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PubMed2000

Human skeletal muscle: sodium MR imaging and quantification-potential applications in exercise and disease.

PURPOSE: To use sodium 23 magnetic resonance (MR) imaging to quantify noninvasively total sodium in human muscle and to apply the technique in exercise and musculoskeletal disease. MATERIALS AND METHODS: Total [Na] sodium was determined from the ratio of the relaxation-corrected (23)Na signal intensities measured from short echo-time (0.4 msec) (23)Na images to those from an external saline solution reference. The method was validated with the blinded use of saline solutions of varying sodium concentrations. [Na] was measured in the calf muscles in 10 healthy volunteers. (23)Na MR imaging also was performed in two healthy subjects after exercise, two patients with myotonic dystrophy, and two patients with osteoarthritis. RESULTS: (23)Na MR imaging yielded a total [Na] value of 28.4 mmol/kg of wet weight +/- 3.6 (SD) in normal muscle, consistent with prior biopsy data. Spatial resolution was 0.22 mL, with signal-to-noise ratio of 10-15. Mean signal intensity elevations were 16% and 22% after exercise and 47% and 70% in dystrophic muscles compared with those at normal resting levels. In osteoarthritis, mean signal intensity reductions were 36% and 15% compared with those in unaffected knee joints. CONCLUSION: (23)Na MR imaging can be used to quantify total [Na] in human muscle. The technique may facilitate understanding of the role of the sodium-potassium pump and perfusion in normal and diseased muscle.

Adult↗

PubMed2004

Evaluation of ultrasonographic angle and linear parameters in the diagnosis of developmental dysplasia of the hip.

Angle parameters proposed by Graf and linear parameters introduced by Morin are the most common currently in use for quantification and classification of ultrasonographic findings in the diagnosis of developmental dysplasia of the hip. The aim of this study was to determine which of the two parameters is more suited to routine clinical use. Investigation was carried out on 100 hips of 50 infants by the same examiner who obtained two separate sonograms for each hip. Based on the results of our study, angle parameters appear to be more functional in identifying and classifying pathology, and more adequate for screening and diagnosis.

Acetabulum↗

PubMed1996

Arthroscopic evaluation of chondropathy in osteoarthritis of the knee.

OBJECTIVE: To evaluate arthroscopic findings as a potential measurement of severity and outcome of chondropathy. METHODS: 110 patients with knee osteoarthritis (OA) were included in a cross sectional study and 41 of them in a one year longitudinal study. The evaluation of OA performed once in the cross sectional study and twice (at entry and after one year) in the longitudinal study, included clinical, radiological and arthroscopic variables evaluating disease activity and severity. Arthroscopy was performed. under local anesthesia in an outpatient procedure using a small arthroscope. Chondropathy was evaluated by the overall assessment of the investigator by visual analog scale and the Société Française d'Arthroscopie (SFA) scoring and grading systems, which represent a composite index taking into account depth, size, and localization of the articular cartilage lesions. RESULTS: The intrinsic validity of the arthroscopic variables was suggested by highly significant correlation (R2 = 80-85%) between the overall assessment of the investor and the SFA systems. There was also highly significant correlation (p < 0.01) between the arthroscopic and radiological variables. Intraobserver reliability of the arthroscopic quantification of chondropathy was better than interobserver reliability. In the cross sectional study, severity of chondropathy correlated with both age and body mass index. In the longitudinal study there was statistically significant worsening in the severity of chondropathy and statistically significant correlation between the changes in the severity of chondropathy and changes in functional impairment. CONCLUSION: We conclude that arthroscopy might be considered a relevant measurement of OA outcome for research purposes.

Arthroscopy↗

PubMed1994

Basic fibroblast growth factor (BFGF) immunoreactivity as a possible link between head injury and impaired bone fracture healing.

