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Biomedical subjects

W McGann

Publications and source records attributed to W McGann.

4 recordsLinked to original sources

Tendinosis and tears of gluteus medius and minimus muscles as a cause of hip pain: MR imaging findings.

OBJECTIVE: This study was conducted to determine the prevalence of tendinosis and tears of gluteus medius and minimus muscles in patients presenting with buttock, lateral hip, or groin pain; describe the MR imaging findings; and discuss their probable relationship to the greater trochanteric pain syndrome. SUBJECTS AND METHODS: Two hundred fifty MR imaging examinations of the hip were performed for the evaluation of buttock, lateral hip, or groin pain. The findings were reviewed for changes in the morphology or signal intensity of gluteus medius and minimus muscles and tendons and for any peritendinous abnormality including distention of regional bursae. RESULTS: Thirty-five studies met our criterion of showing either tendinosis or tears of gluteus medius and minimus muscles as the primary positive finding. Eight patients had complete retracted tears of the gluteus medius, and 14 patients had partial tears; in 13 patients, MR findings were consistent with tendinosis. The gluteus minimus muscle was also involved in 10 patients. MR imaging findings were the same as those described for tears and tendinosis of other regions of the body. Surgical proof of a tendon tear was obtained in six patients. CONCLUSION: Tendinopathy of the hip abductors and gluteus medius and minimus muscles was a common finding on MR imaging in our patients with buttock, lateral hip, or groin pain. Tendinopathy is probably a frequent cause of the greater trochanteric pain syndrome, a common regional pain syndrome that can mimic other important conditions causing hip pain including avascular necrosis and stress fracture. Moreover, it is likely that trochanteric bursitis is associated with tendinopathy.

Arthralgia↗

Social competence and head injury: a practical approach.

Social competence assessment and training has long focused on specific skills within the clinical setting. In addition, emphasis has been placed on identifying deficits relative to an arbitrary, often idiosyncratic metric. In this article, we discuss the importance of the principles that underlie communication and which are reflected in the range of behaviours described as 'social competence'. We review methods we have found productive in the training of these principles with persons who have suffered traumatic brain injuries.

Brain Injuries↗

Social competence and head injury: a new emphasis.

In the push for quantifiable outcome-based rehabilitation programmes, sensitivity to the integrity and uniqueness of the individual has been moved to the background. This has been particularly noticeable in the area of social skills therapy for persons who have suffered a traumatic head injury. We review some of the patterns of normal communication, with particular reference to roles, communicative relationships and individual differences, in order to clarify the difficulties in making clinical judgements about these skills. We propose a shift in focus to establishing a symmetrical therapeutic relationship in which communication is based on respect rather than structure and control. We utilize the clients' insights into their own social communication problems to enable them to be primary managers of their activities. The clinician's responsibility is not only to be a resource but also to be actively involved in the therapeutic process by reviewing his or her own social communication patterns in and outside of the therapy sessions. We argue that, with this perspective, activities can focus on principles of communication rather than specific skills, resulting in improved generalization and long-term outcome.

Adult↗

Massive allografting for severe failed total hip replacement.

We are presenting the cases of five patients that illustrate the uses of large, frozen bone and osteoarticular allografts in dealing with severe structural deficiency about the hip joint associated with prior failed total hip replacement. The status of the grafts was assessed at a minimum follow-up of twenty-four months (average, thirty months). In four patients extensive grafts in the proximal part of the femur in conjunction with total hip-replacement components were used, and in the fifth patient a matched whole-joint transplant of the proximal part of the femur and the acetabulum was employed. The short-term clinical advantage of these massive grafts is clear, but the long-term results are uncertain.

Adult↗