Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 39
Filtrar
1.
Eur Radiol ; 31(11): 8542-8553, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33963449

RESUMO

OBJECTIVES: To assess the current evidence regarding the efficacy of percutaneous vertebroplasty (PVP) over conservative treatment (CT) and placebo in osteoporotic vertebral fractures (OVFs) by performing a meta-analysis of randomized controlled trials (RCTs). MATERIALS AND METHODS: A systematic search was conducted on PubMed, EMBASE, and Cochrane databases. The main outcomes were pain relief, improvement of functional disability, and quality of life at different time points: short-term (1-2 weeks), medium-term (1-3 months), and long-term (≥ 6 months). Subgroup analyses based on time from fracture onset and sham procedure were also performed. RESULTS: A total of 14 RCTs were included in the meta-analysis. PVP showed significant benefits over CT in all outcomes, but slight-to-none clear differences over placebo. Subgroup analyses revealed that PVP performed in fractures < 6 weeks provided superior short-term pain relief than the control group (p = .02), and better quality of life in the medium-term (p = .03) and long-term (p = .006). Placebo based on infiltrating the skin alone was significantly inferior to PVP at most time points in all outcomes, but no significant differences between PVP and placebo were found when the sham procedure consisted of infiltrating both the skin and periosteum. CONCLUSIONS: PVP showed significant advantages over CT in terms of efficacy, but benefits were more limited when compared to placebo. In addition, benefits of PVP are more prominent in recent OVFs. Differences in the sham procedure or criteria regarding patient's selection/allocation seem to be the main causes of disparity in previous RCTs. KEY POINTS: • Previous RCTs showed significant advantages of PVP over CT in terms of efficacy, but benefits were more limited when compared to placebo. • Differences in patient allocation or in the sham procedure might explain the lack of benefits of PVP versus placebo found in previous RCTs. • Despite controversial opinions, PVP should be offered to patients with OVFs as an alternative option to conservative treatment.


Assuntos
Fraturas por Compressão , Fraturas por Osteoporose , Fraturas da Coluna Vertebral , Vertebroplastia , Tratamento Conservador , Fraturas por Compressão/cirurgia , Humanos , Fraturas por Osteoporose/terapia , Fraturas da Coluna Vertebral/cirurgia , Resultado do Tratamento
2.
Radiologia ; 58(6): 454-459, 2016.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27692484

RESUMO

OBJECTIVE: To evaluate the usefulness of ultrasound-guided versus fluoroscopy-guided injection in CT arthrography and MR arthrography. MATERIAL AND METHODS: We reviewed all CT arthrography and MR arthrography studies done at our center between October 1, 2014 and October 1, 2015. We analyzed 32 studies: 26 with fluoroscopic guidance and 6 with ultrasound guidance. We compared the two techniques on the following parameters: presence of sufficient contrast material in the joint, extravasation or injection of contrast material in the soft tissues (presence of contrast material in the psoas or other soft tissues), and intra-articular gas bubbles. We used SPSS V. 20 to compare the techniques with Pearson's chi-square tests. RESULTS: Contrast material was observed in soft tissues in 56.3% of ultrasound-guided injections, making 6.3% of the procedures invalid for diagnostic purposes. Extravasation of contrast material was observed in 53.8% of fluoroscopy-guided procedures, making 3.8% invalid for diagnostic purposes. Intra-articular gas was observed in 21.9% of ultrasound-guided studies and in 38.5% of fluoroscopy-guided studies. None of the differences between techniques were statistically significant at p<0.05. CONCLUSIONS: Our study shows that ultrasound is as useful as fluoroscopy for injecting contrast material for CT arthroscopy and MR arthroscopy; ultrasound has the advantage of not using ionizing radiation.


Assuntos
Artrografia/métodos , Meios de Contraste/administração & dosagem , Fluoroscopia , Articulação do Quadril/diagnóstico por imagem , Artropatias/diagnóstico por imagem , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Ultrassonografia , Adolescente , Adulto , Feminino , Humanos , Injeções , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
3.
Radiologia ; 58 Suppl 1: 94-103, 2016 Apr.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-26778583

RESUMO

We review the state of the art in imaging-guided percutaneous interventional procedures used to diagnose and/or treat the diverse causes of back pain. These procedures can be used for diagnosis, treatment, or both. They are focused on the vertebral bodies, the facet joints, the intervertebral discs, and the nerve structures.


