meniscal Extrusion During Thessaly Test in Healthy Knees

2021 ◽  
Author(s):  
Chin-Suk Cho ◽  
Lauren Tollefson ◽  
Kenneth Reckelhoff
Keyword(s):  
Knee Flexion ◽  
Interrater Reliability ◽  
Medial Meniscus ◽  
Intraclass Correlation ◽  
Meniscus Tear ◽  
Meniscal Extrusion ◽  
Dynamic Changes ◽  
Convenience Sample ◽  
Knee Position ◽  
The Difference

Abstract ObjectiveThe Thessaly test is a commonly used orthopedic test for meniscus tear evaluation. The study’s objective is to evaluate the degree of medial meniscal extrusion during different loading phases of the Thessaly test. MethodsA convenience sample of 60 healthy knees (35 participants) was examined. Sonographic measurement of the degree of physiologic extrusion of the medial meniscus deep to the medial collateral ligament was taken by two examiners at six different loading phases: supine, standing, 5° knee-flexion with internal (IR)/external (ER) rotation and 20° knee-flexion with IR/ER. The difference in meniscal extrusion by knee position was compared with ANOVA. Interrater reliability assessment was analyzed using intraclass correlation coefficient. ResultsThe mean meniscal extrusion for each position was - supine: 2.3±0.5mm, standing: 2.8±0.8mm, 5° IR: 2.3±0.9mm, 5° ER: 2.4±0.7mm, 20° IR: 1.9±0.8mm, and 20° ER: 2.3±0.7mm. Significant increase in extrusion was observed from supine to standing (p<0.05) and from 20° IR to 20° ER (p=0.015). Significant decreased measurement was observed from standing to 5° IR (p<0.05), 5° ER (p<0.05), 20° IR (p<0.05) and 20° ER (p<0.05). There is no significant change between 5° IR and 5° ER (p=1.0). Interrater reliability of the measurements across the six positions was poor to moderate (0.35-0.57, p<0.05). ConclusionOur study’s novel findings showed clear dynamic changes during Thessaly test, which implies increase in compressive stress across the medial meniscus and a potential mechanism for pain generation during this test. Further testing is needed to address the poor-moderate reliability and confirm findings.

scholarly journals Sonographic evaluation of the degree of medial meniscal extrusion during Thessaly test in healthy knees

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
John C. Cho ◽  
Lauren Tollefson ◽  
Kenneth Reckelhoff
Keyword(s):  
Knee Flexion ◽  
Medial Meniscus ◽  
Meniscus Tear ◽  
Data Sets ◽  
Meniscal Extrusion ◽  
Collateral Ligament ◽  
Convenience Sample ◽  
Knee Position ◽  
The Mean ◽  
The Difference

Abstract Objective The Thessaly test is a commonly used orthopedic test for meniscus tear evaluation. The study’s objective is to evaluate the degree of medial meniscal extrusion during different loading phases of the Thessaly test. Methods A convenience sample of 60 healthy knees (35 participants) was examined and the data sets were collected from October 8, 2018 through February 8, 2019. Sonographic measurement of the degree of physiologic extrusion of the medial meniscus deep to the medial collateral ligament was taken by two examiners at six different loading phases: supine, standing, 5° knee-flexion with internal (IR)/external (ER) rotation and 20° knee-flexion with IR/ER. The difference in meniscal extrusion by knee position was compared with ANOVA. Interexaminer reproducibility assessment was analyzed using limits of agreement. Results The mean meniscal extrusion for each position was—supine: 2.3 ± 0.5 mm, standing: 2.8 ± 0.8 mm, 5° IR: 2.3 ± 0.9 mm, 5° ER: 2.4 ± 0.7 mm, 20° IR: 1.9 ± 0.8 mm, and 20° ER: 2.3 ± 0.7 mm. Significant increase in extrusion was observed from supine to standing (p < 0.05) and from 20° IR to 20° ER (p = 0.015). Significant decreased measurement was observed from standing to 5° IR (p < 0.05), 5° ER (p < 0.05), 20° IR (p < 0.05) and 20° ER (p < 0.05). There is no significant change between 5° IR and 5° ER (p = 1.0). Agreement parameters revealed that the differences between examiner measurements were minimal; 75% of both examiners’ meniscal extrusion measurements were within 1.0 mm with 97% of measurements falling within 2.0 mm. Conclusion Our study’s novel findings showed various degrees of physiological extrusion of the medial meniscus in asymptomatic knees during the loading phases involved in the Thessaly test. Physiological MME does exist and should not be defaulted to pathologic meniscus as previously described. Agreement parameters suggest that measurement of meniscal extrusion during the Thessaly test is reproducible between different examiners.