Healing of fractures of long bones or large joints is often accelerated in patients with severe traumatic brain injury (TBI). However, in these patients an early fracture healing is accompanied by hypertrophic callus formation or heterotopic ossifications which might even result in an ankylosis of the affected joints. It seems that enhanced osteogenesis in patients suffering from TBI could be caused by some humoral factors, since the sera of these patients strongly promote the growth of osteoblast cells in vitro. However, humoral growth promoting factors which could perhaps induce enhanced osteogenesis are not yet identified. Hence, the aim of this study was to analyse if basic fibroblast growth factor (bFGF) could be related to the phenomenon of enhanced osteogenesis, since bFGF stimulates the growth of osteoblasts in vitro and could be found both in the brain and the bone tissue. For that purpose the values of bFGF immunoreactivity were determined in the sera of patients with TBI and bone fractures (n = 8) as well as in the sera of patients with either TBI alone (n = 10) or bone fractures alone (n = 7), during a period of three months after injury. Quantification of the bFGF immunoreactivity was done using the ELISA based on monoclonal antibodies raised against the recombinant human bFGF. The bFGF immunoreactivity values obtained were also compared with the values determined in the sera of normal, healthy persons (n = 9). In the group of patients with bone fractures alone only a transient increase of bFGF immunoreactivity (threefold above the normal values) was observed in the second week after injury. A similar increase of the values of bFGF immunoreactivity was also determined in the sera of patients with TBI only, but it lasted longer (from the 1st until the 7th to 8th week after injury). In the case of patients with TBI and bone fractures a specific pattern of post-traumatic dynamic change of the values of serum bFGF immunoreactivity was observed. Namely, the increase of bFGF immunoreactivity (up to seven-fold above the normal values) was determined even during the first week after injury. Afterwards, periods of high values of bFGF immunoreactivity observed during the 2nd, 4th and the 7-10th weeks after injury were interrupted by sudden decreases even to the normal values (during the 3rd and the 5-6th week after injury).(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

PubMed2002

Locomotor performance of the rat after neonatal repairing of spinal cord injuries: quantitative assessment and electromyographic study.

In spinal cord injuries, various attempts have been made to reconstruct neural connections once disrupted. To improve current procedures and develop therapeutic methodologies it appears important to compare these reconstructive attempts via a standardized quantification of any ensuing functional recovery with parallel correlations to any potentially repaired neural connections. We have reported previously a quantitative assessment of neural connections across the graft site of rats whose spinal cord segments were neonatally replaced with embryonic spinal cord segments or a peripheral nerve section under comparable conditions. Using this same experimental model the present study assessed locomotor performance quantitatively using an open field locomotor scale at various postoperative intervals from day 0 to 5 weeks postinjury. To examine hind-forelimb coordination in further detail, electromyography was employed to record simultaneously from all four limbs during locomotion. Half of the rats whose spinal cord segments were repaired by replacement with embryonic homologous structures acquired virtually normal locomotor function, with a delay of five days compared with that of sham-operated rats. Detailed analysis revealed an abnormality in ankle joint movement and the stability of trunk during locomotion. Electromyography revealed that the pattern of locomotion in these rats was similar to controls. Grafted segments joined with the host spinal cord without gliosis at the host-graft interface. The remaining rats with an embryonic tissue graft showed various grades of hind-forelimb coordination. Gliosis and cavity were observed at the host-graft interface. The rats whose spinal cord was repaired by periphral nerve graft lacked hind-forelimb coordination despite the achievement of weight-supported steps. It appears likely that the grade of locomotor performance depends on quantity and quality of reestablished neural connections across the graft.

Animals↗

PubMed1996

Pathologic staging of prostate carcinoma. What are the issues?

BACKGROUND: Stage is a significant predictor of outcome for patients with carcinoma of the prostate. The American Joint Committee on Cancer (AJCC) and the International Union Against Cancer (UICC) TNM staging system has gained general favor as the clinical staging system of choice for prostate carcinoma. With an increasing number of publications assessing prognostic markers for patients with carcinoma of the prostate, there is a need for the development of a uniform system of pathologic staging to support the clinical stage. METHODS: The literature related to pathologic prognostic markers for patients with carcinoma of the prostate, particularly with regard to staging, was reviewed. From this, issues important to the development of a pathologic correlate to the AJCC/ UICC TNM system were identified. RESULTS: A number of issues were identified related to the development of a pathologic staging system. For radical prostatectomy specimens some of the more important are whether or not subcategorization is needed in the pathologic classification of T2 tumors, definition and quantification of extraprostatic extension, and the reporting of positive surgical margins. CONCLUSIONS: There is a need for the development of a pathologic equivalent to the AJCC/UICC TNM clinical staging system for prostate carcinoma. Consensus needs to be reached on several important issues prior to the adoption and testing of such a system.

Carcinoma↗

PubMedDate not supplied

Ultrasound assessment of the polycystic ovary: international consensus definitions.

