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https://www.readbyqxmd.com/read/29042408/impact-of-restricting-diagnostic-imaging-reimbursement-for-uncomplicated-low-back-pain-in-ontario-a-population-based-interrupted-time-series-analysis
#1
Benjamin Fine, Susan E Schultz, Lawrence White, David Henry
BACKGROUND: In 2012, the Ontario government withdrew public insurance coverage of imaging tests for uncomplicated low back pain. We studied the impact of this restriction on test ordering by physicians. METHODS: We compared the numbers of lumbar spine radiography, computed tomography (CT) and single-segment magnetic resonance imaging (MRI) studies ordered by physicians in the 3 years before and after the policy change. We linked claims data from the Ontario Health Insurance Program with physician details to calculate rates per test-ordering physician...
October 13, 2017: CMAJ Open
https://www.readbyqxmd.com/read/29039154/severe-headache-following-ozone-therapy-pneumocephalus
#2
Hüseyin Toman, Uğur Özdemir, Hasan Ali Kiraz, Nurettin Lüleci
Pneumocephalus is defined as air in the cranial cavity. Pneumocephalus can result from inadvertent dural puncture during lumbar epidural anesthesia or epidural steroid injection. Presently described is case of 41-year-old woman who had undergone lumbar disc hernia operation but due to ongoing complaints, was diagnosed as having failed back surgery syndrome. Percutaneous epidural neuroplasty was performed. In the operating room, under sterile conditions and under sedoanalgesia, Racz catheter was inserted in caudal area and guided to epidural area with scope...
July 2017: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
https://www.readbyqxmd.com/read/29034045/severe-obstructive-calcification-of-the-descending-aorta-a-case-report-of-coral-reef-aorta
#3
Takahiro Ishigaki, Hitoshi Matsuda, Soichiro Henmi, Masato Yoshida, Nobuhiko Mukohara
An 82-year-old man suffering from lower back pain and dyspnea presented to our institute in a state of shock. Computed tomography showed subtotal occlusion of the descending aorta with massive atherosclerotic calcification. As the proximal portion of the superior mesenteric artery was obstructed, emergency bypass from the right axillary artery to the bilateral external iliac arteries was performed, but the patient died 2 days later. Autopsy revealed that reddish-brown and verrucous masses obstructed the descending aorta, and high-grade thickening of the intima and extensive deposits of calcium in the lumina and medial layer were detected in the descending aorta histologically...
June 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29034040/infected-thoracic-aortic-aneurysm-caused-by-helicobacter-cinaedi
#4
Kazuo Kushimoto, Ryusuke Yonekura, Masayoshi Umesue, Yumi Oshiro, Hitoshi Yamasaki, Kenji Yoshida, Kensuke Oryoji, Eisuke Yokota
The causative organism is not identified in some cases of infected aneurysms, a life-threatening condition. A 68-year-old man presented with chest/back pain and a 1-year history of intermittent fever and fatigue. Computed tomography revealed a thoracic aortic aneurysm. After several negative blood cultures, he was eventually diagnosed with an infected aneurysm caused by Helicobacter cinaedi via gene analysis of an aortic tissue specimen. As H. cinaedi is a low-virulence bacterium, infection with this pathogen should be suspected in cases of aortic aneurysms with unidentified causative organism and a long history of subjective symptoms...
June 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29034025/replacement-of-the-thoracoabdominal-aorta-after-endovascular-abdominal-aneurysm-repair-for-ruptured-infected-aneurysm-a-case-report
#5
Nobuo Kondo, Kentaro Tamura, Taichi Sakaguchi, Genta Chikazawa, Hidenori Yoshitaka
A 73-year-old man underwent emergency endovascular abdominal aneurysm repair (EVAR) for a ruptured infected abdominal aortic aneurysm. Two years after EVAR, he was admitted with a spiking fever and left lower back pain. Computed tomography scan revealed not only recurrent graft infection with psoas abscess but also infection around the orifice of the superior mesenteric artery. Because conservative medical therapy with antibiotics could not control the infection, we performed complete removal of the infected stent graft, debridement of psoas abscess, and in situ replacement of the thoracoabdominal aorta using rifampicin-soaked prosthetic grafts, followed by the omental flap...
