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Stress radiography

Tarek M Hegazi, Jeffrey A Belair, Eoghan J McCarthy, Johannes B Roedl, William B Morrison
Injuries of the hip and surrounding structures represent a complex and commonly encountered scenario in athletes, with improper diagnosis serving as a cause of delayed return to play or progression to a more serious injury. As such, radiologists play an essential role in guiding management of athletic injuries. Familiarity with hip anatomy and the advantages and limitations of various imaging modalities is of paramount importance for accurate and timely diagnosis. Magnetic resonance (MR) imaging is often the modality of choice for evaluating many of the injuries discussed, although preliminary evaluation with conventional radiography and use of other imaging modalities such as ultrasonography (US), computed tomography, and bone scintigraphy may be supplementary or preferred in certain situations...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
S Y Lee, S-S Kwon, M S Park, M K Chung, K B Kim, S Koo, K M Lee
This study aimed to investigate the relationship between bone morphology and injured ligaments on imaging studies and laxity on ankle stress radiographs in patients with lateral ankle instability. In total, 115 patients who had undergone ankle MRI, ankle radiography, and stress radiography were included. Distal tibial articular surface angle, bimalleolar tilt, medial and lateral malleolar relative length, medial malleolar slip angle, anterior inclination of the tibia, and fibular position were measured on ankle radiographs...
September 27, 2016: International Journal of Sports Medicine
Justin Chak Yiu Lam, Ka Lok Ryan Lee, James F Griffith
Brachialis periosteal avulsion injury is an uncommon injury occurring in young children. The injury may be misinterpreted or overlooked because of misleading or subtle radiological findings. A case of 7-year-old child with post-traumatic elbow pain and subtle findings on elbow radiography is presented. The injury was initially misinterpreted as an avulsion fracture of the medial epicondyle. Following radiological review, a diagnosis of brachialis periosteal avulsion injury was made. The radiographic and magnetic resonance imaging (MRI) findings of this injury are presented to stress the value of comparing the radiographic findings with previous imaging and to increase awareness of this uncommon injury...
November 2016: Skeletal Radiology
Sang Ki Lee, Kap Jung Kim, Yong Han Cha, Won Sik Choy
Treatments for acute distal radioulnar joint (DRUJ) instability with distal radius fracture vary from conservative to operative treatment, although it seems to be no consensus regarding which treatment is optimal. This prospective randomized study was designed to compare the clinical outcomes for operative and conservative treatment of acute DRUJ instability with distal radius fracture, according to the presence or absence and type of ulnar styloid process fracture and the degree of its displacement. Between July 2008 and February 2013, we enrolled 157 patients who exhibited an unstable DRUJ during intraoperative manual stress testing (via the ballottement test) after fixation of the distal radius...
September 2016: Annals of Plastic Surgery
James R Holmes, William B Acker, Joshua M Murphy, Amy McKinney, Anish R Kadakia, Todd A Irwin
INTRODUCTION: Stability of isolated Weber B ankle fractures can be difficult to determine. Using weight-bearing radiographs, a reliable method to determine the stability of isolated Weber B ankle fractures is described. METHODS: A retrospective review of prospectively gathered data was performed. Weber B ankle fractures were defined as stable when having a medial clear space (MCS) of <7 mm on initial gravity stress radiographs and a normal mortise relationship on weight-bearing radiographs...
September 2016: Journal of the American Academy of Orthopaedic Surgeons
Alison Shmerling, Jonathan T Bravman, Morteza Khodaee
Traumatic swelling/effusion in the knee region is a relatively common presenting complaint among athletes and nonathletes. Due to its broad differential diagnosis, a comprehensive evaluation beginning with history and physical examination are recommended. Knee joint effusion can be differentiated from other types of swelling by careful physical examination. Imaging, including plain radiography, ultrasound, and magnetic resonance imaging (MRI), is preferred modality. Aspiration of a local fluctuating mass may help with the diagnosis and management of some of these conditions...
2016: Case Reports in Orthopedics
Olga Panagiotopoulou, Jeffery W Rankin, Stephen M Gatesy, John R Hutchinson
Horse racing is a multi-billion-dollar industry that has raised welfare concerns due to injured and euthanized animals. Whilst the cause of musculoskeletal injuries that lead to horse morbidity and mortality is multifactorial, pre-existing pathologies, increased speeds and substrate of the racecourse are likely contributors to foot disease. Horse hooves have the ability to naturally deform during locomotion and dissipate locomotor stresses, yet farriery approaches are utilised to increase performance and protect hooves from wear...
