ABSTRACT
This article describes the use of ultrasound (US) in the evaluation of the elbow. US is able to visualize several abnormalities affecting tendons, muscles, ligaments and bursae around the elbow joint as well as to delineate the nature of soft-tissue swelling, such as a space-occupying lesion or synovial enlargement. Occult fractures, osteophytes and intra-articular loose bodies can be depicted with this technique as well. At the cubital tunnel, US allows accurate imaging of the ulnar nerve and to document changes that occur in compressive syndromes. Over other imaging modalities, US offers several key advantages, including cost effectiveness, availability and ability to perform a dynamic examination of tendon movement and joint motion. With continued experience, it is likely that the use of US will increase further with regards to evaluation of soft-tissue abnormalities of the elbow.
Subject(s)
Elbow/diagnostic imaging , Joint Diseases/diagnostic imaging , Elbow/anatomy & histology , Elbow/pathology , Humans , Joint Diseases/pathology , Joint Loose Bodies/diagnostic imaging , Nerve Compression Syndromes/diagnostic imaging , Tendon Injuries/diagnostic imaging , Tendon Injuries/pathology , Ultrasonography/methods , Elbow InjuriesABSTRACT
To validate the Italian versions of the Delirium Rating Scale (DRS) and the Memorial Delirium Assessment Scale (MDAS), 105 cancer patients consecutively referred for neurological or psychiatric consultation for mental status change were evaluated using the Confusion Assessment Method (CAM), the DRS, the MDAS, and the Mini-Mental State Examination (MMSE). According to the CAM criteria and clinical examination, 66 patients were delirious, and 39 received diagnoses other than delirium. The DRS and the MDAS scores significantly distinguished delirious from non-delirious patients. The MDAS and the DRS were mutually correlated. When using the proposed cut-off scores for the two scales, the MDAS had higher specificity (94%) but lower sensitivity (68%) than the DRS (sensitivity = 95%, specificity = 61% for DRS cut-off 10; sensitivity = 80%, specificity = 76%, DRS cut-off 12). The MMSE showed high sensitivity (96%) and very low specificity (38%). Exploratory factor analysis of the DRS and the MDAS suggested a three-factor and two-factor structure, respectively. Both instruments in their Italian version proved to be useful for the assessment of delirium among cancer patients. Further research is needed to examine the use of the DRS and the MDAS in other clinical contexts.