scholarly journals Compound dorsal dislocation of lunate with trapezoid fracture

2016 ◽  
Vol 6 (4) ◽  
Author(s):  
Bong-Sung Kim ◽  
Gerrit Grieb ◽  
Patrick Rhodius ◽  
Arne H. Böcker ◽  
Jan-Philipp Stromps ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Conservative Treatment ◽  
Satisfactory Result ◽  
Closed Reduction ◽  
Kirschner Wires ◽  
Partial Loss ◽  
X Ray ◽  
Motorcycle Accident ◽  
Loss Of Strength

We report about a dorsal dislocation of the lunate accompanied by a trapezoid fracture in a 41-year old male patient after a motorcycle accident. The lunate dislocation with no dorsal or volar intercalated segment instability (DISI, VISI) was diagnosed by x-ray whereas the trapezoid fracture was only diagnosable by computed tomography. A closed reduction and internal fixation of the lunate by two Kirschner wires was performed, the trapezoid fracture was conservatively treated. Surgery was followed by immobilization, intense physiotherapy and close follow-up. Even though complaints such as swelling and pain subsided during the course of rehabilitation, partial loss of strength and range of motion remained even after 16 months. In conclusion, a conservative treatment of trapezoid fractures seems to be sufficient in most cases. Closed reduction with Kwire fixation led to an overall satisfactory result in our case. For dorsal lunate dislocations in general, open reduction should be performed when close reduction is unsuccessful or DISI/VISI are observed in radiographs after attempted close reduction.

scholarly journals Efficacy of chest X-ray in the diagnosis of COVID-19 pneumonia: comparison with computed tomography through a simplified scoring system designed for triage

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Akın Çinkooğlu ◽  
Selen Bayraktaroğlu ◽  
Naim Ceylan ◽  
Recep Savaş
Keyword(s):  
Computed Tomography ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Scoring System ◽  
Imaging Modality ◽  
Ground Glass Opacity ◽  
Initial Presentation ◽  
X Ray ◽  
Chest X Ray

Abstract Background There is no consensus on the imaging modality to be used in the diagnosis and management of Coronavirus disease 2019 (COVID-19) pneumonia. The purpose of this study was to make a comparison between computed tomography (CT) and chest X-ray (CXR) through a scoring system that can be beneficial to the clinicians in making the triage of patients diagnosed with COVID-19 pneumonia at their initial presentation to the hospital. Results Patients with a negative CXR (30.1%) had significantly lower computed tomography score (CTS) (p < 0.001). Among the lung zones where the only infiltration pattern was ground glass opacity (GGO) on CT images, the ratio of abnormality seen on CXRs was 21.6%. The cut-off value of X-ray score (XRS) to distinguish the patients who needed intensive care at follow-up (n = 12) was 6 (AUC = 0.933, 95% CI = 0.886–0.979, 100% sensitivity, 81% specificity). Conclusions Computed tomography is more effective in the diagnosis of COVID-19 pneumonia at the initial presentation due to the ease detection of GGOs. However, a baseline CXR taken after admission to the hospital can be valuable in predicting patients to be monitored in the intensive care units.

scholarly journals Effect of childhood overweight on distal metaphyseal radius fractures treated by closed reduction

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yu Liu ◽  
Chunjie Liu ◽  
Dongmei Guo ◽  
Ning Wang ◽  
Ying Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Closed Reduction ◽  
Pediatric Population ◽  
Normal Weight ◽  
Medical Community ◽  
Overweight Children ◽  
Radius Fractures

