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1.
BMC Med Ethics ; 25(1): 52, 2024 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-38734602

RESUMO

BACKGROUND: The integration of artificial intelligence (AI) in radiography presents transformative opportunities for diagnostic imaging and introduces complex ethical considerations. The aim of this cross-sectional study was to explore radiographers' perspectives on the ethical implications of AI in their field and identify key concerns and potential strategies for addressing them. METHODS: A structured questionnaire was distributed to a diverse group of radiographers in Saudi Arabia. The questionnaire included items on ethical concerns related to AI, the perceived impact on clinical practice, and suggestions for ethical AI integration in radiography. The data were analyzed using quantitative and qualitative methods to capture a broad range of perspectives. RESULTS: Three hundred eighty-eight radiographers responded and had varying levels of experience and specializations. Most (44.8%) participants were unfamiliar with the integration of AI into radiography. Approximately 32.9% of radiographers expressed uncertainty regarding the importance of transparency and explanatory capabilities in the AI systems used in radiology. Many (36.9%) participants indicated that they believed that AI systems used in radiology should be transparent and provide justifications for their decision-making procedures. A significant preponderance (44%) of respondents agreed that implementing AI in radiology may increase ethical dilemmas. However, 27.8%expressed uncertainty in recognizing and understanding the potential ethical issues that could arise from integrating AI in radiology. Of the respondents, 41.5% stated that the use of AI in radiology required establishing specific ethical guidelines. However, a significant percentage (28.9%) expressed the opposite opinion, arguing that utilizing AI in radiology does not require adherence to ethical standards. In contrast to the 46.6% of respondents voicing concerns about patient privacy over AI implementation, 41.5% of respondents did not have any such apprehensions. CONCLUSIONS: This study revealed a complex ethical landscape in the integration of AI in radiography, characterized by enthusiasm and apprehension among professionals. It underscores the necessity for ethical frameworks, education, and policy development to guide the implementation of AI in radiography. These findings contribute to the ongoing discourse on AI in medical imaging and provide insights that can inform policymakers, educators, and practitioners in navigating the ethical challenges of AI adoption in healthcare.


Assuntos
Inteligência Artificial , Atitude do Pessoal de Saúde , Radiografia , Humanos , Estudos Transversais , Inteligência Artificial/ética , Masculino , Adulto , Feminino , Inquéritos e Questionários , Radiografia/ética , Arábia Saudita , Pessoa de Meia-Idade , Radiologia/ética
2.
Saudi Med J ; 45(5): 531-536, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38734438

RESUMO

OBJECTIVES: To evaluate the role of artificial intelligence (Google Bard) in figures, scans, and image identifications and interpretations in medical education and healthcare sciences through an Objective Structured Practical Examination (OSPE) type of performance. METHODS: The OSPE type of question bank was created with a pool of medical sciences figures, scans, and images. For assessment, 60 figures, scans and images were selected and entered into the given area of the Google Bard to evaluate the knowledge level. RESULTS: The marks obtained by Google Bard in brain structures, morphological and radiological images 7/10 (70%); bone structures, radiological images 9/10 (90%); liver structure and morphological, pathological images 4/10 (40%); kidneys structure and morphological images 2/7 (28.57%); neuro-radiological images 4/7 (57.14%); and endocrine glands including the thyroid, pancreas, breast morphological and radiological images 8/16 (50%). The overall total marks obtained by Google Bard in various OSPE figures, scans, and image identification questions were 34/60 (56.7%). CONCLUSION: Google Bard scored satisfactorily in morphological, histopathological, and radiological image identifications and their interpretations. Google Bard may assist medical students, faculty in medical education and physicians in healthcare settings.


Assuntos
Inteligência Artificial , Humanos , Educação Médica/métodos , Avaliação Educacional/métodos , Radiografia/métodos
3.
J Orthop Surg Res ; 19(1): 300, 2024 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-38760821

