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At least 163 records · Page 9Linked to original sources
PubMed2004

Procedural applications of ultrasound.

Many invasive procedures are now safer and more efficient with the use of ultrasound guidance. As emergency physicians continue to develop skills in sonography, new applications of this technology will continue to impact the practice of emergency medicine.

Abscess↗
PubMed2003

The effect of a simulated knee joint effusion on postural control in healthy subjects.

OBJECTIVE: To determine the effects of a simulated knee joint effusion on center of pressure (COP) path and mean power frequency (MPF) during standing. DESIGN: Quasi-experimental design. SETTING: Sports injury research laboratory in a university setting. PARTICIPANTS: Twenty healthy volunteers, 10 of whom (age, 20.1+/-2.4y; height, 168.0+/-8.1cm; weight, 70.4+/-13.3kg) were assigned to an effusion group and 10 of whom (age, 25+/-3.8y; height, 169.4+/-8.9cm; weight, 74.7+/-7.7kg) were assigned to a control group. INTERVENTIONS: COP data were collected before and after a 60-mL injection of sterile saline into the knee joint space. MAIN OUTCOME MEASURES: COP path and mediolateral and anteroposterior MPF. RESULTS: COP path decreased after the effusion (pre-effusion mean, 92.2+/-21.9cm; posteffusion mean, 77.27+/-23.0cm). No change was found within the control group for COP path (P>.05). No differences were detected before or after joint effusion when the MPF was examined (P>.05). CONCLUSIONS: Possible explanations for the improved postural control after the effusion include additional somatosensory feedback, an augmented neural drive to the soleus, and/or increased capsular tension.

Adult↗
PubMed2000

Intra-articular knee joint effusion induces quadriceps avoidance gait patterns.

OBJECTIVES: (1) To identify adaptations caused by intra-articular knee joint effusion during walking and (2) to determine if knee joint effusion may be a causative factor in promoting quadriceps avoidance gait patterns. DESIGN: Gait testing of 14 healthy individuals who underwent incremental saline injections of the knee joint capsule.Background. Gait adaptations have been reported in the literature for knee injured and rehabilitating individuals. Knee joint capsular afferent activity can influence knee joint function. METHODS: Gait analysis was employed in a pre- and post-test, repeated measures design to determine lower extremity joint kinematics, kinetics, energetics and thigh EMG adaptations due to intra-articular knee joint effusion. RESULTS: Knee effusion caused an increase in hip and knee flexion through the stance phase. Knee extensor torque, impulse and negative and positive work were diminished with increased effusion levels. Quadriceps activity decreased and hamstring activity increased due to intra-articular knee joint effusion. DISCUSSION: These adaptations cannot be attributed to an injury, surgery or rehabilitation. Thus, the results of this experiment suggest knee joint capsular distention, via knee joint effusion, may be responsible for many gait adaptations reported for knee injured individuals in previous investigations. CONCLUSIONS: Knee joint effusion and the subsequent capsular distention can cause major alterations in the normal gait cycle and can be considered a causative factor promoting the acquisition of quadriceps avoidance gait patterns. RELEVANCE: This study provides reference data on the effects of intra-articular knee joint effusion on gait parameters by which future studies of injured or rehabilitating individuals can be compared.

Adaptation, Physiological↗
PubMedDate not supplied

Intra-articular fluid volume and restricted motion in the elbow.

Eleven fresh-frozen cadaveric upper extremities were studied to determine the effect of intra-articular fluid volume on the range of motion of the elbow. The flexion arc of the cadaveric elbows was measured before and after incremental injections of saline solution. Linear regression analysis showed that the relationship between the flexion arc and intra-articular fluid volume is linear up to a total volume of 25 mL. The flexion arc of motion decreased by a mean of 2.1 degrees per milliliter of fluid injected. A mean volume of 10.8 mL of saline solution decreased the flexion arc to the point where surgery has traditionally been recommended for type II radial head fractures. On the basis of these findings, the use of post-aspiration range of motion should be reconsidered as a criterion for surgical treatment of radial head fractures.

Elbow Joint↗
PubMed2002

Utility of frequency-selective fat saturation T2-weighted MR images for the detection of joint effusion in the temporomandibular joint.

OBJECTIVES: To evaluate joint effusion in the temporomandibular joint (TMJ) using frequency-selective fat saturation (FS) T2-weighted images and assess this technique. To investigate whether bone marrow abnormalities and magnetic resonance imaging (MRI) findings of internal derangement may be linked to joint effusion in the TMJ in patients with pain. METHODS: TMJ effusion was sought on FS T2-weighted images and conventional T2-weighted images in 400 joints from 200 patients with TMJ-related pain. Self-reported pain records were obtained from patients immediately before MRI and images assessed by the amount of TMJ fluid graded bilaterally using reference films by two radiologists. Other parameters recorded included disk displacement categories and condyle marrow abnormalities. The association between the recorded parameters and TMJ effusion judged by FS-sequences or conventional sequences was analysed using chi-square and Kappa tests. RESULTS: The detection rate of TMJ effusion by FS-sequences was significantly greater than by conventional methods, and the results showed a significant relationship between MRI interpretation of TMJ effusion using FS-sequences or conventional methods and the presence of pain. The correlation between TMJ effusion on FS-sequences and pain was significantly stronger than the conventional method. Kappa test indicated good agreement between pain and MRI TMJ effusion by FS-sequences (kappa = 0.66), but not by conventional sequences (kappa = 0.56). The other parameters showed a similar trend for TMJ-related pain. CONCLUSIONS: FS T2-weighted imaging is useful for detection of TMJ effusion, without known causes and confirms the importance of TMJ effusion as an indicator in patients with TMJ-related pain, bone abnormalities, and disk displacement.

