scholarly journals MARKER INDICATORS OF DEGENERATIVE-DYSTROPHIC PROCESSES OF THE SPINE, PELVIS AND HIP JOINTS OF DYSPLASTIC GENESIS

2018 ◽  
Vol 3 (5) ◽  
pp. 87-93
Author(s):  
Z. V. Koshkareva ◽  
M. B. Negreeva
Keyword(s):  
Mutual Influence ◽  
Plain Radiograph ◽  
Clinical Manifestations ◽  
Diagnostic Algorithm ◽  
Pain Syndrome ◽  
Lumbosacral Spine ◽  
Hip Joints ◽  
Results Of Treatment ◽  
Combined Lesions ◽  
Diagnostic Signs

Degenerative and dystrophic diseases of the spine, pelvis and hip joints are considered as a single pathogenetically conditioned process with an interdependent condition. The significance of the problem is determined by the high incidence of spinal and hip dysplasia, the syndrome of mutual burdening, the diversity and polymorphism of clinical manifestations, the growth of disability, the difficulties of diagnosis and treatment. Questions remain about the root cause of the occurrence of combined lesions, their mutual influence. The aim of the work was to identify the most common, diagnostic, pathognomonic signs of dysplastic syndrome. The patients were examined according to a single diagnostic algorithm, including clinical and neurological examination, plain radiograph of the pelvis; spondylography, MSCT, MRI of the lumbar and lumbosacral spine; study of the locomotion act of walking, anthropometric measurements; statistical methods. We analyzed the results of treatment of 39 patients (26 women and 13 men; mean age – 53 years) with dysplastic syndrome including degenerative-dystrophic changes in the spine, pelvis and hip joints. The most common diagnostic signs of combined degenerative-dystrophic diseases of the spine and pelvis have been established, among which pain syndrome, noted in varying degrees in all patients. The established diagnostic indices, supplementing existing knowledge of the problem studied, will allow to specify diagnostics and optimize the treatment of combined degenerative-dystrophic diseases of dysplastic genesis.

scholarly journals Algorithm of Radiological Diagnostics of Dystrophic Damage to Ligaments of the Lumbosacral Spine in the Lower Back Pain Syndrome: the Potential of Sonography

2018 ◽  
pp. 109-114
Author(s):  
A. N. Mihailov ◽  
A. M. Yurkovskiy ◽  
I. V. Nazarenko
Keyword(s):  
Back Pain ◽  
Lower Back Pain ◽  
Structural Changes ◽  
Clinical Manifestations ◽  
Diagnostic Errors ◽  
Diagnostic Algorithm ◽  
Pain Syndrome ◽  
Lumbosacral Spine ◽  
Lower Back ◽  
Magnetic Resonance Imaging Mri

Objective: to formulate the main points of the diagnostic algorithm in the lower back pain syndrome caused by pathology of the ilio-lumbar, posterior long sacroiliac, and sacrotuberal ligaments based on the limits and potential of visualization methods. Material. Data of X-ray, multispiral computer tomography (MSCT), magnetic resonance imaging (MRI) and sonography of 184 patients aged 19-79 with clinical manifestations of the lower back pain syndrome caused by pathology of the ilio-lumbar, posterior long sacroiliac, and sacrotuberal ligaments were analyzed. Results. The potential of the visualization methods in the assessment of structural changes of the ilio-lumbar, posterior long sacroiliac, and sacrotuberal ligaments has been identified. The main points of the algorithm which makes it possible to diagnose the lower back pain syndrome, caused by pathology of ilio-lumbar, posterior long sacroiliac and sacrotuberal ligaments have been formulated. Conclusion. The choice of the visualization method in the lower back pain syndrome, caused by ligamentosis of the ilio-lumbar, posterior long sacroiliac, and sacrotuberal ligaments must be made taking into account the limits and potential of MSCT, MRI and sonography, which will shorten the time of diagnostic search and reduce the risk of diagnostic errors.

scholarly journals Clinical and radiological aspects of the sagittal balance of the spine in children with achondroplasia

