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Knee diagnosis

Tomas Urbina, Naïke Bigé, Yann Nguyen, Pierre-Yves Boelle, Vincent Dubée, Jérémie Joffre, Idriss Abdallah, Jean-Luc Baudel, Eric Maury, Bertrand Guidet, Hafid Ait-Oufella
We aimed to assess the relationship between alterations of tissue perfusion parameters at admission (highly predictive of mortality in septic shock) and outcome in patients admitted to the intensive care unit (ICU) for acute pulmonary embolism (PE). We conducted a retrospective study to analyze the association between arterial lactate level, skin mottling and urinary output, and 28-day mortality.Over a 22-year period, 317 patients with PE were identified but we finally analyzed 108 patients whose main diagnosis for ICU admission was acute PE...
October 2018: Medicine (Baltimore)
Erin FitzGerald Alaia, Michael J Alaia, Soterios Gyftopoulos
OBJECTIVE: The purpose of this study is to familiarize the radiologist with knee arthroscopy, including the setup, equipment, and standard procedure used. This is followed by a discussion of the strengths and weaknesses of knee MRI and arthroscopy and presentation of images showing normal knee anatomy and pathologic findings. CONCLUSION: By having an understanding of basic arthroscopic principles as well as the strengths and limitations of MRI and arthroscopy in the diagnosis of knee abnormalities, radiologists will improve image interpretation and add value to interactions with the consulting orthopedic surgeon...
October 17, 2018: AJR. American Journal of Roentgenology
Cheol Hee Park, Jung Kwon Bae, Sang Jun Song
PURPOSE: The purposes of the present study were to assess the levels of prosthetic constraint chosen during revision total knee arthroplasty (TKA) and to identify factors influencing the choice of a constrained prosthesis. METHODS: We retrospectively reviewed data on 274 revision TKAs. The mean follow-up period after revision TKA was 7.2 years. The femorotibial angle (FTA), joint line height (JLH), and Insall-Salvati ratio (ISR) were radiographically evaluated...
October 16, 2018: International Orthopaedics
Robert F LaPrade, Tyler R Cram, Justin J Mitchell, Andrew G Geeslin, Carly A Lockard, Eric K Fitzcharles, Grant J Dornan
Background: Imaging of the femoral trochlea has been inherently difficult because of its convex anatomy. Purpose/Hypothesis: The purpose of this study was to compare the diagnostic utility of a standard axial magnetic resonance imaging (MRI) sequence with an axial-oblique MRI sequence of the knee for the detection of trochlear articular cartilage lesions on a high-field 3-T MRI scanner. We hypothesized that axial-oblique MRI scans of the knee obtained along the true axis of the trochlea would significantly improve the detection of high-grade cartilage lesions...
October 2018: Orthopaedic Journal of Sports Medicine
Christopher W Bunt, Christopher E Jonas, Jennifer G Chang
Knee pain affects approximately 25% of adults, and its prevalence has increased almost 65% over the past 20 years, accounting for nearly 4 million primary care visits annually. Initial evaluation should emphasize excluding urgent causes while considering the need for referral. Key aspects of the patient history include age; location, onset, duration, and quality of pain; associated mechanical or systemic symptoms; history of swelling; description of precipitating trauma; and pertinent medical or surgical history...
November 1, 2018: American Family Physician
Saoussen Bacha, Améni Sghaier, Sonia Habibech, Sana Cheikhrouhou, Hager Racil, Naouel Chaouch, Mohamed Fethi Ladeb, Abdellatif Chabbou
Sarcoidosis is a systematic, granulomatous disease of unknown cause which can affect any organ in the body. Pulmonary involvement is the most common. Musculoskeletal manifestations of sarcoidosis are less common affecting 10-25% of patients and chronic arthritis occurs rarely. We report the case of sarcoidosis revealed by left knee chronic and destructive monoarthritis with only asymptomatic pulmonary involvement in a Caucasian male miner exposed to silica. The patient was treated with corticosteroids during 2 years after diagnosis...
