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At least 271 records · Page 15Linked to original sources

[Fast and ultra-fast imaging of the musculoskeletal system].

Using fast and ultra fast MRI-techniques saves considerable investigation time. Particularly, gradientecho- und fast-spinecho-sequences are alternatives to time-consuming T2-weighted spinecho-sequences. Peculiarities in contrast and applications of these new techniques are discussed considering musculoskeletal MRI. Ultra fast techniques as fast-gradientecho-, GRASE- and EPI-sequences may be beneficial for joint cinematographic and contrast-dynamic studies in arthritis or tumors. Advantages and applications are summarized.

Contrast Media↗

Pain and discomfort in the musculoskeletal system among dentists. A prospective study.

The aim of this prospective study was to follow the pain and discomfort among dentists in the Public Dental Service in Malmöhus District and the Municipality of Malmö. In this investigation 311 dentists, who had answered questionnaires in 1987 and in 1990, took part. The prevalence of musculoskeletal pain and discomfort had increased, except the lower back pain and headache. However, the only significant difference was found with respect to the shoulders. As in 1987, female dentists had also in 1990 a higher prevalence of pain and discomfort in the neck and shoulders than their male colleagues. Of the 311 dentists, 262 had symptoms both in 1987 and in 1990. In 1987 forty-nine dentists were free of symptoms, while 24 of them reported symptoms in the locomotor system in 1990. Of the 262 dentists with symptoms in 1987 twenty-four were without symptoms at the follow-up in 1990. The aim of the investigation was also to study the influence of some ergonomic factors on the course of symptoms. However, these ergonomic variables showed a low predictive value for recovery or for the development of pain and discomfort in the locomotor system.

Absenteeism↗

[Tuberculosis manifestations in the musculoskeletal system exemplified by Poncet's disease].

Tuberculosis is a communicable disease that is occasionally complicated by arthritis, either as part of a disseminated primary infection or through late reactivation, often in immunocompromised hosts such as elderly people, HIV-positive patients or patients under immunosuppressive therapy. Even though musculoskeletal manifestations occur in only about 2% of tuberculosis cases, they can be very heterogeneous and present as spondylitis, osteomyelitis or mono-oligo-polyarthritis. Because of the potential for disastrous outcomes in cases where the diagnosis is delayed, it is important to recognize the multiple rheumatological manifestations of tuberculosis. This case report on a patient with Poncet's disease discusses a current hypothesis regarding pathogenesis of reactive arthritis based on rheumatological manifestations of tuberculosis. The genomic detection of Mycobacterium tuberculosis, to differentiate between infectious arthritis and reactive arthritis by polymerase chain reaction, is of particular importance.

AIDS-Related Opportunistic Infections↗

Aging in the musculoskeletal system of rhesus monkeys: II. Degenerative joint disease.

In order to discuss the rate and onset of adult aging in rhesus monkeys, 55 adult animals from the Wisconsin Regional Primate Research Center and the University of Wisconsin Psychology Primate Laboratory were examined. Degenerative joint disease (DJD) at the hip and spine was scored, and loss of passive joint mobility at the hip was measured. Development of DJD at both the hip and spine was significantly and positively correlated with age. Spinal changes, especially at the thoraco/lumbar intervertebral symphyses, appeared to develop somewhat more rapidly than hip degeneration. In some individuals, DJD was observed soon after the completion of growth, but pronounced changes seldom occurred before the middle of the second decade of life. Similarly, age-dependent losses of passive joint mobility appeared to begin early in ontogeny and to become increasingly pronounced in the aging adult. Although interspecific comparisons are difficult due to intraspecies and intraindividual variation, the timing of musculoskeletal aging in the rhesus spine and hip differs from that observed in humans in a way that parallels previously documented species differences in patterns of musculoskeletal growth. These observations and data on age-related change in other systems, suggest that rates and durations of many ontogenetic processes in rhesus monkeys are approximately three times as fast and one-third as long as those of the corresponding human processes. Importantly, differences in the timing of reproduction do not appear to follow the same scaling factor observed in other systems. Although reproduction may, therefore, be under separate control, the consistent pattern observed in other aspects of somatic growth and aging supports the hypothesis (Cutler, 1976; Sacher, 1978) that evolutionary changes in ontogeny have resulted from selection acting upon a few genes with widespread regulatory effects.

Aging↗

Secondary conditions of the musculoskeletal system in adolescents and adults with cerebral palsy.

Cerebral palsy (CP) is a disability that affects individuals throughout their lifespan. Adolescents and adults with CP are at risk for many secondary conditions that cause a loss of function and deterioration of quality of life. This article presents a review of the literature of musculoskeletal conditions of people with CP that can develop or worsen across the lifespan as a consequence of the primary neuromotor impairments. Health care behaviors of adolescents and adults with CP are discussed and their impact on secondary conditions is examined. Suggestions for how pediatric occupational therapists and physical therapists can assist children and adolescents to take responsibility for their own health and wellbeing are presented. Lastly, occupational therapists and physical therapists are encouraged to take responsibility for treating musculoskeletal impairments and disabilities in adults with CP.

Adolescent↗

Imaging in orthopedic surgery and other conditions of the musculoskeletal system.

Interest continues in total joint replacement and its complications. Now that noncemented arthroplasties have been introduced, further radiographic signs are being elucidated. The roles of bone scanning and aspiration arthrography are also being reevaluated. Ultrasonography has become the imaging modality of choice in congenital hip dysplasia and is being used increasingly in the evaluation of other musculoskeletal conditions. The ilizarov distraction osteogenesis technique is also discussed and there has been increasing interest in anterior cruciate ligament reconstruction and its sequelae.

