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1.
Orthop Clin North Am ; 51(1): 77-86, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31739882

RESUMO

Scapholunate ligament injuries are common and can lead to a predictable pattern of arthritis (scaphoid lunate advanced collapse wrist) if unrecognized or untreated. This article describes the relevant anatomy, biomechanics, and classification system, and provides an up-to-date literature-based review of treatment options, including acute repair and various reconstruction techniques. It also helps guide surgeons in making decisions regarding a systematic treatment algorithm for these injuries.


Assuntos
Ligamentos Articulares/lesões , Ligamentos Articulares/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Traumatismos do Punho/complicações , Artrite/epidemiologia , Artrite/etiologia , Fenômenos Biomecânicos , Articulações do Carpo/lesões , Articulações do Carpo/patologia , Articulações do Carpo/cirurgia , Humanos , Ligamentos Articulares/anatomia & histologia , Osso Semilunar/lesões , Osso Semilunar/patologia , Osso Semilunar/cirurgia , Radiografia/métodos , Amplitude de Movimento Articular , Osso Escafoide/lesões , Osso Escafoide/patologia , Osso Escafoide/cirurgia , Resultado do Tratamento , Traumatismos do Punho/diagnóstico por imagem , Traumatismos do Punho/cirurgia , Articulação do Punho/patologia , Articulação do Punho/cirurgia
2.
Emerg Med Clin North Am ; 38(1): 1-13, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31757244

RESUMO

Acute musculoskeletal injuries are commonly seen in our emergency departments, and are commonly missed. There are many reasons for more missed injures and a significant one is over-reliance on radiographs. An emergency department orthopedic assessment goes far beyond the radiographs. A focused, yet comprehensive history is vital to understand the forces and mechanism of injury. That injury must be understood in the context of the patient, because older and much younger patients have weaker bone. Finally, the physical examination is instrumental in localizing the pathology and is essential to put radiograph results in the proper clinical context.


Assuntos
Gerenciamento Clínico , Medicina de Emergência/métodos , Procedimentos Ortopédicos/métodos , Exame Físico/métodos , Radiografia/métodos , Ferimentos e Lesões/terapia , Humanos , Ferimentos e Lesões/diagnóstico
3.
Emerg Med Clin North Am ; 38(1): 103-124, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31757245

RESUMO

Shoulder pain is a common presentation in the emergency department. The list of differential diagnoses is broad. This article summarizes common diagnoses of shoulder pain, including bony, infectious, and connective tissue pathologies and their proper treatment. It also reviews which shoulder pain conditions are emergency diagnoses and need immediate treatment and which diagnoses need conservative management and outpatient follow-up.


Assuntos
Articulação Acromioclavicular/lesões , Clavícula/lesões , Emergências , Úmero/lesões , Procedimentos Ortopédicos/métodos , Radiografia/métodos , Ferimentos e Lesões/diagnóstico , Articulação Acromioclavicular/diagnóstico por imagem , Clavícula/diagnóstico por imagem , Gerenciamento Clínico , Humanos , Úmero/diagnóstico por imagem , Ferimentos e Lesões/terapia
4.
Emerg Med Clin North Am ; 38(1): 125-142, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31757246

RESUMO

Traumatic injuries of the hip and pelvis are commonly encountered in the emergency department. This article equips all emergency medicine practitioners with the knowledge to expertly diagnose, treat, and disposition these patients. Pelvic fractures occurring in young patients tend to be associated with high-energy mechanisms and polytrauma. Pelvic and hip fractures in the elderly are often a result of benign trauma but are associated with significant morbidity and mortality.


Assuntos
Gerenciamento Clínico , Emergências , Fraturas Ósseas/diagnóstico , Traumatismo Múltiplo , Procedimentos Ortopédicos/métodos , Ossos Pélvicos/lesões , Radiografia/métodos , Fraturas Ósseas/terapia , Humanos , Ossos Pélvicos/diagnóstico por imagem
5.
Emerg Med Clin North Am ; 38(1): 31-59, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31757254

RESUMO

Approximately one-third of children sustain a fracture before the age of 16 years; however, their unique anatomy and healing properties often result in a good outcome. This article focuses on the diagnosis and management of pediatric extremity injuries. The article describes the anatomic features and healing principles unique to children and discusses pediatric upper and lower extremity fractures and presents evidence-based and standard practice for their management. Finally, the article describes the conditions under which emergency physicians are likely to miss pediatric fractures by highlighting specific examples and discussing the general factors that lead to these errors.


