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Zhongguo Gu Shang = China Journal of... Feb 2024To investigate the risk factors of hip osteoarthritis(HOA) after hip arthroscopy in patients with femoro-acetabular impingement(FAI) syndrome, and to reduce and...
OBJECTIVE
To investigate the risk factors of hip osteoarthritis(HOA) after hip arthroscopy in patients with femoro-acetabular impingement(FAI) syndrome, and to reduce and prevent HOA.
METHODS
From September 2018 to September 2020, 106 patients with FAI underwent hip arthroscopy, including 40 males and 66 females, aged from 20 to 55 years old with an average age of (33.05±10.19) years old. The mechanism of injury included 51 cases for sports injury, 36 for traffic accidents, and 19 for blunt object injury. The duration of the disease ranged from 5 to 19 days with an average of (12.02±3.69) days. All patients were followed up for 18 months. Patients were divided into HOA group (23 cases) and non-HOA group (83 cases) according to the occurrence of HOA. Multivariate Logistic regression was used to analyze the risk factors of HOA after hip arthroscopy in FAI patients.
RESULTS
By univariate analysis, aged from 50 to 70 years old, female, body mass index(BMI)> 30 kg·m, physical labor, cam type, postoperative infection, last follow-up hip degree of motion (range of motion, ROM) (flexion, abduction, adduction, internal rotation) and Tönnis grade 1 and above of the HOA group were higher than those of the non-HOA group (<0.05), and the relative appendicular skeletal muscle index (RASM) was lower than that of non-HOA group(<0.05). By multiple Logistic regression analysis, cam type, BMI>30 kg·m, last follow-up hip internal rotation ROM and Tönnis grade 1 were risk factors for HOA after hip arthroscopy in FAI patients (<0.05).
CONCLUSION
FAI classification, body mass index, hip ROM and Tönnis grade are all related to HOA after hip arthroscopy in FAI patients. Follow-up and intervention should be strengthened in high-risk FAI patients to reduce the occurrence of HOA.
Topics: Male; Humans; Female; Young Adult; Adult; Middle Aged; Aged; Femoracetabular Impingement; Osteoarthritis, Hip; Arthroscopy; Range of Motion, Articular; Risk Factors; Hip Joint; Treatment Outcome
PubMed: 38425070
DOI: 10.12200/j.issn.1003-0034.20230405 -
Radiographics : a Review Publication of... Mar 2024Cone-beam CT (CBCT) is a promising tool with increasing applications in musculoskeletal imaging due to its ability to provide thin-section CT images of the appendicular...
Cone-beam CT (CBCT) is a promising tool with increasing applications in musculoskeletal imaging due to its ability to provide thin-section CT images of the appendicular skeleton and introduce weight bearing, which accounts for loading forces that typically interact with and affect this anatomy. CBCT devices include an x-ray source directly opposite a digital silicon detector panel that performs a single rotation around an object of interest, obtaining thin-section images. Currently, the majority of research has been focused on the utility of CBCT with foot and ankle pathologic abnormalities, due to the complex architectural arrangement of the tarsal bones and weight-bearing nature of the lower extremities. Associated software can provide a variety of options for image reconstruction, including metal artifact reduction, three-dimensional biometric measurements, and digitally reconstructed radiographs. Advancements in this technology have allowed imaging of the knee, hip, hand, and elbow. As more data are published, it is becoming evident that CBCT provides many additional benefits, including fast imaging time, low radiation dose, lower cost, and small equipment footprint. These benefits allow placement of CBCT units outside of the traditional radiology department, including the orthopedic clinic setting. These technologic developments have motivated clinicians to define the scope of CBCT for diagnostics, surgical planning, and longitudinal imaging. As efforts are made to create standardized protocol and measurements, the current understanding and surgical approach for various orthopedic pathologic conditions will continue to shift, with the hope of improving outcomes. RSNA, 2024 Test Your Knowledge questions for this article are available in the supplemental material.
Topics: Humans; Cone-Beam Computed Tomography; Software; Hand; Lower Extremity
PubMed: 38421913
DOI: 10.1148/rg.230143 -
Radiography (London, England : 1995) Mar 2024New Zealand has seen an increase in the X-ray examinations in the emergency departments (ED), and the radiology report is generally unavailable immediately. This...