scholarly journals Is it possible to use stress radiographs as a tool to diagnose medial meniscus posterior root tears?

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0007
Author(s):  
Ali Engin Daştan ◽  
Elcil Kaya Biçer ◽  
Hüseyin Kaya ◽  
Emin Taşkıran
Keyword(s):  
Medial Meniscus ◽  
Weight Bearing ◽  
Joint Space Width ◽  
Joint Space ◽  
X Rays ◽  
Meniscal Extrusion ◽  
Valgus Stress ◽  
Varus Stress ◽  
The Difference ◽  
Space Width

Aim: Medial meniscus posterior root tear (MMPRT) causes meniscal extrusion, loss of meniscus function, arthritic changes. Clinical history, physical examination and magnetic resonance imaging (MRI) findings are useful for the diagnosis of MMPRT. The aim of this study is to evaluate the utility of stress X-rays in the diagnosis of MMPRT. Methods: Twenty patients who had undergone high tibial osteotomy between March 2015 and May 2016 and whose preoperative bilateral varus and valgus stress x-rays (Telos device) along with weight bearing x-rays were available were included. These patients were grouped into two according to integrity of posterior roots of their medial menisci; there were ten patients both in the study and control groups. Lateral joint space width (LJW) on varus stress x-rays, medial joint space width (MJW) on valgus stress x-rays as well as LJW and MJW on weight bearing x-rays were measured bilaterally. Intragroup comparisons of joint space widths between index and opposite knees were performed. Differences of MJW and LJW between index and opposite knees were calculated. Differences of joint space widths between stress x-rays and weight bearing x-rays were also calculated. The changes in joint space widths between the two groups were compared. Statistical analyses were performed utilizing SPSS 18.0. Significance level was set at 0.05. Results: In MMPRT group, opening of LJ space of index knees under varus stress was greater than that of opposite knees (Index: (mean±SD) 10,27±1,17 mm, opposite: 8,61±1,37 mm; p<0,0001). In the control group the difference was not significant (Index: 9,29±2,55 mm, opposite: 9,68±1,44 mm; p=0,566). The difference in the opening of LJW (under varus stress) between index and opposite knees was significantly greater in the study group (p=0,013). The difference between LJW under weight-bearing and varus stress conditions was significantly greater in the study group. (Study: 3,64±0.217 mm, control:2,28±0,182 mm, p=0.018). Conclusions: The findings of this study showed that in patients who had MMPRTs, an increased opening in the LJW was observed under varus stress conditions. This may be relevant with the fact that when varus stress is applied, meniscal extrusion is increased in case of a MMPRT. Stress x-rays could be a useful tool in the diagnosis of MMPRTs. Further studies are needed to determine the sensitivity and specificity of this diagnostic tool.

scholarly journals Measurement of Scapular Asymmetry and Assessment of Shoulder Dysfunction Using the Lateral Scapular Slide Test: A Reliability and Validity Study

2001 ◽  
Vol 81 (2) ◽  
pp. 799-809 ◽  
Author(s):  
Corrie J Odom ◽  
Andrea B Taylor ◽  
Christine E Hurd ◽  
Craig R Denegar
Keyword(s):  
Sensitivity And Specificity ◽  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Distance Measures ◽  
Intrarater Reliability ◽  
Shoulder Dysfunction ◽  
Difference Measurement ◽  
Slide Test ◽  
The Difference