Assuntos
Traumatismos do Braço/diagnóstico , Emergências , Serviço Hospitalar de Emergência , Fraturas Ósseas/diagnóstico , Traumatismos da Perna/diagnóstico , Procedimentos Ortopédicos/métodos , Radiografia/métodos , Traumatismos do Braço/terapia , Criança , Gerenciamento Clínico , Fraturas Ósseas/terapia , Humanos , Traumatismos da Perna/terapia
6.
Emerg Med Clin North Am ; 38(1): 81-102, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31757256

RESUMO

This article provides an updated review of the emergent evalution and treatment of elbow and forearm injuries in the emergency department. Clinically necessary imaging is discussed. Common and uncommon injuries of the elbow and forearm are reviewed with an emphasis on early recognition, efficient management, and avoidance of complications. The astute emergency physician will rely on a focused history and precise examination, applied anatomic knowledge, and strong radiographic interpretative skills to avoid missed injuries and complications.


Assuntos
Gerenciamento Clínico , Articulação do Cotovelo/lesões , Emergências , Traumatismos do Antebraço/diagnóstico , Procedimentos Ortopédicos/métodos , Radiografia/métodos , Articulação do Cotovelo/diagnóstico por imagem , Traumatismos do Antebraço/terapia , Humanos
7.
Radiol Clin North Am ; 58(1): 133-150, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31731897

RESUMO

Imaging plays a central role in the evaluation of patients following cardiothoracic surgery, both for monitoring in the early postoperative period and for assessing for suspected complications. Patients with postsurgical complications can develop a range of signs and symptoms, from hypotension and tachycardia, as the result of severe bleeding, to fever and leukocytosis because of infection. The radiologist is an important member of the care team in the postoperative period, helping identify and manage complications of cardiothoracic surgery. This article reviews the common complications of cardiothoracic surgery focusing on the role of imaging and clues to diagnosis.


Assuntos
Cardiopatias/diagnóstico por imagem , Complicações Pós-Operatórias/diagnóstico por imagem , Doenças Respiratórias/diagnóstico por imagem , Procedimentos Cirúrgicos Torácicos/efeitos adversos , Tomografia Computadorizada por Raios X/métodos , Doenças Vasculares/diagnóstico por imagem , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Cardiopatias/etiologia , Humanos , Complicações Pós-Operatórias/etiologia , Radiografia/métodos , Doenças Respiratórias/etiologia , Doenças Vasculares/etiologia
8.
Radiol Clin North Am ; 58(1): 151-165, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31731898

RESUMO

Patients hospitalized in the intensive care unit (ICU) often have multiple support lines and devices that need routine imaging evaluation by radiologists. In patients with cardiogenic shock or depressed cardiac function, mechanical circulation support devices are used in combination with medical therapies to improve patient outcomes and sometimes can stabilize patients for surgical intervention. This article discusses some of the more commonly encountered mechanical circulation devices seen in ICU patients, including intra-aortic balloon pumps, Impella devices, extracorporeal membrane oxygenation cannulas, and ventricular assist devices. Normal appearance and commonly encountered device-related complications that can be diagnosed on imaging are reviewed.


Assuntos
Oxigenação por Membrana Extracorpórea/instrumentação , Coração Auxiliar , Coração/diagnóstico por imagem , Balão Intra-Aórtico/instrumentação , Tomografia Computadorizada por Raios X/métodos , Cuidados Críticos/métodos , Humanos , Radiografia/métodos
9.
Medicine (Baltimore) ; 98(46): e17701, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31725613