The polycystic ovary syndrome (PCOS) is a heterogeneous condition, the pathophysiology of which appears to be both multifactorial and polygenic. The definition of the syndrome has been much debated. Key features include menstrual cycle disturbance, hyperandrogenism and obesity. There are many extra-ovarian aspects to the pathophysiology of PCOS, yet ovarian dysfunction is central. At a recent joint ASRM/ESHRE consensus meeting, a refined definition of the PCOS was agreed, encompassing a description of the morphology of the polycystic ovary (PCO). According to the available literature, the criteria fulfilling sufficient specificity and sensitivity to define the PCO should have at least one of the following: either 12 or more follicles measuring 2-9 mm in diameter, or increased ovarian volume (> 10 cm3). If there is a follicle > 10 mm in diameter, the scan should be repeated at a time of ovarian quiescence in order to calculate volume and area. The presence of a single PCO is sufficient to provide the diagnosis. The distribution of follicles and a description of the stroma are not required in the diagnosis. Increased stromal echogenicity and/or stromal volume are specific to PCO, but it has been shown that the measurement of ovarian volume (or area) is a good surrogate for quantification of the stroma in clinical practice. A woman having PCO in the absence of an ovulation disorder or hyperandrogenism ('asymptomatic PCO') should not be considered as having PCOS, until more is known about this situation. Three-dimensional and Doppler ultrasound studies may be useful research tools but are not required in the definition of PCO. This review outlines evidence for the current ultrasound definition of the polycystic ovary and technical specifications.

Female↗

PubMed2003

Contamination of rural surface and ground water by endosulfan in farming areas of the Western Cape, South Africa.

BACKGROUND: In South Africa there is little data on environmental pollution of rural water sources by agrochemicals. METHODS: This study investigated pesticide contamination of ground and surface water in three intensive agricultural areas in the Western Cape: the Hex River Valley, Grabouw and Piketberg. Monitoring for endosulfan and chlorpyrifos at low levels was conducted as well as screening for other pesticides. RESULTS: The quantification limit for endosulfan was 0.1 microg/L. Endosulfan was found to be widespread in ground water, surface water and drinking water. The contamination was mostly at low levels, but regularly exceeded the European Drinking Water Standard of 0.1 microg/L. The two most contaminated sites were a sub-surface drain in the Hex River Valley and a dam in Grabouw, with 0.83 +/- 1.0 microg/L (n = 21) and 3.16 +/- 3.5 microg/L (n = 13) average endosulfan levels respectively. Other pesticides including chlorpyrifos, azinphos-methyl, fenarimol, iprodione, deltamethrin, penconazole and prothiofos were detected. Endosulfan was most frequently detected in Grabouw (69%) followed by Hex River (46%) and Piketberg (39%). Detections were more frequent in surface water (47%) than in groundwater (32%) and coincided with irrigation, and to a lesser extent, to spraying and trigger rains. Total dietary endosulfan intake calculated from levels found in drinking water did not exceed the Joint WHO/FAO Meeting on Pesticide Residues (JMPR) criteria. CONCLUSION: The study has shown the need for monitoring of pesticide contamination in surface and groundwater, and the development of drinking water quality standards for specific pesticides in South Africa.

Agriculture↗

PubMed2001

Predictive value of bone mineral density and morphology determined by peripheral quantitative computed tomography for cancellous bone strength of the proximal femur.

Peripheral quantitative computed tomography (pQCT) is an established diagnostic method for assessment of bone mineral density in the diagnosis of osteoporosis. However, the capacity of structural parameters of cancellous bone measured by high-resolution computed tomography remains to be explored. In 33 patients, bone mineral density (BMD) of the proximal femur was measured in vitro by pQCT using cylindrical biopsies from the intertrochanteric region harvested before the implantation of an artificial hip joint. By digital image analysis of CT scans, parameters derived from histomorphometry describing the microarchitecture of cancellous bone were measured. The biopsies were also loaded to failure by an uniaxial compression test to determine the biomechanical parameters, Young's modulus, strength, and maximum energy absorption (E(max)). Strong correlations were found for BMD vs. mechanical parameters (r = 0.73 for Young's modulus, r = 0.82 for strength, and r = 0.79 for E(max); p < 0.001, n = 29). The morphological parameters, bone volume per trabecular volume (BV/TV), apparent trabecular thickness (app.Tb.Th), apparent trabecular separation (app.Tb.Sp), and trabecular number (Tb.N), correlated significantly with all mechanical parameters. The combination of morphological parameters with BMD in a multivariate regression model led to an overall, but only moderate, increase in R(2) in all cases. Our data confirm the high predictive value of BMD for the mechanical competence of cancellous bone of the intertrochanteric region. However, quantification of cancellous bone structure by image analysis of CT scans may provide additional qualitative information for the analysis of bone strength.