2018 ◽  
Vol 6 (4) ◽  
pp. 6-12
Author(s):  
Oksana G. Prudnikova ◽  
Anna M. Aranovich
Keyword(s):  
Sagittal Balance ◽  
Lumbar Lordosis ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Lower Limbs ◽  
Sagittal Imbalance ◽  
Compensatory Mechanisms ◽  
Lateral Instability ◽  
Hip Joints ◽  
Cross Sectional

Background. Changes in the spine with achondroplasia are represented by disorders of synostosis, the presence of wedge-shaped vertebrae, underdevelopment of the sacrum, changes in the size of the roots of the arches, stenosis of the spinal canal, and changes in the sagittal balance. Aim. To investigate the clinical and radiological features of the sagittal balance of the spine in children with achondroplasia. Materials and methods. We performed a cross-sectional clinical and radiological study of 16 patients with achondroplasia aged 6–17 years (mean, 9.2 ± 3.3 years). Radiographically, the parameters of the sagittal balance of the spine and pelvis and scoliosis were evaluated. Clinical evaluation included orthopedic and neurological status and back pain syndrome. Results. The anatomic features of patients with achondroplasia are limb shortening, O-shaped curvature of the lower extremities with lateral instability of the knee joints, and flexural contractures of the hip joints. With restriction of mobility in the hip joints, compensatory mechanisms for correcting sagittal imbalance are triggered: pelvic incline, lumbar lordosis, and thoracic kyphosis change. The clinical manifestations of sagittal imbalance in enrolled children were hypokyphosis of the thoracic spine in 100% and an increase in lumbar lordosis in 56.25% of patients. In 50% of patients, wedge-shaped deformation of vertebral bodies was diagnosed at the level of the thoracolumbar transition with the formation of local kyphosis. Neurological disorders have not been diagnosed in children. Conclusions. The anatomical features of the lower limbs and hip joints in achondroplasia reflect the biomechanical features of the relationship between the spine, pelvis, and lower limbs, which should be considered when planning for orthopedic and spinal surgery after prediction.

scholarly journals Ureteral stump syndrome after ureteroureteroanastomosis, heminephrectomy and nephrectomy in children

2020 ◽  
Vol 8 (4) ◽  
pp. 32-43
Author(s):  
I. V. Kagantsov ◽  
D. N. Shchedrov ◽  
V. V. Sizonov ◽  
V. I. Dubrov ◽  
S. G. Bondarenko ◽  
...  
Keyword(s):  
Recurrent Urinary Tract Infection ◽  
Treatment Approach ◽  
Rare Complication ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Distal Ureter ◽  
Results Of Treatment ◽  
The Russian Federation ◽  
The Republic ◽  
The Right

Introduction. Nephrectomy (NE), heminephrectomy (HNE) and the formation of ipsilateral ureteroureteroanastomosis (UUA) do not exclude the possibility of preserving the distal ureter. The remaining ureteral stump can cause the formation of ureteral stump syndrome (USS) in the form of recurrent urinary tract infection (UTI), hematuria, pain syndrome, and stump empyema in some cases.Purpose of the study. To assess the incidence and treatment approach of USS in children after NE, HNE and UUA performed using open and laparoscopic access in different Russian clinics.Material and methods. The study is based on the results of treatment of 778 patients from 9 clinics in the Russian Federation and the Republic of Belarus in the period from 1998 to 2020. Patients underwent NE, HNE and UUA by open or laparoscopic access. The ureter was not removed completely, its stump was left. Open access was used in 313 (40.2%) children, laparoscopic in 465 (59.8%) cases. USS was detected in 27 (3.5%) patients. The ureteral stump was removed in 26 (96.3%) children. Open removal of the ureteral stump was performed in 11 (42.3%) patients, through laparoscopic access in 13 (50.0%) and vesicoscopically in 2 (7.7%) children.Results. There were 12 boys (44.4%) and 15 girls (55.6%) among the patients with USS. USS was detected on the right in 13 (48.1%) children, on the left - in 14 (51.9%). The median age of the patients was 25 [12; 42] months at the time of USS detection. Ureteral stump was sutured and ligated in 15 (55.6%) children during the primary operation, the stump was left open after excision in 4 (14.8%) children, it was not indicated how the stump was processed in 8 (29.6%) patients. Reflux to the stump was detected in 13 (48.1%) patients, USS against the background of obstruction was detected in 14 (51.9%) children. It was determined that the frequency of SCM is lower (9 (1.9%)) with the use of laparoscopic access than with open (18 (5.8%)) operations (p < 0.004). Clinical manifestations occurred in 85% of patients with USS within a year after surgery.Conclusion. USS is a rare complication (3.5% of cases) in patients who have undergone NE, HNE and UUA with the distal ureteric stump preserving. Performing these operations by laparoscopic access allows carrying out total ureterectomy and significantly reduces the likelihood of USS development.

