scholarly journals The Validation of Clinical Examination and MRI as a Diagnostic Tool for Cruciate Ligaments and Meniscus Injuries of the Knee Against Diagnostic Arthroscopy

Cureus ◽  
2021 ◽  
Author(s):  
Kumar Shantanu ◽  
Shailendra Singh ◽  
Shubham Srivastava ◽  
Atul K Saroj
2021 ◽  
Vol 9 (5) ◽  
pp. 1000-1006
Author(s):  
Bhoomika Patel ◽  
Sanjay Srivastava

For effective management of disease, diagnosis and prognosis are two important aspects. Clinical examination is an important tool for assessment of disease as well as condition of patient. Different types of examination depicted in Ayurveda among that Ashtavidha Pariksha viz. Nadi (Pulse), Mootra (Urine), Mala (Faeces), Jihwa (Tongue), Shabda (Speech), Sparsha (Touch), Drika (Eyes) and Akriti (Posture) an effective tool for clinical examination of patient, which was routinely used by traditional Ayurvedic practitioner, but is missing in present era. In this paper, the clinical utility of Ashtavidha Pariksha is discussed which will be helpful for scholars to use it as a diagnostic and therapeutic tool in their clinical practice. Keywords: Ashtasthana Pariksha, Ayurveda, Examination, Diagnosis, Prognosis.


2015 ◽  
pp. 39-44
Author(s):  
Miriam América Jesús-Silva ◽  
Ramón Fernández-Martínez ◽  
Rodrigo Roldán-Marín ◽  
Roberto Arenas

Background: Onychomycosis is the most common nail disease, representing 50% of cases affecting the nail apparatus. The diagnosis is made by clinical examination along with the KOH exam of the nail and culture of the sample. However, not all dermatologists have access to a mycology lab. Objective: To determine the correlation between KOH examination and dermoscopic patterns in patients with clinical diagnosis of onychomycosis. Patients/Methods: A descriptive, open, observational, prospective, cross-sectional study of 178 patients with clinical suspicion of onychomycosis was conducted. All patients underwent clinical examination, dermoscopy with a DermLite PHOTO dermatoscope (3Gen, San Juan Capistrano, CA, USA), KOH assessment and culture analysis. The most frequent dermoscopic patterns were identified and their correlation with the clinical subtype of onychomycosis was analyzed. Results: The study included 178 patients with clinical suspicion of onychomycosis. Of these, 155 (87.1%) had positive direct KOH examination for onychomycosis. Eighty-seven patients (56.13%) presented with clinical onychomycosis pattern of total dystrophic onychomycosis (TDO), 67 (43.23%) with distal lateral subungual onychomycosis (DLSO), 1 (0.65%) with trachyonychia). Dermoscopic patterns of onychomycosis showed the following frequencies: the spiked pattern was present in 22 patients (14.19%), longitudinal striae pattern in 51 patients (32.9%) and linear edge pattern in 21 patients (13.55%). We identified a pattern described as “distal irregular termination” in 41 patients with TDO and 26 with DLSO. Conclusions: This is the fist study conducted in a Mexican population that uses dermoscopy as a diagnostic tool along with the KOH examination for the diagnosis of onychomycosis. Dermoscopy may be used as an important diagnostic tool when evaluating nail disease. However, it should not be used as the only diagnostic criteria for onychomycosis.


2021 ◽  
Vol 10 (1) ◽  
pp. 76-78
Author(s):  
R. KC ◽  
R. Poudel

Absence seizures involve brief, sudden lapses of consciousness and are more common in children than in adults. We report a case of absence seizure in a girl with atypical presentation which was diagnosed by electroencephalogram. She responded well to sodium valproate. Detailed history, clinical examination and use of electroencephalogram for diagnosis is necessary especially when such atypical presentations are encountered.


This chapter provides guidance on how to perform clinical examinations in the following specialties: cardiovascular, respiratory, gastrointestinal, neurological, cranial nerves, peripheral nerves, nervous system, obstetrics, gynaecology, ophthalmology, orthopaedic, general upper limb, spine, lower limb, and paediatrics. This chapter on clinical examination emphasizes the ability to elicit physical signs and use them to complement laboratory or radiological investigations as a diagnostic tool. It reviews important do’s and don’ts as well as end-of-the-bed observations. It also discusses signs present with diseases, and tips for around the bed space. The use of tables and illustrations is a useful aide-memoire both for revision and for use in practice. Although clinical examination is primarily taught on a patient, the structured and detailed approach of this chapter provides an insightful guide for a medical student.