Assuntos
Dor nas Costas/diagnóstico por imagem , Dor nas Costas/cirurgia , Doenças da Medula Espinal/diagnóstico por imagem , Doenças da Medula Espinal/cirurgia , Doenças da Coluna Vertebral/diagnóstico por imagem , Doenças da Coluna Vertebral/cirurgia , Dor nas Costas/etiologia , Humanos , Procedimentos Ortopédicos/métodos , Doenças da Medula Espinal/complicações , Doenças da Coluna Vertebral/complicações , Cirurgia Assistida por Computador
4.
Radiologia (Engl Ed) ; 65(3): 239-250, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37268366

RESUMO

Low-energy vertebral fractures pose a diagnostic challenge for the radiologist due to their often-inadvertent nature and often subtle imaging semiology. However, the diagnosis of this type of fractures can be decisive, not only because it allows targeted treatment to prevent complications, but also because of the possibility of diagnosing systemic pathologies such as osteoporosis or metastatic disease. Pharmacological treatment in the first case has been shown to prevent the development of other fractures and complications, while percutaneous treatments and various oncological therapies can be an alternative in the second case. Therefore, it is necessary to know the epidemiology and typical imaging findings of this type of fractures. The objective of this work is to review the imaging diagnosis of low-energy fractures, with special emphasis on the characteristics that should be outlined in the radiological report to guide a specific diagnosis that favours and optimizes the treatment of patients suffering of low energy fractures.


Assuntos
Osteoporose , Fraturas da Coluna Vertebral , Humanos , Diagnóstico por Imagem , Osteoporose/complicações , Osteoporose/diagnóstico , Fraturas da Coluna Vertebral/diagnóstico por imagem
5.
Radiologia ; 54(6): 532-8, 2012.
Artigo em Espanhol | MEDLINE | ID: mdl-22578911

RESUMO

In 2009, two clinical trials that questioned the usefulness of vertebroplasty for the treatment of osteoporotic fractures compared with conservative treatment were reported in the New England Journal of Medicine, leading to wide debate in the literature. In this article, we provide a critical review of the scientific evidence in this field and discuss our own experience with this technique.


Assuntos
Fraturas da Coluna Vertebral/cirurgia , Vertebroplastia , Ensaios Clínicos como Assunto , Humanos , Fraturas por Osteoporose/cirurgia , Vertebroplastia/estatística & dados numéricos
6.
Radiologia ; 53(2): 116-33, 2011.
Artigo em Espanhol | MEDLINE | ID: mdl-21353687

RESUMO

The use of tomographic imaging techniques, computed tomography (CT) and magnetic resonance imaging (MRI), to complement or replace plain-film radiography in the study of spine pain is becoming more and more common. The aim of this paper is to provide a general review of the CT and MRI manifestations of the wide spectrum of lesions that can cause pain in the spinal column. This spectrum includes degenerative disease, malalignment, tumors, inflammatory processes, and infectious processes. Precise knowledge and accurate reporting of the findings at CT and MRI are fundamental for clinical decision making in patients with spine pain.


Assuntos
Dor nas Costas/diagnóstico , Imageamento por Ressonância Magnética , Doenças da Coluna Vertebral/diagnóstico , Tomografia Computadorizada por Raios X , Dor nas Costas/etiologia , Humanos , Doenças da Coluna Vertebral/complicações
7.
Radiologia ; 53 Suppl 1: 70-7, 2011 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-21764411

RESUMO

Multidetector computed tomography (MDCT) has significant advantages over plain-film X-rays in the study of the extremities. Acute trauma poses diagnostic challenges, especially in joints in which the overlapping of bony structures impedes the view of the fractures or luxations. Each major joint has at least one classification system for fractures that aims to include the fundamental aspects necessary to orient the most effective treatment. These are the cases in which MDCT's capabilities for multiplanar and three-dimensional reconstructions provide information that is crucial for the management of trauma to the joint.