March 24, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29034023/retrograde-ascending-aortic-dissection-after-stent-grafting-for-stanford-type-b-aortic-dissection-with-severe-limb-ischemia
#6
Yoshiro Higuchi, Masato Tochii, Yoshiyuki Takami, Akihiro Kobayashi, Tsutomu Yanagisawa, Kentaro Amano, Yusuke Sakurai, Michiko Ishida, Hiroshi Ishikawa, Koji Hattori, Yasushi Takagi
We report a rare case of retrograde Stanford type A aortic dissection after endovascular repair for complicated Stanford type B aortic dissection. A 45-year-old man presented with a sudden onset of back pain and was transferred to our hospital. Computed tomography demonstrated acute Stanford type B aortic dissection with lower limb ischemia. Emergency endovascular surgery was planned for repair of the Stanford type B aortic dissection. The patient suddenly developed recurrent chest pain 10 days after the initial procedure...
March 24, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29033685/evaluation-and-identification-of-lumbosacral-transitional-vertebra-causing-intractable-low-back-pain-utilizing-bone-single-photon-emission-tomography-with-computed-tomography
#7
Khulood S Al Riyami, Suliman M Alahmed, Ziauddin Z Saad, Jamshed Bomanji
The cause of low back pain due to lumbosacral transitional vertebra (LSTV) still remains a debated topic. Functional imaging with bone scintigraphy has been a valuable adjunct in its assessment; however, in recent years, the additional utility of single-photon emission tomography with computed tomography (SPECT/CT) is evolving as the imaging modality of choice in identifying range of complex lower back pain sources, leading to the provision of suitable treatment options. We present a case demonstrating a variant type of LSTV as a source of pain localized and delineated on hybrid SPECT/CT imaging treated by minimally invasive microendoscopic resection of the pseudoarticulations...
October 2017: World Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/29021883/brodie-s-abscess-of-posterior-ilium-with-gluteal-syndrome-an-unusual-cause-of-paediatric-low-back-pain-a-case-report
#8
G Behera, M Poduval, D K Patro, S Sahoo
Brodie's abscess is a variety of subacute osteomyelitis with a long duration of presentation and intermittent pain. It usually involves the metaphyseal region of long bones of the lower limbs. Brodie's abscess of pelvic bone is very rare. Involvement of posterior ilium with gluteal syndrome is extremely unusual and can be easily missed or misdiagnosed. We present a 9-year old boy who reported to us with intermittent low back pain of three months duration without any other constitutional symptoms. Clinically, there was mild tenderness over the posterior ilium...
July 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29019888/an-upper-cervical-cord-compression-secondary-to-occult-follicular-thyroid-carcinoma-metastases-successfully-treated-with-multiple-radioiodine-therapies-a-clinical-case-report
#9
Ping Dong, Ni Chen, Lin Li, Rui Huang
RATIONALE: The spine is the most common site of bone metastases due to thyroid cancer; however, spinal cord compression as a complication of metastatic thyroid cancer is very rare. PATIENT CONCERNS: A 48-year-old female patient was presented to the Neurosurgical Department, complaining of progressive back neck pain with bilateral upper extremities numbness and weakness for 4 months. DIAGNOSIS: Imaging studies revealed osteolytic destruction in bodies and accessories of the second and third cervical vertebrae with a huge soft-tissue mass compressing spinal cord and causing swelling...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29018654/double-crush-of-l5-spinal-nerve-root-due-to-l4-5-lateral-recess-stenosis-and-bony-spur-formation-of-lumbosacral-transitional-vertebra-pseudoarticulation-a-case-report-and-review
#10
Motoyuki Iwasaki, Masahiko Akiyama, Izumi Koyanagi, Yoshimasa Niiya, Tatsuo Ihara, Kiyohiro Houkin
We present a case of double-crushed L5 nerve root symptoms caused by inside and outside of the spinal canal with spur formation of the lumbosacral transitional vertebra (LSTV). A 78-year-old man presented with 7-year history of moderate paresis of his toe and left leg pain when walking. Magnetic resonance imaging (MRI) revealed spinal stenosis at the L3/4 and 4/5 spinal levels and he underwent wide fenestration of both levels. Leg pain disappeared and 6-min walk distance (6MWD) improved after surgery, however, the numbness in his toes increased and 6MWD decreased 9 months after surgery...