The impact of intensive training in preliminary image evaluation (PIE) for radiographers in the emergency department of a regional hospital in New Zealand - A pilot study.
INTRODUCTION
New Zealand has seen an increase in the X-ray examinations in the emergency departments (ED), and the radiology report is generally unavailable immediately. This requires practitioners managing the patient to take the responsibility of detecting any abnormalities in the images and using such information for the management of the patient. There is, therefore, a need for consideration of the contribution that radiographers could make in the accurate management of the patients in ED in New Zealand. The aim of this study was to assess if an intensive preliminary image evaluation (PIE) training course improved radiographer accuracy, sensitivity, and specificity on extremity X-ray examinations in a regional ED in New Zealand.
METHOD
A pre-post-intervention design was employed for this study. Seven radiographers working at a regional base hospital in New Zealand undertook image evaluation tests to evaluate their ability to detect and describe abnormalities prior to and following a 2-day intensive PIE training course. The training concentrated on acute extremity abnormalities. Tests were then scored to determine sensitivity, specificity, and accuracy.
RESULTS
Following an intensive PIE training course, the post-intervention test mean demonstrated an improved sensitivity by an average of 3.99% (89.01-93.0), specificity improved by an average of 6.13% (79.77-85.90%), and accuracy improved by an average of 3.33% (77.55-80.87%).
CONCLUSION
This study demonstrated that an intensive training course in PIE improved the participants' sensitivity, specificity, and accuracy when evaluating acute extremity X-ray examinations in ED at the study site, however further research is required to see if these results also represent clinical ability.
IMPLICATION FOR PRACTICE
The NZ healthcare system could benefit by the introduction of a radiographers' PIE system. It is therefore recommended that when introducing PIE into an ED in New Zealand, radiographers should undertake additional training to improve image evaluation sensitivity, specificity, and accuracy prior to participation.
Topics: Humans; Radiology; Pilot Projects; New Zealand; Clinical Competence; Emergency Service, Hospital
PubMed: 38394826
DOI: 10.1016/j.radi.2024.02.008 -
Molecular Imaging and Radionuclide... Feb 2024A biopsy-proven patient with prostate carcinoma aged 70 years was referred to the department of nuclear medicine for radionuclide-based therapy. His prostate-specific...
A biopsy-proven patient with prostate carcinoma aged 70 years was referred to the department of nuclear medicine for radionuclide-based therapy. His prostate-specific antigen levels were >1000 ng/mL, and prostatic magnetic resonance imaging showed an enlarged prostate with a heterogeneous signal and size 3.8x3.7x3.5 cm with few small heterogeneous nodular signals in the transition zone. He was scheduled for F prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) scan before therapy. F PSMA PET/CT revealed PSMA-expressing prostate lesions (maximum standardized uptake value ~10.2) with extension into the urinary bladder along with bilateral supraclavicular, mediastinal, retrocrural, retroperitoneal, and pelvic lymph nodes and sclerotic lesions in the entire axial and appendicular skeleton.
PubMed: 38390777
DOI: 10.4274/mirt.galenos.2023.68815 -
Skeletal Radiology Aug 2024Phosphaturic mesenchymal tumor (PMT) is a rare tumor that causes tumor-induced osteomalacia. Patients present with non-specific symptoms secondary to renal phosphate...
BACKGROUND
Phosphaturic mesenchymal tumor (PMT) is a rare tumor that causes tumor-induced osteomalacia. Patients present with non-specific symptoms secondary to renal phosphate wasting and decreased bone mineralization. We sought to assess: (1) What are the common presenting features, laboratory and imaging findings, histologic findings of phosphaturic mesenchymal tumors? (2) What are the available treatment strategies for phosphaturic mesenchymal tumors and their long-term outcomes in terms of local recurrence and symptom control after treatment?
METHODS
We retrospectively identified patients with a histologic diagnosis of PMT located in the axial or appendicular skeleton, or surrounding soft tissues. A total of 10 patients were finally included in our study.