Abstract Background and Purpose. The Lateral Scapular Slide Test (LSST) is used to determine scapular position with the arm abducted 0, 45, and 90 degrees in the coronal plane. Assessment of scapular position is based on the derived difference measurement of bilateral scapular distances. The purpose of this study was to assess the reliability of measurements obtained using the LSST and whether they could be used to identify people with and without shoulder impairments. Subjects. Forty-six subjects ranging in age from 18 to 65 years (X̄=30.0, SD=11.1) participated in this study. One group consisted of 20 subjects being treated for shoulder impairments, and one group consisted of 26 subjects without shoulder impairments. Methods. Two measurements in each test position were obtained bilaterally. From the bilateral measurements, we derived the difference measurement. Intraclass correlation coefficients (ICC [1,1]) and the standard error of measurement (SEM) were calculated for intrarater and interrater reliability of the difference in side-to-side measures of scapular distance. Sensitivity and specificity of the LSST for classifying subjects with and without shoulder impairments were also determined. Results. The ICCs for intrarater reliability were .75, .77, and .80 and .52, .66, and .62, respectively, for subjects without and with shoulder impairments in 0, 45, and 90 degrees of abduction. The ICCs for interrater reliability were .67, .43, and .74 and .79, .45, and .57, respectively, for subjects without and with shoulder impairments in 0, 45 and 90 degrees of abduction. The SEMs ranged from 0.57 to 0.86 cm for intrarater reliability and from 0.79 to 1.20 cm for interrater reliability. Using the criterion of greater than 1.0 cm difference, sensitivity and specificity were 35% and 48%, 41% and 54%, and 43% and 56%, respectively, for 0, 45, and 90 degrees of abduction. Sensitivity and specificity based on the criterion of greater than 1.5 cm difference were 28% and 53%, 50% and 58%, and 34% and 52%, respectively, for the 3 scapular positions. Conclusion and Discussion. Our results suggest that measurements of scapular positioning based on the difference in side-to-side scapular distance measures are not reliable. Furthermore, the results suggest that sensitivity and specificity of the LSST measurements are poor and that the LSST should not be used to identify people with and without shoulder dysfunction.

scholarly journals Thumb Proprioception in Hypermobile and Non-Hypermobile Adults: An Observational Study

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Leon Fonseka ◽  
Nicola Massy-Westropp ◽  
Steve Milanese ◽  
Arjun Burlakoti
Keyword(s):  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Joint Hypermobility ◽  
Angular Distance ◽  
Test Reliability ◽  
Joint Position ◽  
Convenience Sample ◽  
Intraclass Correlation Coefficients ◽  
The Difference ◽  
Design And Methods

Aims and Background Hypermobility is a common presentation in the community and is reported related to higher rates of injury and musculoskeletal pain, however the mechanism underpinning this relationship remains unclear. Poor proprioception in hypermobile joints has been proposed as a potential mechanism. This study aims to determine if there is a difference in proprioceptive acuity, as measured by joint position reproduction, in adults with generalised joint hypermobility. Design and methods A convenience sample of 26 university students and staff (mean age 29.23 years, range 18-47) were recruited, of which 12 participants displayed generalised joint hypermobility, and 14 did not. A laser light, mounted to the dominant thumb, was used to test joint position reproduction sense by pointing to targets using a unilateral active-active position reproduction protocol. Results/Findings Test reliability across a range of targets was poor to good (intraclass correlation coefficients ranged from 0.1163 to 0.7256), indicating significant variability between participants. No significant differences was found in absolute angle of error between generalised joint hypermobility and non-generalised joint hypermobility participants. For direction of error in relation to the proprioceptive targets, only 30° thumb extension above horizontal was found to be significantly different between the hypermobile and non-hypermobile groups, with hypermobile participants tending to underestimate distance to target. Age and sex were not correlated to thumb proprioception. Application and Conclusion The difference found in direction of error and tendency to underestimate angular distance may be protective against straying into possibly injurious end-ranges; however, larger studies are recommended to confirm this.

