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Biomedical subjects

Clyde A Helms

Publications and source records attributed to Clyde A Helms.

23 records · Page 2Linked to original sources
PubMed2002

Observer variability in assessing lumbar spinal stenosis severity on magnetic resonance imaging and its relation to cross-sectional spinal canal area.

STUDY DESIGN: Magnetic resonance image grading of lumbar spinal stenosis severity was analyzed retrospectively using a common clinical format. OBJECTIVE: To assess the interobserver and intraobserver reliability of magnetic resonance image used to grade patients with lumbar spinal stenosis, as compared with cross-sectional spinal canal area. SUMMARY OF BACKGROUND DATA: Physicians currently classify the degree of lumbar spinal stenosis on magnetic resonance imaging as mild, moderate, or severe. Unfortunately, there is no consensus on criteria for these definitions. METHODS: The magnetic resonance image scans of 15 patients with lumbar stenosis were blindly rated by seven observers for the degree of central, lateral recess, and foraminal stenosis between L1-L2 and L5-S1. Weighted kappa statistics were performed to analyze the inter- and intraobserver agreement. Digitized spinal canal area measurements were calculated. Linear regression models were used to assess the reliability of the grading system in predicting the cross-sectional area. RESULTS: The average interobserver kappa score was 0.26. Within different specialties, the interobserver reliability was higher among radiologists (0.40), followed by neurosurgeons (0.21) and orthopedic surgeons (0.15). The average intraobserver kappa score was 0.11, rising to 0.43 after categories were combined (P = 0.001). The classification of central stenosis highly predicted spinal canal area (P < 0.001). CONCLUSIONS: The findings indicate only a fair level of agreement among all observers. However, the ability of the various readers to predict the degree of central stenosis was high. Further studies should evaluate a consensus-based, standardized magnetic resonance image classification aimed at improved agreement among observers.

Humans↗
PubMed2002

The impact of MR imaging in sports medicine.

Sports medicine is one of the most rapidly growing subspecialties in orthopedics. Magnetic resonance (MR) imaging in sports medicine includes depiction of normal anatomy and pathologic conditions in almost every joint in the body, but the MR examinations most frequently requested are of the knee and shoulder. The reported high accuracy of MR imaging in the knee has resulted in MR imaging being preferred to diagnostic arthroscopy by most leading orthopedic surgeons. MR imaging is particularly helpful for sports medicine surgeons in evaluating menisci to determine if they are repairable, in posterolateral corner syndrome, and in evaluating the hyaline articular cartilage. In evaluating the shoulder, MR arthrography is becoming the preoperative imaging procedure of choice for many sports medicine surgeons. Shoulder MR imaging is particularly important in helping identify abnormalities that may mimic rotator cuff or labral abnormalities at clinical examination, thus preventing unnecessary surgery in some patients. These abnormalities include Parsonage-Turner syndrome and quadrilateral space syndrome, each of which has a distinctive MR imaging appearance. As the field of sports medicine expands, radiologists will continue to see increased requests for MR imaging, because sports medicine and high-quality imaging are inextricably linked.

Athletic Injuries↗
PubMed2002

MR imaging of the knee: findings in asymptomatic collegiate basketball players.

OBJECTIVE: The purpose of our study was to evaluate the knees of asymptomatic high-level collegiate basketball players before the beginning of the basketball season to gain an understanding of nonclinical findings in this patient population. SUBJECTS AND METHODS: Bilateral knee MR imaging examinations of 17 varsity basketball players (12 men and five women) were performed before basketball season began. All of the subjects were imaged on a 1.5-T magnet. The MR imaging studies were reviewed by two musculoskeletal radiologists. Structures analyzed were the menisci, ligaments, cartilage, plicae, and bone marrow. The presence of a joint effusion was also noted. RESULTS: Fourteen (41%) of the 34 knees had bone marrow edema, eight (24%) showed signal in the patellar tendon, and 14 (41%) had abnormal cartilage signal or a focal abnormality. Twelve (35%) of the 34 knees showed a joint effusion. Two knees (6%) showed abnormal signal along the infrapatellar plica. Four knees (12%) were noted to have a discoid meniscus. CONCLUSION: An MR examination of the knees of high-level collegiate basketball players may show changes unique to this population. The changes seen on MR imaging in these athletes may be asymptomatic abnormalities. For instance, changes suggestive of patellar tendinopathy were identified in these asymptomatic subjects.

Adult↗
PubMedDate not supplied

Radiographic findings associated with symptomatic rotator cuff tears.

This study compared shoulder radiographs of patients with a documented rotator cuff tear with those of asymptomatic age-matched controls. Radiographs of 40 subjects with documented rotator cuff tears were evaluated along with similar films of 84 asymptomatic age-matched controls. Three radiographs were taken of each shoulder: (1) acromioclavicular joint view, (2) anterior-posterior view with 30 degrees of external rotation, and (3) supraspinatus outlet view. Two fellowship-trained radiologists interpreted 14 radiographic areas in a blinded fashion. Inspection of the greater tuberosity showed large positive abnormal ratings for sclerosis, osteophytes, subchondral cysts, and osteolysis. No association was noted between acromial morphology and rotator cuff tears. These results indicate that shoulder radiographs of subjects with a documented rotator cuff tear have greater tuberosity radiographic abnormalities that are not noted in asymptomatic subjects without a rotator cuff tear. No relationship was found between tear length and any of the degenerative conditions.

Acromion↗