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P Adravanti

Publications and source records attributed to P Adravanti.

6 recordsLinked to original sources
PubMed2000

[Shoulder instability: diagnostic imaging].

Shoulder instability is often diagnosed among athletes; two clinical forms are distinguished: anatomical instability, with recurrent luxation of the shoulder, and functional instability, with pain, articular "click" and sensation of instability. Lesions of periarticular soft tissues (capsula, fibrocartilaginous labrum, gleno-humeral ligaments and rotator cuff) are common in both forms, while lesions of bone structures (humeral head and glenoid of scapula) are typical of shoulder with previous dislocation. Purpose of our retrospective study was to verify the value of magnetic resonance (MRI) and computed arthrography (arthro-CT) in diagnosing these lesions in 57 patients suffering from shoulder instability. On the basis of our results and experience we think that in a preoperative evaluation of an unstable shoulder, arthro-CT and arthro-MRI are more accurate because the intra-articular injection of a contrast medium better identifies lesions of capsula, gleno-humeral ligaments and fibrocartilaginous labrum. In other circumstances, such as the study of the shoulder for legal purposes, MRI is preferable because it offers an accurate and global evaluation of periarticular structures.

Adolescent↗
PubMed2000

[Shoulder diseases in throwing athletes: radiologic assessment and surgical correlation].

Lesions of the shoulder, especially rotator cuff tears and glenoid labrum (SLAP) lesions, are commonly caused by traumatic episodes in athletes such as repeated trauma from throwing. The available radiological methods are MRI, CT and MR arthrography. Twelve athletes suffering from shoulder pain or instability have been studied and then underwent successful treatment in arthroscopy. On the basis of our results and experience, we think that MR, especially with intra-articular injection of contrast medium, is the best examination because it offers an accurate evaluation of both rotator cuff and glenoid labrum. Nevertheless difficulties are often encountered and definitive diagnosis sometime rests on arthroscopic exploration.

Adolescent↗
PubMed2000

[Injuries of the cruciate ligament of the knee: diagnostic contribution of MR and spiral CT].

Lesions of cruciate ligament are common after knee trauma of different degree of gravity. Lesions evaluation is possible thanks to CT and MRI. Our purpose is to verify their value in diagnosis of cruciate ligaments lesions. We retrospectively evaluated 160 patients (80 CT and 80 MRI) with subsequent diagnosis of cruciate ligaments injury. CT and MRI were performed in the acute phase and in the subacute phase within 2-3 weeks from trauma. On the basis of our results CT and MRI shown a reduced sensitivity in acute phase owing to the intraarticular haemorrhage; in this phase MRI gives more information about fibres interruption. In subacute or chronic phase, both methods are correct in recognising the lesions but MRI is more sensitive and accurate. It is a real wish that, with more MRI machines diffusion, this method will be preferred in the study of cruciate ligaments both in acute phase and subacute-chronic phase.

Adolescent↗
PubMed1986

Subcapital fractures of the femur. Treatment by reduction and fixation and 3 spongy bone screws.

The authors reviewed 21 cases of subcapital fracture of the femur treated by reduction and fixation with 3 spongy bone screws (AO type) between 1980 and 1983. There were 4 failures (2 non-union and 2 ischaemic necrosis, one definite and one suspected). In all patients with a reasonable life expectancy the treatment should be reduction and fixation, but the technique must be extremely accurate. If open reduction is necessary to ensure perfect reduction, it must be by the anterior route so as not to inflict further damage on the blood supply. Fixation must be rigid and sustained. This can be best achieved by using 3 screws of the AO spongy type which also ensures a degree of compression which enhances consolidation.

Adolescent↗
PubMedDate not supplied

[Radiologic assessment of femoro-patellar instability. Personal experience and review of the literature].

PURPOSE: To propose a simple and reproducible radiological evaluation of patellofemoral instability to enable the orthopaedic surgeon to choose the best therapy. MATERIAL AND METHODS: We have evaluated retrospectively the radiographs and CT examinations of 25 patients, 15 female and 10 male, aged between 18 and 32 years. They underwent surgical treatment for patellar instability in the past 4 years. Lateral retinacular release has been performed in every patient, medial transposition of the anterior tibial tuberosity has been performed in 23 patients and in 5 of them also its distal replacement, proximal Insall's realignement was performed in 20 cases and only 1 patient underwent trochleoplasy. Preoperative conventional radiographs included antero-posterior view, true lateral view (exact superimposition of the posterior trochlear edges) and axial views at 30 degrees of knee flexion. On lateral view, the patellar height was evaluated based on Caton-Deshamps index and trochlear dysplasia assessed using the methods suggested by Dejour. A CT examination of both knees was performed: the images were taken first with knees in extension, with and without quadriceps contraction, then in flexion at 20 degrees. Patellar "bascùle" angles were measured both with quadriceps relaxed and contracted as an index of quadriceps dysplasia; the TAGT in extension was evaluated as an index of the degree of lateral position of the anterior tibial tuberosity. Preoperative conventional and CT findings were compared with those obtained postoperatively at 30.4 months from the surgical intervention. RESULTS: All patients were free from complaints after surgery. In 5 patients a high patella was corrected by distal realignement of anterior tibial tuberosity. A trochlear dysplasia with different degrees of severity was present in all cases and it was not modified by surgical treatment, with the exception of the patient who underwent trochleoplasty. In the 20 patients who underwent proximal Insall's realignment, patellar "bascùle" angles--pathological before surgery--were restored to normal values with the exception of 3 cases. In 23 patients who underwent medial transposition of anterior tibial tuberosity, the values of the TAGT were all normalized: nevertheless, in three patients low values of the TAGT were found after surgery and this condition may predispose to the development of medial patellofemoral by iperpression syndrome. CONCLUSIONS: In patients suffering from patellofemoral instability, a radiological protocol which includes conventional radiographs in two projections and a CT examination both in extension, with and without quadriceps contraction, and in flexion at 20 degrees supplies all the information needed for evaluating patellar height and mobility, trochlear dysplasia, valgism of the knee and the degree of excessive lateral position of the anterior tibial tuberosity. Careful evaluation of such abnormalities is important for selecting the best surgical treatment for each patient. It's a simple, quick, and accurate protocol that may be reproduced, even using different radiographic equipment. The collaboration between the radiologist and the orthopaedic surgeon is crucial for the correct interpretation of radiological findings, which must be evaluated together with clinical findings so that an adequate therapeutical plan could be proposed.

Adolescent↗