RESUMO

BACKGROUND: Despite advancements in school scoliosis screening (SSS), there are still no effective indicators to estimate the severity of spinal curvature. We aim to investigate the association between incorrect postures and curve magnitude of adolescent idiopathic scoliosis (AIS) among Chinese adolescents. METHODS: In this SSS program, we examined the incorrect posture, Adam's forward bending test (FBT) results, and angle of trunk rotation (ATR) in adolescents. Those with suspected scoliosis were referred for a standing anteroposterior whole-spine radiography as outpatients. The radiographic data of 426 students with lateral Cobb angles were collected from 2016 to 2022 and the associations were studied using logistic regression (LR) models and receiver operating characteristic (ROC) curves. RESULTS: Univariate LR revealed that female gender [odds ratio (OR) = 2.92, 95% confidence interval (CI) 1.67-5.09, P < 0.001], age 16-19y (OR = 2.83, 95%CI 1.10-7.28, P = 0.031), right shoulder height (OR = 2.15, 95%CI 1.23-3.75, P = 0.007), right scapula tilt (OR = 2.03, 95%CI 1.18-3.50, P = 0.010), right rib hump (OR = 1.88, 95%CI 1.23-2.85, P = 0.003), right thoracic rotation ≥ 5° (OR = 2.14, 95%CI 1.43-3.20, P < 0.001), and left thoracolumbar kyphosis (OR = 3.79, 95%CI 1.06-13.56, P = 0.041) were all significantly associated with the severity of the curve magnitude. Multivariate LR showed that female gender [adjusted OR (AOR) = 3.23, 95%CI 1.81-5.73, P < 0.001], those aged 16-19y (AOR = 5.08, 95%CI 1.86-13.91, P = 0.002), and with a right rib hump (AOR = 1.72, 95%CI 1.11-2.64, P = 0.015) presented with a higher risk of severe curve magnitude than men, those aged 7-12y, and without a rib hump, respectively. ROC curves further proved that sex, age, shoulder-height difference, scapula tilt, flat back, rib hump, angle of thoracic rotation were the risk predictors for curve magnitude. CONCLUSION: Incorrect posture and ATR, especially the right rib hump, were significantly associated with the curve magnitude of AIS. Early screening for incorrect postures and ATR could be an effective and economical strategy to predict the severity of AIS through SSS in Chinese adolescents.


Assuntos
Postura , Escoliose , Humanos , Escoliose/diagnóstico por imagem , Escoliose/fisiopatologia , Adolescente , Feminino , Masculino , China/epidemiologia , Postura/fisiologia , Adulto Jovem , Índice de Gravidade de Doença , Radiografia
4.
J Bodyw Mov Ther ; 38: 339-345, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38763578

RESUMO

OBJECTIVES: To determine the effects of Pilates exercises on lumbo-pelvic alignment in non-specific low back pain (NSLBP) patients. METHODS: Twenty-two patients (Male:7; Female:15) with NSLBP aged 20-65 years were recruited and classified based on a modified O'Sullivan's classification system into flexion pattern (FP) or active extension pattern (EP) groups. Oswestry Disability index (ODI), Roland-Morris Disability Questionnaire (RMDQ) as well as radiographic lumbar global range of motion (ROM) and lumbo-pelvic alignment were measured Pre- and immediately post-intervention and at 6- and 12-month. The intervention included supervised six-weeks Pilates program with 60 min per session and up to two sessions per week. RESULTS: Lumbar lordosis, sacral slope and sacral inclination were found to be significantly different between the FP and EP groups based on the O'Sullivan's classification system. However, despite the significant changes in RMDQ (p = 0.001), no significant changes were found for any of the alignment parameters (p > 0.05) post intervention for both groups. For lumbar global ROM, a statistically significant change was observed for the EP group (p = 0.028) but not for the FP group (p = 0.249). No significant correlations were identified between any of the self-reported outcomes, radiographic alignment and ROM parameters. CONCLUSIONS: Patients self-perceived long-term functional improvements based on responding to questionnaires after Pilates exercises were not reflected in significant changes in lumbo-pelvic alignment or lumbar ROM. This may be due to the current cohort demonstrating within normal ranges due to the lesser severity of their condition, but further research is needed for clarification.


Assuntos
Técnicas de Exercício e de Movimento , Dor Lombar , Vértebras Lombares , Amplitude de Movimento Articular , Humanos , Dor Lombar/reabilitação , Dor Lombar/terapia , Dor Lombar/fisiopatologia , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Técnicas de Exercício e de Movimento/métodos , Amplitude de Movimento Articular/fisiologia , Vértebras Lombares/fisiopatologia , Idoso , Adulto Jovem , Região Lombossacral , Pelve , Avaliação da Deficiência , Radiografia
5.
Jt Dis Relat Surg ; 35(2): 324-329, 2024 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-38727111