2016: PeerJ
Miguel Montero-Baker, Gregory J Ziomek, Luis Leon, Aaron Gonzales, Robert S Dieter, Crystal L Gadd, John P Pacanowski
BACKGROUND: The structural limitations of currently available laser-cut nitinol stents in the highly diseased arterial system of the lower extremity are well described. These devices are frequently used in long-segment occlusions, at the adductor hiatus, and across the knee into the popliteal artery and tibial-peroneal trunk despite concerns related to the high mobility of the knee joint and the potential for external stent compression, fractures, and occlusion. The Supera stent (Abbott Vascular, Santa Clara, Calif) was developed to provide superior radial strength, fracture resistance, and flexibility compared with laser-cut nitinol stents...
October 2016: Journal of Vascular Surgery
Vineet Jain, Ankit Goyal, Mukul Mohindra, Rahul Kumar, Deepak Joshi, Deepak Chaudhary
PURPOSE: Anatomically, posterior cruciate ligament (PCL) consists of two bundles, i.e. anterolateral (AL) and posteromedial (PM) bundle. Single-bundle PCL (SBPCL) reconstruction remains most popular method of reconstruction, though double-bundle PCL (DBPCL) reconstruction is more anatomical. This study was done to analyse the clinical and functional outcome after both SBPCL and DBPCL reconstructions using autologous hamstring grafts. METHODS: This was a retrospective study including patients who underwent either DBPCL or SBPCL reconstruction for chronic symptomatic PCL injury...
November 2016: Archives of Orthopaedic and Trauma Surgery
Alexander Dozet, Bodil Ivarsson, Karin Eklund, Rosemarie Klefsgård, Mats Geijer
RATIONALE, AIMS AND OBJECTIVES: The process of transferring older, vulnerable adults from an elder care facility to the hospital for medical care can be an emotionally and physically stressful experience. The recent development of modern mobile radiography may help to ease this anxiety by allowing for evaluation in the nursing home itself. Up until this point, no health economic evaluation of the technology has been attempted in a Swedish setting. The objective of this study was to determine whether examinations of patients in elder care facilities with mobile radiography were cost-effective from a societal perspective compared with hospital-based radiological examinations...
July 14, 2016: Journal of Evaluation in Clinical Practice
Yon Sik Yoo, Si Young Song, Cheol Jung Yang, Jong Mun Ha, Yoon Sang Kim, Young Jin Seo
PURPOSE: The purpose of this study was to compare the clinical outcomes of arthroscopic anatomical double bundle (DB) anterior cruciate ligament (ACL) reconstruction with either selective anteromedial (AM) or posterolateral (PL) bundle reconstruction while preserving a relatively healthy ACL bundle. MATERIALS AND METHODS: The authors evaluated 98 patients with a mean follow-up of 30.8±4.0 months who had undergone DB or selective bundle ACL reconstructions. Of these, 34 cases underwent DB ACL reconstruction (group A), 34 underwent selective AM bundle reconstruction (group B), and 30 underwent selective PL bundle reconstructions (group C)...
September 2016: Yonsei Medical Journal
Jin-Young Park, Youngbok Kim, Kyung-Soo Oh, Hwa-Kyung Lim, Joo-Yong Kim
BACKGROUND: The purpose of this study was to examine the validity of stress radiography using the Telos GA-IIE as a clinical methodology to evaluate shoulder instability. METHODS: On 36 anterior shoulder dislocators and 23 uninjured volunteers, 4 types of stress radiographs were captured while applying 15 daN of force anteriorly (AER0 and AER60) and posteriorly (PER0 and PER60) at 2 different positions: (1) 90° of abduction combined with 0° external rotation and (2) 90° of abduction combined with 60° external rotation...
June 6, 2016: Journal of Shoulder and Elbow Surgery
M Uhl
Bone stress injuries are due to repetitive mechanical overuse of the skeleton and occur as a result of microscopic lesions sustained when bone is subjected to repeated submaximal stress. Over time accumulation of such injuries can lead to bone failure and fractures. Stress-related bone injuries are relatively common among otherwise healthy persons who have recently started new or intensified forms of physical training activities. Stress injuries lead to typical findings on radiography, bone scintigraphy, computed tomography (CT) and magnetic resonance imaging (MRI) and need to be discriminated from other conditions, in particular infections and neoplasms...
