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Sovira Tan, Michael M Ward
PURPOSE OF REVIEW: Computed tomography (CT) is increasingly being used in ankylosing spondylitis (AS) for imaging the spine and sacroiliac joint (SIJ). We review new insights to diagnosis and evaluation revealed by the use of CT. RECENT FINDINGS: Studies using low-dose CT in AS to detect syndesmophytes can image the entire spine, but semiquantitative scoring of the scans by human readers decreases the reliability and validity of this method. The thoracic spine is the segment most involved with syndesmophytes...
March 13, 2018: Current Opinion in Rheumatology
Rabia Iqbal, Tahir Zahoor, Nuzhat Huma, Amer Jamil, Gülhan Ünlü
Longevity of probiotic is the main concern for getting maximum benefits when added in food product. Bifidobacterium, a probiotic, tends to lose its viability during gastrointestinal track (GIT) transit and storage of food. Their viability can be enhanced through microencapsulation technology. In this study, Bifidobacterium bifidum (B. bifidum) ATCC 35914 was encapsulated by using two experimental plans. In the first plan, chitosan (CH) at 0.6, 0.8, and 1.0% and sodium alginate (SA) at 4, 5, and 6% were used...
March 12, 2018: Probiotics and Antimicrobial Proteins
Amin Joukar, Anoli Shah, Ali Kiapour, Ardalan Seyed Vosoughi, Bradley Duhon, Anand K Agarwal, Hossein Elgafy, Nabil Ebraheim, Vijay K Goel
STUDY DESIGN: The comparison of sacroiliac joint (SIJ) angular motions, pelvis ligaments strain, load sharing, and stress distribution across the joint for male and female spine-pelvis-femur models using finite element analysis. OBJECTIVE: To quantify biomechanical parameters at SIJ for all motions for both male and female models. SUMMARY OF BACKGROUND DATA: SIJ has been recognized as a main source of pain in 13% to 30% of patients with low back pain...
March 5, 2018: Spine
Yushane C Shih, Brian P Beaubien, Qingshan Chen, Jonathan N Sembrano
BACKGROUND CONTEXT: Fusion typically consists of joint preparation, grafting and rigid fixation. Fusion has been successfully used to treat symptomatic disruptions of the SIJ and degenerative sacroiliitis using purpose-specific, threaded implants. The biomechanical performance of these systems is important but has not been studied. PURPOSE: To compare two techniques for placing primary (12.5mm) and secondary (8.5mm) implants across the SIJ. STUDY DESIGN: A human cadaveric biomechanical study of sacroiliac joint (SIJ) fixation...
February 23, 2018: Spine Journal: Official Journal of the North American Spine Society
Cédric Lukas, Catherine Cyteval, Maxime Dougados, Ulrich Weber
Recognition of axial spondyloarthritis (SpA) remains challenging, as no unique reference standard is available to ascertain diagnosis. Imaging procedures have been used for long in the field, in particular pelvic radiography, to capture structural changes evocative of sacroiliitis, the key feature in SpA. The introduction of MRI of the sacroiliac joints (SIJs) has led to a major shift in recognition of the disorder. MRI has been shown to detect the initial inflammatory processes, in particular osteitis depicted by bone marrow oedema, even in patients having not yet developed structural lesions...
2018: RMD Open
Ulrich Weber, Anne Grethe Jurik, Anna Zejden, Ejnar Larsen, Steen Hylgaard Jørgensen, Kaspar Rufibach, Christian Schioldan, Søren Schmidt-Olsen
OBJECTIVE: Low grade bone marrow edema (BME) was reported in the sacroiliac joints (SIJ) of 25% of healthy individuals and mechanical back pain patients, challenging the imaging discrimination from early spondyloarthritis (SpA). It is unknown whether stress injury in competition sports may trigger BME. We explored frequency and anatomical distribution of SIJ MRI lesions in recreational and elite athletes. METHODS: After pre-test calibration, semicoronal SIJ MRI scans of 20 recreational runners (RR) before/after running and 22 elite ice-hockey players (IP) were assessed by 3 blinded readers for BME and structural lesions using an SIJ quadrant-based module...
February 12, 2018: Arthritis & Rheumatology
William W Cross, Arnold Delbridge, Donald Hales, Louis C Fielding
Background: Sacroiliac joint (SIJ) degeneration is a common source of low back pain (LBP). Minimally invasive (MI) SIJ fusion procedures have demonstrated meaningful clinical improvement. A recently developed MI SIJ fusion system incorporates decortication, placement of bone graft and fixation with threaded implants (DC/BG/TF). Patients and Methods: Nineteen patients who had MI SIJ fusion with DC/BG/TF were enrolled at three centers. Fusion was assessed in CT images obtained 12 and 24 months postoperatively by an independent radiographic core laboratory...