Aged↗

PubMed2003

Toxicological effects of chronic low doses of aflatoxin B(1) and fumonisin B(1)-containing Fusarium moniliforme culture material in weaned piglets.

The effects of chronic oral exposure (28 days) to aflatoxin B(1) (AFB(1)) and fumonisin B(1) (FB(1)) were studied in weaned piglets. Six experimental groups, each comprising two neutered males and two females, were fed ad libitum with rations containing: (A) 0 mg of FB(1) and 0 mg of AFB(1)/kg of feed (control); (B) 10 mg of FB(1)/kg of feed; (C) 30 mg of FB(1)/kg of feed; (D) 50 microg of AFB(1)/kg of feed; (E) 10 mg of FB(1) plus 50 microg of AFB(1)/kg of feed; (F) 30 mg of FB(1) plus 50 microg of AFB(1)/kg of feed. The animals were inspected twice daily and their body weight and feed consumption were recorded weekly and daily, respectively. Samples of feces and urine were collected 24 h after the start of the experiment, to check for fumonisin residues by HPLC analysis. Blood samples were drawn at the start of the experiment and after 28 days for quantification of hematological and biochemical parameters. Necropsies were performed after 28 days; at necropsy, the organs were weighed, inspected macroscopically and processed for histopathological and toxicological analyses. All piglets from groups C and F presented typical signs of pulmonary edema, with reduced feed consumption and body weight gain as well as pathological alterations. FB(1) was detected in feces and urine at 24 h of intoxication and in liver after 28 days of intoxication. Increases were detected regarding the following hematological and biochemical parameters in animals from treatments C and F: erythrocyte number; hematocrit; total bilirubin; total protein; activity of serum alkaline phosphatase, aspartate aminotransferase, and alanine aminotransferase. Cholesterol levels were significantly aumented only in animals from groups C and F, whereas albumin concentrations increased in groups C, F, B and E. The average organ/body weight ratio of piglets (hearth, liver and lung) were significantly greater in groups C and F. The only joint effects of FB(1) and AFB(1) detected (group F) were a decrease in feed consumption during the last week of intoxication and in feed conversion throughout the 28 days of intoxication. Chronic intoxication of piglets with AFB(1) and FB(1) leads to important losses of productivity.

Aflatoxin B1↗

PubMed1989

[Stress and quantification of pressures borne by the hip in unilateral support in the sagittal plane. I].

Thanks to the works of Pauwels, the pressures sustained by the hip during unilateral weightbearing in the frontal plane are now well known and have given rise to a number of surgical applications. Considered as negligible by Pauwels, the sagittal plane has been little studied; in fact, with Pauwels' methodology, but taking into account the muscular moments, it appears that the forces exerted in the sagittal plane are far from being negligible and vary, according to the phase of weightbearing, from once the weight of the body (weightbearing on the sole) to two and a half times the weight of the body (weightbearing on the heel).

Biomechanical Phenomena↗

PubMed2006

Combined uptake of [18F]FDG and [18F]FMISO correlates with radiation therapy outcome in head-and-neck cancer patients.

PURPOSE: FDG PET is frequently used for radiotherapy (RT) planning to determine the tumour extent. Similarly, FMISO is used to assess the hypoxic sub-volume. The relationship between the volumes determined on the basis of FDG and FMISO was investigated. Additionally, the quantitative correlation of the tracers on a voxel basis was studied. METHODS: Twelve head-and-neck cancer (HNC) patients underwent FDG and FMISO PET examinations prior to RT treatment. The tumour volumes assessed by the two tracers and also the voxel-based joint uptake values were investigated. The characteristic shapes and patterns of the determined scatter plots were analyzed. A number of different variables such as the maximum uptake values of FDG and FMISO, the FDG and FMISO positive volumes, the slope m of the regression line and the scatter width sigma of the scatter plots were tested for their ability to stratify the patient group with respect to treatment outcome. RESULTS: A diversity of characteristic FDG-FMISO distributions was observed in the patient group. However, no general correlation of enhanced glucose metabolism and FMISO uptake was observed. The maximum uptake of FMISO (p=0.045) showed borderline significance for stratifying the patient group. FDG positive tumour volume, hypoxic fraction, maximum FDG uptake and m were not significant. Sigma turned out to be the most significant variable (p=0.008) to predict treatment success probabilities. CONCLUSION: FMISO and FDG PET data provide independent information about the examined tumour. A quantification of the correlated tracer uptake seems to be meaningful.

