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M H Kathol

Publications and source records attributed to M H Kathol.

38 records · Page 3Linked to original sources

Radiographic abnormalities of the lumbar spine in college football players. A comparative analysis.

The purpose of this study was to make a direct comparison between lumbar spine radiographs of incoming college football players and of an age-matched control group to determine whether there is a higher prevalence of lumbar spine abnormalities in football players before competing at the Division I level. We reviewed 187 lumbar spine radiographs. Of these, 104 were taken as a standard part of the preparation physical examination for incoming college football players. The remaining 83 radiographs were taken during routine preemployment physicals at a local factory. Each radiograph was read independently by three separate orthopaedic radiologists in a blinded fashion. Data were collected and statistically evaluated for 13 variables. The rate of spondylolysis was only 4.8% in our group of athletes and 6.0% in the control group (not significantly different). Only in the category of degenerative changes was a significant difference found. The control group had a 16.9% incidence of disk space narrowing and spurring and the football players had a 6.7% incidence. The remainder of the variables were not significantly different between the two groups. Our findings differ from previously published reports and indicate that football players entering college at the Division I level may have a similar prevalence of radiographic lumbar spine abnormalities, including spondylolysis and spondylolisthesis, as age-matched controls.

Adult↗

Correct placement of epidural steroid injections: fluoroscopic guidance and contrast administration.

We prospectively evaluated 316 caudal-approach epidural steroid injections given by staff radiologists and residents in our department over a 1-year period. Needle placement was checked with fluoroscopy and corrected if necessary. When the needle tip was within the sacral canal, nonionic contrast material was injected. If epidural contrast was not observed, the needle tip was repositioned. Of 111 procedures performed by physicians who had given fewer than 10 epidural steroid injections, 53 (47.7%) resulted in correct nonfluoroscopically directed placement of the needle. For physicians who had performed between 10 and 50 such procedures, 62 (53.4%) of 116 had correct nonfluoroscopically directed placement. For staff physicians, 55 (61.7%) of 89 placements were correct. Even when the sacral hiatus was easily palpated and a staff physician was confident that he or she was within the epidural space, fluoroscopy revealed incorrect placement 14.2% of the time (seven of 49 procedures). In addition, when the needle was positioned within the sacral canal and no blood was evident on Valsalva maneuver or aspiration, the injection was venous in 29 of 316 procedures (9.2%). The presence of blood on the needle stylus was not a reliable indicator of venous placement of the needle. Our findings indicate that fluoroscopy is essential for correct placement of epidural steroid injection. Contrast administration is necessary to avoid venous injection of steroids.

Adult↗