Abstract Background The medical community has recognized overweight as an epidemic negatively affecting a large proportion of the pediatric population, but few studies have been performed to investigate the relationship between overweight and failure of conservative treatment for distal radius fractures (DRFs). This study was performed to investigate the effect of overweight on the outcome of conservative treatment for DRFs in children. Methods We performed a retrospective study of children with closed displaced distal metaphyseal radius fractures in our hospital from January 2015 to May 2020. Closed reduction was initially performed; if closed reduction failed, surgical treatment was performed. Patients were followed up regularly after treatment, and redisplacement was diagnosed on the basis of imaging findings. Potential risk factors for redisplacement were collected and analyzed. Results In total, 142 children were included in this study. The final reduction procedure failed in 21 patients, all of whom finally underwent surgical treatment. The incidences of failed final reduction and fair reduction were significantly higher in the overweight/obesity group than in the normal-weight group (P = 0.046 and P = 0.041, respectively). During follow-up, 32 (26.4%) patients developed redisplacement after closed reduction and cast immobilization. The three risk factors associated with the incidence of redisplacement were overweight/obesity [odds ratio (OR), 2.149; 95% confidence interval (CI), 1.320–3.498], an associated ulnar fracture (OR, 2.127; 95% CI, 1.169–3.870), and a three-point index of ≥ 0.40 (OR, 3.272; 95% CI, 1.975–5.421). Conclusions Overweight increases the risk of reduction failure and decreases the reduction effect. Overweight children were two times more likely to develop redisplacement than normal-weight children in the present study. Thus, overweight children may benefit from stricter clinical follow-up and perhaps a lower threshold for surgical intervention.

scholarly journals Assessment of the effect of alpha-tocopherol on the course of newly diagnosed pulmonary sarcoidosis: a comparative study

2020 ◽  
Vol 98 (10) ◽  
pp. 33-40
Author(s):  
A. A. Vizel ◽  
D. A. Culver ◽  
I. Yu. Vizel ◽  
G. R. Shakirova ◽  
E. A. Bakunina
Keyword(s):  
Computed Tomography ◽  
Vitamin E ◽  
High Frequency ◽  
Control Point ◽  
Pulmonary Sarcoidosis ◽  
Alpha Tocopherol ◽  
Newly Diagnosed ◽  
X Ray ◽  
Löfgren Syndrome

The objective: to compare the results of follow-up over patients with a mild form of pulmonary sarcoidosis who received alpha-tocopherol and those receiving no treatment. Subjects and methods. The results of follow-up over 80 sarcoidosis patients were retrospectively analyzed – two groups of 40 patients enrolled according to the copy – pair principle (gender, age, initial X-ray stage, Löfgren syndrome, and follow-up duration). The only sign that statistically distinguished the groups was a high frequency of complaints about weakness in those who received vitamin E – 55% versus 30% (p < 0.05). The follow-up period for patients in both groups was a year or more (a control point). The database was maintained and processed using SPSS-18, Windows 10. A clear advantage of vitamin E administration was revealed when comparing the data of computed tomography, which resulted in improvement in 87.5%, and the disease progressed in 2.5%, while in the group receiving no treatment – 60 and 12.5%, respectively. The OR of improvement in computed tomography with alpha-tocopherol versus the group receiving no treatment made 4.67 (95% CI, 1.51-14.46).Conclusion. The use of vitamin E in mild forms of thoracic sarcoidosis gives a better result compared to the group receiving no treatment.

scholarly journals Descriptive study of chest x-ray examination in mandatory annual health examinations at the workplace in Japan

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262404
Author(s):  
Yuya Watanabe ◽  
Toru Nakagawa ◽  
Kota Fukai ◽  
Toru Honda ◽  
Hiroyuki Furuya ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Detection Rate ◽  
Low Dose ◽  
Care Center ◽  
Stage I ◽  
X Ray ◽  
Health Care Center ◽  
Chest X Ray