Aged↗

PubMed1997

International Cooperative Ataxia Rating Scale for pharmacological assessment of the cerebellar syndrome. The Ataxia Neuropharmacology Committee of the World Federation of Neurology.

Despite the involvement of cerebellar ataxia in a large variety of conditions and its frequent association with other neurological symptoms, the quantification of the specific core of the cerebellar syndrome is possible and useful in Neurology. Recent studies have shown that cerebellar ataxia might be sensitive to various types of pharmacological agents, but the scales used for assessment were all different. With the long-term goal of double-blind controlled trials-multicentric and international-an ad hoc Committee of the World Federation of Neurology has worked to propose a one-hundred-point semi-quantitative International Cooperative Ataxia Rating Scale (ICARS). The scale proposed involves a compartimentalized quantification of postural and stance disorders, limb ataxia, dysarthria and oculomotor disorders, in order that a subscore concerning these symptoms may be separately studied. The weight of each symptomatologic compartment has been carefully designed. The members of the Committee agreed upon precise definitions of the tests, to minimize interobserver variations. The validation of this scale is in progress.

Cerebellar Ataxia↗

PubMed1996

Older males secrete luteinizing hormone and testosterone more irregularly, and jointly more asynchronously, than younger males.

New statistical perspectives on the secretory patterns of both luteinizing hormone (LH) and testosterone (T) may prove useful in further understanding the aging process, and possibly ultimately in improving the diagnosis and treatment of spermatogenetic failure and loss of sexual interest. We examined serum concentration time-series for LH and T in 14 young (21-34 years of age) and 11 aged (62-74 years of age) healthy men. For each subject, blood samples were obtained at 2.5-min intervals during a sleep period, with an average sampling duration of 7 hr. For each of LH and T, we used the model-independent statistic approximate entropy (ApEn) to quantify the irregularity of the serum concentration time-series; to quantify joint LH-T secretory asynchrony, we employed the recently introduced cross-ApEn. Although mean (and SD) LH and T concentrations were indistinguishable in the two age groups (P > 0.25), for LH, aged subjects had greater ApEn values (1.525 +/- 0.221) than younger individuals (1.207 +/- 0.252), P < 0.003, indicating more irregular secretion in the older cohort. For T, aged subjects also had greater ApEn values (1.622 +/- 0.120) than younger counterparts (1.384 +/- 0.228), P < 0.004. In young, but not older men, ApEn(T) significantly exceeded ApEn(LH), P < 0.02. Aged subjects had greater cross-ApEn values (1.961 +/- 0.121) than younger subjects (1.574 +/- 0.249), P < 10(-4), with nearly 100% sensitivity and specificity, indicating greater LH-T asynchrony in the older group. In conjunction with previous findings of greater irregularity of growth hormone release with increasing age, we propose that increased secretory irregularity with advancing age may be a widespread hormonal phenomenon. Finally, theoretically, we clarify the need for quantifications such as ApEn and cross-ApEn via a study of a "variable lag" pulsatile process, and empirically note the potential wide applicability of cross-ApEn to quantify asynchrony in interconnected (hormonal) networks.

Adult↗

PubMed2001

Morphometry of the supra sciatic notch intrailiac implant anchor passage.

STUDY DESIGN: Anatomic study of human ilia. OBJECTIVE: To determine the anatomic dimensions influencing intrailiac anchor placement and design. SUMMARY OF BACKGROUND DATA: The development of the Galveston intrailiac implant anchor markedly improved results of spinal instrumentation to the pelvis. Better quantification of the passage dimensions is needed for the design of anatomically specific implants. METHODS: The length and outer diameter of two intrailiac anchor passages were determined from randomly selected, disease-free pairs of ilia from 129 white skeletons belonging to the Hamann-Todd Osteological Collection (Cleveland, OH, Museum of Natural History). RESULTS: Path B, an anchor passage running from the posterior superior iliac spine to the anterior inferior iliac spine, was significantly longer than path A, proceeding from the posterior superior iliac spine to the superior rim of the acetabulum, in adult and teenage males and females. For example, in adult females path B measured 141.2 +/- 7.5 mm versus 124.9 +/- 7.1 mm, P = or < 0.0001. The absolute minimum path A length available for an intrailiac post or screw anchor, following the required posterior superior iliac spine removal, was 80 mm in adults and male teenagers and 70 mm in female teenagers. For path B the hip joint was not at risk, and a safe anchor passage of at least 90 mm in teenagers and 110 mm in adults was available. The minimum thickness of the paths occurred directly above the sciatic notch. It was significantly larger in path A than path B, 20.2 +/- 2.4 mm versus 14.4 +/- 3.2 mm, P < 0.0001. CONCLUSION: Of the two supra sciatic intrailiac paths studied, the path passing from the posterior superior iliac spine toward the anterior inferior iliac spine provided a longer and potentially safer anchor site. These studies suggest techniques for accessing longer anchor paths and the need for larger diameter anchors in order to achieve optimum intra iliac anchor stiffness and strength.

