PELVIC INCIDENCE AND OSTEITIS PUBIS IN PROFESSIONAL SOCCER PLAYERS.

INTRODUCTION: Osteitis pubis is a common inflammatory disease of the pubic symphysis, defined as a chronic pain syndrome caused by repetitive microtrauma. Since adaptative changes are necessary in the pelvis to adjust the equilibrium of the myotendinous structures, the aim of this study was to evaluate the correlation between pelvic incidence and osteitis pubis among professional soccer players. MATERIALS AND METHODS: An observational, cross-sectional study was performed with professional soccer players from five teams during pre-season. Athletes with previous congenital pelvic abnormalities or a history of surgery were excluded. Radiographs of the pelvis were analyzed by two radiologists and assessed for findings consistent with osteitis pubis, and the following parameters were measured: pelvic incidence (PI), sacral inclination (SI), and pelvic version (PV). RESULTS: A total of 107 subjects were included in the study, with a mean age of 25.6 ± 3.1 years. Findings compatible with osteitis pubis were present in 74.8% of the subjects (80/107). There was no statistical correlation between osteitis pubis and PI (52.3°±12.7° vs. 48.4°±10.8°; p=0.156), SI (43.1°±9.8° vs. 39.9°±10.1°; p=0.146), or PV (9.2°± 6.3° vs 8.6°± 7.5°; p=0.649). Agreement between readers was excellent (p<0.0001). CONCLUSION: There was no significant correlation between pelvic parameters and radiographic diagnosis of osteitis pubis. Leve of Evidence II; Diagnostic study.

Introdução. A osteíte púbica é uma doença inflamatória comum da sínfise púbica, definida como síndrome de dor crônica causada por microtraumas de repetição. Uma vez que são necessárias mudanças adaptativas na pelve para adequar o equilíbrio das estruturas miotendíneas, o objetivo deste estudo foi avaliar a correlação entre e a incidência pélvica e a osteíte púbica em jogadores profissionais de futebol. Materiais e Métodos. Estudo transversal, observacional, conduzido com jogadores profissionais de futebol de cinco times profissionais durante a pré-temporada. Foram excluídos do estudo atletas com anormalidades congênitas prévias ou com história de cirurgia. As radiografias de pelve foram avaliadas por dois médicos radiologistas quanto aos achados compatíveis com osteíte púbica, e os seguintes parâmetros foram medidos: incidência pélvica (PI), inclinação sacral (SI) e versão pélvica (PV). Resultados. Foram incluídos 107 participantes, com média de idade de 25,6 ± 3,1 anos. Achados compatíveis com osteíte púbica estavam presentes em 74,8% dos indivíduos (80/107). Não houve correlação estatística entre osteíte púbica e PI (52,3°± 12,7° vs. 48,4° ± 10,8°; p = 0,156), SI (43,1° ± 9,8° vs. 39,9° ± 10,1°; p = 0,146) ou PV (9,2° ± 6,3° vs. 8,6° ± 7,5°; p = 0,649). A concordância entre os médicos radiologistas foi excelente (p < 0,0001). Conclusões. Não houve correlação significativa entre os parâmetros pélvicos e o diagnóstico radiográfico de osteíte púbica. Nível de Evidência II; Estudo diagnóstico.

Pelvic incidence and osteitis pubis in professional soccer players / Incidência pélvica e osteíte púbica em jogadores profissionais de futebol

ABSTRACT Introduction. Osteitis pubis is a common inflammatory disease of the pubic symphysis, defined as a chronic pain syndrome caused by repetitive microtrauma. Since adaptative changes are necessary in the pelvis to adjust the equilibrium of the myotendinous structures, the aim of this study was to evaluate the correlation between pelvic incidence and osteitis pubis among professional soccer players. Materials and Methods. An observational, cross-sectional study was performed with professional soccer players from five teams during pre-season. Athletes with previous congenital pelvic abnormalities or a history of surgery were excluded. Radiographs of the pelvis were analyzed by two radiologists and assessed for findings consistent with osteitis pubis, and the following parameters were measured: pelvic incidence (PI), sacral inclination (SI), and pelvic version (PV). Results. A total of 107 subjects were included in the study, with a mean age of 25.6 ± 3.1 years. Findings compatible with osteitis pubis were present in 74.8% of the subjects (80/107). There was no statistical correlation between osteitis pubis and PI (52.3°±12.7° vs. 48.4°±10.8°; p=0.156), SI (43.1°±9.8° vs. 39.9°±10.1°; p=0.146), or PV (9.2°± 6.3° vs 8.6°± 7.5°; p=0.649). Agreement between readers was excellent (p<0.0001). Conclusion. There was no significant correlation between pelvic parameters and radiographic diagnosis of osteitis pubis. Leve of Evidence II; Diagnostic study.