Bone and Bones↗

Sweet's syndrome involoving the musculoskeletal system during treatment of promyelocytic leukemia with all-trans retinoic acid.

Induction therapy of promyelocytic leukemia with all-trans retinoic acid is a standard therapy despite significant side-effects. The most important, the "retinoic acid syndrome", consists of a hyperinflammatory reaction with capillary leakage (edema, pleural, and pericardial effusion), infiltration of myeloid cells into internal organs and systemic signs of inflammation. We describe here two cases of another hyperinflammatory reaction during all-trans retinoic acid therapy, the Sweet's syndrome, consisting of infiltrates of the skin and internal organs by neutrophilic granulocytes. Fever, painful erythematous cutaneous plaques, prominent musculoskeletal involvement (myositis, fasciitis), a sterile pulmonary infiltration and intercurrent proteinuria characterized the clinical course of all-trans retinoic acid-associated Sweet's syndrome. Treatment with glucocorticoids led to resolution of the syndrome within 48 h. Three other cases of all-trans retinoic acid-associated Sweet's syndrome without involvement of internal organs, prominent on our cases, were published previously. Recognition of ATRA-associated Sweet's syndrome is of practical importance.

Adult↗

Learning combined feedback and feedforward control of a musculoskeletal system.

The goal of this paper is the learning of neuromuscular control, given the following necessary conditions: (1) time delays in the control loop, (2) non-linear muscle characteristics, (3) learning of feedforward and feedback control, (4) possibility of feedback gain modulation during a task. A control system and learning methodology that satisfy those conditions is given. The control system contains a neural network, comprising both feedforward and feedback control. The learning method is backpropagation through time with an explicit sensitivity model. Results will be given for a one degree of freedom arm with two muscles. Good control results are achieved which compare well with experimental data. Analysis of the controller shows that significant differences in controller characteristics are found if the loop delays are neglected. During a control task the system shows feedback gain modulation, similar to experimentally found reflex gain modulation during rapid voluntary contraction. If only limited feedback information is available to the controller the system learns to co-contract the antagonistic muscle pair. In this way joint stiffness increases and stable control is more easily maintained.

Cybernetics↗

Factors interacting with perceived work-related complaints in the musculoskeletal system among home care service personnel. An explorative multivariate study.

The interrelationships between reported complaints, certain sociodemographic data and ergonomic, physical and psychosocial aspects of the work-environment were investigated in a cross-sectional study of home care service personnel using a questionnaire. Ninety-seven out of 160 randomly selected women took part in pre-tests (presented here), post-tests and one year exercise program. Significant correlations existed between musculoskeletal complaints, other (somatic and psychosomatic) symptoms and anxiety/threat for differently, mainly work-related negative changes. The group of subjects could be divided into three subgroups. A "complaint group" was identified with a high prevalence of musculoskeletal and other somatic/psychosomatic symptoms. This group had the most negative ratings on the ergonomic and physical work-environment indices. A "young group" had the most negative perception of the psychosocial work-environment. The "healthy group" generally perceived the situation best. The present preliminary study could indicate that work-related interventions/rehabilitation programmes undertaken for the complaint group must be designed in another way and with other goals than those directed towards the other two identified groups.

Adult↗

[Differential diagnosis of chronic pain syndromes of the musculoskeletal system--coding according to ICD-10].

Primary care for patients suffering from chronic pain is regularly provided by either family physicians or inpatient medical wards. A delay in initiating specific pain treatment is associated with poor outcome in terms of pain intensity, work disability and diminished quality of life. We present a diagnostic classification scheme for chronic pain disorders following the biopsychosocial disease model. This classification may help primary care providers initiate appropriate treatment early in the course of chronic pain, and aid in referral of their patients to services familiar with the treatment of chronic pain. Given increasing requests for quality control in health care and for transparency in disease management by health insurance companies, we propose a coding system of chronic non-malignant pain syndromes with the ICD-10.

Adult↗

Malignancies of the musculoskeletal system.

Malignant bone tumors (sarcomas) are uncommon but diverse in presentation and biological behavior. Major advances in diagnostic imaging, histologic evaluation, operative strategies, and adjuvant therapies have contributed to limb-sparing surgical procedures and improved patient survival rates.

Adolescent↗

3T MR imaging of the musculoskeletal system (Part I): considerations, coils, and challenges.

As 3T MR imaging systems become more wide-spread in the clinical realm, a full understanding of the opportunities for image improvement and the limitations in the applications of the signal gain is needed. It is clear that even with current coil technology, much of the gain in signal can be harnessed effectively; however, continued coil development is necessary to realize the full potential of 3T, especially with the wonderful synergy that can be achieved with the use of parallel imaging and multiple-channel phased-array extremity coils. Furthermore, despite the theoretic imaging challenges at higher field strengths (eg, susceptibility, chemical shift, SAR, pulsation, T1 time prolongation, and T2 time shortening), the techniques and methods that were discussed above can eliminate any obstacles to clinical imaging. This creates excellent opportunities to improve image quality, spatial resolution, and diagnostic accuracy in the musculo-skeletal system. From the author's experience, the superb image quality has impressed referring orthopedic surgeons, and the reduction in scan time has resulted in greater patient satisfaction and reduced anxiety.

Artifacts↗

Applications of magnetization transfer contrast in the musculoskeletal system in children.

Magnetization transfer (MT) is a new MR imaging technique which has the potential to create contrast differences between normal and pathologic tissues distinct from T1- and T2-weighted contrast. The technique has been used in adults but received little consideration for pediatric imaging. This article reports the successful creation of MT contrast between normal and abnormal tissues in seven children.

Adolescent↗