scholarly journals Usefulness of ultrasonography for dynamic evaluation of medial meniscus hoop function in early knee osteoarthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kengo Shimozaki ◽  
Junsuke Nakase ◽  
Kazuki Asai ◽  
Rikuto Yoshimizu ◽  
Mitsuhiro Kimura ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Medial Meniscus ◽  
Knee Extension ◽  
Meniscus Tear ◽  
Meniscal Tears ◽  
Meniscal Extrusion ◽  
Mri Findings ◽  
Characteristic Finding ◽  
Flexion Extension ◽  
Group D

AbstractThis study aimed to evaluate the dynamics of the medial meniscus during knee flexion–extension by ultrasonography and compare them with MRI findings to confirm the usefulness of ultrasonography for evaluating early knee osteoarthritis (KOA). In total, 100 patients were diagnosed with early KOA using clinical and radiographical findings. Dynamic ultrasonographic evaluation and MRI were performed in all patients. Medial meniscal extrusion (MME) and medial meniscal tears were evaluated via ultrasonography and MRI. Abnormal MME was defined as MME > 2 mm on ultrasonography during knee extension. Patients with abnormal MME were divided into two groups: a decrease group (group D) and a non-decrease group (group N). Age, sex, absence or type of meniscus tear, and MME were compared between the two groups. Of the 100 patients, 75 demonstrated MME > 2 mm at knee extension. MME at all assessment positions using ultrasonography and MRI were significantly greater in group N (n = 34) than that in group D (n = 41). Medial meniscus posterior root tears or radial tears were observed in most cases in group N. A lack of decrease in MME from 0° to 90° of flexion on ultrasonography was a characteristic finding in patients with a loss of meniscal hoop function.

Interrater Reliability of a Novel Goniometric Technique to Measure Scapular Protraction and Retraction

2022 ◽  
Vol 76 (1) ◽  
Author(s):  
Nathan Short ◽  
Thomas Almonreoder ◽  
Michelle Mays ◽  
Abigail Baist ◽  
Tony Clifton ◽  
...  
Keyword(s):  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Frontal Plane ◽  
Occupational Therapists ◽  
Occupational Performance ◽  
Convenience Sample ◽  
Study Implementation ◽  
Study Support ◽  
Goniometric Measurements

Importance: Scapular protraction and retraction are often essential for occupational performance; however, clinical assessment of these movements is uniquely challenging. Objective: To analyze the interrater reliability of a novel goniometric method to measure scapular protraction and retraction. Design: An observational, descriptive design was implemented to evaluate interrater reliability between two experienced occupational therapists who were also certified hand therapists. Setting: Academic institution. Participants: Convenience sample of graduate students (N = 80). Outcomes and Measures: The hypothesis, developed before study implementation, was that the technique would demonstrate clinically acceptable interrater reliability, defined as a standard error of measurement (SEM) &lt;8°. Goniometric measurements of the scapula at rest, in maximal protraction, and in maximal retraction were independently obtained from each participant by each evaluator. The goniometer was aligned on the scapula using the superior angle as the axis of motion to measure the movement of the acromion relative to the frontal plane. The SEM was calculated in each position using the intraclass correlation coefficient values and the average of the standard deviations from the two raters. Results: The SEM values between the two evaluators for the resting, protracted, and retracted positions were 3.46°, 2.93°, and 2.74°, respectively. Conclusions and Relevance: The SEM between the two evaluators for each scapular position was &lt;4°, suggesting that the technique may be clinically reliable. However, additional research regarding the reliability and validity of the technique is recommended. What This Article Adds: The findings of this study support the use of goniometry to measure scapular protraction and retraction in relation to occupational performance. The technique provides a way to quantify baseline scapular mobility and track progress.

