Clinical Value of Physical Examination and Electromyography in Acute and Chronic Lumbosacral Radiculopathy

Objective. To investigate the clinical value of high-frequency ultrasound in psoriatic arthritis (PSA). The study subjects were 32 outpatients and inpatients with PSA who were pathologically diagnosed from January 2018 to September 2020, including 11 males and 21 females, aged 25–70 years old, with an average of (49.8 ± 14.0) years old. All patients underwent ultrasound and physical examination, including the small joints of the hands and feet on both sides, nails, and the main attachment points of the lower limbs (quadriceps tendon, patellar ligament, Achilles tendon, and plantar fascia attachment). The involvement of these joints, attachment points, and nails was observed and counted, respectively, and statistically analyzed. Results. Physical examination revealed 406 (406/1792, 22.66%) joint lesions, 79 (79/320, 24.69%) attachment inflammation, and 84 (84/320, 26.25%) nail lesions. Ultrasonography revealed 492 (492/1792, 27.46%) joint lesions, 166 (166/320, 51.88%) attachment inflammation, and 203 (203/320, 63.44%) nail lesions. The positive rate of ultrasound examination was higher than that of physical examination ( P < 0.001 ). Conclusion. Ultrasonography can detect joint, attachment, and nail lesions earlier than physical examination in patients with PSA. Ultrasonography is of great value in the diagnosis of PSA.

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Correlation between Findings in Physical Examination, Magnetic Resonance Imaging, and Nerve Conduction Studies in Lumbosacral Radiculopathy Caused by Lumbar Intervertebral Disc Herniation

Advances in Orthopedics ◽

10.1155/2020/9719813 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Safa Yousif ◽

Afraa Musa ◽

Ammar Ahmed ◽

Ahmed Abdelhai

Keyword(s):

Intervertebral Disc ◽

Physical Examination ◽

Nerve Root ◽

Nerve Conduction Studies ◽

Intervertebral Disc Herniation ◽

Nerve Root Compression ◽

Resonance Imaging ◽

Lumbar Intervertebral Disc ◽

Lumbosacral Radiculopathy ◽

Lumbar Intervertebral Disc Herniation

Purpose. The aim of this study was to find out the correlation between magnetic resonance imaging (MRI) and nerve conduction studies’ (NCS) findings in patients with lumbosacral radiculopathy caused by lumbar intervertebral disc herniation. In addition, the study aimed at finding the correlation between the clinical manifestations of lumbosacral radiculopathy and both MRI and NCS. Patients and Methods. The study was a cross-sectional analytic study which included thirty patients with a history suggestive of lumbosacral radiculopathy. Inclusion criteria were as follows: patients who had an MRI confirmed L4/5 and/or L5/S1 intervertebral disc prolapse in addition to one or more of the following (dermatomal distribution of symptoms appropriate with MRI level, presence of motor weakness, sensory impairment, absent ankle jerk, or positive straight leg raising test). All patients underwent clinical assessment and NCS, and their MRI examination was reviewed. The Chi-Squared/Fisher’s exact test was used to test the correlation. Results. There was a statistically significant correlation between abnormal physical findings and nerve root compression in MRI. Statistically significant correlation was neither found between abnormal physical examination findings and abnormal NCS nor between nerve root compression in MRI and abnormal NCS findings. Conclusion. Abnormal neurological examination findings can be used to predict nerve root compression in MRI examination. On the contrary, positive findings of physical examination do not predict abnormal NCS, as well as negative findings do not exclude abnormal NCS; therefore, it is useful to add NCS when MRI findings do not match clinical examination findings or when no neuroimaging abnormalities can be identified.

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The clinical value of screening for paracetamol in patients with acute poisoning

Human & Experimental Toxicology ◽

10.1177/096032719501400205 ◽

1995 ◽

Vol 14 (2) ◽

pp. 187-189 ◽

Cited By ~ 10

Author(s):

Thomas Y.K. Chan ◽

Albert Y.W. Chan ◽

C.S. Ho ◽

Julian A.J.H. Critchley

Keyword(s):

Retrospective Study ◽

Physical Examination ◽

Plasma Levels ◽

Acute Poisoning ◽

Chinese Patients ◽

History Taking ◽

Paracetamol Poisoning ◽

Clinical Value ◽

Treatment Line ◽

Medical Wards

In this retrospective study, we determined the clinical value of screening for paracetamol in 294 Chinese patients with acute poisoning presenting to the general medical wards at the Prince of Wales Hospital between January 1992 and June 1993. Of the 86 patients suspected of having ingested paracetamol, eight had levels above the recom mended 'treatment line'. Of the 208 patients with no sus pected paracetamol ingestion, four were found to have ele vated but non-toxic plasma levels. The incidence of missed, potentially serious paracetamol poisoning in our patients with no suspected paracetamol ingestion is extremely uncommon. Routine screening of all patients with acute poisoning for toxic plasma paracetamol con centrations is therefore not indicated and should never be a substitute for thorough history taking and physical examination.