The utility of chest x-ray examination (CXR) in mandatory annual health examinations for occupational health is debatable in Japan. This study aimed to provide basic data to consider future policies for mandatory annual health examinations in the workplace. A nationwide descriptive survey was performed to determine the rate of detection of tuberculosis, lung cancer, and other diseases through CXR in organizations associated with National Federation of Industrial Health Association. The rate of finding on CXR conducted during annual health examinations in FY2016 was evaluated. Data regarding diagnosis based on follow-up examination findings were obtained and compared with the national statistics. In addition, CXR findings were compared with the results of low-dose lung computed tomography performed at the Hitachi Health Care Center. From 121 surveyed institutions, 88 institutions with 8,669,403 workers were included. For all ages, 1.0% of examinees required follow-up examination. Among 4,764,985 workers with diagnosis data, the tuberculosis detection rate was 1.8–5.3 per 100,000 persons. For Lung cancer, 3,688,396 workers were surveyed, and 334 positive cases were detected. The lung cancer detection rate using CXR was 9.1–24.4 per 100,000 persons. From 164 cases with information regarding the clinical stage, 72 (43.9%) had Stage I lung cancer. From 40,045 workers who underwent low-dose computed tomography multiple times, 31 lung cancer cases, all with Stage I disease, were detected (detection rate: 77.4 per 100,000 persons). Our findings suggest that CXR plays a little role in the detection of active tuberculosis. With regard to LC screening, the detection rate of LC by CXR was lower, approximately 50%, than the expected rate (41.0 per 100,000 persons) of LC morbidity based on the age–sex distribution of this study population. However, the role of CXR for LC screening cannot be mentioned based on this result, because assessment of mortality reduction is essential to evaluate the role.

scholarly journals Application of Ultrasonography in Conservative Treatment of Humeral Shaft Fracture in Children

2021 ◽  
Author(s):  
Jun Li ◽  
Xin Tan ◽  
Xiang Li ◽  
Pan Gou ◽  
Xiaowei Yuan ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Nerve Injury ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Humeral Shaft ◽  
Dash Score ◽  
X Ray ◽  
Epidemic Period ◽  
Significant Difference

Abstract Purpose: Most of humeral shaft fractures in children could be treated satisfactorily by conservative treatment. This study aimed to evaluate the application value of ultrasonography in conservative treatment of humeral shaft fracture in children.Methods: We retrospectively reviewed children admitted to our hospital, for humeral shaft fracture from January 2014 to March 2018. The patients were divided into two groups: ultrasonography group and X-ray group. All patients were instructed to re-examined at 1 week, 2 weeks, 4 weeks, 12 weeks, 24 weeks and 1 year from the injury date for follow-up, and evaluated the prognosis according to the Disabilities of Arm, Shoulder and Hand (DASH) score at 12 months.Results: A total of 37 children were divided into ultrasonography group, 32 children were divided into X-ray group. There was no significant difference in prognosis between the two groups. The mean number of radiation exposures of ultrasonography group was less and ultrasonic examination found radial nerve injury, and using ultrasound reduced the chance of direct or in direct contact with infected peoples.Conclusion: Ultrasound is a non-invasive, non-radioactive test, which could decrease risk of COVID-19 infection and detect the vascular nerve injury caused by fracture. Ultrasonography may be the examination method for follow-up conservative treatment of humeral shaft fracture in children during the epidemic period.

scholarly journals Necrotizing Fasciitis Secondary to a Primary Suture for Anoperineal Trauma by Motorcycle Accident in a Healthy Adult

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Susumu Saigusa ◽  
Masaki Ohi ◽  
Hiroki Imaoka ◽  
Ryo Uratani ◽  
Minako Kobayashi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Necrotizing Fasciitis ◽  
Healthy Adult ◽  
Perineal Pain ◽  
Suture Repair ◽  
Low Grade ◽  
Primary Suture ◽  
Left Chest ◽  
Motorcycle Accident

A 41-year-old man experienced a swollen scrotum three days after a motorcycle accident and presented to our hospital. He had had a primary suture repair for anoperineal trauma in an outside hospital at the time of the injury. He presented to us with general fatigue, low grade fevers, and perineal pain. Abdominal computed tomography showed subcutaneous emphysema from the scrotum to the left chest. The sutured wound had foul-smelling discharge and white exudate. We made the diagnosis of necrotizing fasciitis and immediately opened the sutured wound and performed initial debridement and lavage with copious irrigation. We continued antibiotics and lavage of the wound until the infection was controlled. Fortunately, the necrotizing fasciitis did not worsen and he was discharged after 15 days. Our experience indicates that anoperineal injuries should not be closed without careful and intensive follow-up due to the potential of developing necrotizing fasciitis.