2018: Open Orthopaedics Journal
Hui-Hui Sun, Su-Yang Zhuang, Xin Hong, Xin-Hui Xie, Lei Zhu, Xiao-Tao Wu
BACKGROUND: Cooled radiofrequency procedure is a novel minimally invasive surgical technique and has been occasionally utilized in managing chronic sacroiliac joint (SIJ) pain. A meta-analysis was conducted to systematically assess the efficacy and safety of using cooled radiofrequency in treating patients with chronic SIJ pain in terms of pain and disability relief, patients' satisfaction degree as well as complications. METHODS: Studies of using cooled radiofrequency procedure in managing SIJ pain were retrieved from Medline and Web of Science according to inclusion and exclusion criteria...
February 2018: Medicine (Baltimore)
Paurush Babbar, Nitin Yerram, Andrew Sun, Sij Hemal, Prithvi Murthy, Darren Bryk, Naveen Nandanan, Yaw Nyame, Maxx Caveney, Ryan Nelson, Ryan Berglund
Robotic surgery in the treatment in certain urological diseases has become a mainstay. With the increasing use of the robotic platform, some surgeries which were historically performed open have transitioned to a minimally invasive technique. Recently, the robotic approach has become more utilized for ureteral reconstruction. In this article, the authors review the surgical techniques for a number of major ureteral reconstuctive surgeries and briefly discuss the outcomes reported in the literature.
January 2018: Urology Annals
Shannon L Roberts, Alison Stout, Eldon Y Loh, Nathan Swain, Paul Dreyfuss, Anne M Agur
Objective: To compare the percentage of sacral lateral branches (LBs) that would be captured if lesions were created by seven current sacroiliac joint (SIJ) radiofrequency ablation (RFA) techniques: three monopolar and four bipolar. Design: Cadaveric fluoroscopy study. Setting: Anatomy and surgical skills laboratories. Subjects: Forty cadaveric SIJs. Methods: LBs were exposed, radiopaque wires were sutured to LBs, and anterior-posterior fluoroscopic images through the S1 superior endplate were obtained...
February 5, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
F van Stiphout, J E F Zwart-van Rijkom, J Versmissen, H Koffijberg, J E C M Aarts, I H van der Sijs, T van Gelder, R A de Man, C B Roes, A C G Egberts, E W M T Ter Braak
AIMS: Electronic prescribing systems may improve medication safety, but only when used appropriately. Effects of a task-analysis based training were evaluated in the outpatient setting on clinical, learning and behavioral outcomes, compared with usual educational approach. METHODS: Multicenter, cluster-randomized trial (MEDUCATE trial) with physicians as unit of analysis. SETTING: Outpatient clinics of two academic hospitals. PARTICIPANTS: Specialist and residents of internal medicine and their patients...
February 4, 2018: British Journal of Clinical Pharmacology
Arman Taheri, Mahbod Lajevardi, Mohsen Abad, Jayran Zebardast, Sanaz Shaabani
BACKGROUND: The anatomic characteristics of the sacroiliac joint (SIJ) make it difficult to achieve intraarticular injection without radiologic guidance. The classic C-arm guided SIJ intervention technique is difficult. Here we describe a new and simple method for SIJ intraarticular intervention. OBJECTIVE: This study aims to introduce a new, simple approach for SIJ intraarticular intervention. STUDY DESIGN: An observational case series study...
January 2018: Pain Physician
Désirée van der Heijde, Xenofon Baraliakos, Kay-Geert A Hermann, Robert B M Landewé, Pedro M Machado, Walter P Maksymowych, Owen R Davies, Natasha de Peyrecave, Bengt Hoepken, Lars Bauer, Tommi Nurminen, Juergen Braun
OBJECTIVES: To report 4-year imaging outcomes in the RAPID-axSpA (NCT01087762) study of patients with ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA), treated with certolizumab pegol (CZP). METHODS: This phase III, randomised trial was placebo-controlled and double-blind to week 24, dose-blind to week 48 and open-label to week 204. Patients fulfilling the Assessment of Spondyloarthritis International Society (ASAS) axSpA criteria with active disease were stratified (AS/nr-axSpA) according to the modified New York (mNY) criteria at randomisation...