RESUMO

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by SFTS virus (SFTSV) which involves multiple organ systems, including lungs. However, there is limited data on lung involvement of SFTS. Therefore, the present study investigated the chest radiographic findings of SFTS, including computed tomography (CT), and compared these with those of scrub typhus, which is the most common tick-borne illness in South Korea and share risk factors and occur in similar settings.Medical records of patients with confirmed SFTS and scrub typhus in a tertiary hospital in Seoul (South Korea), between January 2014 and June 2018, were reviewed. Initial chest radiography and CT were reviewed by 2 experienced radiologists.A total of 39 patients with SFTS and 101 patients with scrub typhus were analyzed. All patients except 3 patients with scrub typhus in both groups received chest radiography. Cardiomegaly (90%) and patchy consolidation with ground glass opacity (GGO) pattern (31%) were more common in SFTS group than scrub typhus group (20%, P < .001 and 2%, P < .001, respectively). About half of each group received chest CT. Consolidation (29%) and pericardial effusion (24%) were more common in SFTS group than scrub typhus group (6%, P = .02 and 4%, P = .008, respectively). Interstitial thickening in chest radiography (58%) and chest CT (65%) was more frequent in scrub typhus group than SFTS group (18%, P < .001 and 19%, P < .001, respectively).Cardiomegaly with/without pericardial effusion and patchy consolidation with GGO pattern were more frequent in SFTS group, whereas interstitial thickening was more frequent in scrub typhus group. These findings will assist the early differentiation of SFTS from scrub typhus.


Assuntos
Orientia tsutsugamushi , Febre por Flebótomos/diagnóstico por imagem , Phlebovirus , Radiografia/estatística & dados numéricos , Infecções Respiratórias/diagnóstico por imagem , Tifo por Ácaros/diagnóstico por imagem , Idoso , Estudos Transversais , Feminino , Humanos , Pulmão/diagnóstico por imagem , Pulmão/microbiologia , Masculino , Pessoa de Meia-Idade , Febre por Flebótomos/microbiologia , Radiografia/métodos , República da Coreia , Infecções Respiratórias/microbiologia , Tifo por Ácaros/microbiologia , Síndrome , Trombocitopenia
10.
Medicine (Baltimore) ; 98(41): e17547, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593135

RESUMO

RATIONALE: Leakage of bone cement from femoral medullary cavity is a rare complication after hip arthroplasty, and there is no report on the leaked bone cement entering into iliac vessels. PATIENT CONCERNS: An 89-year-old woman presented with a fracture in the right femoral neck. She had well-fixed right femoral head replacement after careful preoperative examinations, and no adverse reactions appeared. She was able to get off bed to walk at the 2nd day after surgery. DIAGNOSES: Postoperative radiograph showed leakage of bone cement into the joint through femoral medullary cavity entering into iliac vessels, but the patient complained no discomforts. She received a treatment with low-molecular weight heparin and rivaroxaban. OUTCOMES: The patient was able to walk with normal gait, without swelling in both lower extremities and discomfort in the hip. There was no other complication concerning intravascular foreign bodies. LESSONS: This case calls into the phenomenon of leakage of injected bone cement in femoral head replacement regardless of complete and nonfractured femur, which may be into the lower limb and pelvic veins, given that, dangerous consequences will not occur.


Assuntos
Artroplastia de Quadril/efeitos adversos , Cimentos para Ossos/efeitos adversos , Cabeça do Fêmur/cirurgia , Veia Ilíaca/patologia , Idoso de 80 Anos ou mais , Anticoagulantes/uso terapêutico , Inibidores do Fator Xa/uso terapêutico , Feminino , Heparina de Baixo Peso Molecular/uso terapêutico , Humanos , Veia Ilíaca/diagnóstico por imagem , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/etiologia , Radiografia/métodos , Rivaroxabana/uso terapêutico , Resultado do Tratamento
11.
Bone Joint J ; 101-B(10): 1307-1312, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31564143