RESUMO

OBJECTIVES: This study aims to evaluate the inter-observer reliability of fibula-condyle-patella angle measurements and to compare it with other measurement techniques. PATIENTS AND METHODS: Between January 01, 2023 and January 31, 2023, a total of 108 patients (20 males, 88 females; mean age: 47.5±12.0 years; range, 18 to 72 years) who underwent X-rays using the fibula-condyle-patella angle, Insall-Salvati, Caton-Deschamps, Blackburne-Pell, and plateau-patella angle (PPA) methods were retrospectively analyzed. Knee lateral radiographs taken in at least 30 degrees of flexion and appropriate rotation were scanned. All measurements were made by two orthopedic surgeons who were blinded to measurement methods. RESULTS: Right knee patellar height measurements were conducted in 56 patients, while left knee patellar heights were assessed in 52 patients. The highest inter-observer concordance was found in the fibula-condyle-patella angle. The second highest concordance was found in the Insall-Salvati. The highest concordance correlation was found with PPA in the measurements of both researchers. CONCLUSION: The fibula-condyle-patella angle is a reliable technique with a good inter-observer reliability for measuring patellar height. We believe that this study will inspire future research to establish comprehensive reference values for clinical applications.


Assuntos
Fíbula , Variações Dependentes do Observador , Patela , Humanos , Feminino , Masculino , Fíbula/diagnóstico por imagem , Fíbula/anatomia & histologia , Adulto , Patela/diagnóstico por imagem , Patela/anatomia & histologia , Pessoa de Meia-Idade , Idoso , Estudos Retrospectivos , Adolescente , Adulto Jovem , Reprodutibilidade dos Testes , Radiografia/métodos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/anatomia & histologia
6.
Jt Dis Relat Surg ; 35(2): 330-339, 2024 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-38727112

RESUMO

OBJECTIVES: The study aims to investigate the relationship between the vastus medialis obliquus (VMO) muscle distal insertion features and patellar chondral lesion presence. PATIENTS AND METHODS: This cross-sectional study included a total of 100 patients (18 males, 82 females, mean age 67.2±7.1 years; range, 50 to 86 years) who underwent total knee arthroplasty (TKA). Radiological assessments, including merchant view and standing orthoroentgenograms, were conducted. The current osteoarthritis stage, varus angle, quadriceps angle (Q angle), patella-patellar tendon angle (P-PT angle), congruence angle, and sulcus angle were calculated. The VMO tendon length, muscle fiber angle, tendon insertion width measurements, and patellar chondral lesion localization data were obtained intraoperatively. Grouping was done according to the distal insertion width of the VMO tendon to the medial edge of the patella. The medial rim of the patella was divided into three equal-sized sectors. The first group (Group 1, n=31) consisted of patients who had an insertion from the quadriceps tendon into the upper one-third of the patella. The second group (Group 1, n=48) consisted of patients with a distal insertion expanding into the middle one-third of the patella. The third group (Group 3, n=21) consisted of patients who had a distal insertion extending into the distal third region of the medial patella margin. The patella joint surface was divided into sectors, and the presence and location of cartilage lesions were noted in detail. RESULTS: The mean tendon insertion width rate was 45.99±16.886% (range, 16.7 to 83.3%). The mean muscle fiber insertion angle was 51.85±11.67º (range, 20º to 80º). The mean tendon length was 12.45±3.289 (range, 4 to 20) mm. There was no significant difference between the mean age, weight, height, body mass index, BMI, fiber angle, tendon length, varus angle, Q angle, sulcus angle, and congruence angle data among the groups. In terms of the P-PT angle, Groups 1 and 2 had a significant relationship (p=0.008). No relationship was found between the mean fiber insertion angle, mean tendon length, or the presence of chondral lesions. There was a statistically significant difference among the groups regarding the presence of chondral lesions. The highest percentage of chondral lesion frequency was observed in Group 3 (95.24%), followed by Group 1 (90.3%) and Group 2 (89.6%), respectively. Compared to the other two groups, Group 3 had a higher average ratio of lesion areas per patient. CONCLUSION: Our study results demonstrate that the formation and localization of the patellar chondral lesions are affected by the insertion width type of the VMO muscle into the patella. Group 2-type insertion is associated with a lower lesion frequency rate than Groups 1 and 3.


