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Biomedical subjects

J E Dacre

Publications and source records attributed to J E Dacre.

24 records · Page 2Linked to original sources
PubMed1989

The automatic assessment of knee radiographs in osteoarthritis using digital image analysis.

We have developed an automatic system for the measurement of joint space in the knee using computerized analysis of digital stored images of knee radiographs. PA X-rays of the knee are positioned on a conventional viewing box. A video image of the radiograph is converted to digital form, stored and displayed on a closed circuit television monitor. This is edited and analysed by a microcomputer. After careful positioning under a computer generated grid on the television screen, automatic measurements are made using an edge detection facility. Two different edge detection algorithms were compared. Reproducibility is very good. Inter- and intra-observer relationships are also good with no significant difference between observers using a paired t-test and very good correlations. Results show that rapid, reliable and accurate measurement of joint space size can be achieved using digital image analysis. The application of image handling computers to radiological scoring is important in our understanding of joint destruction and the progression of the rheumatic diseases.

Algorithms↗
PubMed1989

Development of a new radiographic scoring system using digital image analysis.

A scoring system using computerised analysis of digital stored images of knee radiographs has been developed. Measurement is based on the assessment of joint space size. It is sensitive, rapid, and reproducible. Plain radiographs are positioned on an acetate grid; a computer generated grid is superimposed on a digital image of the radiograph viewed on a closed circuit television monitor and the joint space measured automatically. Area and distance have been assessed; area measurements are more reproducible. Application of microcomputer based digital image analysis to radiological scoring systems is an important step in understanding the nature and progression of arthritis.

Arthritis↗
PubMed1989

Injections and physiotherapy for the painful stiff shoulder.

Cost effective treatment is needed for common self limiting rheumatological conditions. Periarthritis of the shoulder is an example. There is no consensus for one type of treatment, though local steroids or physiotherapy are conventionally used. Their cost and efficacy were compared in a prospective randomised observer-blind trial--in essence a medical audit of the treatment of a common rheumatological problem. Sixty two consecutive patients presenting with a painful stiff shoulder were studied. Patients with coexistent diseases like cervical spondylosis or a stroke were excluded. They were randomly allocated to receive local steroids, six weeks' physiotherapy, or both. The three groups were of similar age, sex, and disease severity. Assessments of pain and shoulder movement were made initially, at six weeks, and at six months by a 'blinded' observer. Physiotherapy was given by one therapist and injections by one physician. All three groups showed significant improvements by six weeks, with further improvement at six months. Improvements were identical in all three groups. No treatment gave complications. The costs of treatment varied: an injection of triamcinolone cost 2.10 pounds; a six week course of physiotherapy cost 48.50 pounds; combination treatment cost 50.60 pounds. Patients expect treatment for a painful stiff shoulder. The results show that local steroid injections are as effective as physiotherapy alone or a combination. They provide rapid treatment and are less expensive. In the uncomplicated case a local steroid injection is the most cost effective treatment.

Costs and Cost Analysis↗
PubMed1988

Arthritis in Down's syndrome.

A 31 year old man with Down's syndrome presented with a 10 year history of an inflammatory polyarthritis resembling juvenile chronic arthritis. This case was similar to those already reported of an arthropathy associated with Down's syndrome but was eventually found to be gout. This emphasised the importance of serum uric acid estimation in patients with Down's syndrome and coexistent arthritis.

Adult↗
PubMed1988

Adverse reactions to sulfasalazine: the British experience.

Sulfasalazine has been used for a decade in the United Kingdom for treating rheumatoid arthritis. There is now considerable experience with its adverse reaction profile and the incidence of serious events. In the initial weeks of treatment minor side effects are common, especially upper gastrointestinal problems and nausea. Therapy is thus usually introduced slowly and enteric coated tablets are preferred. In 20-30% of patients treatment is discontinued due to an adverse reaction. Most of such reactions occur within 3 months of starting therapy, are trivial, and are self-limiting after withdrawal of the drug. Potentially more serious adverse reactions include leukopenia, rash, abnormal liver function tests, and dyspnea. These reactions also reverse after treatment is stopped. Side effects leading to drug withdrawal after 1 year of therapy are unusual.

Arthritis, Rheumatoid↗