January 2018: La Tunisie Médicale
Mahmoud Jabalameli, Hossein A Hadi, Abolfazl Bagherifard, Mohammad Rahbar, Mohammadreza Minator Sajjadi
Background: Presentation of proximal tibia stress fracture is not infrequent among elderly patients due to their poor bone stock. Optimal management of patients with severe gonarthrosis of the knee and concurrent tibial stress fracture is not known yet. In this study we report the outcome of primary total knee arthroplasty (TKA) using stemmed components in elderly patients. Methods: Between 2009 and 2014, a total of 16 elderly patients with proximal tibial stress fractures and concurrent gonarthrosis were treated with TKA using long stemmed components...
September 2018: Archives of Bone and Joint Surgery
E Carlos Rodriguez-Merchan
Background: Periprosthetic infection is the most serious joint replacement complication, occurring in 0.8-1.9% of total knee arthroplasties (TKAs).This review aims to define the role of preoperative aspiration culture (PAC) for diagnosis of TKA infection. Methods: A PubMed (MEDLINE) search related to TKA infection and PAC was analyzed. The main criteria for selection were that the articles were focused in the aforementioned question. Results: Twenty articles were found, but only fourteen were selected and reviewed because they were deeply focused on the topic...
September 2018: Archives of Bone and Joint Surgery
Andreas Lundberg Zachrisson, Pia Desai, Jon Karlsson, Elias Johanesson, Stefan Grau
BACKGROUND: Overuse injuries (OI) are common in elite athletics. Previous studies have had athletes self-report injuries rather than having a medical professional provide a clear diagnosis. This might be a major reason for the inconsistencies in reported incident proportions of OI in elite athletics, in addition to the varying definitions of OI in current literature. Risk factors or combinations of risk factors (biomechanical, clinical, and training-related) have been shown to be important in the developmental process of OI...
October 13, 2018: BMC Musculoskeletal Disorders
Berk Norman, Valentina Pedoia, Adam Noworolski, Thomas M Link, Sharmila Majumdar
Osteoarthritis (OA) classification in the knee is most commonly done with radiographs using the 0-4 Kellgren Lawrence (KL) grading system where 0 is normal, 1 shows doubtful signs of OA, 2 is mild OA, 3 is moderate OA, and 4 is severe OA. KL grading is widely used for clinical assessment and diagnosis of OA, usually on a high volume of radiographs, making its automation highly relevant. We propose a fully automated algorithm for the detection of OA using KL gradings with a state-of-the-art neural network. Four thousand four hundred ninety bilateral PA fixed-flexion knee radiographs were collected from the Osteoarthritis Initiative dataset (age = 61...
October 10, 2018: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
John Koo, Gregory D Deans
Bacteria of the Burkholderia cepacia complex have rarely been reported to cause septic arthritis. Cases have been reported in patients who were immunocompromised, at extremes of age or who had history of steroid injection or penetrating trauma. A 67-year-old man with a history of opioid use disorder, osteoarthritis, and gout but no known immunocompromise was admitted to hospital with pain and swelling of his right knee. Cultures of synovial fluid and urine grew Burkholderia cepacia complex. Microscopy of synovial fluid also identified intracellular calcium pyrophosphate crystals...
2018: Case Reports in Infectious Diseases
Kathryn Malherbe
We report a case of a 12-year-old boy who presented with infrapatellar pain, with subsequent diagnosis of traction apophysitis of the knee (Sinding-Larsen-Johansson disease). Conventional radiographs are frequently reported with no significant findings in the acute setting, leading to ultrasound as the modality of choice for diagnostic efficacy of apophyseal traction injuries in young athletes. Sinding-Larsen-Johansson disease has a 2%-5% incidence in children aged 10-15 years, with the most common cause related to sporting activities related to jumping...
January 2019: Radiology Case Reports
Fehmi Kacmaz, Adnan Kaya, Muhammed Keskin, Serdar Keceoglu, Ibrahim Halil Algin, Bayram Yilmazkaya, Erdogan Ilkay
Objective Buerger's disease is one of the worst diseases causing peripheral artery occlusions (especially lower extremity) with increased morbidity and mortality. Endovascular treatment of the diseased arteries gains preference over bypass surgery nowadays. Here, we aimed to present the clinical outcomes of 16 consecutive Buerger's disease patients underwent extended endovascular recanalization which is a new technique to restore direct blood flow to at least one foot artery, with the performance of angioplasty for each tibial and foot artery obstructions...