Assuntos
Patela , Músculo Quadríceps , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Idoso , Músculo Quadríceps/patologia , Músculo Quadríceps/diagnóstico por imagem , Estudos Transversais , Idoso de 80 Anos ou mais , Patela/patologia , Patela/diagnóstico por imagem , Patela/anatomia & histologia , Artroplastia do Joelho , Osteoartrite do Joelho/cirurgia , Osteoartrite do Joelho/patologia , Osteoartrite do Joelho/diagnóstico por imagem , Cartilagem Articular/patologia , Cartilagem Articular/diagnóstico por imagem , Radiografia , Articulação do Joelho/patologia , Articulação do Joelho/cirurgia , Articulação do Joelho/diagnóstico por imagem
7.
Jt Dis Relat Surg ; 35(2): 443-447, 2024 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-38727127

RESUMO

While the usual etiology of slipped capital femoral epiphysis (SCFE) is idiopathic, there are many other factors that increase the predisposition to slippage. Chemotherapy can be one of them. In this article, we report a rare case of acute SCFE after tumor prosthesis implantation in a patient who received chemotherapy. A 10-year-old girl with osteosarcoma of the right distal femur underwent (neo-) adjuvant chemotherapy, wide tumor resection, and reconstruction using a growing tumor prosthesis and a short non-cemented femoral stem. Half a year after implantation, she developed aseptic loosening. Revision surgery was performed using a hydroxyapatite (HA)-coated cementless femoral stem. Postoperative plain radiographs revealed SCFE that was treated by closed reduction and screw fixation. The patient recovered without complications, and unaffected hip showed no radiographic signs of slippage on follow-up. The forces of implanting a tumor prosthesis, particularly with a non-cemented stem, can increase the risk of an acute SCFE. The controversy over prophylactic pinning of the uninvolved hip in chemotherapy-associated SCFE is unresolved. Pinning can be considered only in the presence of abnormal prodromal radiological findings.


Assuntos
Neoplasias Ósseas , Neoplasias Femorais , Osteossarcoma , Escorregamento das Epífises Proximais do Fêmur , Humanos , Feminino , Criança , Escorregamento das Epífises Proximais do Fêmur/cirurgia , Escorregamento das Epífises Proximais do Fêmur/diagnóstico por imagem , Neoplasias Femorais/cirurgia , Osteossarcoma/tratamento farmacológico , Osteossarcoma/cirurgia , Neoplasias Ósseas/tratamento farmacológico , Neoplasias Ósseas/cirurgia , Reoperação , Falha de Prótese , Radiografia , Desenho de Prótese , Quimioterapia Adjuvante/efeitos adversos , Resultado do Tratamento
8.
BMC Musculoskelet Disord ; 25(1): 387, 2024 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-38762722

RESUMO

PURPOSE: This study aimed to evaluate the cervical sagittal profile after the spontaneous compensation of global sagittal imbalance and analyze the associations between the changes in cervical sagittal alignment and spinopelvic parameters. METHODS: In this retrospective radiographic study, we analyzed 90 patients with degenerative lumbar stenosis (DLS) and sagittal imbalance who underwent short lumbar fusion (imbalance group). We used 60 patients with DLS and sagittal balance as the control group (balance group). Patients in the imbalance group were also divided into two groups according to the preoperative PI: low PI group (≤ 50°), high PI group (PI > 50°). We measured the spinal sagittal alignment parameters on the long-cassette standing lateral radiographs of the whole spine. We compared the changes of spinal sagittal parameters between pre-operation and post-operation. We observed the relationships between the changes in cervical profile and spinopelvic parameters. RESULTS: Sagittal vertical axis (SVA) occurred spontaneous compensation (p = 0.000) and significant changes were observed in cervical lordosis (CL) (p = 0.000) and cervical sagittal vertical axis (cSVA) (p = 0.023) after surgery in the imbalance group. However, there were no significant differences in the radiographic parameters from pre-operation to post-operation in the balance group. The variations in CL were correlated with the variations in SVA (R = 0.307, p = 0.041). The variations in cSVA were correlated with the variations in SVA (R=-0.470, p = 0.001). CONCLUSION: Cervical sagittal profile would have compensatory changes after short lumbar fusion. The spontaneous decrease in CL would occur in patients with DLS after the spontaneous compensation of global sagittal imbalance following one- or two-level lumbar fusion. The changes of cervical sagittal profile were related to the extent of the spontaneous compensation of SVA.