October 2017: NMC Case Rep J
https://www.readbyqxmd.com/read/29018631/multi-parameter-ensemble-learning-for-automated-vertebral-body-segmentation-in-heterogeneously-acquired-clinical-mr-images
#11
Bilwaj Gaonkar, Yihao Xia, Diane S Villaroman, Allison Ko, Mark Attiah, Joel S Beckett, Luke Macyszyn
The development of quantitative imaging biomarkers in medicine requires automatic delineation of relevant anatomical structures using available imaging data. However, this task is complicated in clinical medicine due to the variation in scanning parameters and protocols, even within a single medical center. Existing literature on automatic image segmentation using MR data is based on the analysis of highly homogenous images obtained using a fixed set of pulse sequence parameters (TR/TE). Unfortunately, algorithms that operate on fixed scanning parameters do not avail themselves to real-world daily clinical use due to the existing variation in scanning parameters and protocols...
2017: IEEE Journal of Translational Engineering in Health and Medicine
https://www.readbyqxmd.com/read/28987432/abdominal-aortic-emergencies
#12
REVIEW
Christie Lech, Anand Swaminathan
This article discusses abdominal aortic emergencies. There is a common thread of risk factors and causes of these diseases, including age, male gender, hypertension, dyslipidemia, and connective tissue disorders. The most common presenting symptom of these disorders is pain, usually in the chest, flank, abdomen, or back. Computed tomography scan is the gold standard for diagnosis of pathologic conditions of the aorta in the hemodynamically stable patient. Treatment consists of a combination of blood pressure and heart rate control and, in many cases, emergent surgical intervention...
November 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28976332/bone-single-photon-emission-computed-tomography-in-the-detection-of-sacroiliitis-in-seronegative-spondyloarthritis-a-comparison-with-magnetic-resonance-imaging
#13
Theodoros Pipikos, Dimitrios Kassimos, George Angelidis, John Koutsikos
OBJECTIVE: Seronegative spondyloarthritis (SpA) is characterized by chronic inflammation affecting the axial skeleton, entheses and occasionally peripheral joints. The involvement of the sacroiliac joints, sacroiliitis, is considered as a pathognomonic radiographic finding. Magnetic resonance imaging (MRI) is the method of choice for its early detection. Bone scintigraphy (BS) is characterized by high sensitivity in the diagnosis of bone and articular diseases. Limited value of BS in the diagnosis of sacroiliitis may be attributed to the use of planar imaging...
October 3, 2017: Molecular Imaging and Radionuclide Therapy
https://www.readbyqxmd.com/read/28972599/determination-of-pain-in-musculoskeletal-system-reported-by-office-workers-and-the-pain-risk-factors
#14
Sevim Celik, Kadir Celik, Elif Dirimese, Nurten Taşdemir, Tarik Arik, İbrahim Büyükkara
OBJECTIVES: This research was conducted as a cross-sectional descriptive study aimed at determining the existence of pain in the musculoskeletal system among office workers and the reasons for it. MATERIAL AND METHODS: The sample consisted of 528 office workers. Collection of data was achieved using a questionnaire prepared by the researchers in line with information from the literature. RESULTS: The male and female office workers most frequently complained of pain in the lower back (55...
October 2, 2017: International Journal of Occupational Medicine and Environmental Health
https://www.readbyqxmd.com/read/28964934/a-nomogram-predicting-the-need-for-abdominal-and-pelvic-computed-tomography-in-blunt-trauma-patients-a-retrospective-cohort-study
#15
Jin Young Lee, Dae Hyun Cho, Jae Gil Lee, Hyejung Shin, Yeon Ju Lee, Seung Hwan Lee
BACKGROUND: Abdominal and pelvic computed tomography (APCT) has become the preferred means for the initial evaluation of blunt trauma patients. However, computed tomography examination has some disadvantages, such as radiation exposure, the requirement for intravenous iodinated contrast medium, high cost, and time. We aimed to develop a nomogram to predict the need for APCT scanning after the primary survey of blunt trauma patients. MATERIALS AND METHODS: We conducted a retrospective observational cohort study at a single-center and reviewed medical records of 972 trauma patients admitted between January 2013 and June 2016...
