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Knee diagnosis

Tetyana Gorbachova, Yulia Melenevsky, Micah Cohen, Brett W Cerniglia
Several pathologic conditions may manifest as an osteochondral lesion of the knee that consists of a localized abnormality involving subchondral marrow, subchondral bone, and articular cartilage. Although understanding of these conditions has evolved substantially with the use of high-spatial-resolution MRI and histologic correlation, it is impeded by inconsistent terminology and ambiguous abbreviations. Common entities include acute traumatic osteochondral injuries, subchondral insufficiency fracture, so-called spontaneous osteonecrosis of the knee, avascular necrosis, osteochondritis dissecans, and localized osteochondral abnormalities in osteoarthritis...
August 17, 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Alessandro Vidoni, Rachit Shah, Davina Mak, David Beale, Sioned Beale, Steven James, Rajesh Botchu
INTRODUCTION: To describe a novel secondary sign of subchondral insufficiency fracture of the knee, metaphyseal burst sign (soft tissue oedema in the meta-epiphyseal region of the affected condyle). METHODS: An electronic database research of 7926 knee MRI examinations was performed. Forty-eight scans were included in the study. The diagnosis of subchondral insufficiency fracture (SIF) was confirmed in a consensus review by one fellowship trained musculoskeletal (MSK) radiologist and one radiology fellow...
August 16, 2018: Journal of Medical Imaging and Radiation Oncology
Marie Reisener, Carsten Perka
Background: Culture-negative periprosthetic joint infections (CN PJI) have not been well studied, and due to the lack of consensus on PJI, especially with culture-negative infections, there are considerable uncertainties. Due to the challenging clinical issue of CN PJI the aim of this systematic review is to describe incidence, diagnosis, and treatment outcomes based on the current literature on CN PJI. Hypothesis: The review is designed to assess the formal hypothesis that CN PJI of the hip and knee have a poorer outcome when compared with culture-positive ones...
2018: BioMed Research International
Seth L Sherman, Trevor R Gulbrandsen, Hal A Lewis, Martin H Gregory, Nicholas M Capito, Aaron D Gray, B Sonny Bal
Background: MRI in the evaluation of end-stage knee joint osteoarthritis (OA) is usually unnecessary when radiographic and clinical evidence of gonarthrosis is clear. The purpose of this study was to assess the prevalence of MRI scans ordered in patients with radiographically obvious gonarthrosis and to examine the characteristics of health care providers who ordered these imaging studies. Methods: We retrospectively identified 164 patients diagnosed with moderate to severe OA who were referred for total knee replacement (TKA) over a one-year period...
2018: Iowa Orthopaedic Journal
Christopher N Carender, Craig Chike Akoh, Heather R Kowalski
Mycobacterium tuberculosis monoarthritis is a rare form of TB, occurring in 1-2% of cases in the United States. Delays in definitive diagnosis and subsequent treatment are common. While case reports of tuberculous arthritis have been presented in international literature, there is a relative paucity of literature from within the United States. Given the difficulty in diagnosis and adverse outcomes of delayed diagnosis, we present the case of an 11-year-old otherwise healthy male with isolated monoarticular TB septic arthritis of the right knee...
2018: Iowa Orthopaedic Journal
Allison K Cinats, Laurie M Parsons, Richard M Haber
Dermatitis herpetiformis is a cutaneous manifestation of celiac disease that classically presents as a symmetric pruritic vesicular eruption on extensor surfaces. Typical locations include elbows, knees, and buttocks. Facial involvement has been reported rarely. Here, we report a case of a 44-year-old woman with dermatitis herpetiformis presenting as pruritic vesicles on the face that had previously been misdiagnosed as allergic contact dermatitis. Diagnosis was confirmed with direct immunofluorescence demonstrating granular IgA in the papillary dermis...
August 13, 2018: Journal of Cutaneous Medicine and Surgery
Zhong-Xing Zhang, Feng Xu, Xiao-Long Yang
As a common disease of knee joint disease, the diagnosis and treatment of patellofemoral arthritis has not clear clinical consensus at present, conservative treatment only has a certain value for the disease with early stage and single disease. With the continuous improvement of understanding of pathogenesis and advancement of surgical techniques, minimally invasive and joint replacement technology has been rapid development, more and more alternative treatment options could be chosen. Technique of osteotomy of tibial tuberosity and removal of patella at the early stage were seldom used...