Assuntos
Ossos do Braço/diagnóstico por imagem , Ossos do Braço/lesões , Fraturas Ósseas/diagnóstico por imagem , Ossos da Perna/diagnóstico por imagem , Ossos da Perna/lesões , Tomografia Computadorizada Multidetectores , Humanos
8.
Radiologia (Engl Ed) ; 60(6): 465-475, 2018.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30274850

RESUMO

Platelet-rich plasma (PRP) is a preparation for therapeutic purposes that is increasingly accepted for various musculoskeletal disorders, due to its theoretical potential to repair tissues with poor healing capacity. Several randomised clinical trials have investigated the capacity of PRP to repair tendons, ligaments, muscles and cartilage, and to date there is level 1a evidence to support its use for lateral epicondylitis, osteoarthritis of the knee, plantar fasciitis and rotator cuff tendinopathy; and level 1b for patellar tendinopathy and osteoarthritis of the hip. Retrospective cohort studies and case series describe promising results with PRP for treating other musculoskeletal disorders. Since its side effects are fewer than those of the control groups, the treatment is considered practically harmless and is being increasingly used. Further randomised clinical trials are necessary to establish future indications, and to confirm effectiveness and safety.


Assuntos
Doenças Musculoesqueléticas/terapia , Plasma Rico em Plaquetas , Humanos
9.
Radiologia (Engl Ed) ; 65 Suppl 2: S1-S2, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37858347

Assuntos
Radiologia , Radiografia
11.
Nutr Hosp ; 22(4): 417-24, 2007.
Artigo em Espanhol | MEDLINE | ID: mdl-17650882

RESUMO

Child growth constitutes a very sensitive indicator for the assessment of their health state. Any deviation from standard parameters could entail the appearance of any congenital or acquired disorder. Identifying with precision children's bone age during their growth period can be very useful in different situations. From a clinical point of view, it is a tool for diagnosis, which can offer the possibility of monitoring treatment effects in the case of standard deviations. This is why we need to study in depth current methods and carry out regular controls that insure their reliability. Currently, the most frequent radiological methods in our country for the determination of children's bone age were designed in the middle of the 20th century on the basis of X-rays performed on children from other countries. Thus, it would be interesting to find out whether social, economic, nutritional and health changes in Spain have influenced child growth and development in a significant way. Hence it would invalidate traditional methods for the determination of bone age. This study came from a main hypothesis: the child's environment significantly influences the concordance of bone age and chronological age. Our aim was to study a possible relationship between nutrition and bone development. Thus, the fastest way of testing this hypothesis was to implement a cross-sectional prevalence study in order to determine the percentage of children showing a chronological age concording with bone age. The study was entirely carried out in the Traumatology Hospital of Granada, which belongs to the University Hospital Virgen de las Nieves. We used the information provided by the Emergency Department about slight traumatisms. The cross-section sample was adapted to our main hypothesis. The overall number of patients was 100, which exceeds the necessary cases to test the reliability of this particular study. On the other hand, in order to determine the concordance of bone age and its different variables, an analitical study was also carried out, which includes: an univariant analysis, a bivariate analysis and a multivariate analysis, with the various tests they usually include. We found out that children showing a delayed bone age eat less bread than those showing an advanced bone age. It would be necessary to determine whether bone age and bone mass have inversely related values before considering it as concordant information. We could only determine that, currently, advanced bone maturation is usually associated with rapid growth. It is possible that children who eat more bread actually show an advanced bone age, a more rapid growth and a reduced bone mass. However, in this study, the outcomes must be considered just as preliminar, due to the size of the cross-section sample. Our research on the influence of nutrition should also include a further longitudinal study.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Desenvolvimento Ósseo , Estado Nutricional , Meio Social , Adolescente , Doenças do Desenvolvimento Ósseo/diagnóstico , Doenças do Desenvolvimento Ósseo/epidemiologia , Pão , Aleitamento Materno , Criança , Pré-Escolar , Comorbidade , Estudos Transversais , Dieta , Feminino , Transtornos do Crescimento/diagnóstico , Transtornos do Crescimento/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Desnutrição/complicações , Modelos Biológicos , Obesidade/epidemiologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Prevalência , Curva ROC , Valores de Referência , Espanha/epidemiologia , Poluição por Fumaça de Tabaco/efeitos adversos
13.
Spine (Phila Pa 1976) ; 22(15): 1730-4; discussion 1734-5, 1997 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-9259783