Adipose Tissue↗
PubMed1981

[Plasma concentration and systemic effect of betamethasone after intra-articular injection (author's transl)].

Plasma concentrations of betamethasone, cortisol and corticosterone were measured before and after intraarticular injection of a betamethasone-depot preparation (Celestan-Depot) by radioimmuno-assay in 31 patients. Plasma concentration of betamethasone reached its maximum of between of 10 and 17 microgram/dl 30 min after injection. It had fallen to half after 2 hours, and practically to nil from the eighth day onwards. Lowest plasma levels of cortisol and corticosterone occurred after 6--24 hours, returning to the normal range after four days. In nine patients with knee-joint effusion and synovitis the plasma concentration of betamethasone was significantly higher after 24 hours, and cortisol and corticosterone values after 48 hours significantly more suppressed, than in patients without joint effusions and signs of inflammation. The results indicate that plasma concentration of betamethasone and the suppressant effect on the adrenal cortex after intra-articular injection is similar to that after intramuscular applications. Correspondingly, systemic application of the cortisol derivatives can cause significant side effects and be contra-indicated also after intra-articular injection.

Adolescent↗
PubMed1987

Comparison of two continuous passive motion protocols for patients with total knee implants.

We compared the effects of continuous passive motion (CPM) given for a minimum of 20 hours a day to Group 1 patients (n = 15) or a maximum of 5 hours a day to Group 2 patients (n = 8) who received total knee joint replacements. Four variables were analyzed on the third and sixth days after surgery: 1) range of motion, 2) edema-effusion, 3) pain, and 4) length of hospital stay. We found significant improvements in knee extension (p less [corrected] than .001) in the Group 2 patients on Day 6 after surgery. We also found a significant negative correlation between the length of hospital stay and the number of physical therapy treatments received. No between-group differences were found in measurements of 1) total knee excursion, 2) edema-effusion, 3) pain, 4) length of hospital stay, and 5) number of PT treatments received. This lack of differences implies that comparable results can be obtained by using the CPM machine either 20 hours a day or 5 hours a day.

Edema↗
PubMedDate not supplied

Magnetic resonance evidence of joint fluid with temporomandibular joint disorders.

OBJECTIVES: The relationship between temporomandibular joint (TMJ) effusion and TMJ disorders is controversial. The frequency of TMJ effusion has varied as shown in previous studies. Furthermore, though some authors have suggested a correlation between TMJ effusion and pain, others question the relationship. In order to clarify the relationship, it is necessary to quantify the degree of effusion and thoroughly investigate its relationship to other factors. The purpose of this study was to analyze the amount of TMJ fluid present in joints with TMJ disorders and to see how TMJ effusion is related to TMJ status and pain. METHODS: We studied 577 joints in 293 patients referred to us for magnetic resonance imaging. The joints were divided into painful and nonpainful categories and also classified according to Westesson's criteria for the status of the TMJ. The grading system of Larheim et al was used for categorizing the amount of fluid. Statistical methods were used for analyzing the relationship between TMJ fluid and TMJ status and pain. RESULTS: TMJs with disk displacement without reduction showed the largest amount of fluid while TMJs with normal superior disk position showed the least fluid (Kruskal-Wallis test, P<0.001; Scheffe test, P<0.001). There was a significant difference in the amount of the fluid between painful and nonpainful joints in the group of disk displacement without reduction (Wilcoxon rank sum test, P<0.001). No significant differences were found between other groups. CONCLUSIONS: Joint effusion is likely to appear in painful TMJs with disk displacement without reduction. Joint effusion may be an abnormal entity just suited to joints with disk displacement without reduction.

Adult↗
PubMedDate not supplied

Magnetic resonance imaging of synovial proliferation in temporomandibular disorders with pain.

OBJECTIVE: The objective of this study was to assess the clinical significance of synovial proliferation in patients with painful temporomandibular disorders based on magnetic resonance imaging findings. METHODS: The current study was conducted in 100 joints of 100 patients with unilateral painful temporomandibular disorders. One hundred joints on the contralateral side of patients with unilateral disease were used as nonpain group. Areas in the articular space that showed a low signal intensity on T1-weighted imaging, a high signal intensity on T2-weighted imaging, and high signal intensity on gadolinium-enhanced fat-suppressed T1-weighted imaging were judged to be regions of synovial proliferation. RESULTS: Synovial proliferation alone was observed in 8.0% of the pain group, but in none of the nonpain group. Synovial proliferation + effusion was observed in 33.0% of the pain group and in 7.0% of the nonpain group. Effusion alone was observed in 7.0% of the pain group and in 3.0% of the nonpain group. The mean visual analog scale value of pain was in the order of synovial proliferation alone > synovial proliferation + effusion > effusion alone. The incidence rates of anterior displacement of the disk were 100% for synovial proliferation alone, 93.9% for synovial proliferation + effusion, 57.1% for effusion alone, and 57.7% for "without synovial proliferation/effusion." CONCLUSIONS: Strong correlations were observed between synovial proliferation, pain, and disk displacement. It is considered that evaluating effusion alone provides only limited information on the disease state in painful temporomandibular disorders. Thus, it is essential to include enhanced T1-weighted imaging as a means to judge the disease state as well as to assess disease progression.

Adolescent↗