July 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Kerry J MacDonald, Luz Maria Palacios-Derflingher, Carolyn A Emery, Willem H Meeuwisse
A time-loss injury definition continues to be the most widely used injury definition despite evidence that it fails to accurately capture overuse injuries. An overuse injury questionnaire, using an "all complaints" definition has been created to address the limitation of a time-loss definition. The main aim of this work was to determine the effect that injury definition and registration methodology has on the collection of knee injuries among elite level volleyball players. To reach this goal, seventy-two volleyball players were prospectively followed over 32-weeks...
August 13, 2018: International Journal of Sports Medicine
Ernesto Muñoz-Mahamud, Ignacio Molinas, Luis Lozano, Jordi Bosch, Laura Morata, Andrés Combalia, Álex Soriano, Guillem Bori
INTRODUCTION: Identification of microorganisms is critical for correct management of an infected arthroplasty. Our hypothesis is that the culture yield depends on the location around the prosthesis from which samples are obtained. METHODS: This prospective study included 298 revisions of the hip (123) and knee (175). We compared the yield of the intraoperative samples obtained, which included synovial fluid (two), neosynovium (two), and periprosthetic membrane (two)...
August 10, 2018: Journal of the American Academy of Orthopaedic Surgeons
Ye Tian, Edward Fox, Joseph Drabick, Colette Pameijer
A 54-year-old man presented with a painful lesion on the right posterior calf with MRI identifying a 5 cm lesion in the medial head of the gastrocnemius. He underwent wide local excision of the tumour, and the final pathology was consistent with atypical granular cell tumour. Three years later, he developed a recurrent right popliteal mass. Complete staging workup also identified multiple lung nodules and a caecal polyp that were consistent with metastatic granular cell tumour. He was started on pazopanib and deemed a poor candidate for palliative resection due to encasement of the popliteal vessels...
August 11, 2018: BMJ Case Reports
Antonios Stylianakis, Georgios Schinas, Pavlos C Thomaidis, Joseph Papaparaskevas, Dimitrios C Ziogas, Maria N Gamaletsou, George L Daikos, Spyros Pneumaticos, Nikolaos V Sipsas
We assessed the value of conventional culture, vial culture, and broad-range PCR of the sonication fluid (SF), individually or in combinations, for the diagnosis of prosthetic joint infection (PJI). We studied 114 consecutive patients (median age:72.5 years, males: 28.07%) undergoing removal of a total knee or hip prosthesis. By non-microbiologic criteria, 87 patients had aseptic failure, and 27 PJI. All patients had periprosthetic tissue culture, sonication of prosthesis, and study of SF by conventional and vial culture, and PCR...
September 2018: Diagnostic Microbiology and Infectious Disease
Mark Bilinyi Ulanja, Mohamed Taha, Arshad Al-Mashhadani, Bryce D Beutler, Marwah Al-Tekreeti, Christie Elliot, Santhosh Ambika
Metastasis from breast cancer to the gastrointestinal (GI) tract is uncommon, and such events presenting as GI bleeding are exceedingly rare. In some individuals, the absence of classical findings of primary breast cancer coupled with the non-specific nature of GI symptoms may make early detection and diagnosis challenging. Our patient is a 75-year-old female who presented with symptomatic anemia manifesting as progressive dizziness, weakness, and early satiety that developed eight days after right knee arthroplasty...
June 7, 2018: Curēus
Teresa Martins Rocha, Rui Costa, João Barroso, Alexandra Bernardo, Márcio Rodrigues, Catarina Meireles, Filipe Duarte, Alberto Vieira, Mariana Afonso
Epithelioid sarcoma is a rare mesenchymal neoplasm characterized by aggregates of epithelioid cells. Intra-articular occurrence is exceedingly rare with only few reports described in the literature. A 22 year-old man presented a progressive mechanical knee pain. Initially, the investigation revealed a non-infectious unspecific synovitis. The patient gradually presented increasing knee enlargement and functional impairment. Intra-articular nodular proliferation with bone invasion was later observed on magnetic resonance imaging reevaluation...
April 2018: Acta Reumatológica Portuguesa
Ryan T Galloway, Yingying Xu, Timothy E Hewett, Kim Barber Foss, Adam W Kiefer, Christopher A DiCesare, Robert A Magnussen, Jane Khoury, Kevin R Ford, Jed A Diekfuss, Dustin Grooms, Gregory D Myer, Alicia M Montalvo
BACKGROUND: Female athletes are at an increased risk of developing patellofemoral pain (PFP) relative to male athletes. The unique effects of maturation may compound that risk. Hypothesis/Purpose: The purpose was to evaluate the neuromuscular control mechanisms that are adaptive to pubertal maturation and determine their relative contribution to PFP development. It was hypothesized that aberrant landing mechanics (reduced sagittal-plane and increased frontal- and transverse-plane kinematics and kinetics) would be associated with an increased risk for PFP...