Adolescent↗

PubMed2003

Long-term follow-up of manipulative treatment in a horse with back problems.

In order to objectively quantify the effect of manipulation on back-related locomotion anomalies in the horse, a recently developed kinematic measuring technique for the objective quantification of thoracolumbar motion in the horse was applied in a dressage horse that was suffering from a back problem. In this horse, clinically, a right-convex bending (scoliosis) from the 10th thoracic vertebra to the second lumbar vertebra was diagnosed. As a result, there was a marked asymmetric movement of the thoracolumbar spine. Functionally, there was severe loss of performance. Thoracolumbar motion was measured in terms of ventrodorsal flexion, lateral flexion, and axial rotation using an automated gait analysis system. Measurements were repeated before and 2 days after treatment, before the second treatment 3 weeks later, and at 4 weeks and 8 months after the second treatment to assess long-term effect. At the same time, performance of the horse was assessed subjectively by the trainer as well. Symmetry of movement improved dramatically after the first treatment. After this, there was a slight decrease in symmetry, but 8 months after the last treatment the symmetry indexes for the various joints were still considerably better than during the first (pre-treatment) measuring session. Subjectively, the trainer did not notice improvement until after measurement session 4. Between sessions 4 and 5 (at 4 weeks and 8 months after the second treatment) there was a change of trainer. The new trainer did not report any back problem, and succeeded in bringing the horse back to its former level in competition. It is concluded that manipulation had a measurable influence on the kinematics of the thoracolumbar spine. However, it is recognized that an improvement in symmetry of motion is not equivalent to clinical improvement and that other measures, such as changes in management, may be more decisive.

Animals↗

PubMed2000

Glenohumeral kinematics and capsulo-ligamentous strain resulting from laxity exams.

OBJECTIVE: Identification and quantification of strain in shoulder capsular-ligamentous structures during clinical exams and validation of this testing on cadavers. METHODS: Mercury strain gauges were sutured in seven locations on shoulders from cadavers. An electromagnetic tracker quantified humeral head translations during laxity exams. Strain and humeral position were acquired during performance of Sulcus, Feagin, Apprehension, Load and Shift, Drawer, and Hawkins tests. RESULTS: Anterior humeral head translation in neutral position was primarily constrained by the coracohumeral ligament. With the arm abducted, anterior middle and inferior ligaments also became active. External rotation and abduction activated inferior and middle capsules. Posterior capsule constrained motion for posterior tests in neutral and abduction. Superior and inferior capsular ligaments were active during inferior tests in neutral position. With abduction, inferior ligaments provided primary translation constraint. CONCLUSION: Study of kinematics and strain evaluation on cadavers can yield useful information on mechanisms of glenohumeral instability. Relevance This study clarifies the contribution of specific structures of the shoulder to strain in the joint capsule. It also identifies which structures are challenged by provocative laxity exams commonly used by orthopaedic physicians.

Analysis of Variance↗

PubMed2000

The axial view in evaluating tibial translation in cases of insufficiency of the posterior cruciate ligament.

The purpose of this report is to present a new radiological method of diagnosis and evaluation of posterior instability using the patellofemoral axial view. During a period of 22 months, we performed clinical and radiological assessments on 20 patients (6 acute and 14 chronic) with isolated posterior instability caused by posterior cruciate ligament (PCL) rupture and on 20 patients with normal knees. The radiological examination included stress radiographs using the Telos device (Telos, Griesheim, Germany) as well as a modification of the routine axial patellofemoral view. Both diagnosis and quantification of the posterior tibial translation was possible in all cases by measuring, on the axial view, the distance between the anterior edge of the tibial plateau and the center of the femoral groove (trochlea). Clinical examination, conventional radiography, KT-1000 arthrometry, stress radiography at 90 degrees and at 20 degrees of flexion, and magnetic resonance imaging all assist in diagnosing a PCL tear. This new radiographic technique is simple, fast, and consistently effective both in patients with acute and those with chronic PCL tears, as well as in those who have undergone PCL reconstruction.

Adult↗