Evaluation of the effectiveness of adjuvant anti-progestogen therapy after conservative myomectomy in women of reproductive age

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (4) ◽  
pp. 19-23
Author(s):  
Yanina A Lebedeva ◽  
Inna I Kovalenko ◽  
Oleg L Molchanov ◽  
Dmitrii V Baibuz ◽  
Natalia V Kulikova
Keyword(s):  
Reproductive Potential ◽  
Clinical Manifestations ◽  
Uterine Fibroids ◽  
Pain Syndrome ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Results Of Treatment ◽  
High Prevalence ◽  
Group 2 ◽  
Group 1

Relevance. Due to the high prevalence of uterine fibroids in young women and the possible effect on reproductive potential, the development, implementation and application of the most benign treatment methods are a priority. Aim. To evaluate the effectiveness of adjuvant anti-progestogen therapy after conservative myomectomy in women of reproductive age. Materials and methods. A comparative analysis of the results of treatment of patients of reproductive age with uterine myoma has been carried out. Group 1 (n=38) included patients who underwent conservative myomectomy and/or hysteroresectoscopy without subsequent anti-relapse drug therapy. The average age is 31.5 years (4.6). Group 2 (n=43) included patients after conservative myomectomy who received mifepristone as anti-relapse therapy after surgery. The average age is 31.9 years (4.5). Results. Mifepristone therapy, as an adjuvant treatment after conservative myomectomy, can significantly reduce the risk of recurrence, stabilize the size of the uterus, reduce the severity of clinical manifestations in the form of pain syndrome and heavy menstruation associated with relapse, thereby improving the reproductive health of women. Conclusions. The use of adjuvant anti-progestogen therapy after conservative myomectomy in women of reproductive age is a very effective method for treating uterine fibroids and can be considered as a therapy of choice in such patients.

scholarly journals Application of the complex algorithm for rehabilitation of patients needing a full reconstruction of dentition (clinical case)

2020 ◽  
Vol 24 (3) ◽  
pp. 158-163
Author(s):  
Fatima K. Dzalaeva ◽  
S. O. Chikunov ◽  
A. S. Utyuzh ◽  
Z. K. Dzhagaeva ◽  
A. V. Yumashev
Keyword(s):  
Clinical Case ◽  
Myofascial Pain ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Diagnostic Methods ◽  
Instrumental Analysis ◽  
Results Of Treatment ◽  
Full Reconstruction ◽  
Complex Algorithm

Introduction. Aim of the study is testing the algorithm of complex clinical, functional and instrumental analysis in the treatment of patients with the need for total restoration of the dentition with manifestations of myofascial pain syndrome. Material and methods. A system for the rehabilitation of patients with adentia is proposed, in which, when planning occlusion correction, objective examination data for patients obtained using a set of diagnostic methods should be taken into account. Particular attention is paid to assessing the function of the temporomandibular joint and the presence of pathological signs of disorders of maxillofacial muscles. Results. A clinical case is described a patient who has been diagnosed with a set of indicators of clinical, functional and instrumental analysis obtained using methods of condylography and cephalometry. The results of treatment and rehabilitation measures allowed achieving the optimal distribution of loads on the dentition, while reducing the risk of ceramic chipping and improving oral hygiene. The approach used allowed timely correction of functional and aesthetic disorders. Conclusions. The algorithm for working with patients who need total restoration of the dentition should include a thorough history taking, clinical functional analysis using condylography methods, model analysis to register and evaluate the static and dynamic ratios of the dentition. As well as performing cephalometric analysis and other manipulations, in accordance with standard criteria for clinical examination. The developed algorithm is anatomically and pathogenetically justified, since it takes into account the entirety of changes and interconnections of the structures of the dentofacial system and other body systems that underlie the clinical manifestations in this category of patients.

