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Stress radiography of joint

K Bušková, D Kuběnová, M Tuček
Fractures of the fifth metatarsal base are among the most common fractures of the foot. They are typically caused by indirect violence during sports activities. This region is also a site where stress fractures occur frequently. Diagnosis is based on the patients medical history, clinical examination and imaging methods. The fundamental imaging method is radiography of the foot in three views. MRI is used primarily for early diagnosis of stress fractures. CT examination is beneficial mainly in complex foot injuries, in order to rule out associated fractures...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Ryan Tai, Tyson Bolinske, Varand Ghazikhanian, Jacob C Mandell
OBJECTIVE: To determine the prevalence of intra-articular gas (IAG) on elbow radiography and evaluate variables, including IAG, as predictors of UCL injury. MATERIALS AND METHODS: This IRB-approved retrospective study consisted of 241 consecutive elbow radiographic studies containing AP radiographs with valgus stress of both symptomatic and asymptomatic sides in 234 patients. The IAG, medial joint space (MJS), and MJS difference between the symptomatic and asymptomatic elbow (MJSD) were evaluated by two readers, as well as patient age, gender, sport played, and handedness...
January 10, 2018: Skeletal Radiology
Fernando Ruiz Santiago, Alberto Martínez Martínez, Pablo Tomás Muñoz, José Pozo Sánchez, Antonio Zarza Pérez
This extended review tries to cover the imaging findings of the wide range of shoulder injuries secondary to shoulder joint instability. Usefulness of the different imaging methods is stressed, including radiography, computed tomography (CT) and magnetic resonance. The main topics to be covered include traumatic, atraumatic and minor instability syndromes. Radiography may show bone abnormalities associated to instability, including developmental and post-traumatic changes. CT is the best technique depicting and quantifying skeletal changes...
August 2017: Quantitative Imaging in Medicine and Surgery
Rachel J Hill, Holly M Mason, Gavin Yeip, Samer S Merchant, Aaron L Olsen, Rusty D Stott, Arnaud J Van Wettere, Eadric Bressel, Jeffrey B Mason
Large animal models of osteoarthritis are a necessary testing ground for FDA approval of human medicine applications. Sheep models have advantages over other available large animals, but development and progression of osteoarthritis in sheep is exceedingly slow, which handicaps progress in development of potential treatments. We combined oblique angle forced exercise to increase stress on the stifle, with surgical destabilization to hasten the development of osteoarthritis in ewes. Methods for early detection of clinical signs included radiography, urine, and serum biomarker assays and gait analysis and ex vivo we used microcomputed tomography and macroscopic joint analysis...
2017: Arthritis
Benjamin Erdle, Kaywan Izadpanah, Martin Jaeger, Patrizia Jensen, Lukas Konstantinidis, Jörn Zwingmann, Norbert P Südkamp, Dirk Maier
INTRODUCTION: Controversy exists on optimal operative treatment of vertically unstable Neer IIB lateral clavicle fractures. Aim of this study was to analyse and compare clinical and radiological results and complications of locking plate osteosynthesis (LPO) versus hook plate osteosynthesis (HPO) with acromioclavicular joint (ACJ) stabilization. The hypothesis was, that HPO would recreate coracoclavicular stability more effectively and potentially lead to a superior outcome. METHODS: This retrospective, observational cohort study included 32 patients (19 HPO, 13 LPO) with a mean age of 44...
May 2017: Archives of Orthopaedic and Trauma Surgery
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
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
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...
November 2016: Journal of Shoulder and Elbow Surgery
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
Patrick C McCulloch, Hugh L Jones, Kendall Hamilton, Michael G Hogen, Jonathan E Gold, Philip C Noble
BACKGROUND: The objective of rehabilitation following meniscal repair is to promote healing by limiting stresses on repairs, while simultaneously preserving muscle strength and joint motion. Both protective protocols limiting weight bearing and accelerated which do not, have shown clinical success. This study assesses the effects of physiologic gait loading on the kinematic behavior of a repaired medial meniscus. METHODS: The medial menisci of eight fresh cadaveric knees were implanted with arrays of six 0...
December 2016: Journal of Experimental Orthopaedics
Nathaniel S Nye, Carlton J Covey, Lucas Sheldon, Bryant Webber, Mary Pawlak, Barry Boden, Anthony Beutler
CONTEXT: Lower extremity stress fractures among athletes and military recruits cause significant morbidity, fiscal costs, and time lost from sport or training. During fiscal years (FY) 2012 to 2014, 1218 US Air Force trainees at Joint Base San Antonio-Lackland, Texas, were diagnosed with stress fracture(s). Diagnosis relied heavily on bone scans, often very early in clinical course and often in preference to magnetic resonance imaging (MRI), highlighting the need for an evidence-based algorithm for stress injury diagnosis and initial management...
