PubMed Health⌕ Search

Biomedical subjects

K Jonsson

Publications and source records attributed to K Jonsson.

At least 55 records · Page 3Linked to original sources
PubMed1998

Knee osteoarthritis after meniscectomy: prevalence of radiographic changes after twenty-one years, compared with matched controls.

OBJECTIVE: To study the long-term outcome of surgical removal of a meniscus in the knee with regard to radiographic signs of osteoarthritis (OA). METHODS: Of the 123 patients who underwent an open meniscectomy due to an isolated meniscus tear in 1973 at Lund University Hospital, 107 were followed up 21 years later by clinical examination and by review of knee radiographs obtained with weight bearing. Seventy-nine of the 107 patients were men, and the mean age of the total study group at examination was 55 years (range 35-77). Sixty-eight sex- and age-matched individuals with healthy knees served as controls. RESULTS: Mild radiographic changes were found in 76 (71%) of the knees, while more advanced changes, comparable with a Kellgren-Lawrence grade of 2 or higher, were seen in 51 (48%). The corresponding prevalence values in the control group were 12 (18%) and 5 (7%), respectively. The relative risk for the presence of the more advanced radiographic changes representing definite radiographic tibiofemoral OA was 14.0 (95% confidence interval 3.5-121.2), using age- and sex-matched pairs for comparison. No correlation with sex, localization to compartment, type of meniscus tear, or work load was found. Knee symptoms were reported twice as often in the study group as in the controls. CONCLUSION: Surgical removal of a meniscus following knee injury represents a significant risk factor for radiographic tibiofemoral OA, with a relative risk of 14.0 after 21 years.

Activities of Daily Living↗
PubMed1998

Non-operative treatment versus tension-band osteosynthesis in three- and four-part proximal humeral fractures. A retrospective study of 34 fractures from two different trauma centers.

Thirty-four patients with three- and four-part proximal humeral fractures from two different trauma centres were studied retrospectively. Sixteen were treated without osteosynthesis and compared with 18 patients treated with tension-band fixation. Fracture classification and clinical examination were made by the same persons in both groups. Most of the three-part fractures healed with good pain relief and good function in daily life but often with a loss of motion. Four-part fractures often led to pain, loss of motion and of function. Conservative treatment seemed superior to tension-band fixation for three-part fractures. Four-part fractures healed with better function and range of motion after tension-band fixation.

Adult↗
PubMed1998

Background pain in burn patients: routine measurement and recording of pain intensity in a burn unit.

It goes without saying that pain following a burn must be treated but it is not so evident to measure and document the intensity of pain and the efficacy of treatment. Since 1994 the authors have routinely measured background pain, that is, at rest, along with temperature and pulse rate. For analysis and quality assessment a relational database programme is used in the ward. In this paper the authors' experience is reported from a consecutive series of 98 patients with burn injuries who assessed the intensity of pain on a visual analogue scale. There were great intra- and inter-individual variations in pain intensity. Highest values were found during the first week of treatment when female patients experienced pain more intensively than male. For other time periods there was no statistical significant difference between the sexes. Pain intensity and severity of burn was not related except during the second week when patients with major burns had a tendency to express more pain than moderate burns. Measurement of background pain along with other routine registrations is easy and not time-consuming. Patients needing intensified pain treatment can be identified. For research and quality assessment a computerized patient register is of great help.

Adolescent↗
PubMed1998

Joint-space width in the axial view of the patello-femoral joint. Definitions and comparison with MR imaging.

PURPOSE: To validate a bony landmark on the dorsal aspect of the patella for measurement of the interbone distance in the axial radiogram of the patello-femoral joint (PFJ); to assess the reproducibility of this radiogram and the minimal joint-space (MJS) width measurements in the medial and lateral compartments of the PFJ in this view; and to relate the MJS of the PFJ to MR-detected cartilage defects in the same joint. MATERIAL AND METHODS: Fifty-seven individuals with chronic knee pain (aged 41-58 years, mean 50 years) were examined with an axial view of the PFJ in the standing position. The MJS was measured with a mm-graded ruler. On the same day, an MR examination was performed with proton density- and T2-weighted turbo spin-echo sequences on a 1.0 T imager. We noted the cartilage defects in the PFJ in axial and sagittal MR images, and the shape of the subchondral cortex of the medial and lateral articular surfaces of the patella in sagittal MR images. RESULTS AND CONCLUSION: The bony landmark was found on all articular surfaces. The axial view of the PFJ and the MJS measurements were reproducible. An MJS of <5 mm showed high specificity for MR-detected cartilage defects. Thus an MJS of 5 mm proved to be a limit in the diagnosis of joint-space narrowing in the PFJ in middle-aged individuals with chronic knee pain.

