scholarly journals Non-Invasive Diagnostics in Acute Compartment Syndrome

2021 ◽  
Author(s):  
Richard Martin Sellei ◽  
Philipp Kobbe ◽  
Frank Hildebrand
Keyword(s):  
Compartment Syndrome ◽  
Gold Standard ◽  
Clinical Signs ◽  
Acute Compartment Syndrome ◽  
Non Invasive ◽  
Unconscious Patients ◽  
New Applications ◽  
Invasive Diagnostics ◽  
Complementary Measurement ◽  
Compartmental Pressure

Diagnosis of acute compartment syndrome (ACS) of the extremities is based on clinical signs with or without complementary measurement of muscle compartmental pressure. However, in cases of imminent compartment syndrome, unconscious patients or children the appropriate diagnose remains challenging. Despite all efforts to improve technical devices to objectify the signs by measurements of numerous parameters, needle compartment pressure measurement is to date accepted as the gold standard to facilitate decision making. But its invasiveness, the controversy about pressure thresholds and its potentially limited validity due to a single measurement support the need for further developments to diagnose ACS. Numerous technical improvements have been published and revealed promising new applications for non-invasive diagnostics. Since the pathology of an ACS is well characterized two approaches of measurements are described: to detect either increasing compartmental pressure or decreasing perfusion pressure. In the following, currently known investigations are reviewed and related to their pathophysiological principals, modes of clinical application, value and reliability.

scholarly journals Shear Wave Elastography in Evaluating Acute Kidney Allograft Dysfunction: Preliminary Results.

2021 ◽  
Vol 9 (6) ◽  
Author(s):  
Carmen Roch ◽  
Fernando García ◽  
María Flores ◽  
Ruben González ◽  
Miguel Cepeda ◽  
...  
Keyword(s):  
Shear Wave ◽  
Gold Standard ◽  
Clinical Signs ◽  
Standard Technique ◽  
Shear Wave Elastography ◽  
Tissue Stiffness ◽  
Preliminary Results ◽  
Non Invasive ◽  
Allograft Dysfunction ◽  
Gold Standard Technique

In absence of pharmacological toxicity, allograft dysfunction is usually due to parenchymal inflammation and tubulointerstitial fibrosis, but its clinical signs are often non-specific and tend to appear when advanced damage has been established. We investigated whether Shear Wave Elastography (SWE), a new non-invasive ultrasound (US) based technique that estimates tissue stiffness, could provide early confident diagnosis of acute allograft dysfunction compared to biopsy (gold standard technique).

scholarly journals Idiopathic spontaneous compartment syndrome of the right lower limb: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Sareesh Bandapaati ◽  
Rayno Navinan Mitrakrishnan
Keyword(s):  
Risk Factors ◽  
Compartment Syndrome ◽  
Lower Limb ◽  
Clinical Signs ◽  
Acute Compartment Syndrome ◽  
Gradual Evolution ◽  
Lower Limb Pain ◽  
History Of ◽  
Extrinsic Risk ◽  
The Right

Abstract Background Acutely painful lower limb is a common presentation to the emergency department, and acute compartment syndrome is an important differential diagnosis to consider given the correct predisposing history and clinical presentation. However, idiopathic spontaneous compartment syndrome is an uncommon occurrence. Case presentation A 54-year-old Caucasian man with no previous comorbidities presented with acute right-sided lower limb pain with classical symptoms showing gradual evolution. He had no other history of medical relevance and no preceding injury. Examination showed a marginally enlarged right lower limb with stretched skin and tenderness. Routine blood tests were normal including D-dimer levels. However, in the absence of any underlying risk factors, acute compartment syndrome was suspected on clinical merit and confirmed with magnetic resonance imaging. He underwent successful surgical intervention with fasciotomy and achieved good recovery. Discussion Acute compartment syndrome, though commonly attributed to trauma, can occur due to varied causes. Spontaneous acute compartment syndrome is attributed to diabetes mellitus. Idiopathic acute spontaneous compartment syndrome occurs in the absence of either intrinsic or extrinsic risk factors and is rarely documented in the literature. This case highlights the importance of appreciating classical clinical signs and having the clinical acumen to consider an obvious diagnosis even in its rarer form of presentation.

Phonomyography as a non-invasive continuous monitoring technique for muscle ischemia in an experimental model of acute compartment syndrome

Injury ◽  
2017 ◽  
Vol 48 (11) ◽  
pp. 2411-2416 ◽  
Author(s):  
Adriana P. Martinez ◽  
Thomas P. Moser ◽  
Neil Saran ◽  
Marilène Paquet ◽  
Thomas Hemmerling ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Experimental Model ◽  
Continuous Monitoring ◽  
Acute Compartment Syndrome ◽  
Non Invasive ◽  
Monitoring Technique ◽  
Muscle Ischemia

Continual near-infrared spectroscopy monitoring in the injured lower limb and acute compartment syndrome

2018 ◽  
Vol 100-B (6) ◽  
pp. 787-797 ◽  
Author(s):  
M. S. Shuler ◽  
M. Roskosky ◽  
T. Kinsey ◽  
D. Glaser ◽  
W. Reisman ◽  
...  
Keyword(s):  
Infrared Spectroscopy ◽  
Compartment Syndrome ◽  
Near Infrared Spectroscopy ◽  
Lower Limb ◽  
Near Infrared ◽  
Multilevel Modelling ◽  
Acute Compartment Syndrome ◽  
Graphical Methods ◽  
Non Invasive ◽  
Control Compartment