January 17, 2018: Annals of the Rheumatic Diseases
Kemal Erol, Kevser Gok, Gizem Cengiz, Gamze Kilic, Erkan Kilic, Salih Ozgocmen
OBJECTIVE: Although the prevalence of peripheral and extra-articular disease in ankylosing spondylitis (AS) has been assessed in many studies, data on non-radiographic axial spondyloarthritis (nr-axSpA) is scanty. The aim of this study was first, to compare radiographic-axSpA/AS (r-axSpA/AS) and nr-axSpA concerning peripheral arthritis and extra-articular manifestations (EAMs), and second, to assess potential differences between patient subgroups with or without EAMs regarding disease burden...
January 16, 2018: Acta Reumatológica Portuguesa
Eiichi Murakami, Daisuke Kurosawa, Toshimi Aizawa
OBJECTIVE: Pain at or around the posterior superior iliac spine (PSIS) is characteristic of sacroiliac joint (SIJ) -related pain. This pain can be treated by either a peri- or intra-articular injection into the joint, with the former being much easier to perform. We investigated whether peri- or intra-articular injections were more frequently effective in patients with SIJ-related pain, and aimed to create an efficient treatment strategy for SIJ-related pain at or around the PSIS. DESIGN: Prospective case-control study...
February 2018: Clinical Neurology and Neurosurgery
Hamid Abbasi, John A Hipp
Sacroiliac joint fusions (SIJF) have been the subject of many research studies. The technical success of an SIJF is in part determined by whether osseous bridging occurs across the sacroiliac joint (SIJ). However, no validated SIJF assessment method has been described. Our objective was to document previously described SIJF assessment methods and define and validate a detailed assessment system for SIJF. Our results are only intended to establish computed tomography (CT)-based guidelines for SIJF to be used in a subsequent large clinical study to correlate them with clinical outcomes...
October 20, 2017: Curēus
Keita Nishi, Toshiyuki Tsurumoto, Keishi Okamoto, Keiko Ogami-Takamura, Takashi Hasegawa, Takefumi Moriuchi, Junya Sakamoto, Joichi Oyamada, Toshio Higashi, Yoshitaka Manabe, Kazunobu Saiki
The sacroiliac joint (SIJ) is responsible for weight transmission between the spine and lower extremity. However, details of the structure and function of the SIJ remain unclear. In a previous study, we devised a method of quantitatively evaluating the level of degeneration of the SIJ using an age estimation procedure for the auricular surface of the ilium. Our results in that study suggested that the degree of degeneration of the joint surface may be associated with the morphology of the auricular surface of the ilium...
February 2018: Journal of Anatomy
Danmin Wang, Zhiduo Hou, Yao Gong, Subiao Chen, Ling Lin, Zhengyu Xiao
OBJECTIVE: This study aimed to assess the relationship between bone marrow edema (BME) on magnetic resonance imaging (MRI) and bone mineral density (BMD) in patients with ankylosing spondylitis (AS). METHODS: The study included 333 patients with AS who underwent BMD measurements and axial MRI. Additionally, 106 normal controls were included. The modified New York criteria were used as the classification criteria of AS. Clinical, laboratory, and imaging data were collected and analyzed...
2017: PloS One
Alison Stout, Paul Dreyfuss, Nathan Swain, Shannon Roberts, Eldon Loh, Anne Agur
Background: Current sacroiliac joint (SIJ) cooled radiofrequency (RF) is based on fluoroscopic anatomy of lateral branches (LBs) in three specimens. Recent studies confirm significant variation in LB positions. Objectives: To determine if common fluoroscopic needle placements for cooled SIJ RF are adequate to lesion all S1-3 LBs. If not, would different targets improve lesion accuracy? Methods: The LBs of 20 cadavers were dissected bilaterally (40 SIJs), and 26 G radiopaque wires were sutured to the LBs...
November 23, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Xenofon Baraliakos
Axial spondyloarthritis (axSpA) covers the stage of non-radiographic axial spondyloarthritis (nr-axSpA) and classic ankylosing spondylitis. The pathognomonic findings of axSpA are mainly inflammatory and osteoproliferative changes in the sacroiliac joints (SIJ) and the spine. Various imaging techniques are being used in daily practice for assessment of disease-specific changes, such as periarticular bone marrow edema, erosions, sclerosis, fat metaplasia and ankylosis in the SIJ or spondylitis, spondylodiscitis, facet joint involvement, or syndesmophytes in the spine of patients with axSpA...
November 2017: Israel Medical Association Journal: IMAJ
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