RESUMO

AIMS: In order to determine whether and for whom serial radiological evaluation is necessary in one-part proximal humerus fractures, we set out to describe the clinical history and predictors of secondary displacement in patients sustaining these injuries. PATIENTS AND METHODS: Between January 2014 and April 2016, all patients with an isolated, nonoperatively treated one-part proximal humerus fracture were prospectively followed up. Clinical and radiological evaluation took place at less than two, six, 12, and 52 weeks. Fracture configuration, bone quality, and comminution were determined on the initial radiographs. Fracture healing, secondary displacement, and treatment changes were recorded during follow-up. RESULTS: In 100 patients (59 female, 41 male; mean age 57 years), 91 of the fractures (91%) remained stable. In five of nine patients (55%) with secondary displacement, surgery was recommended. Comminution, present in 23 patients (23%), was identified as a predictor of secondary displacement (p < 0.001). Patients' age, sex, fracture configuration, and bone quality were not associated with secondary displacement (p ≥ 0.438). Nonoperative treatment resulted in a mean absolute Constant score (CS) of 80 (49 to 98), relative CS of 101% (63% to 138%), median subjective shoulder value of 95% (interquartile range (IQR) 90% to 100%), and median EuroQol five-dimensional questionnaire score of 0.89 (IQR 0.80 to 1.00) with bone union in all cases at one-year follow-up. CONCLUSION: Radiological re-evaluation was only necessary in patients presenting with comminution and may be redundant for 77% of patients with one-part proximal humerus fractures. Nonoperative treatment of one-part proximal humerus fractures remains the mainstay of treatment with a low rate of secondary surgery, a high union rate, and good clinical results. Cite this article: Bone Joint J 2019;101-B:1307-1312.


Assuntos
Tratamento Conservador/métodos , Consolidação da Fratura/fisiologia , Radiografia/estatística & dados numéricos , Sistema de Registros , Fraturas do Ombro/diagnóstico por imagem , Procedimentos Desnecessários/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Seguimentos , Fixação de Fratura/métodos , Humanos , Escala de Gravidade do Ferimento , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Radiografia/métodos , Fraturas do Ombro/terapia , Estatísticas não Paramétricas , Fatores de Tempo
12.
Bone Joint J ; 101-B(10): 1300-1306, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31564159

RESUMO

AIMS: The primary aim of this study was to develop a reliable, effective radiological score to assess the healing of humeral shaft fractures, the Radiographic Union Score for HUmeral fractures (RUSHU). The secondary aim was to assess whether the six-week RUSHU was predictive of nonunion at six months after the injury. PATIENTS AND METHODS: Initially, 20 patients with radiographs six weeks following a humeral shaft fracture were selected at random from a trauma database and scored by three observers, based on the Radiographic Union Scale for Tibial fractures system. After refinement of the RUSHU criteria, a second group of 60 patients with radiographs six weeks after injury, 40 with fractures that united and 20 with fractures that developed nonunion, were scored by two blinded observers. RESULTS: After refinement, the interobserver intraclass correlation coefficient (ICC) was 0.79 (95% confidence interval (CI) 0.67 to 0.87), indicating substantial agreement. At six weeks after injury, patients whose fractures united had a significantly higher median score than those who developed nonunion (10 vs 7; p < 0.001). A receiver operating characteristic curve determined that a RUSHU cut-off of < 8 was predictive of nonunion (area under the curve = 0.84, 95% CI 0.74 to 0.94). The sensitivity was 75% and specificity 80% with a positive predictive value (PPV) of 65% and a negative predictive value of 86%. Patients with a RUSHU < 8 (n = 23) were more likely to develop nonunion than those with a RUSHU ≥ 8 (n = 37, odds ratio 12.0, 95% CI 3.4 to 42.9). Based on a PPV of 65%, if all patients with a RUSHU < 8 underwent fixation, the number of procedures needed to avoid one nonunion would be 1.5. CONCLUSION: The RUSHU is reliable and effective in identifying patients at risk of nonunion of a humeral shaft fracture at six weeks after injury. This tool requires external validation but could potentially reduce the morbidity associated with delayed treatment of an established nonunion. Cite this article: Bone Joint J 2019;101-B:1300-1306.


Assuntos
Consolidação da Fratura/fisiologia , Fraturas não Consolidadas/diagnóstico por imagem , Fraturas do Úmero/cirurgia , Radiografia/métodos , Adulto , Fatores Etários , Tratamento Conservador/métodos , Bases de Dados Factuais , Feminino , Seguimentos , Fixação de Fratura/métodos , Fraturas não Consolidadas/cirurgia , Humanos , Fraturas do Úmero/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Valor Preditivo dos Testes , Curva ROC , Reoperação/métodos , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Medição de Risco , Fatores Sexuais , Fatores de Tempo
13.
Medicine (Baltimore) ; 98(39): e17280, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574843