scholarly journals Differential approach to diagnosis and treatment of tendinites, enthesites and degenerative arthropathies

2018 ◽  
Vol 35 (4) ◽  
pp. 46-49
Author(s):  
V. A. Samartsev ◽  
I. V. Kadyntsev
Keyword(s):  
Hyaluronic Acid ◽  
Diagnostic Algorithm ◽  
Pain Syndrome ◽  
Long Term Results ◽  
Movement Amplitude ◽  
Lequesne Index ◽  
Combined Application ◽  
Results Of Treatment ◽  
Periarticular Tissue

Aim. To improve the results of treatment of periarticular tissue diseases and degenerative arthropathies at the expense of differential use of modern technologies. Materials and methods. During the period of 2010–2017, examination and treatment of 10608 patients, suffering from the locomotor diseases, was carried out. There were 5792 (54,6 %) patients with degenerative arthropathies and 4816 (45,4 %) patients with tendinites and enthesites of different localization. Results. The long-term results of treatment with chondroprotector Alflutop, used in complex therapy of 1969 (33,9 %) patients with arthropathies were studied for the period from 1 to 3 years. Pain syndrome was arrested after 4–5 injections. After 8–9 injections of this preparation, no pain syndrome was revealed, movement amplitude in the joint increased, patients returned to their previous work, Lequesne index declined and varied within the range of 3–6 scores. When using hyaluronic acid, pain syndrome was arrested in most cases after 2 injections. After the third injection of preparation, no pain factor was registered, movement amplitude in the joint increased, patients returned to their previous work, Lequesne index declined and varied within 3–6 scores. The long-term results from 1 to 5 years were studied in 1179 (20,3 %) patients. Conclusions. One-year remission with combined application of chondroprotector and hyaluronic acid was 76,5 %. Two-year and longer remission was 47,6 %. Diagnostic algorithm for locomotor diseases was developed and approach to conservative therapy was differentiated.

INFLUENCE OF THE ORTOSANO RESTORATION METHOD ON CHRONIC PAIN SYNDROME IN DEGENERATIVE-DYSTROPHIC DISEASES OF THE SPINE

2021 ◽  
Vol 74 (6) ◽  
pp. 1485-1487
Author(s):  
Iuliia O. Maliarenko ◽  
Olha I. Riznyk
Keyword(s):  
Chronic Pain ◽  
Pain Syndrome ◽  
Physical Rehabilitation ◽  
Knee Joints ◽  
Psychological State ◽  
Lumbosacral Spine ◽  
Hip Joints ◽  
Ankle Joints ◽  
Group Members ◽  
Restoration Method

The aim: Was to assess the influence and the effectiveness of complex physical rehabilitation using the ORTOSANO technique for people with degenerative-dystrophic diseases of the spine (DDS) on the severity of chronic pain (CHD). Materials and methods: We studied the condition of 166 patients. The observation group included patients with chronic pain caused by DDS of the spine. The patients underwent a course of complex physical rehabilitation in the center using the ORTOSANO method. Results: The following results were obtained statistically: pain with localization in the lumbosacral spine was registered in 67 patients (40.4%), in the cervical spine – in 42 patients (25.3%), in the thoracic spine – in 37 patients (22.3%). Pain in the shoulder joints was registered in 24 patients (14.5%), in the hip joints in 16 (9.6%), knee joints – in 12 (7.2%), in the ankle joints – in 9 patients (5.4%). Initially, the level of pain among all the group members according to the VAS scale was on average (7.6 ± 0.35) points in men and (6.4 ± 0.72) in women (p <0.05). Conclusions: 1.It was established that the proposed complex physical rehabilitation using the ORTOSANO method reduces the severity of chronic pain significantly, improves functional and daily activity, quality of life, and stabilizes the neuro-psychological state of patients. 2. The ORTOSANO method can be recommended to be used in the complex of rehabilitation exercises in physiotherapeutic departments of educational and medical establishments.

