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PubMed1986

Optimizing pulse sequences for magnetic resonance imaging of the musculoskeletal system.

On the surface, pulse sequence optimization seems like a difficult problem because of the many variables involved. In practice, however, the simple strategy of obtaining both T1- and T2-weighted images of the body part in question is adequate in most musculoskeletal imaging. This strategy virtually guarantees the production of images with adequate contrast between normal and abnormal tissue, no matter which of the common background tissues is considered. Although intravenous contrast agents can improve the already excellent contrast between musculoskeletal tissues, it is too early to tell the exact role they will play in the work-up of musculoskeletal disease.

Adipose Tissue↗
PubMed1991

Pain and discomfort in the musculoskeletal system among dentists.

The dentists in the Public Dental Service were found to have a high prevalence of pain and discomfort in the locomotor system. Only 60 (17%) dentists reported no pain or discomfort in the study in 1987. Of 359 dentists 72 per cent reported headache and pain and discomfort in the neck and shoulders. Female dentists had a higher prevalence of pain and discomfort. Younger dentists had pain and discomfort in the neck, shoulders and headaches to a greater extent than older dentists. Male dentists, who positioned their patient carefully to gain a direct view suffered less from headache. Furthermore, dentists who used the mirror reported less headache and pain and discomfort in the shoulders. Differences in working position in a simulated case were analysed during a visit to the workplace of 143 dentists. The ergonomic examination showed that dentists without symptoms applied a wedge cushion under the upper part of the patient's back to obtain an optimum view when they examined tooth 2 6 d. They also made use of the pauses intrinsic in the work. The dentists with symptoms experienced the workload as more unsatisfactory, were more burdened by anxiety, had poorer psychosomatic health and less confidence in the future than the dentists without symptoms. Specialists, both with and without cervico-brachial symptoms, were more satisfied with their personal control over their work and the stimulation from their work than were general practitioners. The specialists also had more self-confidence, and experienced less anxiety than general practitioners and head dentists. Physiotherapy with a psychosomatic approach and individual ergonomic instruction gave better relief from pain and discomfort and an increased feeling of mental well-being than did ergonomic instruction only. In the prospective study it was found that the prevalence of musculoskeletal pain and discomfort had increased since 1987, except with respect to low back pain and headache. However, the only significant difference was found with respect to the shoulders. As in 1987, female dentists had a higher prevalence of pain and discomfort in the neck and shoulders than their male colleagues in 1990. It can be concluded that pain and discomfort in the locomotor system among dentists had a high incidence. The high incidence among dentists could not be explained by the ergonomic risk factors such as positioning of the patient, use of the mirror or alteration of the dentist's position. Regression analysis showed that personal harmony and age had the highest value for explaining the number of painful sites in the musculoskeletal system.

Adult↗
PubMed2004

[Determinants of musculoskeletal system load and their health effects among nurses from four Poznan hospitals].

BACKGROUND: This paper is an analysis of a current knowledge of ergonomic weight lifting, work conditions, and their health effects on the locomotion system in selected groups of nurses employed in four hospitals in Poznań. MATERIALS AND METHODS: The analysis was carried out in 213 hospital nurses. The 22-32 age group was most representative (108 persons, 50.7%). In the analysis, a questionnaire on work conditions, ergonomic knowledge, and locomotion system complaints was used. RESULTS: Unfortunately, the nurses' knowledge of maximum values of lifting weights for working women is very limited, and their familiarity with ergonomic work with patients is inadequate. The number of auxiliary devices facilitating the work with patients in hospitals under study was far from being satisfactory. Of the total number of the interviewed nurses, 73.23% reported complaints of joint and back pains. Pains in L-S and cervical sections of the backbone were most frequently reported (110 nurses, 51.64%; 30 nurses, 14.08%, respectively). More than a half of nurses (55.86%) link their pain complaints with patient lifting. The authors found a significant statistical relationship between the presence of facilitating devices and the presence of L-S backbone pains. More devices, less pains. In the analysed population, nurses carrying >30 kg compared to those carrying < or =25 kg, frequency of complains concerning low-back-pain increased about 90% (p-value = 0.02). CONCLUSIONS: This analysis showed the significance of the problem of the locomotion system load among nurses, whereas preventive means and actions to solve it are unsatisfactory in Poland. Also the study population of nurses showed insufficient knowledge of ergonomic lifting of patients and adopted norms in this area. This highlights striking ineffectiveness or lack of training in work hygiene and safety addressed to nurses. An insufficient number of nurses is another problem responsible for breaking or neglecting maximum allowable values of lifting weights for women, which are binding in Poland. Owing to these the locomotion system complaints among hospital nurses are so frequently reported.

Adult↗
PubMed1997

GRASE: ultra-fast turbo gradient spin-echo sequence. A new approach to fast MR imaging of the musculoskeletal system.