RESUMO

BACKGROUND: This study will aim to evaluate the diagnostic accuracy of digital X-ray radiogrammetry (DXR) on hand bone loss (HBL) for rheumatoid arthritis (RA). METHODS: In this study, we will search the literature from PubMed, EMBASE, Cochrane Library, PsycINFO, Web of Science, Google Scholar, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, and WANFANG from the inception to June 1, 2019 without language restrictions. All case-controlled studies on assessing diagnostic accuracy of DXR on HBL for diagnosis of RA will be included. Quality Assessment of Diagnostic Accuracy Studies tool will be used for eligible studies. We will apply RevMan V.5.3 software and Stata V.12.0 software for statistical analysis. RESULTS: We will evaluate diagnostic accuracy of DXR on HBL in patients with RA by assessing the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio. CONCLUSION: This study will detect the diagnostic accuracy of DXR evaluation on HBL in patients with RA. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019139489.


Assuntos
Artrite Reumatoide/diagnóstico por imagem , Doenças Ósseas Metabólicas/diagnóstico por imagem , Densitometria/estatística & dados numéricos , Intensificação de Imagem Radiográfica/métodos , Radiografia/estatística & dados numéricos , Artrite Reumatoide/complicações , Doenças Ósseas Metabólicas/etiologia , Estudos de Casos e Controles , Densitometria/métodos , Progressão da Doença , Feminino , Ossos da Mão/diagnóstico por imagem , Humanos , Masculino , Radiografia/métodos , Projetos de Pesquisa , Índice de Gravidade de Doença , Revisão Sistemática como Assunto
14.
Medicine (Baltimore) ; 98(39): e17316, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574861

RESUMO

The purpose of this study was to investigate the effect of intraoperative positions in single-level (L4-5) transforaminal lumbar interbody fusion (TLIF) on segmental and overall lumbar lordosis (LL) in patients with lumbar degenerative disease. Thirty-eight consecutive patients who had undergone single-segment (L4-5) TLIF with 0° polyetheretherketone (PEEK) cage and pedicle screw fixation were evaluated. Twenty patients underwent surgery on the four-poster type frame with hip flexion at 30° (Group I) and 18 patients were operated on a Jackson spinal table to adjust their hip flexion to 0° (Group II). Preoperative standing, intraoperative prone, and postoperative standing lateral radiographs were obtained in each patient. The overall and segmental LL were analyzed according to the position in which the patients were placed for their operation and results compared between Groups I and II. Intraoperative intervertebral segmental LL at L4-5 and L5-S1 was increased in Group II than in Group I, whereas postoperative intervertebral segmental LL at L4-5 (fused level) was increased LL. In Group I intraoperative intervertebral segmental LL at L4-5 did not achieve sufficient lordosis, whereas postoperative intervertebral segmental LL at L3-4 was increased. The overall spinal alignment was unaffected by the decreased segmental LL in the fused level owing to the compensation of the upper adjacent segments. The more the hip was extended intraoperatively, the more the segmental lordosis increased in the lower lumbar spine. Thus, selecting the appropriate surgical table and hip position are very important. Underachievement of segmental lordosis leads to the acceleration of upper adjacent segment load.


Assuntos
Cuidados Intraoperatórios/métodos , Lordose , Vértebras Lombares , Mesas Cirúrgicas , Posicionamento do Paciente/métodos , Fusão Vertebral , Idoso , Feminino , Humanos , Lordose/diagnóstico , Lordose/fisiopatologia , Lordose/cirurgia , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/patologia , Vértebras Lombares/cirurgia , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados (Cuidados de Saúde) , Radiografia/métodos , Amplitude de Movimento Articular , Fusão Vertebral/efeitos adversos , Fusão Vertebral/métodos , Espondilolistese/cirurgia
15.
Pan Afr Med J ; 33: 40, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31384355

RESUMO

Triplane fractures of the proximal tibia are less well known than the distal extremity. The diagnosis is based on a good analysis of X-rays and possibly CT images to better plan the management. The authors reports a triplane fracture of the proximal tibial in a 12 year old boy treated by closed reduction and internal fixation. To our knowledge, only a dozen cases have been reported in the literature with generally a good evolution of the fracture.