Assuntos
Vértebras Cervicais , Lordose , Vértebras Lombares , Fusão Vertebral , Estenose Espinal , Humanos , Fusão Vertebral/efeitos adversos , Fusão Vertebral/métodos , Masculino , Feminino , Estudos Retrospectivos , Idoso , Pessoa de Meia-Idade , Vértebras Lombares/cirurgia , Vértebras Lombares/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Vértebras Cervicais/diagnóstico por imagem , Estenose Espinal/cirurgia , Estenose Espinal/diagnóstico por imagem , Lordose/diagnóstico por imagem , Lordose/cirurgia , Equilíbrio Postural/fisiologia , Radiografia
9.
Semin Musculoskelet Radiol ; 28(3): 327-336, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38768597

RESUMO

Knee pain is one of the most common indications for radiography in the evaluation of musculoskeletal disorders in children and adolescents. According to international guidelines, knee radiographs should be obtained when there is the suspicion of an effusion, limited motion, pain to palpation, inability to bear weight, mechanical symptoms (such as "locking"), and persistent knee pain after therapy. When indicated, radiographs can provide crucial information for the clinical decision-making process. Because of the developmental changes occurring in the knee during growth, the assessment of knee radiographs can be challenging in children and adolescents. Radiologists unfamiliar with the appearance of the knee on radiographs during skeletal maturation risk overcalling or overlooking bone lesions. Image acquisition techniques and parameters should be adapted to children. This article describes the most common challenges in distinguishing pathology from the normal appearance of knee radiographs in the pediatric population, offering some pearls and pitfalls that can be useful in clinical practice.


Assuntos
Articulação do Joelho , Humanos , Criança , Articulação do Joelho/diagnóstico por imagem , Adolescente , Radiografia/métodos , Artropatias/diagnóstico por imagem , Traumatismos do Joelho/diagnóstico por imagem , Diagnóstico Diferencial
10.
Artigo em Inglês | MEDLINE | ID: mdl-38743847

RESUMO

INTRODUCTION: Pediatric ankle injuries are a common presentation in the emergency department (ED). A quarter of pediatric ankle fractures show no radiographic evidence of a fracture. Physicians often correlate non-weight bearing and tenderness with an occult fracture. We present this study to predict the probability of an occult fracture using radiographic soft-tissue swelling on initial ED radiographs. METHODS: This is a retrospective study at a Level 1 pediatric trauma center from 2021 to 22. Soft-tissue swelling between the lateral malleolus and skin was measured on radiographs, and weight-bearing status was documented. Statistical analysis was conducted using Stata software. DISCUSSION: The study period involved 32 patients with an occult fracture, with 8 (25%) diagnosed with a fracture on follow-up radiographs. The probability of an occult fracture was calculated as a function of the ankle swelling in millimeters (mm) using a computer-generated predictive model. False-negative and false-positive rates were plotted as a function of the degree of ankle swelling. CONCLUSION: Magnitude of ankle soft-tissue swelling as measured on initial ED radiographs is predictive of an occult fracture. Although weight-bearing status was not a sign of occult fracture, it improves the predictive accuracy of soft-tissue swelling.


Assuntos
Fraturas do Tornozelo , Edema , Fraturas Fechadas , Radiografia , Humanos , Fraturas do Tornozelo/diagnóstico por imagem , Estudos Retrospectivos , Masculino , Feminino , Criança , Edema/diagnóstico por imagem , Fraturas Fechadas/diagnóstico por imagem , Adolescente , Serviço Hospitalar de Emergência , Suporte de Carga , Probabilidade , Pré-Escolar , Valor Preditivo dos Testes
11.
Artigo em Inglês | MEDLINE | ID: mdl-38748497

RESUMO

INTRODUCTION: The Kellgren and Lawrence (KL) classification for knee osteoarthritis estimates disease severity. Its utility in predicting patient-reported outcomes (PROs) after primary total knee arthroplasty (pTKA) has been suggested. We hypothesized that patients who had higher preoperative KL grades would demonstrate greater improvements in PROs after pTKA. METHODS: This was a retrospective review of patients who underwent pTKA between 2016 and 2021. Two observers graded preoperative radiographs (KL1/2, KL3, and KL4). Knee Injury and Osteoarthritis Outcome Score (KOOS) for activities of daily living (KOOS-ADL) and pain (KOOS-Pain) were collected at preoperative and 12-month postoperative visits. Changes in KOOS-ADL (ΔADL) and changes in KOOS-Pain (ΔPain) scores were compared from the preoperative to 12-month postoperative mark across different groups, with the minimal clinically important difference (MCID) for both ΔADL (MCID-ADL) and ΔPain (MCID-Pain) also being calculated. A P-value of < 0.05 was considered statistically significant. RESULTS: A total of 1651 patients were included in the study. The KL3 and KL4 groups exhibited significantly higher ΔADL scores and ΔPain scores compared with the KL1/2 group (P < 0.01). Patients who had KL3 and KL4 were 1.42 (P = 0.03) and 1.88 (P < 0.01) times, respectively, more likely to achieve MCID-ADL compared with those who had KL1/2. Furthermore, patients who had a KL4 were 1.92 times (P < 0.01) more likely to reach MCID-Pain compared with those who had KL1/2. CONCLUSIONS: This study determined that patients who had higher preoperative KL grades experienced markedly greater improvements in KOOS-ADL and KOOS-Pain scores than those who had lower KL grades. These findings offer surgeons an objective tool when counseling patients on expected outcomes after pTKA.


