Biomedical subjects

S M Lachmann

Publications and source records attributed to S M Lachmann.

9 recordsLinked to original sources

PubMed1993

The mobility outcome for amputees with rheumatoid arthritis is poor.

This study examines the reasons for amputation of the lower limb in 11 patients with RA. The reasons for amputation were ischaemia due to peripheral vascular disease; rheumatoid vasculitis; or complications of knee arthroplasty. Delayed healing was common in patients on steroid therapy. The patients had difficulty donning and doffing their prostheses due to poor hand function and impaired agility. Walking training and rehabilitation were slow and tended to precipitate a generalized flare-up of disease activity. Rheumatoid nodules developed on pressure points between stump and socket. Despite these problems the majority of patients preferred to wear a prosthesis for help in transferring in and out of the wheelchair, to complete their appearance and for limited mobility. Most found using an electric powered indoor wheelchair helped maintain their independence.

Adult↗

PubMed1987

Racquet sports--patterns of injury presenting to a sports injury clinic.

In an 8-year retrospective study, 631 injuries due to the racquet sports of squash (59%), tennis (21%) and badminton (20%) were seen in a sports injury clinic, males predominating (58 to 66%). The proportion of squash injuries was higher than expected and probably relates to higher physical stress and risk of contact in this sport. Also they occurred mainly in persons over 25 years (59%) i.e. the reverse for sport in general. Acute traumatic injuries were seen especially in squash players, a majority affecting the knee, lumbar region, muscles and ankle. Tennis injuries differed most with lateral epicondylitis, patello-femoral pain and lumbar disc prolapse being relatively common. The badminton injury pattern overlapped the others. Lower limb injuries predominated in all three. Detailed assessment of 106 cases showed many to be new, infrequent, social players. Poor warm-up was a common factor in new and established players. The importance of these findings is discussed.

Adolescent↗

PubMed1986

Thermographic diagnosis in athletes with patellofemoral arthralgia.

Pain in front of the knee is common in athletes and is often called patellofemoral arthralgia, but it is difficult to prove that the pain arises in that joint. Thermograms of 30 athletes clinically considered to have patellofemoral arthralgia were compared with those of a similar number of unaffected athletes matched for age and sex. A comparison was also made with thermograms of two older groups of 30 patients with knee involvement from either rheumatoid arthritis or osteoarthritis. Twenty-eight of the athletes with patellofemoral arthralgia had a diagnostic pattern on thermography. The anterior knee view showed a rise in temperature on the medial side of the patella and the medialis knee view showed that this temperature rise radiated from the patellar insertion of the vastus medialis into the muscle itself. The possible aetiological role of quadriceps muscle imbalance in athletes with patellofemoral arthralgia is discussed in relation to these findings.

Adolescent↗

PubMed1985

Spina bifida occulta: lesion or anomaly?

Failure of fusion of the posterior arches of the lumbosacral spine above S3 was sought on frontal radiographs of 653 patients attending an accident and emergency (A & E) department. The patients were aged from 2 months to 98 years and represent all those with relevant information discharged as A & E outpatients over a 2-year period. Presenting complaints of backache or enuresis and inadequate radiographs were excluded. Spina bifida occulta was diagnosed in 22% of the whole group. The incidence was much higher in those below the age of 40 years (29.2%) compared with those above (9.8%). The overall age-adjusted incidence was 17.3%. Our study is an attempt to judge the off-the-street' prevalence of spina bifida occulta. It supports the notion that spina bifida occulta is a common anomaly, of no clinical significance on its own.

Adolescent↗

PubMed1984

The diagnosis of stress fractures in athletes.

Eighteen patients with shin pain that was clinically considered to be caused by a stress fracture of the tibia or fibula underwent radiological, thermographic, and scintigraphic studies and a test of ultrasound-induced pain. When initially seen, 15 had stress fractures confirmed by scintigraphy. Of these, 12 had abnormal thermograms, eight had positive test results for ultrasound-induced pain, and seven had abnormal radiographs. Thermography used alone seemed to be a safe, rapid means of diagnosis for stress fractures in the tibia or fibula and was not found to be related to symptom duration. In the radiologically normal group of stress fractures, four (50%) had positive test results for ultrasound stress tests and normal thermograms. The combination of these two tests should provide an early method of detecting stress fractures in the tibia and fibula, thereby avoiding scintiscans in some athletes.

Adolescent↗

PubMed1984

Patello-femoral arthralgia in athletes attending a Sports Injury Clinic.

Over a five year period, 137 athletes presented to a Sports Injury Clinic with patello-femoral arthralgia. This was 5.4% of the total injuries seen and a quarter of all knee problems treated. Running contributed to 32% of the athletes with patello-femoral pain. There was a 4:1 male:female ratio and nearly 70% were in the 16-25 year age range. A follow-up questionnaire was sent to 72 athletes seen in the last two years with a 78% response rate. Symptoms and treatment are discussed. After conservative therapy only 28.6% were entirely symptom free with a mean follow up of 13.1 months.

Adolescent↗

PubMed1983

Athletes attending a sports injury clinic--a review.

In a prospective study over the two years 1981-1982, there were 1186 separate sporting injuries treated at a Sports Injury Clinic. Just over 75% of patients were aged between 16 and 25 years old, while 80% were male. Football, Rugby, Running, Squash and Rowing contributed over 70% of these injuries. The commonest injuries were to the lower limb and lumbar region. In 43% of knee injuries there was strain of the collateral ligaments, while another 26% had patello-femoral pain. Short distance running was associated with an increase in shin splints, tibial stress fractures and hamstring injuries. Long distance running was associated with an increase in ankle and foot injuries. Sports Injury Clinics can benefit the injured athlete and there appears to be a need for their development in major hospitals.

Adolescent↗

PubMed1978

Scleritis and associated disease.

One hundred patients (66 women and 34 men) who presented consecutively to Moorfields Eye Hospital with scleral disease underwent medical examination. Thirteen were found to have seropositive rheumatoid arthritis and another 16 also had rheumatoid factor present (Rheumaton test). Autoantibodies were present in 35% of patients, being most common in the elderly and most frequent in cases of necrotising and diffuse scleritis. Although scleral disease is uncommon, it is associated with connective-tissue disorders. Scleritis may be severe and destructive locally, and one series showed that 27% of patients who develop necrotising scleritis are dead from systemic complications within five years. It is therefore important for it to be correctly diagnosed and effectively treated at an early stage.

Adolescent↗

PubMed1977

Parallel studies of HLA antigens in patients with rheumatic heart disease and scleritis: comparisons with three control populations.

Parallel studies were carried out on HLA antigens in patients with rheumatic heart disease and scleritis. Comparison with one control population showed a significant excess of BW15 in both disease samples, while a comparison with two other control populations, showed the excess not to be significant. Possible reasons for this discrepancy are discussed, together with the effect on statistical significance of a small percentage of false antigen assignments in one of the samples. A small systematic serological false assignment of an antigen can, by itself, produce a significant result more easily if the frequency of the antigen being detected is low than if it is high. It is suggested that this effect may contribute to the discrepant significant results obtained by different workers in some HLA and disease studies.

Eye Diseases↗