August 9, 2018: American Journal of Sports Medicine
Kejie Wang, Minjie Chu, Wenge Ding, Qing Jiang
BACKGROUND: Knee osteoarthritis (KOA) is the most common form of chronic degenerative joint disease worldwide. Its incidence has increased in recent years. Aberrant expression profile of lncRNAs in damaged bone and cartilage of KOA patients has been reported recently, indicating its potential contributions in KOA development and a promising target for disease diagnosis and treatment. The aim of this study was to identify the association between genetic variation in lncRNA and KOA. METHODS: We retrieved relevant articles from the PubMed, Medline and Embase databases up to Jul 2017 investigating the association between lncRNA and the risk of osteoarthritis...
August 7, 2018: BMC Musculoskeletal Disorders
Filippo Del Grande, Marco Delcogliano, Riccardo Guglielmi, Esther Raithel, Steven E Stern, Derek F Papp, Christian Candrian, Jan Fritz
OBJECTIVES: The aim of this study was to test the hypothesis that magnetic resonance imaging (MRI) of the knee with 10-minute 3-dimensional (3D) controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA) sampling perfection with application optimized contrast using different flip angle evolutions (SPACE) turbo spin echo (TSE) protocols can replace 20-minute 2-dimensional (2D) TSE standard-of-reference protocols for the diagnosis of internal derangement. MATERIALS AND METHODS: After internal review board approval and prospective informed consent, 100 symptomatic subjects underwent MRI of the knee at 3 T and 50 symptomatic subjects at 1...
August 6, 2018: Investigative Radiology
Richard Yarznbowicz, Minjing Tao, Matthew Wlodarski, Alexandra Matos
Objectives : The lack of a standardized intervention taxonomy in comparative effectiveness research trials has led to uncertainty regarding the management of individuals with knee impairments. Inconsistently and poorly defined interventions affect frontline-care providers' abilities to understand and assimilate research findings into practice. An intervention taxonomy could help overcome the lack of treatment specificity commonly found in research trials. Methods : In the present study, we aimed to develop a Mechanical Diagnosis and Therapy (MDT)-based taxonomy and test the levels of reliability between providers who currently manage individuals with knee impairments in a rehabilitation setting...
August 2018: Journal of Manual & Manipulative Therapy
Vinod Kumar, Nishit Bhatnagar, Jeetendra Singh Lodhi
Background: Osteochondritis dissecans (OCD) is a disorder primarily affecting subchondral bone, with secondary effects on the overlying articular cartilage. Knee joint (75%) and radiocapitellar joint (6%) are the most common sites for OCD lesions. The presence of an open growth plate differentiates juvenile osteochondritis dissecans from adult form of osteochondritis. Early diagnosis and treatment produce best long term results. The objective of this study is to determine the best mode of management of a Grade I osteochondritis lesion in a young athlete...
July 2018: Indian Journal of Orthopaedics
Paola Saccheri, Luciana Travan
BACKGROUND: osteochondritis dissecans (OCD) is an ancient disease with few well-described cases in paleopathological records. Here, we report a very rare case of OCD on both lateral femoral condyles and on the lateral condyle of the right tibia in an early medieval human skeleton. METHODS: macroscopic examination of the bone vestiges of a young male unearthed from a 6th-8th Lombard cemetery in the northeast Italy was perform. RESULTS: We observed a circular crater-like depression with well-defined smooth margins and exposure of the trabecular bone on both lateral femoral condyles and in the lateral condyle of the right tibia...
August 1, 2018: Knee
Fu-Huang Lin, Hsiang-Cheng Chen, Chin Lin, Yu-Lung Chiu, Herng-Sheng Lee, Hung Chang, Guo-Shu Huang, Hsueh-Lu Chang, Shih-Jen Yeh, Wen Su, Chih-Chien Wang, Sui-Lung Su
Total knee replacement (TKR) is considered as one of the most success among clinical interventions for patients with who suffering from knee osteoarthritis (OA). We sought to estimate the incidence of TKR using demographics, incidence rates, lengths of hospital stay, and costs from 1996 to 2010 by analyzing Taiwan's National Health Insurance Research Database. A total of 154,553 patients obtained primary TKR surgery between 1996 and 2010. The diagnosis code for knee OA and the procedure code for TKR were selected from the records...
August 2018: Medicine (Baltimore)
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