Assuntos
Atividades Cotidianas , Artroplastia do Joelho , Osteoartrite do Joelho , Medidas de Resultados Relatados pelo Paciente , Radiografia , Índice de Gravidade de Doença , Humanos , Osteoartrite do Joelho/cirurgia , Osteoartrite do Joelho/diagnóstico por imagem , Feminino , Masculino , Estudos Retrospectivos , Idoso , Pessoa de Meia-Idade , Medição da Dor
12.
Med Eng Phys ; 127: 104167, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38692766

RESUMO

BACKGROUND: Recent studies have stated the relevance of having new parameters to quantify the position and orientation of the scapula with patients standing upright. Although biplanar radiography can provide 3D reconstructions of the scapula and the spine, it is not yet possible to acquire these images with patients in the same position. METHODS: Two pairs of images were acquired, one for the 3D reconstruction of the spine and ribcage and one for the 3D reconstruction of the scapula. Following 3D reconstructions, scapular alignment was performed in two stages, a coarse alignment based on manual annotations of landmarks on the clavicle and pelvis, and an adjusted alignment. Clinical parameters were computed: protraction, internal rotation, tilt and upward rotation. Reproducibility was assessed on an in vivo dataset of upright biplanar radiographs. Accuracy was assessed using supine cadaveric CT-scans and digitally reconstructed radiographs. FINDINGS: The mean error was less than 2° for all clinical parameters, and the 95 % confidence interval for reproducibility ranged from 2.5° to 5.3°. INTERPRETATION: The confidence intervals were lower than the variability measured between participants for the clinical parameters assessed, which indicates that this method has the potential to detect different patterns in pathological populations.


Assuntos
Imageamento Tridimensional , Postura , Escápula , Escápula/diagnóstico por imagem , Humanos , Masculino , Feminino , Adulto , Reprodutibilidade dos Testes , Radiografia/métodos , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Idoso
14.
Sci Rep ; 14(1): 10342, 2024 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-38710901

RESUMO

To compare the demographic, clinical, and laboratory characteristics, disease onset, and clinical features of radiographic axial Spondyloarthritis (r-axSpA) and non-radiographic axial Spondyloarthritis (nr-axSpA) patients. All patients who attended outpatient spondylarthritis (SpA) clinics at Hospital General de Mexico and the Instituto Nacional de la Nutrición from 1998 to 2005 and met the rheumatologist diagnostic criteria for SpA were selected. Then the SpA patients were classified by European Spondyloarthropathy Study Group criteria (ESSG). We selected SpA patients with axial presentation as axial SpA (axSpA), and they were classified as r-axSpA if they met modified New York (mNY) criteria for sacroiliitis and as nr-axSpA if they did not meet mNY criteria; to compared clinical, demographic, and laboratory test between the subgroups. It included 148 SpA patients; 55 (37.2%) patients had r-axSpA, and 70 (47.3%) had nr-axSpA. The nr-axSpA patients had a lower proportion of males (58.6% vs 78.2%, P < 0.05), lower HLA-B27 frequency (54.3%. vs. 92.7%, P < 0.05), were older at disease onset (21 vs 16 years; P < 0.01) and had a higher frequency of infections at disease onset (9.1% vs 32.9, P < 0.05) than r-axSpA. BASFI (2.9 vs 4.8; P < 0.0001), Dougados functional index (7 vs. 14; P < 0.05), and BASDAI (4.1 vs. 5.2; P < 0.001) were lower in patients with nr-axSpA than r-axSpA, respectively. The factors that most influenced the presentation of r-axSpA were history of uveitis (OR 14, 95% CI 2.3-85), HLA-B27 (OR 7.97, 95% CI, 2.96-122), male sex (OR 6.16, 95% CI, 1.47-25.7), axial enthesopathy count (OR 1.17 95% CI, 1.03-1.33). This study provides insight into the differences between nr-axSpA and r-axSpA in Mexico. Patients with r-axSpA were mainly male, with a younger presentation age, a higher prevalence of HLA-B27, more history of uveitis, fewer episodes of dactylitis, more axial enthesopathy, and higher disease activity than nr-axSpA.