Assuntos
Fixação Interna de Fraturas/métodos , Radiografia/métodos , Fraturas da Tíbia/diagnóstico por imagem , Criança , Humanos , Masculino , Fraturas da Tíbia/cirurgia
16.
J Pediatr Orthop ; 39(8): 400-405, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31393297

RESUMO

BACKGROUND: The Shilla procedure was designed to correct and control early-onset spinal deformity while harnessing a child's remaining spinal growth. It allows for controlled axial skeletal growth within the construct, avoiding the need for frequent surgeries to lengthen implants. We hypothesized that curve characteristics evolve over time after initial apex fusion and placement of the Shilla implants. The purpose of this study was to identify trends in curve evolution after Shilla implantation and understand how these changes influence ultimate outcome. METHODS: A single-center, retrospective review of all patients with Shilla implants in place for ≥5 years yielded 21 patients. Charts and radiographs were reviewed to compare coronal curve characteristics preoperatively, postoperatively, and at last follow-up to note changes in the apex of the primary curve. Also noted were the development of adjacent compensatory curves, the overall vertical spinal growth, and the need for definitive spinal fusion once skeletal maturity was reached. RESULTS: Of the 21 patients, the curve apex migrated caudally in 12 patients (57%) and cephalad in 1 patient (5%), with a mean migration of 2.7 vertebral levels. Two patients (10%) developed new, significant compensatory curves (1 caudal and 1 cephalad). All patients demonstrated spinal growth in T1-S1 length following index surgery (mean, 45 mm). At skeletal maturity, 10 patients underwent definitive posterior spinal fusion and instrumentation, and 3 underwent implant removal alone. CONCLUSIONS: This study constitutes the longest follow-up of Shilla patients evaluating curve and implant behavior. Results of this review suggest that the apex of the fused primary curve shifts in approximately 62% of patients, with nearly all of these (92%) involving a distal migration. Compensatory curves did develop after Shilla placement as well. Overall, these findings represent adding-on distal to the apex after Shilla instrumentation rather than a crankshaft phenomenon about the apex. A better understanding of spinal growth mechanics and outcomes after Shilla placement may improve our ability to appropriately select patients and instrumentation levels. LEVEL OF EVIDENCE: Level III.


Assuntos
Escoliose , Fusão Vertebral , Coluna Vertebral , Adolescente , Criança , Feminino , Seguimentos , Humanos , Masculino , Próteses e Implantes , Radiografia/métodos , Estudos Retrospectivos , Escoliose/diagnóstico , Escoliose/cirurgia , Fusão Vertebral/efeitos adversos , Fusão Vertebral/instrumentação , Fusão Vertebral/métodos , Fusão Vertebral/estatística & dados numéricos , Coluna Vertebral/diagnóstico por imagem , Coluna Vertebral/cirurgia , Resultado do Tratamento
17.
Cient. dent. (Ed. impr.) ; 16(2): 117-121, mayo-ago. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-183722

RESUMO

La técnica radiográfica de aleta de mordida es el "talón de Aquiles" para el diagnóstico de caries interproximales en pacientes infantiles. En ocasiones las placas radiográficas disponibles están sobredimensionadas dificultando con ello el desarrollo de esta técnica. Se establece como objetivo determinar las dimensiones óseas y dentarias en niños con dentición temporal completa para obtener el tamaño ideal de una placa que permita una adecuada técnica interproximal. Se realizó un estudio transversal, observacional y descriptivo con un tamaño muestral de 65 pacientes de 3 a 5 años que precisen un diagnóstico clínico y radiográfico. Tras realizar las mediciones oportunas se determinó un tamaño radiográfico óptimo para posteriormente comprobar su fiabilidad. La dimensión de la placa definitiva fue de 15x25 mm. No se observó isquemia a nivel de la mucosa, tampoco reflejos nauseosos, sin embargo 4 pacientes expulsaron en un primer intento la placa recortada. En la literatura no se han encontrado estudios con relación al tamaño ideal de placas radiográficas en función de la edad del paciente. El uso de una placa de menores dimensiones es más confortable y fácil de utilizar a edades precoces


The radiographic technique of bite wing is the "Achilles heel" for the diagnosis of interproximal caries in children. Sometimes the available radiographic plates are oversized, making the development of this technique difficult. The objective is to determine the bone and dental dimensions in children with full temporal dentition to obtain the ideal size of a plate that allows an adequate interproximal technique. A cross-sectional, observational and descriptive study was carried out with a sample size of 65 patients from 3 to 5 years of age whore quired a clinical and radiographic diagnosis. After making the appropriate measurements, an optimal radiographic size was determined to subsequently verify its reliability. The size of the final plate was 15 x 25 mm. No ischemia was observed at the mucosa level, neither nauseous reflexes, however 4 patients expelled the cut-off plate in a first attempt. In the literature, no studies have been found in relation to the ideal size of radiographic plates according to the age of the patient. The use of a smaller plate is more comfortable and easier to use at an early age