Adult↗
PubMed1998

Joint-space width in the weight-bearing radiogram of the tibiofemoral joint. Should the patient stand on one leg or two?

PURPOSE: The aim of the study was to compare the minimal joint-space (MJS) width of the tibiofemoral joint (TFJ) in weight-bearing radiograms with the patient in two different positions. MATERIAL AND METHODS: From a study of 54 patients with chronic knee pain (aged 42-59 years, mean 52 years), we selected 21 consecutive patients for this study. In these 21 patients, both knees were examined by means of p.a. weight-bearing radiograms in semiflexion with fluoroscopic guidance. The patient stood with the weight: 1) almost entirely on the examined leg; and 2) equally distributed on both legs. The MJS was measured with a scale loupe in tenths of a millimeter in the medial and lateral compartments of the TFJ. RESULTS: With the patient standing on one leg, the MJS was 0.18 mm wider (p<0.006) in the medial compartment and 0.18 mm narrower (p<0.029) in the lateral compartment as compared to standing on both legs. CONCLUSION: With the technique used, the assessment of the MJS width in the p.a. view of the TFJ in weight-bearing examinations should be performed with equal weight on both legs. Standing on only the examined leg might be an option in cases of suspected narrowing in the lateral compartment.

Adult↗
PubMed1998

Synovitis in Legg-Calvé-Perthes disease. Evaluation with MR imaging in 84 hips.

PURPOSE: To evaluate, by means of MR imaging, the degree and persistence of synovitis in the hip joint in Legg-Calvé-Perthes disease and to correlate the degree of synovitis with the degree of epiphyseal necrosis. MATERIAL AND METHODS: A total of 170 MR images in 72 patients (84 hips) were examined. The T2-weighted MR images were taken in the coronal plane in order to evaluate the degree of synovitis in the hip joint. RESULTS: MR revealed synovitis in all cases in the early phase of the disease. In Catterall group II, synovitis was discreet to moderate for up to 6 months after diagnosis. Hips with more severe necrosis, Catterall groups III and IV, had moderate or intense degrees of synovitis. There was a correlation between the degree of synovitis and the lateral pillar classification according to HERRING et al. Also, there was a good correlation between the extent of signal changes in the epiphysis on MR imaging and the degree of synovitis. There was no difference when signal changes were evaluated on T1- or T2-weighted images. Signs of synovitis could be seen for up to 30 months after diagnosis in Catterall group I hips, and in Catterall groups II and III for up to 36 months, and in 2 cases even longer. Some Catterall group IV hips had discreet or mild synovitis for 60 months or more, after diagnosis. CONCLUSION: The degree of synovitis on MR imaging correlates to the extent of epiphyseal necrosis seen on radiographs or MR imaging as well as to the lateral pillar classification, i.e. to a poor clinical outcome. In Catterall group IV hips, synovitis can even persist for up to 60 months after diagnosis.

Child↗
PubMed1998

Long-term results after infantile Blount's disease.

A long-term follow-up of 49 patients with an average age of 38 years (range: 25-67 years) who had experienced infantile Blount's disease was done. Thirty-seven patients had bilateral disease, giving a total of 86 affected knees. Thirty-eight knees had conservative or no treatment during childhood; 13 were treated by epiphysiodesis, and 35 by osteotomy. At follow-up, 11 knees showed arthrosis, and 9 were graded as mild. Ten knees had been surgically treated by medial meniscectomy at an average age of 29 years (range: 19-45 years), after the diagnosis of Blount's disease. Four of the knees showed arthrosis. Most of the patients had a straight leg and mild or no pain from their knee. It is concluded that most children with infantile Blount's disease will, at the age of 40 years, have a straight leg without arthrosis and that one third can reach this result without any treatment.

Adult↗
PubMed1998

Correlation between radiographically diagnosed osteophytes and magnetic resonance detected cartilage defects in the patellofemoral joint.