May 2016: Sports Health
Fernando Ruiz Santiago, Alicia Santiago Chinchilla, Afshin Ansari, Luis Guzmán Álvarez, Maria Del Mar Castellano García, Alberto Martínez Martínez, Juan Tercedor Sánchez
Hip pain can have multiple causes, including intra-articular, juxta-articular, and referred pain, mainly from spine or sacroiliac joints. In this review, we discuss the causes of intra-articular hip pain from childhood to adulthood and the role of the appropriate imaging techniques according to clinical suspicion and age of the patient. Stress is put on the findings of radiographs, currently considered the first imaging technique, not only in older people with degenerative disease but also in young people without osteoarthritis...
2016: Radiology Research and Practice
Seung-Suk Seo, Chang-Wan Kim, Jin-Hyuk Seo, Do-Hun Kim, Chang-Rack Lee
BACKGROUND: Medial open-wedge high tibial osteotomy (OWHTO) requires the release of the superficial medial collateral ligament (sMCL). However, research on medial laxity among patients who undergo OWHTO is rare. PURPOSE: To evaluate the changes in medial laxity of the knee joint as related to the complete release of the sMCL through serial valgus stress radiographs in patients who underwent OWHTO. STUDY DESIGN: Cohort study; Level of evidence, 2...
April 2016: American Journal of Sports Medicine
Patrick J Battaglia, Kate Craig, Norman W Kettner
OBJECTIVE: The purpose of this case report is to describe the diagnostic value of ultrasonography (US) in a patient with injury to the lateral ligaments of the ankle with concomitant ankle joint osteoarthritis and anterior impingement. CLINICAL FEATURES: A 28-year-old male had a history of an inversion injury of the left ankle. Diagnostic US of the left ankle using an 8- to 15-MHz linear array transducer demonstrated a full thickness tear of the anterior talofibular ligament, partial thickness tearing of the calcaneofibular ligament, and laxity of the ankle with varus stress testing...
December 2015: Journal of Chiropractic Medicine
Sho Kohyama, Akihiro Kanamori, Toshikazu Tanaka, Yuki Hara, Masashi Yamazaki
BACKGROUND: The carpal scaphoid is the most commonly fractured carpal bone in young adults after a fall on an outstretched arm that results in acute dorsal flexion of the wrist. However, stress fractures of the scaphoid are relatively rare. To the best of our knowledge, we describe the first case in the literature of carpal scaphoid stress fracture in a tennis player. CASE PRESENTATION: An 18-year-old Japanese man who was an elite junior tennis player was referred to our hospital after radiography and computed tomography revealed a carpal scaphoid fracture...
January 18, 2016: Journal of Medical Case Reports
D Wenger, C Siversson, L E Dahlberg, C J Tiderius
OBJECTIVE: Developmental dysplasia of the hip (DDH) is associated with an increased risk of early hip osteoarthritis (OA). We aimed to examine the outcome at the completion of growth in a cohort of children who had residual acetabular dysplasia at age 1 year following early treatment for neonatal instability of the hip (NIH). DESIGN: We examined 21 of 30 subjects who had been treated with the von Rosen splint neonatally for NIH and had residual acetabular dysplasia at age 1 year...
March 2016: Osteoarthritis and Cartilage
Thomas Mittlmeier, Alice Wichelhaus
PURPOSE: Subtalar joint instability may frequently be overlooked and erroneously be integrated under the diagnosis of ankle joint instability. It was the scope of this review to characterize the present state-of-art with regard to the adequate diagnosis and treatment. METHODS: While the clinical picture is mostly inconclusive for subtalar joint instability, a high degree of suspicion for this diagnosis is needed to employ weight-bearing x-rays, standardized stress radiography, CT scanning and MRI to further elucidate the etiopathology RESULTS: Geometrical reasons as hindfoot deformities, isolated or combined injuries or instabilities in conjunction with the ankle ligament complex do exist which should be differentiated in detail and classified to indicate the adequate treatment...
December 2015: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Jose Javier Dominguez Gonzalez, Pedro Zorrilla Ribot, Elba Nieves Perez Riverol, Ana Sarai Martinez Rodriguez
In any thumb injury, particularly one caused by hyperabduction, an ulnar collateral ligament lesion (gamekeeper's or skier's thumb) must be considered. If the diagnosis is suspected, and radiographs show no fracture, comparative radiographs should be obtained in forced valgus. This examination, which uses a stress test to cause joint tilt, is crucial in making an accurate diagnosis and deciding on the most appropriate therapeutic approach. The forced valgus maneuver typically is performed by the examiner, who must stay with the patient in the radiography room and wear radiologic protection...
August 2015: American Journal of Orthopedics
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