September 28, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28958067/an-intra-aortic-floating-metastatic-malignancy-of-unknown-primary-origin
#16
Yoshinori Kuroda, Tetsuro Uchida, Jun Hayashi, Mitsuaki Sadahiro
A 69-year-old man with sudden strong back pain was transported to our hospital by ambulance. The computed tomography scan revealed an intra-aortic floating mass with a stalk arising from the descending aortic wall, which was thought to be a thrombus. The floating mass displayed the characteristics of a thrombus rather than a neoplastic tumour on magnetic resonance imaging scan. Under extracorporeal circulation, the descending aorta was cut open, and the mass was resected. Subsequently, a stent graft was placed to cover the abnormal aortic intima to prevent recurrent thrombus formation...
August 29, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28955005/accurate-diagnosis-of-chronic-low-back-pain-in-a-high-level-college-athlete-a-case-report
#17
Kenji Yokoyama, Kazuta Yamashita, Masatoshi Morimoto, Fumitake Tezuka, Fumio Hayashi, Yoichiro Takata, Toshinori Sakai, Kosaku Higashino, Takashi Chikawa, Hiroshi Yonezu, Akihiro Nagamachi, Koichi Sairyo
A 21-year-old woman who was high-level college softball player presented with a 6-month history of low back pain that had been treated unsuccessfully by medication at local clinics. There was tenderness in the left paravertebral muscle at the lower lumbar level. X-ray and computed tomography revealed congenital scoliosis and an L6 hemivertebra. Short tau inversion recovery magnetic resonance imaging showed a fluid collection at the left L6-S1 facet joint. We performed a diagnostic facet injection, consisting of 1% lidocaine and steroids, that was infiltrated into the left facet joint at L6-S1...
2017: Journal of Medical Investigation: JMI
https://www.readbyqxmd.com/read/28946543/a-misdiagnosed-case-of-osteoid-osteoma-of-l5
#18
Xiaoyong Sheng, Guangyong Cai, Xingjun Gong, Zouying Yao, Ye Zhu
Clinically, it is difficult to differentiate osteoid osteoma, more than 50% of which occur in the fibia or tibia, from other diseases, i.e. spinal degenerative diseases, inflammatory and noninflammatory arthritis. In this case report, we presented an unusual case of lumbar osteoid osteoma in a 38-year-old male, who experienced low back pain and sciatica as initial symptoms. The patient was initially misdiagnosed as lumbar disc herniation for more than 10 years. With the usage of computed tomography (CT) and magnetic resonance imaging (MRI), the patient was finally diagnosed as osteoid osteoma in L5...
September 8, 2017: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/28944123/preventing-cushing-iatrogenic-cushing-syndrome-due-to-ritonavir-fluticasone-interaction
#19
Fasil Tiruneh, Ahmad Awan, Abiot Didana, Saumil Doshi
Ritonavir is commonly used in low doses to boost plasma levels of protease inhibitors in patients with human immunodeficiency virus (HIV) infections. It is also a potent inhibitor of cytochrome P450. We present a 50-year-old African American male with past medical history of HIV on highly active antiretroviral therapy (HAART), which also included ritonavir and long standing asthma that has been treated with inhaled fluticasone, who presented with back pain. He had central obesity, prominent abdominal striae and wasted extremities on physical examination...
July 17, 2017: Curēus
https://www.readbyqxmd.com/read/28942467/surgical-treatment-of-a-lumbar-aneurysmal-bone-cyst-using-percutaneous-endoscopic-lumbar-discectomy
#20
Isao Shibuya, Akira Dezawa, Shigeki Urayama, Shigeru Nakamura
PURPOSE: Aneurysmal bone cysts of the lumbar spine are usually treated by curettage followed by bone or bioactive ceramics grafting. Here, we present the first case of an aneurysmal bone cyst of the lumbar spine treated by percutaneous endoscopic lumbar discectomy (PELD). METHODS: We describe the clinical characteristics of the patient including the radiological and pathological findings of the tumor and the surgical technique used. RESULTS: A 15-year-old boy presented with low back pain, and he was diagnosed with an aneurysmal bone cyst of the L3 vertebra based on radiological findings, including plain radiograph, computed tomography, and magnetic resonance imaging...
September 23, 2017: European Spine Journal
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