Optimization of diagnostic system of hand diseases in employees working under combined effects of vibration and physical overloads

2019 ◽  
pp. 950-955
Author(s):  
M. M. Poroshina ◽  
E. M. Vlasova ◽  
A. Ya. Perevalov
Keyword(s):  
Working Conditions ◽  
Comparison Group ◽  
Clinical Manifestations ◽  
Diagnostic System ◽  
Pain Syndrome ◽  
Observation Group ◽  
Combined Effects ◽  
X Rays ◽  
Industrial Enterprises ◽  
Special Assessment

The results of research carried out by theFederalScientificCenterfor Medical and Preventive Technologies of Public Health Risk Management Technologies for the period 2013–2018 showed that diseases associated with the combined effects of vibration and physical overload, employees of hazardous industries develop with experience of 15 years or more. The risk group is women older than 35 years and men older than 40 years. Pathology at the stage of detailed clinical manifestations is characterized by persistent pain syndrome, and, as a consequence, a decrease in the ability to work of workers.The aim of the study was to optimize the system of diagnosis of hand diseases in workers of industrial enterprises engaged in labor activities under the combined effects of vibration and physical overload, for the development of primary prevention programs.The observation group consisted of 32 employees aged 39.3±4.3 years, with an experience of 17.4±4.3 years; the comparison group consisted of 30 employees whose working conditions are not related to the studied factors; the average age was 40.6±3.4 years, experience was 19.1±3.1 years. The examination included analysis of the results of a special assessment of working conditions; assessment of neurological status; functional tests; laboratory studies (assessment of inflammation), hand dynamometry, stimulation electroneuromyography; x-rays of the hands and wrist joints, ultrasound examination of the hands.More than half of the surveyed persons of the observation group and 3/4 of the workers of the comparison group did not make complaints. Indicators of dynamometry of workers in both groups corresponded to physiological norm (p>0.05). Analysis of the results of dynamometer with data from previous years of PMO showed a decrease in strength of muscles of the hand leading hands on 2je,0–16. 7% and from 83.3% of the employees of the monitoring group and in 44.4% of the comparison group (p<0.05), in 50 % of the cases there was a decrease in the percentage of changes in the hand force variation (HFV) in the observation group, and in 38.9% of the cases the indicators remained unchanged. According to ultrasound of the hands, signs of tendinopathy were established in 85% of the employees of the observation group in the absence of persons with similar changes in the comparison group.In order to optimize the diagnosis of diseases of the hand in industrial workers who carry out their work under the combined effects of vibration and physical overload, in the case of a decrease in the rate of carpal dynamometry by 5% or more during the year, it is recommended to conduct ultrasound of the tendon-ligamentous apparatus of the hand, which will allow timely identification of early signs of tendinopathy.

Lumbar periarticular cysts of arcorray joint

2020 ◽  
pp. 47-57
Author(s):  
Anton Yarikov ◽  
Maxim Shpagin ◽  
Iliya Nazmeev ◽  
Sergey Gorelov ◽  
Olga Perlmutter
Keyword(s):  
Minimally Invasive ◽  
Severe Pain ◽  
Pain Syndrome ◽  
Long Term Results ◽  
Lumbar Region ◽  
Results Of Treatment ◽  
Invasive Method ◽  
Facet Syndrome

The immediate and long-term results of treatment of 30 patients with severe pain syndrome of the lumbar region, who underwent operations on denervation of DOS, were studied. The aim of the study was to evaluate the effectiveness of minimally invasive technologies for the treatment of pain in the lumbar region (denervation of DOS), to study the near and distant results of these treatment methods. Denervation DOS is an effective minimally invasive method for the treatment of facet syndrome caused by spondylarthrosis. It allows in the early and distant postoperative periods to significantly reduce the pain syndrome and improve the quality of life of patients.

1120 Analysis of Clinical Manifestations and Diagnostic Signs of Osteosarcoma With Lung Metastases

2012 ◽  
Vol 48 ◽  
pp. S269-S270
Author(s):  
D. Polatova ◽  
M. Gafur-Akhunov ◽  
K. Abdikarimov ◽  
S. Urunbaev
Keyword(s):  
Lung Metastases ◽  
Clinical Manifestations ◽  
Diagnostic Signs
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