Assuntos
Espondiloartrite Axial , Humanos , Masculino , México/epidemiologia , Feminino , Adulto , Espondiloartrite Axial/diagnóstico por imagem , Antígeno HLA-B27 , Radiografia/métodos , Pessoa de Meia-Idade , Estudos de Coortes , Adulto Jovem , Espondilartrite/diagnóstico por imagem
15.
Vet Rec ; 194(9): 363, 2024 05 04.
Artigo em Inglês | MEDLINE | ID: mdl-38700193

RESUMO

Elizabeth 'Lizza' Baines talks through her new role at the Canine Health Schemes (CHS), leading the team of vets who score over 14,500 hip and elbow radiographs each year.


Assuntos
Medicina Veterinária , Animais , Cães , Reino Unido , Medicina Veterinária/organização & administração , Humanos , Bem-Estar do Animal , Radiografia/veterinária , Doenças do Cão
16.
Artigo em Inglês | MEDLINE | ID: mdl-38758677

RESUMO

BACKGROUND: First metatarsophalangeal joint arthrodesis with isolated dorsal plating without a lag screw and without a compressive mechanism incorporated into the plate is not well studied. Although surface area for bony fusion is increased, there is concern for lower fusion rates and progressive loss of sagittal plane positioning. We present fusion rates and progressive sagittal plane deviation with isolated dorsal plate fixation. METHODS: A retrospective review was performed of 41 patients (43 feet) who underwent first metatarsophalangeal joint arthrodesis with isolated dorsal plate fixation. Patients were excluded if another form of fixation was used, if there was a compressive feature to the dorsal plate, or if a lag screw was used. Preoperative, immediate postoperative, and final postoperative radiographs were reviewed to assess radiographic alignment and fusion about the first metatarsophalangeal joint. Specific attention was placed on hallux dorsiflexion in relation to the first metatarsal. Statistical significance was set at P ≤ .05 a priori. RESULTS: Patients were followed for an average of 55.7 weeks. Overall union rate was 97.62%. The average time to union was 42.55 days. Reoperation rate was 4.65%, with one patient requiring revisional arthrodesis with a lag screw construct. Hallux abduction and first-second intermetatarsal angle correction reached significance (P < .00001). Hallux dorsiflexion increased by 1.05° between initial postoperative and final postoperative radiographs (P = .542). CONCLUSIONS: Although fusion rates and progressive loss of sagittal plane position have been concerns for first metatarsophalangeal joint arthrodesis with an isolated dorsal plate construct, these results suggest this to be a stable construct without loss of positioning over time.


Assuntos
Artrodese , Placas Ósseas , Articulação Metatarsofalângica , Humanos , Artrodese/métodos , Artrodese/instrumentação , Estudos Retrospectivos , Articulação Metatarsofalângica/cirurgia , Articulação Metatarsofalângica/diagnóstico por imagem , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Radiografia , Adulto , Resultado do Tratamento , Hallux Valgus/cirurgia , Hallux Valgus/diagnóstico por imagem
17.
Bull Hosp Jt Dis (2013) ; 82(2): 154-158, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38739664

RESUMO

We report the treatment of two patient with humeral fractures with one or more risk factors for nonunion. The first patient was elderly with a previously diagnosed central nervous sys-tem injury. The second elderly patient previously sustained a cerebral vascular accident affecting the fractured arm. The fracture was oblique in the proximal third of the humerus. We achieved bone healing non-operatively utilizing a spe-cialized plastic orthosis that included a deforming element made of dense foam. This device asymmetrically increases the soft tissue pressure around the fracture.


Assuntos
Consolidação da Fratura , Fraturas não Consolidadas , Fraturas do Úmero , Aparelhos Ortopédicos , Humanos , Fraturas do Úmero/cirurgia , Fraturas do Úmero/fisiopatologia , Fraturas do Úmero/diagnóstico por imagem , Fraturas não Consolidadas/cirurgia , Fraturas não Consolidadas/fisiopatologia , Fraturas não Consolidadas/etiologia , Fatores de Risco , Masculino , Resultado do Tratamento , Idoso , Feminino , Desenho de Equipamento , Idoso de 80 Anos ou mais , Radiografia
18.
PLoS One ; 19(5): e0299596, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38696414