OBJECTIVE: To assess the correlation between radiographically diagnosed osteophytes in the axial and lateral view of the patellofemoral joint (PFJ) and (1) magnetic resonance (MR) detected cartilage defects in the same joint and (2) knee pain. METHODS: Fifty-seven people with chronic knee pain, (aged 41-58 years, mean 50 years) were examined with axial and lateral radiograms when standing of the right and the left PFJ. The presence and grade of osteophytes was assessed. On the same day, a MR examination was performed of the signal knee with proton density and T2 weighted turbo spin-echo sequences in the sagittal and axial view on a 1.0 T imager. Cartilage defects in the PFJ were noted. The subjects were questioned for current knee pain for each knee. RESULTS: Osteophytes at the PFJ had a specificity varying between 59 and 100% and a positive predictive value between 74 and 100% for MR detected cartilage defects. The corresponding values for osteophytes at the lateral aspect of the femoral trochlea were both 100%. In PFJ with narrowing (< 5 mm) osteophytes had a sensitivity and a positive predictive value of 90 and 95% respectively for MR detected cartilage defects, while in PFJ with non-narrowing (> or = 5 mm) the corresponding values were 75 and 65% and the specificity was 50%. A correlation (p < 0.05) between osteophytes at the inferior pole of the patella and knee pain was found. CONCLUSIONS: Osteophytes at the PFJ are associated with MR detected cartilage defects in the same joint. The relation was strong for osteophytes at the lateral femoral trochlea and in the PFJ with narrowing (< 5 mm), but weak in the PFJ with non-narrowing (> or = 5 mm).

Adult↗
PubMed1998

Correlation between radiographically diagnosed osteophytes and magnetic resonance detected cartilage defects in the tibiofemoral joint.

OBJECTIVE: To assess the correlation between the presence of radiographically diagnosed osteophytes in the tibiofemoral joint (TFJ) and (1) magnetic resonance (MR) detected cartilage defects and meniscal lesions in the same joint and (2) knee pain. METHODS: Fifty-nine people, 29 men and 30 women, with chronic knee pain (aged 41-58 years, mean 50 years) were examined with posteroanterior weightbearing radiograms in semiflexion of both TFJ. The presence and grade of marginal and central osteophytes were assessed. On the same day, an MR examination was performed of the signal knee with proton density and T2 weighted turbo spin-echo sequences on a 1.0 T imager. Cartilage defects and meniscal abnormalities in the TFJ were noted. The subjects were questioned for current knee pain for each knee. RESULTS: Marginal osteophytes had a sensitivity of 77%, specificity of 83%, and positive predictive value of 87% for MR detected cartilage defects in the TFJ and a sensitivity of 71%, specificity of 68%, and positive predictive value of 71% for meniscal abnormalities. A correlation (p < 0.05) between osteophytes at the medial tibial condyle and knee pain was found. CONCLUSIONS: With the presence of marginal osteophytes in the TFJ there is a high prevalence of MR detected cartilage defects in the same joint whether joint space narrowing (< 3 mm) is present or not.

Adult↗
PubMed1998

Assessment of image post-processing and of measuring assistance tools in computed radiography. Evaluation of the weight-bearing knee.

PURPOSE: A system for the examination and measurement of the weight-bearing knee was adapted to computed radiography (CR) and to a picture archiving and communication system (PACS). The examination and measurement system was developed on examination equipment used for QUESTOR precision radiography (QPR). For an easier and more standardised localisation of bony landmarks on the screen, 4 measuring assistance tools (MATs) were developed. The aim of this study was to evaluate the usefulness of the tools developed and of image post-processing, specifically as magnification (zoom) and filtering (edge enhancement), by determining intra-observer variation in the measurement of angles and distances. MATERIAL AND METHODS: The original QPR measurement program, generating 19 angles and distances corrected for parallax and magnification, was converted and installed on a multi-modality workstation (Imtec Image 1200). A CR system (Fuji AC-2) was used for the generation of the related images and the measurements were made on the workstation. Four unilateral examinations of weight-bearing knees were undertaken. These examinations were measured twice under 5 different measurement conditions by 4 viewers. RESULTS AND CONCLUSIONS: The most important factor in reducing intra-observer variation was the ability to magnify (zoom) the images. The MATs also reduced variation. Filtering (edge enhancement), however, did not affect precision.

Biomechanical Phenomena↗
PubMed1998

Oral manifestations in 100 Zimbabwean HIV/AIDS patients referred to a specialist centre.