July 2016: Der Radiologe
Haruhiko Machida, Toshiyuki Yuhara, Mieko Tamura, Takuya Ishikawa, Etsuko Tate, Eiko Ueno, Katelyn Nye, John M Sabol
With flat-panel detector mammography, radiography, and fluoroscopy systems, digital tomosynthesis (DT) has been recently introduced as an advanced clinical application that removes overlying structures, enhances local tissue separation, and provides depth information about structures of interest by providing high-quality tomographic images. DT images are generated from projection image data, typically using filtered back-projection or iterative reconstruction. These low-dose x-ray projection images are easily and swiftly acquired over a range of angles during a single linear or arc sweep of the x-ray tube assembly...
May 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Lin-Yi Wang, Tsung-Hsun Yang, Yu-Chi Huang, Wen-Yi Chou, Chung-Cheng Huang, Ching-Jen Wang
PURPOSE: This study aimed to elucidate the diagnostic criteria for posterior cruciate ligament (PCL) injury using ultrasonography. METHODS: Thirty-three patients with clinically suspected PCL injuries and 30 normal control subjects were recruited. Both groups were assessed using sonographic examination with reliability testing. Patients also underwent posterior stress radiography and magnetic resonance imaging (MRI). PCL thickness on two-dimensional ultrasonography (2D US), pixel intensity on sonoelastography, displacement on posterior stress view, and severity grading using MRI were analysed...
May 4, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Y Iwata
This study reports a novel stress radiography technique to evaluate an avulsion fracture at the lateral malleolus in children. Radiographs in the stress anteroposterior view or the Haraguchi calcaneofibular ligament or anterior tarofibular ligament (ATFL) projection could not detect any fracture; only manual inversion stress radiography in the Haraguchi ATFL projection could identify the avulsion fracture.
April 2016: Journal of Orthopaedic Surgery
H Zhang, X Liu, L Hong, X S Geng, H Feng
OBJECTIVE: To describe the clinical results of a one-stage operation for posterior cruciate ligament reconstruction and a posterolateral corner reconstruction of popliteus tendon reconstruction, compared with an open popliteofibular ligament reconstruction. METHODS: Our study included 33 patients who had undergone posterior cruciate ligament reconstruction with use of an achilles tendon-bone allograft and posterolateral corner reconstruction with arthroscopic anatomical reconstruction of popliteus tendon or open reconstruction of popliteofibular ligament...
April 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Gary J Browne, Peter Lj Barnett
Young athletes are specialising in sports at a younger age, placing the developing musculoskeletal system under considerable stress. Overuse injuries such as apophysitis are chronic in nature and account for a large proportion of musculoskeletal injuries suffered by young athletes; however, with an increased emphasis on success in sport, tendinopathy and fatigue fractures are now being reported with increasing frequency, in the adolescent population. Correct diagnosis and early protection, rest, ice, compression and elevation therapy is critical, along with supervised rehabilitation an expert in paediatric and adolescent sports medicine...
February 2016: Journal of Paediatrics and Child Health
Morteza Khodaee, Rajwinder S Deu
Unilateral ankle swelling is a relatively common presenting complaint among athletes and non-athletes. Due to its broad differential diagnosis, a comprehensive evaluation beginning with history and physical examination are recommended. Imaging including plain radiography, ultrasound (US), and magnetic resonance imaging (MRI) are preferred modalities. Aspiration of a local fluctuating mass may help with the diagnosis and management of some of these conditions. Morel-Lavallée lesion (MLL) is a rare condition consisting of a closed degloving injury caused by forces of pressure and shear stress between the subcutaneous tissue and the superficial fascia or bone...
April 8, 2016: Journal of Sports Medicine and Physical Fitness
H Toumi, G Larguech, M Cherief, A Batakis, R Hambli, R Jennane, T M Best, E Lespessailles
UNLABELLED: Clinically the sites of Achilles Tendon (AT) overuse conditions can be divided into the tendon mid-portion and osteotendinous attachment. PURPOSE: We propose an anatomical analysis of the triceps surae musculotendon unit that could provide a possible anatomic explanation for these 2 sites of injury. METHOD: Twelve cadavers (age 74±7 years) were studied. In both legs, calf muscles (lateral gastrocnemius (LG), medial gastrocnemius (MG) and soleus) were dissected and their volumes measured...
May 3, 2016: Journal of Biomechanics
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