RESUMO

BACKGROUND: Therapeutic Radiographers (RT) and Speech and Language Therapists (SLT) work closely together in caring for people with head and neck cancer and need a strong understanding of each others' roles. Peer teaching has been shown to be one of the most effective methods of teaching; however, no studies to date, have involved RT and SLT students. This research aims to establish the effectiveness and perceptions of peer-led teaching between undergraduate RT and SLT students in Ulster University. METHODS: Twenty SLT students and 14 RT students participated. Knowledge tests were taken online before the peer-led teaching session (T1), after the session (T2) and 3 months later (T3). Students' perceptions of the experience were collected at the end of the session. Wilcoxon signed-rank tests were used to analyse the impact of the intervention on knowledge scores. Qualitative content analysis was used for open text response data. RESULTS: RT students' own professional knowledge score at T2 was statistically significantly higher than the score at T1; the score at T3 was not deemed to be statistically significantly higher. RT students' SLT knowledge score at T2 and T3 was found to be statistically significantly higher than the score at T1. SLT students' own professional knowledge score was not statistically significantly higher at T2 or T3 than T1. They did have a statistically significantly higher score at T2 on the RT test, but score at T3 was not deemed to be statistically significantly higher. The majority of students across both professions agreed or strongly agreed that the peer-led teaching experience had a positive impact on their learning. CONCLUSION: This investigation highlights the benefits of an interprofessional peer-led teaching intervention for RT and SLT students and the findings add to the evidence of more objective study of knowledge gain as a result of interprofessional peer teaching.


Assuntos
Grupo Associado , Humanos , Masculino , Feminino , Terapia da Linguagem/métodos , Fonoterapia/educação , Fonoterapia/métodos , Aprendizagem , Ensino , Estudantes/psicologia , Estudantes de Ciências da Saúde/psicologia , Adulto , Relações Interprofissionais , Radiografia
19.
JBJS Case Connect ; 14(2)2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38704646

RESUMO

CASE: We report a case of an otherwise healthy 4-month-old male infant presenting with unexplained metaphyseal lucent bands and diaphyseal periosteal reactions in bilateral extremities upon radiograph, who was ultimately diagnosed with congenital syphilis. After subsequent workup and treatment, the patient had appropriate range of motion of all extremities within 2 weeks after discharge. CONCLUSION: The purpose of this report was to increase the awareness of the rising incidence of congenital syphilis in the United States and educate fellow orthopaedic surgeons on ways to differentiate the skeletal manifestations of congenital syphilis from other pathologies with significant bone involvement.


Assuntos
Sífilis Congênita , Humanos , Masculino , Lactente , Radiografia
20.
J Med Case Rep ; 18(1): 251, 2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38741133

RESUMO

INTRODUCTION: Evaluating isolated extremity discomfort can be challenging when initial imaging and exams provide limited information. Though subtle patient history hints often underlie occult pathologies, benign symptoms are frequently miscategorized as idiopathic. CASE PRESENTATION: We present a case of retained glass obscuring as acute calcific periarthritis on imaging. A 48-year-old White male with vague fifth metacarpophalangeal joint pain had unrevealing exams, but radiographs showed periarticular calcification concerning inflammation. Surgical exploration unexpectedly revealed an encapsulated glass fragment eroding bone. Further history uncovered a forgotten glass laceration decade prior. The foreign body was removed, resolving symptoms. DISCUSSION: This case reveals two imperative diagnostic principles for nonspecific extremity pain: (1) advanced imaging lacks specificity to differentiate inflammatory arthropathies from alternate intra-articular processes such as foreign bodies, and (2) obscure patient history questions unearth causal subtleties that direct accurate diagnosis. Though initial scans suggested acute calcific periarthritis, exhaustive revisiting of the patient's subtle decade-old glass cut proved pivotal in illuminating the underlying driver of symptoms. CONCLUSION: Our findings underscore the critical limitations of imaging and the vital role that meticulous history-taking plays in clarifying ambiguous chronic limb presentations. They spotlight the imperative of probing even distant trauma when symptoms seem disconnected from causative events. This case reinforces the comprehensive evaluation of all subtle patient clues as key in illuminating elusive extremity pain etiologies.


Assuntos
Calcinose , Corpos Estranhos , Vidro , Humanos , Masculino , Pessoa de Meia-Idade , Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/complicações , Calcinose/diagnóstico por imagem , Calcinose/diagnóstico , Diagnóstico Diferencial , Articulação Metacarpofalângica/diagnóstico por imagem , Articulação Metacarpofalângica/lesões , Periartrite/diagnóstico por imagem , Periartrite/diagnóstico , Artralgia/etiologia , Radiografia
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