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The clinical value of brain computerised tomography in a general hospital psychiatric service

South African Journal of Psychiatry ◽

10.4102/sajpsychiatry.v23i0.1050 ◽

2017 ◽

Vol 23 ◽

Author(s):

Usha Chhagan ◽

Jonathan K. Burns

Keyword(s):

Substance Use ◽

Physical Examination ◽

Ct Scan ◽

Statistical Significance ◽

Demographic Data ◽

Psychiatric Service ◽

Clinical Markers ◽

Computerised Tomography ◽

Clinical Value ◽

Significant Difference

Background: The use of neuroimaging modalities in psychiatry has been evaluated in several studies. The vast majority seem to suggest that neuroimaging may be overutilised in psychiatry. There is a significant constraint on availability and cost related to neuroimaging of patients at general state medical facilities. The routine use of computerised tomography (CT) scanning is thus questioned.Methods: A retrospective analysis was undertaken of all psychiatric inpatients who had CT scans performed from 01 January 2011 to 31 December 2012. Demographic data, mental state examination, physical examination findings, substance use and diagnosis upon admission were recorded. The relationship between these variables and CT scan findings was analysed.Results: A total of 897 admissions were retrospectively analysed. One hundred and three patients had documented CT scan imaging. In total, 17 of the 23 patients with abnormal findings on CT scan were found to be psychotic (74.0%). The remaining 26.0% included depression and dementia. There was no statistically significant difference between the normal and abnormal CT scan groups with regard to gender, age, family history, substance use and physical examination. The majority (65.2%) had cerebral atrophy and/or cerebral calcifications. A smaller group of other documented findings was noted.Conclusions: Selective indications and clinical markers may be utilised in order to justify brain imaging studies rather than performing them routinely. That being true, a multicentre study with a larger sample size is indicated to further improve the statistical significance and assist in formulating a more concrete guideline for neuroimaging of psychiatric patients.

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The Clinical Value about Pulmonary Tuberculosis of Indirect Chest Radiography in Physical Examination for Conscription

Tuberculosis and Respiratory Diseases ◽

10.4046/trd.2005.59.4.356 ◽

2005 ◽

Vol 59 (4) ◽

pp. 356

Author(s):

Sung Bin Park ◽

Byeong-Kyoo Choi ◽

Keun Woo Ha ◽

Joon Beom Seo

Keyword(s):

Pulmonary Tuberculosis ◽

Physical Examination ◽

Chest Radiography ◽

Clinical Value

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Tools and Resources: Web Sites of Interest

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2001.marapr03 ◽

2001 ◽

Vol 6 (2) ◽

pp. 6-8

Author(s):

Christopher R. Brigham

Keyword(s):

Informed Consent ◽

Physical Examination ◽

Functional Status ◽

Web Sites ◽

Satisfaction Survey ◽

High Quality ◽

Diagnostic Studies ◽

Physician Relationship ◽

Complete History

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, explains that independent medical evaluations (IMEs) are not the same as impairment evaluations, and the evaluation must be designed to provide the data to answer the questions asked by the requesting client. This article continues discussions from the September/October issue of The Guides Newsletter and examines what occurs after the examinee arrives in the physician's office. First are orientation and obtaining informed consent, and the examinee must understand that there is no patient–physician relationship and the physician will not provide treatment bur rather will send a report to the client who requested the IME. Many physicians ask the examinee to complete a questionnaire and a series of pain inventories before the interview. Typical elements of a complete history are shown in a table. An equally detailed physical examination follows a meticulous history, and standardized forms for reporting these findings are useful. Pain and functional status inventories may supplement the evaluation, and the examining physician examines radiographic and diagnostic studies. The physician informs the interviewee when the evaluation is complete and, without discussing the findings, asks the examinee to complete a satisfaction survey and reviews the latter to identify and rectify any issues before the examinee leaves. A future article will discuss high-quality IME reports.

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