Aims The aim of this study was to evaluate near-infrared spectroscopy (NIRS) as a continuous, non-invasive monitor for acute compartment syndrome (ACS). Patients and Methods NIRS sensors were placed on 86 patients with, and 23 without (controls), severe leg injury. NIRS values were recorded for up to 48 hours. Longitudinal data were analyzed using summary and graphical methods, bivariate comparisons, and multivariable multilevel modelling. Results Mean NIRS values in the anterior, lateral, superficial posterior, and deep posterior compartments were between 72% and 78% in injured legs, between 69% and 72% in uninjured legs, and between 71% and 73% in bilaterally uninjured legs. In patients without ACS, the values were typically > 3% higher in injured compartments. All seven limbs with ACS had at least one compartment where NIRS values were 3% or more below a reference uninjured control compartment. Missing data were encountered in many instances. Conclusion NIRS oximetry might be used to aid the assessment and management of patients with ACS. Sustained hyperaemia is consistent with the absence of ACS in injured legs. Loss of the hyperaemic differential warrants heightened surveillance. NIRS values in at least one injured compartment(s) were > 3% below the uninjured contralateral compartment(s) in all seven patients with ACS. Additional interventional studies are required to validate the use of NIRS for ACS monitoring. Cite this article: Bone Joint J 2018;100-B:787–97.

Acute Compartment Syndrome of the Thigh in Combat Casualties

2013 ◽  
Vol 22 (01) ◽  
pp. 42-49 ◽  
Author(s):  
Brendan D. Masini ◽  
Adam W. Racusin ◽  
Joseph C. Wenke ◽  
Tad L. Gerlinger ◽  
Joseph R. Hsu
Keyword(s):  
Compartment Syndrome ◽  
Acute Compartment Syndrome ◽  
Combat Casualties

Diagnostic efficacy and suitability of trans-thoracic ultrasonography for pleural fluid detection – The future non-invasive gold-standard?

2020 ◽  
Vol 13 (4) ◽  
pp. 184-190
Author(s):  
Muhammad Irfan ◽  
Abdul Rasheed Qureshi ◽  
Zeeshan Ashraf ◽  
Muhammad Amjad Ramzan ◽  
Tehmina Naeem ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Pleural Fluid ◽  
Gold Standard ◽  
Pleural Effusions ◽  
Diagnostic Efficacy ◽  
Chest Sonography ◽  
X Ray ◽  
Non Invasive ◽  
Fluid Detection

ABSTRACT Background: Conventionally Pleural effusions are suspected by history of pleuritis, evaluated by physical signs and multiple view radiography. Trans-thoracic pleural aspiration is done and aspirated pleural fluid is considered the gold-standard for pleural effusion. Chest sonography has the advantage of having high diagnostic efficacy over radiography for the detection of pleural effusion. Furthermore, ultrasonography is free from radiation hazards, inexpensive, readily available  and feasible for use in ICU, pregnant and pediatric patients. This study aims to explore the diagnostic accuracy of trans-thoracic ultrasonography for pleural fluid detection, which is free of such disadvantages. The objective is to determine the diagnostic efficacy of trans-thoracic ultrasound for detecting pleural effusion and also to assess its suitability for being a non-invasive gold-standard.   Subject and Methods: This retrospective study of 4597 cases was conducted at pulmonology  OPD-Gulab Devi Teaching Hospital, Lahore from November 2016 to July 2018. Adult patients with clinical features suggesting pleural effusions were included while those where no suspicion of pleural effusion, patients < 14 years and pregnant ladies were excluded. Patients were subjected to chest x-ray PA and Lateral views and chest ultrasonography was done by a senior qualified radiologist in OPD. Ultrasound-guided pleural aspiration was done in OPD & fluid was sent for analysis. At least 10ml aspirated fluid was considered as diagnostic for pleural effusion. Patient files containing history, physical examination, x-ray reports, ultrasound reports, pleural aspiration notes and informed consent were retrieved, reviewed and findings were recorded in the preformed proforma. Results were tabulated and conclusion was drawn by statistical analysis. Results: Out of 4597 cases, 4498 pleural effusion were manifested on CXR and only 2547(56.62%) pleural effusions were proved by ultrasound while 2050 (45.57%) cases were reported as no Pleural effusion. Chest sonography demonstrated sensitivity, specificity, PPV, NPV and diagnostic accuracy 100 % each. Conclusions: Trans-thoracic ultrasonography revealed an excellent efficacy that is why it can be considered as non-invasive gold standard for the detection of pleural effusion.

scholarly journals Non-invasive diagnostics in fossils - Magnetic Resonance Imaging of pathological belemnites

2005 ◽  
Vol 2 (2) ◽  
pp. 133-140 ◽  
Author(s):  
D. Mietchen ◽  
H. Keupp ◽  
B. Manz ◽  
F. Volke
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Soft Tissue ◽  
Clinical Diagnostics ◽  
Resonance Imaging ◽  
Non Invasive ◽  
Physiological Processes ◽  
Magnetic Resonance Imaging Mri ◽  
Invasive Diagnostics

Abstract. For more than a decade, Magnetic Resonance Imaging (MRI) has been routinely employed in clinical diagnostics because it allows non-invasive studies of anatomical structures and physiological processes in vivo and to differentiate between healthy and pathological states, particularly of soft tissue. Here, we demonstrate that MRI can likewise be applied to fossilized biological samples and help in elucidating paleopathological and paleoecological questions: Five anomalous guards of Jurassic and Cretaceous belemnites are presented along with putative paleopathological diagnoses directly derived from 3D MR images with microscopic resolution. Syn vivo deformities of both the mineralized internal rostrum and the surrounding former soft tissue can be traced back in part to traumatic events of predator-prey-interactions, and partly to parasitism. Besides, evidence is presented that the frequently observed anomalous apical collar might be indicative of an inflammatory disease. These findings highlight the potential of Magnetic Resonance techniques for further paleontological applications.

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