RESUMO Introdução. A osteíte púbica é uma doença inflamatória comum da sínfise púbica, definida como síndrome de dor crônica causada por microtraumas de repetição. Uma vez que são necessárias mudanças adaptativas na pelve para adequar o equilíbrio das estruturas miotendíneas, o objetivo deste estudo foi avaliar a correlação entre e a incidência pélvica e a osteíte púbica em jogadores profissionais de futebol. Materiais e Métodos. Estudo transversal, observacional, conduzido com jogadores profissionais de futebol de cinco times profissionais durante a pré-temporada. Foram excluídos do estudo atletas com anormalidades congênitas prévias ou com história de cirurgia. As radiografias de pelve foram avaliadas por dois médicos radiologistas quanto aos achados compatíveis com osteíte púbica, e os seguintes parâmetros foram medidos: incidência pélvica (PI), inclinação sacral (SI) e versão pélvica (PV). Resultados. Foram incluídos 107 participantes, com média de idade de 25,6 ± 3,1 anos. Achados compatíveis com osteíte púbica estavam presentes em 74,8% dos indivíduos (80/107). Não houve correlação estatística entre osteíte púbica e PI (52,3°± 12,7° vs. 48,4° ± 10,8°; p = 0,156), SI (43,1° ± 9,8° vs. 39,9° ± 10,1°; p = 0,146) ou PV (9,2° ± 6,3° vs. 8,6° ± 7,5°; p = 0,649). A concordância entre os médicos radiologistas foi excelente (p < 0,0001). Conclusões. Não houve correlação significativa entre os parâmetros pélvicos e o diagnóstico radiográfico de osteíte púbica. Nível de Evidência II; Estudo diagnóstico.

Relationship of the sacral slope with early gait derangements in robust older women.

BACKGROUND: Trunk pelvic dissociation is fundamental to the compensatory mechanism for muscle weakness during body bending. We carried out an early investigation of gait changes in a sample of community-dwelling women ≥60 years without gait complaints. The primary objective was to correlate spine and pelvic angles with performance tests and accelerometry parameters. The secondary objective was to correlate performance tests with accelerometry. METHODS: In this cross-sectional study, 54 community-dwelling women ≥60 years were subjected to Falls Efficacy Scale-International (FES-I), performance tests (Berg Balance Scale, Timed Up and Go, and Gait analysis), and radiographic analysis of sagittal alignment (Thoracic and Lumbar Cobb, Pelvic Incidence, Sacral Slope, and Pelvic Tilt angles). Gait speed was assessed in a 10-m comfortable walk, and accelerometry parameters were obtained in a 30-m walk distance. RESULTS: The sample, aged 72 ± 6 years, exhibited moderate correlation between Sacral Slope and Step Length (+ 0.615). Sacral Slope weakly correlated with FES-I (- 0.339), Berg Balance Scale (+ 0.367), and with further accelerometry data in the AP plane: RMS, (+ 0.439) and Stride Regularity (+ 0.475), p < 0.05, all. Lumbar Cobb weakly correlated with the following accelerometry data in the AP plane: Step Length (+ 0.405), RMS, (+ 0.392), and Stride Regularity (+ 0.345), p < 0.05, all. Additionally, Stride Regularity in AP moderately correlated with FES-I (0,561, p < 0.05), among other weak correlations between performance tests and accelerometry data in AP. CONCLUSIONS: Early alterations in Sacral Slope and gait abnormalities in the AP plane may provide understanding of the early gait changes in robust older women.

Relationship of the sacral slope with early gait derangements in robust older women

Abstract Background: Trunk pelvic dissociation is fundamental to the compensatory mechanism for muscle weakness during body bending. We carried out an early investigation of gait changes in a sample of community-dwelling women ≥60 years without gait complaints. The primary objective was to correlate spine and pelvic angles with performance tests and accelerometry parameters. The secondary objective was to correlate performance tests with accelerometry. Methods: In this cross-sectional study, 54 community-dwelling women ≥60years were subjected to Falls Efficacy Scale-International (FES-I), performance tests (Berg Balance Scale, Timed Up and Go, and Gait analysis), and radiographic analysis of sagittal alignment (Thoracic and Lumbar Cobb, Pelvic Incidence, Sacral Slope, and Pelvic Tilt angles). Gait speed was assessed in a 10-m comfortable walk, and accelerometry parameters were obtained in a 30m walk distance. Results: The sample, aged 72 ±6 years, exhibited moderate correlation between Sacral Slope and Step Length (+ 0.615). Sacral Slope weakly correlated with FES-I (- 0.339), Berg Balance Scale (+0.367), and with further accelerometry data in the AP plane: RMS, (+ 0.439) and Stride Regularity (+ 0.475), p < 0.05, all. Lumbar Cobb weakly correlated with the following accelerometry data in the AP plane: Step Length (+0.405), RMS, (+0.392), and Stride Regularity (+ 0.345), p < 0.05, all. Additionally, Stride Regularity in AP moderately correlated with FES-I (0,561, p < 0.05), among other weak correlations between performance tests and accelerometry data in AP. Conclusions: Early alterations in Sacral Slope and gait abnormalities in the AP plane may provide understanding of the early gait changes in robust older women.