OBJECTIVE: To document the prevalence, age, sex ratio and clinical features of oral lesions associated with HIV/AIDS among patients referred to the two largest specialist centres in Zimbabwe. DESIGN: Prospective study. SETTING: University Hospital. SUBJECTS: 100 consecutive patients with oral manifestations of HIV/AIDS were interviewed and examined by Dental Surgeons and Physicians. METHODS: Inspection and palpation of head and neck was done in all cases. Examination of the oral cavity and oropharynx with torchlight and wooden spatula was performed and lesions recorded according to WHO recording form for oral lesions possibly related to HIV infection. RESULTS: The median age was 35 years (range 19 to 66 years). The male to female ratio was 4:1. General symptoms and signs found were: weight loss in 52, diarrhoea in 34, lymphadenopathy in 21 and Herpes zoster in 12 patients. Ninety two patients had oral lesions of some sort. These consisted of: oral ulcerations in 26, candidiasis in 22, osteomyelitis in three, necrotizing gingivitis in two and herpetic gingivostomatitis in one patient. Neoplasms recorded were: Kaposi's sarcoma in 72 patients, squamous cell carcinoma in two patients. Four other tumours not associated with HIV/AIDS were found. No hairy leukoplakia was found in this study. CONCLUSIONS: The peak prevalence was in the age group 31 to 40 years with a male dominance of 4:1. The most frequent lesion was Kaposi's sarcoma, M:F ratio 3:1, followed by oral ulcers and candidiasis.

Adult↗
PubMed1997

Wound tissue oxygen tension predicts the risk of wound infection in surgical patients.

OBJECTIVE: To test the hypothesis that subcutaneous wound oxygen tension (PsqO2) has a predictive relation to the development of wound infection in surgical patients. DESIGN: A noninterventional, prospective study. SETTING: A university department of surgery. PATIENTS: One hundred thirty operative general surgical patients at notable risk of infection as predicted by an anticipated Study on the Effect of Nosocomial Infection Control (SENIC) score of 1 or greater. OUTCOME MEASURES: PsqO2 was measured perioperatively. Its relation to the subsequent incidence of surgical wound infection was then determined and compared with the SENIC score as a criterion standard. RESULTS: Although the SENIC score and PsqO2 are inversely correlated, PsqO2 is the stronger predictor of infection. Low PsqO2 identified patients at risk and concentrated them in a cohort that was about half the size of that identified by the SENIC score. CONCLUSIONS: Subcutaneous perfusion and oxygenation are important components of immunity to wound infections. The SENIC score identifies systemic physiological variables that are important to the development of wound infection. Nevertheless, PsqO2 is the more powerful predictor of wound infection. Moreover, PsqO2 can be manipulated by available clinical means, and thus may direct interventions to prevent infection.

Adult↗
PubMed1997

Postero-anterior radiogram of the knee in weight-bearing and semiflexion. Comparison with MR imaging.

PURPOSE: The purpose was four-fold: to assess the reproducibility of p.a. weight-bearing radiograms of the knee and the minimal joint-space (MJS) width measurements in these radiograms; to compare the MJS with MR-detected cartilage defects; to evaluate the location of these cartilage defects; and to estimate the relation between meniscal abnormalities and joint-space narrowing. MATERIAL AND METHODS: Fifty-nine individuals, aged 41-58 years (mean 50), with chronic knee pain were examined by means of p.a. weight-bearing radiograms in semiflexion with fluoroscopic guidance of the knee joint. The MJS was measured with a standard ruler. On the same day MR imaging was performed with proton-density- and T2-weighted turbo spin-echo on a 1.0 T imager. Meniscal abnormalities and cartilage defects in the tibiofemoral joint (TFJ) were noted. RESULTS AND CONCLUSION: The p.a. view of the knee and the MJS measurements were reproducible. MJS of 3 mm is a limit in diagnosing joint-space narrowing in knees with MR-detected cartilage defects. There was a high proportion (p < 0.001) of meniscal abnormality within the narrowed compartments in comparison with those that were not narrowed. A larger number of the cartilage defects (p < 0.05) was found in the medial femoral condyle than in any of the other condyles of the TFJ. The defects had a dorsal location (p < 0.001) as shown in the weight-bearing radiograms of the knee in semiflexion.

Adult↗
PubMed1997

Epiphyseal bone-marrow abnormalities and restitution in Legg-Calvé-Perthes disease. Evaluation by MR imaging in 86 cases.