RESULTS
Median tumor size was 1.9 cm (range, 1.1 to 6.1) and median time from symptom onset to diagnosis was 3 years (range, 0.5 to 15 years). All patients but one presented with hypophosphatemia (median 1.9 mg/dL, range 1.2 to 3.2). Pre-operative FGF-23 was elevated in all cases (median 423.5 RU/mL, range 235 to 8950). Six patients underwent surgical resection, three were treated percutaneously (radiofrequency ablation or cryoablation), and one refused treatment. Only one patient developed local recurrence and no patients developed metastatic disease. At last follow-up, nine patients showed no evidence of disease and one was alive with disease.
CONCLUSION
Phosphaturic mesenchymal tumor is a rare tumor presenting with non-specific symptoms. Surgery is the standard treatment when negative margins can be achieved without significant morbidity. In patients with small tumors in surgically-inaccessible areas, radiofrequency ablation or cryoablation can be performed successfully.
Topics: Humans; Male; Female; Retrospective Studies; Adult; Osteomalacia; Middle Aged; Mesenchymoma; Adolescent; Treatment Outcome; Neoplasms, Connective Tissue; Paraneoplastic Syndromes; Fibroblast Growth Factor-23; Child; Aged; Hypophosphatemia; Young Adult; Magnetic Resonance Imaging
PubMed: 38351410
DOI: 10.1007/s00256-024-04614-6 -
Biology Open Feb 2024Limb regeneration in salamanders is achieved by a complex coordination of various biological processes and requires the proper integration of new tissue with old. Among... (Review)
Review
Limb regeneration in salamanders is achieved by a complex coordination of various biological processes and requires the proper integration of new tissue with old. Among the tissues found inside the limb, the skeleton is the most prominent component, which serves as a scaffold and provides support for locomotion in the animal. Throughout the years, researchers have studied the regeneration of the appendicular skeleton in salamanders both after limb amputation and as a result of fracture healing. The final outcome has been widely seen as a faithful re-establishment of the skeletal elements, characterised by a seamless integration into the mature tissue. The process of skeletal integration, however, is not well understood, and several works have recently provided evidence of commonly occurring flawed regenerates. In this Review, we take the reader on a journey through the course of bone formation and regeneration in salamanders, laying down a foundation for critically examining the mechanisms behind skeletal integration. Integration is a phenomenon that could be influenced at various steps of regeneration, and hence, we assess the current knowledge in the field and discuss how early events, such as tissue histolysis and patterning, influence the faithful regeneration of the appendicular skeleton.
Topics: Animals; Humans; Locomotion; Osteogenesis; Research Personnel; Urodela
PubMed: 38319134
DOI: 10.1242/bio.060152 -
Radiology Case Reports Apr 2024Fetus-in-fetu (FIF) is a rare congenital anomaly in which a malformed parasitic twin develops within the body of a live fetus or child. Abdominal teratoma, a type of...
Fetus-in-fetu (FIF) is a rare congenital anomaly in which a malformed parasitic twin develops within the body of a live fetus or child. Abdominal teratoma, a type of germ cell tumor, can be a great imaging mimicker of FIF and vice-versa, as they both can present as a heterogeneous mass with calcifications and a fat component. Radiological differentiation of these 2 entities should be made because of the difference in surgical planning and treatment options. Features such as visualization of distinct bony vertebral elements and encysted cystic components are the specific features of Fetus in fetu [1]. In contrast, the presence of elevated serum markers can help diagnose teratoma. Here, we report a case of a 5-month-old girl presented with progressive distension of the upper abdomen for the last 2 months, noticed by her mother. Her initial imaging with abdominal X-ray and ultrasonography showed the presence of a large heterogenous solid-cystic mass in the upper abdomen with large elongated calcifications. A provisional diagnosis of teratoma vs FIF was considered. CECT abdomen showed clear identification of osseous structures of the axial and appendicular skeleton within a fat density mass, along with an encapsulated cystic component, strongly suggestive of FIF. Her serum tumor markers were within normal limits. The final diagnosis of FIF was confirmed on Laparotomy and postoperative specimens.
PubMed: 38292806
DOI: 10.1016/j.radcr.2023.12.031 -
Modern Pathology : An Official Journal... Apr 2024Primary bone lymphoma (PBL) is rare and mostly represented by diffuse large B-cell lymphomas (DLBCL). Follicular lymphoma (FL), albeit commonly disseminating to the bone...