October 10, 2018: Vascular
Priyanka Saxena, Radhika Agarwal, Gunjan Nain, Nita Khurana, Pawanindra Lal, Sanjeev Kumar Tudu
Synovial hemangioma is a rare, benign, vascular tumor of synovium leading to joint pain and swelling. The most common site is the knee joint, but rare cases involving other sites have also been reported. We report two rare cases of synovial hemangioma, one involving the ankle joint and other involving the wrist joint. Histopathology is the gold standard for diagnosis of these cases. Early treatment is warranted to prevent the risk of permanent joint damage.
October 2018: Indian Journal of Pathology & Microbiology
Jie Yao, Bin Yang, Yuxing Wang, Yubo Fan
Patellofemoral (PF) pain is a common knee disease. Patella tracking has a significant correlation with PF pain, therefore it could be used as an index for diagnosis and treatment evaluation. Previous research has proposed a method for measuring in vivo patella tracking by means of an interpolation algorithm. The present study aimed to quantify the effect of the interpolation parameters on the accuracy of the patella tracking with a motion capture experiment. The precise patella tracking of 5 knee specimens was collected and compared with the interpolated tracking...
October 5, 2018: Medical Engineering & Physics
C Burnett, P Wright, A-M Keenan, A Redmond, J Ridgway
INTRODUCTION: To measure the range of T1 values of synovitis using three Tesla (3 T) magnetic resonance imaging (MRI) in patients with osteoarthritis to assess the potential of T1 mapping for identifying synovitis from other features in the knee on unenhanced magnetic resonance scans. METHODS: After receiving institutional ethical approval, 83 patients who met the American College of Rheumatology criteria for diagnosis of osteoarthritis of the knee were scanned using a 3 T Magnetic Resonance Imaging scanner...
November 2018: Radiography
Yi-Min Zhang, Jian-Yong Liu, Xue-Dong Sun, Miao Zhang, Xiao-Guang Liu, Xiu-Li Chen
Osteoarthritis (OA) is the third most common diagnosis made by general practitioners in older patients. The purpose of the current study is to investigate effects rivaroxaban had on both hidden blood loss and blood transfusion rate (BTR) in patients with knee OA (KOA) after going through a total knee replacement (TKR).Between the time periods of December 2011 up until January 2015, a total of 235 patients underwent TKR and were selected to be assigned to either the rivaroxaban or nonanticoagulant groups. Coagulation function indexes before surgery and following administration of rivaroxaban, total blood loss, hidden blood loss, dominant blood loss, blood transfusion volume, hemoglobin reduction, degree of postoperative pain (visual analogue scale), the degree of knee swelling, and range of motion following surgery were all recorded...
October 2018: Medicine (Baltimore)
Logan F Hanson, Cameron G Hanson, Kyle L Barner
Charcot arthropathy is an infrequent condition that primarily involves the foot and ankle; rarely, it has been reported to affect the knee. Risk factors for Charcot arthropathy are well described with diabetes being the most common cause. Idiopathic Charcot arthropathy without a secondary etiology is extremely rare, with only a few cases described involving the foot and shoulder. Clinically, idiopathic Charcot arthropathy presents a notable challenge because delayed diagnosis can lead to surgical complications and advancement of joint destruction...
July 2018: Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews
Alexander S Rascoe, Scott Treiman, Ashwath Gunasekar, Heather A Vallier
OBJECTIVES: What are the differences between elective and trauma patient satisfaction and do patient and diagnosis factors predict physician scores? DESIGN: Prospective cohort study SETTING:: Urban Level 1 Trauma center PATIENTS/PARTICIPANTS:: 323 trauma patients and 433 elective orthopaedic patients treated at our center by the same surgeons INTERVENTION:: Trauma patients treated surgery for one or more fractures; elective patients treated with hip, knee, or shoulder arthroplasty, or rotator cuff repair...
September 10, 2018: Journal of Orthopaedic Trauma
Valentina Pedoia, Sharmila Majumdar
In an effort to develop quantitative biomarkers for degenerative joint disease and fill the void that exists for diagnosing, monitoring and assessing the extent of whole joint degeneration, the past decade has been marked by a greatly increased role of noninvasive imaging. This coupled with recent advances in image processing and deep learning opens new possibilities for promising quantitative techniques. The clinical translation of quantitative imaging was previously hampered by tedious non-scalable and subjective image analysis...
October 1, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
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