Reliability of Markers for Breast Hypoplasia in the Early Postpartum Period

2021 ◽  
pp. 089033442199107
Author(s):  
Renee L. Kam ◽  
Meabh Cullinane ◽  
Don Vicendese ◽  
Lisa H. Amir
Keyword(s):  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Future Research ◽  
Measurement Means ◽  
Intrarater Reliability ◽  
Convenience Sample ◽  
Breast Hypoplasia ◽  
Early Postpartum ◽  
Width Measurement ◽  
Prospective Longitudinal

Background Breast hypoplasia is one reason for insufficient milk supply. Case reports use wide intra-mammary width and certain breast appearances as markers of breast hypoplasia. However, the reliability of these variables has not been determined. Research aims To test the (i) interrater and intrarater reliability of intra-mammary width measurement and interrater reliability of categorizing women’s breasts into breast types, and (ii) feasibility and acceptability of study procedures for the participants. Methods This was a prospective, longitudinal, non-experimental design with survey and observational components of a convenience sample of early postpartum women ( N = 31). Interrater and intrarater reliability were measured using intraclass correlation coefficient for agreement for intra-mammary width measurements. Interrater reliability was measured using weighted kappa for agreement for categorizing breast type. Feasibility and acceptability of study procedures were collected 1 month later. Results Excellent intrarater and interrater reliability for the intra-mammary width measurement (ICC = 0.99, 95% CI [0.99, 0.997] and ICC = 0.88, 95% CI [0.74, 0.94], respectively) and fair interrater reliability for breast type categorization (k = 0.35, 95% CI [−0.05, 0.75]) with high level of agreement between raters (97%) were achieved. Proportions of participants agreeing to breast photography and acceptability of study procedures were 68% (21/31) and 100% (28/28) respectively. Conclusion The excellent reliability for the intra-mammary width measurement means it provides a useful measure for future research. Since the “fair” reliability of categorizing breast type was due to lack of breast shape range in our sample, future research could assess the breasts of women with different medical profiles.

scholarly journals Comparison of two simple stitches and modified Mason-Allen suture for medial meniscus posterior root tear based on the progression of meniscal posterior extrusion: A retrospective cohort study

2021 ◽  
Vol 29 (3) ◽  
pp. 230949902110495
Author(s):  
Keisuke Kintaka ◽  
Takayuki Furumatsu ◽  
Yuki Okazaki ◽  
Shin Masuda ◽  
Takaaki Hiranaka ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Medial Meniscus ◽  
Cartilage Degeneration ◽  
Knee Extension ◽  
Posterior Root ◽  
Open Magnetic Resonance Imaging ◽  
Significant Difference ◽  
Pullout Repair ◽  
The Difference ◽  
Repair Techniques

Purpose: Medial meniscus (MM) posterior root (PR) tear leads to severe MM posterior extrusion (PE), resulting in rapid knee cartilage degeneration. MMPR repairs are recommended to reduce MMPE, especially during knee flexion. However, the difference in MMPE between different repair techniques remains unknown. This study aimed to investigate preoperative and postoperative MMPE following several pullout repair techniques. We hypothesized that a technique using two simple stitches (TSS) would be more useful than FasT-Fix-dependent modified Mason-Allen suture (F-MMA) to prevent the progression of MMPE in knee extension. Methods: This retrospective study included 35 patients who underwent MMPR repair. To compare MMPE, patients were divided into two groups according to the use of F-MMA while grasping the posterior capsule and TSS without grasping it. Open magnetic resonance imaging was performed at 10° and 90° knee flexion preoperatively, and at 3 and 12 months postoperatively, and the MMPE of both groups was evaluated. Results: A significant difference was observed between preoperative and 3-month postoperative MMPE at 90° knee flexion in both groups ( p < .01). A significant difference was observed in 3- and 12-month postoperative MMPE at 10° knee flexion between both groups ( p = .04/.02), whereas no significant difference in the preoperative MMPE at 10° knee flexion was observed between them ( p = .45). Conclusions: Both repairs were found to be useful to reduce MMPE in knee flexion. Further, F-MMA repair increased MMPE in knee extension, unlike TSS repair. These findings suggest that TSS might have more advantages for load distribution when standing or walking.

