Paradoxical state anxiety and working memory in a patient with acute stroke.

OBJECTIVE: In view of the negative impact of anxiety on working memory, we induced anxiety in 26 patients with acute stroke and 33 healthy controls, and studied how the anxiety affected their emotional reactivity and how the reactivity affected their verbal and visuospatial working memory. We compared the overall findings with those in 1 of our patients (C.B.) who had presented with an abnormally high level of state anxiety. METHODS: We gave verbal and visuospatial 1-back tasks under both neutral and anxiogenic conditions, and we compared participants' working memory scores, self-reported levels of state anxiety, and electrodermal activity. RESULTS: When comparing performance in the neutral condition, the control and patient groups exhibited disrupted verbal working memory, which was associated with greater electrodermal activity and higher state anxiety during the anxiogenic condition. Although patient C.B. also had heightened electrodermal activity during the anxiogenic condition, she experienced a significant reduction in her state anxiety. Her verbal working memory was better during the anxiogenic than the neutral condition. CONCLUSIONS: Because of the phonological (subvocal speech) nature of verbal working memory, a higher level of anxious apprehension could explain the increase in state anxiety and the corresponding disruption of verbal working memory in our patient and control groups during the anxiogenic condition. C.B.'s lower state anxiety and selective improvement in verbal working memory during the anxiogenic condition suggest that she felt less anxious apprehension.

Standardized way for imaging of the sagittal spinal balance.

Nowadays, conventional or digitalized teleradiography remains the most commonly used tool for the study of the sagittal balance, sometimes with secondary digitalization. The irradiation given by this technique is important and the photographic results are often poor. Some radiographic tables allow the realization of digitalized spinal radiographs by simultaneous translation of X-ray tube and receptor. EOS system is a new, very low dose system which gives good quality images, permits a simultaneous acquisition of upright frontal and sagittal views, is able to cover in the same time the spine and the lower limbs and study the axial plane on 3D envelope reconstructions. In the future, this low dose system should take a great place in the study of the pelvispinal balance. On the lateral view, several pelvic (incidence, pelvic tilt, sacral slope) and spinal (lumbar lordosis, thoracic kyphosis, Th9 sagittal offset, C7 plumb line) parameters are drawn to define the pelvispinal balance. All are interdependent. Pelvic incidence is an individual anatomic characteristic that corresponds to the "thickness" of the pelvis and governs the spinal balance. Pelvis and spine, in a harmonious whole, can be compared to an accordion, more or less compressed or stretched.

[Recent advances in imaging of hip and knee prostheses]. / L'imagerie actuelle des prothèses de hanche et de genou.

More than 222 000 hip and knee prostheses are implanted each year in France and this number is growing. Simple radiography is generally used to examine these prostheses in situ but this method has several limitations, including superimposition, the inability to visualize some parts of the prosthesis and to study them in the axial plane, and poor visualization of intra- and peri-articular soft tissues. This article describes the advantages offered by computed tomography and ultrasonography in this setting

[Foot imaging]. / Imagerie du pied.

Foot and ankle problems are frequent, daily pathologies. Nowadays, imaging is able to put in evidence the most part of these affections, in a simple, non traumatic way. A good clinical examination is of highest importance to guide the imaging technique. Well done simple X-rays in a standing position is the first mandatory step. Ultrasonography has revolutionized the study of the smooth parts of the foot: tendons, sprains, pathologies of plantar aponeurosis, hind-foot problems....It is therefore the first exam to ask for. Ultrasonography is enough to resolve a very important part of the superficial soft tissues pathologies. When this technique fails, whatever the reason, RMI is the best way to study soft tissues and bone marrow (stress fractures, small intraosseous lesions, osteonecrosis...). CTscan remains the best tool to study the hard part of the skeleton. Neither CTscan nor RMI can directly put in evidence the joint's cartilage with a high degree of precision. So, an arthrography remains mandatory to have a good study of the cartilage of the ankle.

Prospective study of refractory greater trochanter pain syndrome. MRI findings of gluteal tendon tears seen at surgery. Clinical and MRI results of tendon repair.

OBJECTIVES: (1) To compare MRI and surgical findings in patients with refractory greater trochanter pain syndrome and (2) to assess surgical outcomes. METHODS: All consecutive patients seen between 2002 and 2006 by a single clinician were selected for surgical treatment according to the following criteria: (1) tendinopathy confirmed by physical tests; (2) painful disability persisting for at least 6 months despite treatment; (3) on MRI: area of high signal intensity on T2-weighted images, in the area of gluteus medius and/or minimus tendon; and (4) absence of marked muscle atrophy or fatty degeneration. Two musculoskeletal radiologists interpreted images by consensus. A single surgeon operated on all patients. RESULTS: Eight patients met the criteria for surgery. All were women, aged 71.1 (SD: 9.4). Mean symptoms duration before surgery: 14.3 months (11.8). Surgery confirmed the presence of a tear of the lateral part of the gluteus medius tendon in all eight patients, with an associated tear of its main tendon in one patient, all tears revealed on MRI. An associated tear of the gluteus minimus tendon was present at surgery in five patients, of which three were not seen on MRI (false negative). Bursitis was confirmed in all eight patients. Steady complete remission of spontaneous and provoked (physical examination) pain was observed in seven patients and partial remission in one (mean follow-up: 22.4 months (SD: 16.3)). Six MRIs performed after 20+/-12 months showed good reinsertion of the sutured tendon. CONCLUSION: The eight MR images of tear of the lateral part of the gluteus medius tendon were all confirmed at surgery. Three of five associated tendon tears (gluteus minimus only) were not seen on MRI. Surgical treatment was very effective in all patients but one.