A Successful Resection of Two Giant Mediastinal Neurogenic Tumors

2015 ◽  
Vol 86 (12) ◽  
Author(s):  
Daniel Brzeziński ◽  
Mariusz łochowski ◽  
Józef Kozak
Keyword(s):  
Computed Tomography ◽  
Pleural Cavity ◽  
Middle Age ◽  
Postoperative Treatment ◽  
X Ray ◽  
Neurogenic Tumors ◽  
Chest X Ray

AbstractWe reported two cases of the giant mediastinal neurogenic tumors. Patients were women in middle age. In both cases the chest X-ray and CT (computed tomography) demonstrated the huge mass in a pleural cavity without intraspinal invasion. Radical procedures with removal of the giant tumors were performed. The postoperative treatment course was uneventful. The pathology showed schwannoma and neurofibroma. The follow up examination (6-24 months) showed no recurrence of the disease.

scholarly journals Computed tomography follow-up identifies radically treatable new primaries after resection for lung cancer

2019 ◽  
Author(s):  
Jenny Mitchell ◽  
Rachel Benamore ◽  
Fergus Gleeson ◽  
Elizabeth Belcher
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Early Stage ◽  
Primary Lung Cancer ◽  
Negative Likelihood Ratio ◽  
University Hospitals ◽  
Early Stage Lung Cancer ◽  
X Ray ◽  
Chest X Ray

Abstract OBJECTIVES The optimal imaging programme for the follow-up of patients who have undergone resection of primary lung cancer is yet to be determined. We investigated the incidence and patterns of new and recurrent malignancy after resection for early-stage lung cancer in patients enrolled into a computed tomography (CT) follow-up programme. METHODS We reviewed the outcomes of consecutive patients who underwent CT follow-up after resection of early-stage primary lung cancer at the Oxford University Hospitals NHS Foundation Trust, between 2013 and 2017. RESULTS Four hundred and sixty-six consecutive patients underwent resection of primary lung cancer between 1 January 2013 and 31 March 2017. Three hundred and thirty-one patients (71.0%) were enrolled in CT follow-up. The median follow-up was 98 weeks (range 26–262). Sixty patients (18.2%) were diagnosed with programme-detected malignancy. Recurrence was diagnosed in 36 patients (10.9%), new primary lung cancer in 16 patients (4.8%) and non-lung primary tumours in 8 patients (2.4%). A routine CT scan identified the majority of new primary lung cancers (84.2%) and those with disease recurrence (85.7%). The majority of programme-detected malignancies were radically treatable (55%). The median survival of programme-detected cancers was 92.4 versus 23.0 weeks for patients with clinically detected tumours (P < 0.0001). Utilizing the CT scout image as a surrogate for chest X-ray, the sensitivity of this modality was 16.95% (8.44–28.97%) and specificity was 89.83% (79.17–96.18%). Negative likelihood ratio was 0.92 (0.8–1.07). CONCLUSIONS CT follow-up of surgically treated primary lung cancer patients identifies malignancy at a stage where radical treatment is possible in the majority of patients. Chest X-ray follow-up may not be of benefit following lung cancer resection.

scholarly journals Combined Dorsal and Ulnarward Carpometacarpal Dislocation Associated with Open Fracture of the Base of First Metacarpal and Severe Degloving Injury

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Ali J. Electricwala ◽  
Jaffer T. Electricwala
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Closed Reduction ◽  
Rare Case ◽  
Open Fracture ◽  
Kirschner Wires ◽  
Degloving Injury ◽  
The Right ◽  
High Index Of Suspicion

We report a rare case of dislocation of second to fourth carpometacarpal (CMC) joints of the right hand with combined dorsal and ulnarward displacement of the second to fourth digits and fracture of the shaft of the first metacarpal associated with degloving injury. These injuries were diagnosed early and treated successfully with closed reduction and internal fixation using Kirschner wires. The functional outcome was good at follow-up at 5 years. A high index of suspicion is required to successfully diagnose and treat this condition.

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