PURPOSE: By means of MR imaging, to determine signal abnormalities in the femoral epiphysis; to determine their location, extent and restitution over time; and to correlate these findings to the Catterall radiological classification. MATERIAL AND METHODS: A total of 247 MR images in 86 patients (101 hips) with Legg-Calvé-Perthes disease were examined. The MR images were taken in the coronal plane, and the images through the center of the femoral head were used for this study. RESULTS: T1-weighted images proved as good as T2-weighted images for the MR evaluation of the extent of the necrosis. In almost every case, the central-cranial part of the epiphysis showed a low initial signal. In Catterall group I, the medial part was never involved. In Catterall III and IV, almost the entire epiphysis showed signal changes. In the period 3-6 years after diagnosis, we still found signal changes in the epiphysis in some hips but there was no correlation with the Catterall classification. After 6 years, the epiphysis showed normal signal intensity in MR imaging. In T1-weighted images, Gd-enhancement occurred in the peripheral regions in the early stages of the disease. The central part of the epiphysis became more enhanced over time and peaked in the period 1-3 years after diagnosis. CONCLUSION: MR is a valuable modality for monitoring changes in the femoral epiphysis. We propose a new classification of the extent and pattern of epiphyseal bone-marrow abnormalities based on the 4 zones most commonly observed in MR imaging.

Bone Marrow↗
PubMed1997

Computed radiography for characterisation of the weight-bearing knee.

PURPOSE: A new method for examining and measuring the weight-bearing knee in computed radiography (CR) and picture archiving and communication systems (PACS) has recently been developed on examination equipment used in QUESTOR Precision Radiography (QPR). QPR is a method for the standardised examination of the knee, and generates 9 angles (e.g. hip-knee-ankle (HKA) angle) and 10 distances, corrected for parallax and magnification. The aim of this present study was to evaluate the reproducibility of this newly developed method and to determine intra- and interobserver variation in its measurements. MATERIAL AND METHODS: The images were generated on a CR system, archived, and transferred to a multimodality work-station that had a monitor with a resolution of 1280x1024 (1kx1k). Photostimulable phosphor plates were used to generate images with a matrix of 1760x2140 pixels (pixel size 0.2 mm, corresponding resolution 2.5 1p/mm). Ten volunteers without knee problems were examined twice, bilaterally, by 2 different radiology technologists. RESULTS: The total reproducibility of the method was good, offering an HKA reproducibility of +/-2.64 degrees in slight flexion and +/-1.62 degrees in extension, at 95% confidence. The intra- and inter-observer variations were low with a reduction of the intra-observer variations in all measurements (except one) by a factor of 2.8 on average compared with the original QPR method for conventional film-screen radiography. CONCLUSION: When QPR is modified for CR, it fulfils the requirement of reproducibility in measurements of the weight-bearing knee.

Adult↗
PubMed1997

Long-term results after adolescent Blount's disease.

A long-term follow-up study was made of 23 patients with an average age of 47 years (range 38-68 years) who had adolescent Blount's disease. Four patients had bilateral disease (27 affected knees). Nine knees had no treatment during childhood, 11 were treated by physiodesis, and seven were treated by osteotomy of the proximal tibia. At follow-up, most of the patients had no pain or mild pain from their knee. Nine knees showed arthrosis. We conclude that most children with adolescent Blount's disease will have a straight leg at middle age without arthrosis and that this result can be obtained in one of four patients without treatment.

Adolescent↗
PubMed1997

Intracapsular pressure and loosening of hip prostheses. Preoperative measurements in 18 hips.

We measured the intracapsular pressure preoperatively in 18 hips (17 patients) before revision of a total hip arthroplasty because of aseptic loosening. Distension of the joint capsule was measured with sonography in 13 cases. In extension, the mean intracapsular pressure was 26 (0-60) mmHg, in extension and inward rotation it was 159 (24-280) mmHg, in extension and outward rotation it was 30 (3-67) mmHg and in 45 degrees of flexion it was 12 (0-28) mmHg. A mean of 6 (0.5-20) mL of joint fluid was aspirated after the pressure measurements. Sonography showed increased joint fluid/synovial edema and/or increased capsular thickness, as compared to 34 unrevised, radiographically not loose prosthetic hips, and that the capsular distension correlated to intracapsular pressure during extension and inward rotation. We conclude that the intracapsular pressure usually is elevated in a hip joint with loose prosthetic components, that the intracapsular pressure varies with the position of the hip and that capsular distension reflects increased intracapsular pressure. The increased and often very high pressure, varying during gait, may pump debris away from the joint along the interfaces and even by itself cause osteolysis and loosening.

Aged↗