Is power Doppler ultrasound useful to evaluate temporomandibular joint inflammatory activity in juvenile idiopathic arthritis?

OBJECTIVE: To evaluate the effectiveness of power Doppler ultrasound (US) in assessing the temporomandibular joint (TMJ) involvement in juvenile idiopathic arthritis (JIA) patients using contrast-enhanced magnetic resonance imaging (MRI) as the reference standard. METHODS: We evaluated the US and MRI examinations of the TMJs from 92 JIA patients. These exams were done and scored for inflammatory activity on the same date. RESULTS: There were considerable differences between the US and MRI findings, with MRI detecting more effectively the TMJ involvement. No association was found between synovial inflammation obtained using power Doppler US to assess synovial vascularity determined by US images and synovial enhancement determined by MRI images. US had very poor sensitivity and very low positive predictive value to detect TMJ arthritis in JIA patients compared with MRI as the reference standard. CONCLUSIONS: Power Doppler US cannot replace MRI for the detection of TMJ inflammatory involvement in JIA patients.Key Points• The early diagnosis of TMJ involvement in JIA patients is very important in order to prevent disturbances in the mandibular growth.• Power Doppler US could be a useful diagnostic tool as a screening exam to identify inflammatory activity in this joint.• However, power Doppler US did not show to have this function and cannot replace MRI for the detection of TMJ inflammatory involvement in JIA patients.

Are temporomandibular joint signs and symptoms associated with magnetic resonance imaging findings in juvenile idiopathic arthritis patients? A longitudinal study.

The aims of this longitudinal study were to perform a comprehensive clinical evaluation of temporomandibular joint (TMJ) and to investigate the association between the clinical and magnetic resonance imaging (MRI) findings in the TMJs of patients with juvenile idiopathic arthritis (JIA). Seventy-five patients with JIA participated in this study. All patients underwent a rheumatological examination performed by a paediatric rheumatologist, a TMJ examination performed by a single dentist and an MRI with contrast of the TMJs. These examinations were scheduled on the same date. The patients were examined again 1 year later. Twenty-eight (37.3 %) patients reported symptoms at the first evaluation and 11 (14.7 %) patients at the second evaluation. In relation to signs, 35 (46.7 %) of the patients presented at least one sign at the first evaluation and 29 (38.7 %) at the second. Intense contrast enhancement of TMJ was significantly associated with disease activity (p < 0.001) at the first evaluation and a trend to significance was observed at the second (p = 0.056), with poly/systemic subtypes (p = 0.028 and p = 0.049, respectively), with restricted mouth opening capacity (p = 0.013 and p = 0.001, respectively), with the presence of erosions at both evaluations (p = 0.0001 and p < 0.0001, respectively) and with altered condylar shape at the second evaluation (p = 0.0005). TMJ involvement is highly prevalent in JIA patients, with asymptomatic children presenting severe structural alterations of the TMJ. The TMJ should always be evaluated in JIA patients, even in the absence of signs and symptoms.

Mandibular morphological changes in low bone mass edentulous females: evaluation of panoramic radiographs.

OBJECTIVE: The objective of this study was to evaluate morphological changes of the mandible in osteopenic and osteoporotic edentulous females. STUDY DESIGN: Fifty-two female edentulous patients underwent panoramic radiography and dual-energy x-ray absorptiometry of the lumbar spine and femoral neck. Measurements of the gonial angle, antegonial angle, antegonial depth, antegonial index (AI), and mental index (MI) were performed. Patients were classified as normal (T-score > -1.0), osteopenic (T-score of -1.0 to 0 -2.5), or osteoporotic (T-score < -2.5). RESULTS: The gonial angle did not show differences among the three categories of skeletal bone status (P > .05). The antegonial angle was significantly smaller in individuals with low bone mass (P < .05). The antegonial depth was significantly greater in osteoporotic (P < .05) and osteopenic individuals (P < .05). The AI and MI were significantly smaller in individuals with low bone mass (P < .05); however, after age adjustment there were no differences among the groups (P > .05). CONCLUSIONS: Edentulous females with low bone mass have a deeper antegonial region. The thickness of the cortical mandibular bone is highly influenced by age.