Primary bone lymphoma (PBL) is rare and mostly represented by diffuse large B-cell lymphomas (DLBCL). Follicular lymphoma (FL), albeit commonly disseminating to the bone marrow, rarely presents primarily as bone lesions. Here, we studied 16 patients (12 men:4 women, median age 60 years) who presented with bone pain and/or skeletal radiologic abnormalities revealing bone FL. Lesions were multifocal in 11 patients (spine ± appendicular skeleton), and unifocal in 5 patients (femoral, tibial, or vertebral). An infiltrate of centrocytes and centroblasts (CD20+ CD5- CD10+ BCL2+ BCL6+) with abundant reactive T cells and an increased reticulin fibrosis massively replaced the marrow spaces between preserved bone trabeculae. The pattern was diffuse ± nodular, often with paratrabecular reinforcement and/or peripheral paratrabecular extension. Ki-67 was usually <15%. Two cases had necrosis. BCL2 rearrangement was demonstrated in 14 of 14 evaluable cases (with concomitant BCL6 rearrangement in one). High-throughput sequencing revealed BCL2, KMT2D, and TNFRSF14 to be the most frequently mutated genes. After staging, 5 qualified for PBL (3 limited stage) and 11 had stage IV systemic FL. All patients received rituximab ± polychemotherapy as firstline treatment, and 7 received local therapy (6 radiotherapy and 2 surgery). Three patients experienced transformation to DLBCL. At the last follow-up (15/16, median 48 months), 11 patients achieved complete remission, including all cases with PBL and most patients with limited extraosseous disease (3-year progression-free survival 71%). One patient died of unrelated cause (3-year overall survival 91%). FL may manifest as a localized or polyostotic bone disease. A minority represent PBL, whereas most reveal systemic disease.
Topics: Male; Humans; Female; Middle Aged; Lymphoma, Follicular; Lymphoma, Large B-Cell, Diffuse; Rituximab; Progression-Free Survival; Proto-Oncogene Proteins c-bcl-2
PubMed: 38290600
DOI: 10.1016/j.modpat.2024.100440 -
BMC Nephrology Jan 2024Respiratory sarcopenia is characterized by the weakness of respiratory muscles associated with sarcopenia due to aging or systemic diseases such as chronic kidney...
BACKGROUND
Respiratory sarcopenia is characterized by the weakness of respiratory muscles associated with sarcopenia due to aging or systemic diseases such as chronic kidney disease (CKD). Patients with CKD undergoing dialysis are particularly susceptible to respiratory muscle weakness caused by factors such as fluid overload and electrolyte imbalance. This weakness not only affects ventilation but also impairs oxygen uptake and delivery to muscle tissue, potentially leading to severe sarcopenia. Thus, the objective of this study is to conduct a respiratory sarcopenia screening in patients with CKD undergoing haemodialysis (HD) and peritoneal dialysis (PD).
METHODS
This is an observational, cross-sectional and multicentre study conducted between March 2023 and March 2025. The study was approved by the Research Ethics Committee at two centres. Sarcopenia diagnosis is determined based on low handgrip strength and amount of appendicular skeletal muscle mass, assessed through bioelectrical impedance analysis. Respiratory sarcopenia is diagnosed in patients with sarcopenia who have low inspiratory muscle strength, evaluated through a manovacuometry test. The severity of sarcopenia and respiratory sarcopenia is defined, respectively, by low physical performance (measured using the Short Physical Performance Battery and Timed-Up and Go test) and pulmonary performance (measured through spirometry). Thus, this study will include 81 patients undergoing dialysis (41 on HD and 40 on PD) from three participating centres.
DISCUSSION
The literature has been focused on respiratory function in CKD; however, the relationship with sarcopenia remains understudied. We believe that, similar to appendicular skeleton muscles, the axial skeleton muscles are also likely to weaken with the presence of chronic disease, such as CKD.
Topics: Humans; Sarcopenia; Renal Dialysis; Hand Strength; Cross-Sectional Studies; Renal Insufficiency, Chronic; Muscle, Skeletal; Observational Studies as Topic; Multicenter Studies as Topic
PubMed: 38287281
DOI: 10.1186/s12882-023-03390-0