Assuntos
Humanos , Pré-Escolar , Radiografia/métodos , Radiografia/normas , Dente/anatomia & histologia , Dente/diagnóstico por imagem , Projetos Piloto , Odontopediatria , Estudos Transversais , Mandíbula/anatomia & histologia , Mandíbula/diagnóstico por imagem , Maxila/anatomia & histologia , Maxila/diagnóstico por imagem
18.
Medicine (Baltimore) ; 98(31): e16545, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31374017

RESUMO

Abnormal cervical curvature and cervical disc herniation are closely related to neck pain and should be taken into account before any treatment. However, studies have rarely reported on the correlation between cervical lordosis and cervical disc herniation in patients with neck pain. Therefore, in this study, we collect young neck pain patients with abnormal cervical curvature to evaluate the relationship between cervical lordosis and cervical disc herniation.Three hundred patients below 40 years old with neck pain were enrolled. Patient sex, age, apical vertebra, segment of intervertebral disc protrusionl, sagittal diameter of spinal duramater, saggital diameter of spinal canal, height of disc space were recorded, and the cervical curvature, and degree of cervical spinal cord compression (G/F ratio) were calculated. The change of degree of disc herniation and degree of cervical spinal cord compression were analyzed in different cervical curvature groups. Further more, collected these patients who had improved cervical curvature over a period of time, to compare the changes of degree of disc herniation, G/F ratio, and height of disc space.The median age of patients with kyphosis was lower than those with lordosis and straight cervical spine. The degree of disc herniation was higher in the straight and kyphosis groups compared to the lordosis group. Cervical lordosis was inversely correlated with the degree of disc herniation and positively with G/F ratio. Cervical curvature was significantly affected by sex, age, and the degree of disc herniation. With the improvement of cervical lordotic curvature, the degree of disc herniation decreased and height of disc space increased.The degree of disc herniation and cervical spinal cord compression are inversely correlated to cervical lordosis in young neck pain patients, and the degree of disc herniation and height of disc space can recover with the recovery of cervical lordotic curvature. These findings may indicating a link between cervical curvature and degenerative changes which have important clinical implications.


Assuntos
Deslocamento do Disco Intervertebral/complicações , Lordose/complicações , Cervicalgia/etiologia , Adulto , Vértebras Cervicais/anormalidades , Distribuição de Qui-Quadrado , Feminino , Humanos , Masculino , Radiografia/métodos , Estatísticas não Paramétricas
19.
J Vet Sci ; 20(4): e44, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31364328

RESUMO

This study evaluated the feasibility of using texture analysis and machine learning to distinguish radiographic lung patterns. A total of 1200 regions of interest (ROIs) including four specific lung patterns (normal, alveolar, bronchial, and unstructured interstitial) were obtained from 512 thoracic radiographs of 252 dogs and 65 cats. Forty-four texture parameters based on eight methods of texture analysis (first-order statistics, spatial gray-level-dependence matrices, gray-level-difference statistics, gray-level run length image statistics, neighborhood gray-tone difference matrices, fractal dimension texture analysis, Fourier power spectrum, and Law's texture energy measures) were used to extract textural features from the ROIs. The texture parameters of each lung pattern were compared and used for training and testing of artificial neural networks. Classification performance was evaluated by calculating accuracy and the area under the receiver operating characteristic curve (AUC). Forty texture parameters showed significant differences between the lung patterns. The accuracy of lung pattern classification was 99.1% in the training dataset and 91.9% in the testing dataset. The AUCs were above 0.98 in the training set and above 0.92 in the testing dataset. Texture analysis and machine learning algorithms may potentially facilitate the evaluation of medical images.


Assuntos
Pulmão/diagnóstico por imagem , Aprendizado de Máquina , Radiografia/veterinária , Algoritmos , Animais , Área Sob a Curva , Gatos , Cães , Feminino , Masculino , Curva ROC , Radiografia/métodos
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