2018 ◽  
Vol 1 (01) ◽  
pp. 19-24
Author(s):  
Sindhu Sharma ◽  
Santosh Pant ◽  
Bibek Rajbhandari

Introduction: Shoulder pain is a common problem encountered in clinical practice. It is often disabling to the patient and results in considerable morbidity and unsatisfactory outcomes if therapy is not instituted effectively or delayed. Ultrasonography is a rapid, real time and cost effective alternative to MRI and diagnostic arthroscopy. Here, we compare sonographic diagnosis with clinical diagnosis in the diagnosis of the various causes of shoulder pain. Methods: This descriptive study was done in the radiology department of Nepalgunj Medical College Teaching Hospital, Kohalpur during a time period of 18 months. About 30 cases of shoulder pain that had been evaluated clinically by a single examiner in the orthopedics OPD were diagnosed with the help of sonography. Correlation between clinical diagnosis and USG diagnosis was done. Results: Clinically, most of these cases were provisionally diagnosed as Frozen shoulder 9 (30%) followed by Cuff tendinopathy 8 (26.66%) and Impingement syndrome 6 (20%). However, USG of the shoulder revealed rotator cuff tendinopathy and cuff tear (n=6 each) to be the main etiology behind shoulder pain. Supraspinatus calcific tendinopathy was found in 4 individuals. Hence, it was seen that the diagnosis of the causes of shoulder pain with clinical tests alone is unsatisfactory. Out of 30 cases, clinical examination could correctly diagnose only 20% of the time (n=6). 73% of the time (n=20), USG showed a different diagnosis compared to clinical examination whereas in 4 (7%) cases a more specific diagnosis was reached.Conclusions: We conclude that USG is more specific and frequently leads to increased diagnostic accuracy when compared to clinical examination.


2020 ◽  
Vol 7 (10) ◽  
pp. 3289
Author(s):  
Pradipkumar V. Solanki ◽  
Iliyas A. Juneja ◽  
Nileshbhai D. Chaudhari

Background: Breast lump is a common complaint of women presenting to surgeons. Most of them are benign, careful evaluation, exact diagnosis and definitive treatment is mandatory to rule out cancer. The diagnosis of breast cancer is suggested on clinical examination. Currently a combination of three tests, i.e. clinical examination, radiological imaging (mammography, ultrasonography) and pathology called as triple assessment test is used to accurately diagnose all palpable breast lumps. Together they give sensitivity of 100%. The triple assessment is taken as positive if any of the three components, two are positive or positive report of FNAC and negative only if all of its components are negative for malignancy.Methods: This study was conducted in the Department of Surgery, P.D.U Medical College, Rajkot, Gujarat over a period of 2 years. A total of 100 patients with a breast lump were selected more than 15 years of age. A detailed history, focused clinical examination, radiological imaging and FNAC were used as diagnostic tools for screening of the patients. The aim of this study was to evaluate accuracy of modified triple assessment in the preoperative diagnosis of patients with breast carcinoma.Results: Results shows sensitivity and specificity of all the modalities used in triple assessment when combined together was 100% and 99.3%, respectively. Positive predictive value was 93.3%, negative predictive value was 100%, p-value was highly significant (p<0.0001). We conclude that modified triple assessment is a very useful diagnostic tool to evaluate patients with breast lumps and an overall accuracy of 98%.Conclusions: Thus, triple assessment is an easily available, cost effective, least invasive, rapid and patient compliant diagnostic tool for diagnosis of breast lump.


Author(s):  
Omkar P. Kulkarni ◽  
Ganesh N. Pundkar ◽  
Satish B. Sonar

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">This study was conducted to compare accuracy of MRI findings taking arthroscopy as standard in knee injuries.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">All patients attending our hospital with knee injury underwent clinical examination. Out of them 100 patients with knee injury were subjected to clinical examination, MRI and then Arthroscopy. The results were compared and analyzed using various statistical tests. The accuracy, sensitivity and specificity were calculated based on these arthroscopic and MRI findings</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The accuracy of clinical diagnosis in our study was 88% for ACL tears and 85% for meniscal tears. Our study proved high sensitivity and specificity and almost high accuracy for ACL injuries of knee joint in comparison to arthroscopy. MRI is an excellent screening tool for therapeutic arthroscopy. We can avoid diagnostic arthroscopy in patients with knee injuries having equivocal clinical and MRI examination and go on for therapeutic modality. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">For the assessment of ligamentous and meniscal injuries magnetic resonance imaging (MRI) is accurate and noninvasive modality. It can be used as a first line investigation but arthroscopy still remains gold standard in diagnosing ACL and meniscal injuries.</span></p><p class="abstract"> </p>


Sign in / Sign up

Export Citation Format

Share Document