Addition of CT to Improve the Diagnostic Confidence for the Detection of Sacroiliac Joint Erosions in Patients with Equivocal MRI Findings

2021 ◽  
pp. 084653712110565
Author(s):  
Ibrahim M. Nadeem ◽  
Sohaib Munir ◽  
Vincent Leung ◽  
Euan Stubbs
Keyword(s):  
Sacroiliac Joint ◽  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Interrater Agreement ◽  
Time Interval ◽  
Diagnostic Confidence ◽  
Mri Findings ◽  
Exact Test ◽  
Joint Erosions ◽  
The Difference

Purpose To determine if CT can improve the diagnostic confidence for the detection of sacroiliac joint (SIJ) erosions in patients with equivocal MRI findings. Methods A retrospective analysis of adult patients who had an SIJ MRI and a subsequent SIJ CT within 12 months was conducted. Using a 5-point Likert scale, two reviewers evaluated the de-identified MRI and CT images in randomized order and in separate sessions to answer the question: “Does the patient have SIJ erosions?”. A Fisher’s exact test was used to analyze the difference in diagnostic confidence, and intraclass correlation coefficient (ICC) was used to determine interrater reliability. Results 54 patients were included in the analysis (average age, 43.9 years). The average time interval between initial SIJ MRI and subsequent CT was 14.4 weeks (range, 5.6–50.3 weeks). CT resulted in significantly more cases with definitive diagnostic confidence than cases with probable or equivocal confidence compared to MRI ( P < .001). Amongst cases with equivocal findings on MRI, 73.2% of cases had definitive diagnoses on CT. There was moderate interrater agreement for MRI, with an ICC of .490 [95% CI, .258–.669], and excellent agreement for CT, with an ICC of .832 [95% CI, .728–.899]. Conclusion Overall, CT led to significantly increased diagnostic confidence and higher interrater reliability for the detection of SIJ erosions compared to MRI. Judicious use of CT may be useful in detecting SIJ erosions in patients with equivocal MRI findings.

scholarly journals Preliminary Results of the Macedonian-Adapted Version of Ages and Stages Developmental Questionnaires

2018 ◽  
Vol 09 (04) ◽  
pp. 510-515
Author(s):  
Blagica Stanoevska ◽  
Luis Anunciação ◽  
Jane Squires ◽  
Ajay Singh ◽  
Vladimir Trajkovski
Keyword(s):  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Cronbach’S Alpha ◽  
Early Intervention Services ◽  
Developmental Problems ◽  
Preliminary Results ◽  
Cronbach's Alpha ◽  
Males And Females ◽  
Ages And Stages Questionnaires ◽  
The Difference

ABSTRACT Context: Early detection of developmental problems is critical, and interventions are more effective when they are carried out early in a child's life. In Macedonia, there are only four centers providing early intervention services. Aims: In this research, we determined the reliability of the translation and adaptation of Ages and Stages Questionnaires 3rd edition (ASQ-3-M) for assessment of children aged 3–5 years old in Macedonia, and reported preliminary results of the gender differences in the development. Materials and Methods: ASQ-3-M was completed by 165 parents and 40 educators in seven kindergarten classrooms. Children were 3–5 years old. Statistical Analysis Used: Cronbach's alpha, Intraclass Correlation coefficient (ICC), and interrater reliability (IRR) were used to assess ASQ-3-M psychometric properties. The Bayesian t-test was performed to estimate the difference in means between males and females. Results: The Cronbach's alpha ranged from 0.65 to 0.87. The overall ICC was 0.89 (ranged from 0.8 to 0.95), which indicates a strong to almost perfect strength of agreement between test-retest. IRR correlation revealed an average of 0.88 (ranged from 0.74 to 0.95), suggesting that ASQ-3-M is reliable and stable. Conclusions: The results from the comparison between males and females on all dimensions of ASQ-3-M were not statistically significant (BF10 <3), indicating no significant gender difference. That said, the ASQ-3 is recommended for routine use in screening children aged 3–5 years old.

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