PURPOSE: Ultra-fast gradient and spin-echo (GRASE) imaging is a hybrid of turbo spin-echo (TSE) and echo-planar imaging (EPI). One scan consists of several spin echoes (SEs) (turbo factor, TF), each of which consists of a number of gradient echoes (EPI factor, EF). The aim of our study was to evaluate different combinations of TF and EF in GRASE imaging and to test its usefulness in musculoskeletal imaging. MATERIAL AND METHODS: On a 1.0 T MR unit, 11 GRASE sequences with different combinations of TF and EF (TR/TE 2150/120 ms) were evaluated in phantom studies with respect to signal-to-noise (S/N) ratio, nonuniformity of images, and geometrical distortion. From this study, the optimal GRASE-sequence was applied to 25 patients with different joint pathologies and compared to a T2-weighted TSE sequence (TR/TE 2855/130 ms). Lesion visualization, conspicuity, overall image quality, and artifacts were qualitatively analyzed by two observers independently of each other. RESULTS: With respect to S/N ratio, signal nonuniformity, and geometrical distortion, the GRASE sequence with TF/EF 7/3 (S/N 47; signal nonuniformity 11.7%; distortion 1 pixel) proved to be superior to the other GRASE sequences within a scanning time of less than 120 s. In a clinical study, the GRASE sequence proved superior to T2-weighted TSE (without fat suppression) in the visualization of bone-marrow and soft-tissue lesions (p < 0.001) and ligamentous injuries, although the image quality was inferior.

Artifacts↗
PubMedDate not supplied

[Disability and attitude to preventive measures in patients with acute and chronic diseases of the musculoskeletal system].

The steady increase in the number of patients with musculoskeletal disorders has increased correspondingly the importance of prevention and health promotion in this area. Under the new health reform laws for health promotion we developed a concept of health counselling for persons suffering from acute or chronic musculoskeletal (rheumatic) disorders. In the context of the formative evaluation we surveyed in 1992 the insured persons via a questionnaire classifying them into three different groups of healthy persons and persons with acute and chronic complaints (criterion: accumulated days of work absenteeism). We asked the patients about frequency of rheumatic complaints, subjective and functional injuries. We also investigated the attitudes towards preventive interventions. Parameters like days of work absenteeism and cluster of diagnosis from the database of the health insurance company complete the subjective data.

Adult↗
PubMed2002

[Basic research of applying extracorporeal shockwaves on the musculoskeletal system. An assessment of current status].

Detailed knowledge concerning the action of extracorporeal shock waves on the locomotor system as well as concerning possible side effects of extracorporeal shock wave therapy (ESWT) are crucial to optimize the clinical use of ESWT for the treatment of illnesses such as calcific tendinitis of the shoulder, tennis elbow, plantar fasciitis, aseptic pseudarthrosis, and aseptic hip necrosis. This study presents the current knowledge gained from animal experiments, which have yielded important findings, in particular concerning possible side effects of ESWT. Very recent studies have also provided valuable insights into the molecular actions of extracorporeal shock waves on the locomotor system. Further intensified experimental animal research will greatly improve the scientific basis for the clinical use of ESWT in the near future.

Animals↗
PubMed1999

Modes of local drug delivery to the musculoskeletal system.

A number of methods for the local delivery of drugs to musculoskeletal tissues in the horse are now available. Further research is required to document the disposition of drugs delivered by such methods and to correlate this information with efficacy. Perhaps the greatest potential area for the methods discussed is the treatment of synovial and bone infections. To be able to provide high and sustained therapeutic concentrations of antimicrobials to the site of infection should increase the chances of success in such cases. These methods of drug delivery need to be used in conjunction with other management procedures, however, including bacterial culture and sensitivity procedures, systemic antimicrobials, surgical drainage, removal of dead bone or surgical implants, establishment of fracture stability, use of autogenous bone grafts, systemic NSAIDs, and rest.

Adrenal Cortex Hormones↗
PubMed2006

Bioreactors for tissues of the musculoskeletal system.

Muskuloskeletal tissue includes bone, cartilage, ligament, skeletal muscle and tendons. These tissues malfunction either due to a natural injury, trauma, or a disorder. In all cases natural regeneration needs to be enhanced by medication and, in many instances, by surgery. Surgical techniques are limited to suturing, autografts or allografts. Tissue engineering stems from the challenge presented by the limited resources for natural implants and the ineffectiveness of previous curing techniques. The challenge in tissue engineering resides in the design of a functional bioreactor that would: (1) house the engineered construct under sterile conditions; and (2) provide the appropriate stimuli that would result in a neotissue with biochemical and biomechanical properties comparable to in situ tissue. The various types and designs of bioreactors for the regeneration of musculoskeletal tissue, including spinner flask, rotating wall vessel, flow perfusion, and mechanical loading devices are presented in this paper.

Animals↗
PubMed2006

The role of biomaterials in stem cell differentiation: applications in the musculoskeletal system.

The capabilities of stem cells continue to be revealed, leading to excitement regarding potential new therapies. Regenerative medicine is an area in which stem cells hold great promise for overcoming the challenge of limited cell sources for tissue repair. Biomaterials play an important role in directing tissue growth and may provide another tool to manipulate and control stem cell behavior. Biomaterials are made from natural or synthetic polymers and can be processed into three-dimensional scaffolds designed to promote cell proliferation and/or differentiation that ultimately produces new tissue. Stem cells will have a significant impact on the fields of regenerative medicine and tissue engineering as a powerful cell source that will work, in conjunction with biomaterials, to treat tissue and organ loss. Herein, we survey our latest research on applying embryonic stem (ES) cells to hydrogel biomaterials for engineering musculoskeletal tissues, emphasizing the unique biomaterial requirements of ES cells for differentiation and tissue development.

Animals↗