RESUMO

STUDY DESIGN: The incidence of calcification in ligamentum flavum and posterior capsule demonstrated by computed tomography was reviewed in a series of 147 patients in whom 419 lumbar levels were studied. OBJECTIVES: To find a relationship between mechanical lumbar pathology and the calcification of the ligamentum flavum and posterior capsule. SUMMARY OF BACKGROUND DATA: Calcification of the ligamentum flavum and posterior capsule has been found in diffuse idiopathic skeletal hyperostosis and in metabolic disorders. Although this fact is considered a manifestation of degenerative disease of the spine, it barely has been studied, and many questions remain unresolved. METHODS: Calcifications were classified according to location as follows: 1) ligamentum flavum: upper attachment, lateral or capsular extension, caudal attachment, interlaminar portion or 2) posterior capsule. RESULTS: The following statistical associations were found: 1) degenerative facet joint disease with posterior capsule and lateral or capsular extension calcifications, 2) lumbarized vertebra with lateral or capsular extension and upper attachment calcifications, and 3) isthmic spondylolisthesis with lateral or capsular extension calcification.


Assuntos
Calcinose/diagnóstico por imagem , Ligamento Amarelo/patologia , Espondilolistese/diagnóstico por imagem , Adulto , Calcinose/etiologia , Humanos , Ligamento Amarelo/diagnóstico por imagem , Dor Lombar/etiologia , Pessoa de Meia-Idade , Ciática/etiologia , Espondilolistese/complicações , Tomografia Computadorizada por Raios X
14.
Rev Esp Enferm Dig ; 81(2): 131-3, 1992 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-1567705

RESUMO

Two cases of jejunojejunal intussusception in whom diagnosis was reached preoperatively by ultrasonography and small bowel follow-through meal are presented. We review the sonographic patterns of intussusception that allow the differential diagnosis with miscellaneous gastrointestinal abnormalities detected by ultrasound.


Assuntos
Intussuscepção/diagnóstico por imagem , Doenças do Jejuno/diagnóstico por imagem , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ultrassonografia
15.
Acta Otorrinolaringol Esp ; 44(4): 302-4, 1993.
Artigo em Espanhol | MEDLINE | ID: mdl-8217274

RESUMO

We present a cervical thymic cyst clinically manifest as a lateral neck mass and studied preoperatively with ultrasound. We point to the sonographic findings that allow us to include the cervical thymic cyst as one of the diagnostic possibilities.


Assuntos
Cistos/fisiopatologia , Timo/fisiopatologia , Adulto , Cistos/diagnóstico , Cistos/diagnóstico por imagem , Cistos/ultraestrutura , Diagnóstico Diferencial , Feminino , Humanos , Doenças Respiratórias/diagnóstico , Doenças da Glândula Tireoide/diagnóstico , Doenças da Glândula Tireoide/fisiopatologia , Ultrassonografia
16.
Radiología (Madr., Ed. impr.) ; 65(3): 239-250, May-Jun. 2023. ilus, tab
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-221004

RESUMO

Las fracturas vertebrales de baja energía suponen un reto diagnóstico para el radiólogo debido a su naturaleza, frecuentemente inadvertida, y a su semiología en imagen, a menudo sutil. Sin embargo, el diagnóstico de este tipo de fracturas puede resultar determinante, no solo por permitir realizar un tratamiento dirigido que evite complicaciones, sino también por la posibilidad de diagnosticar patologías sistémicas como la osteoporosis o la enfermedad metastásica. El tratamiento farmacológico en el primer caso ha demostrado evitar el desarrollo de otras fracturas y complicaciones, mientras que los tratamientos percutáneos y las diversas terapias oncológicas pueden ser una alternativa en el segundo caso. Por lo tanto, es preciso conocer la epidemiología y los hallazgos por imagen de este tipo de fracturas. El objetivo de este trabajo es revisar el diagnóstico por imagen de las fracturas de baja energía, con especial énfasis en las características que deben reseñarse en el informe radiológico para orientar a un diagnóstico específico que favorezca y optimice el tratamiento de los pacientes que padecen este tipo de fracturas.(AU)


Low-energy vertebral fractures pose a diagnostic challenge for the radiologist due to their often-inadvertent nature and often subtle imaging semiology. However, the diagnosis of this type of fractures can be decisive, not only because it allows targeted treatment to prevent complications, but also because of the possibility of diagnosing systemic pathologies such as osteoporosis or metastatic disease. Pharmacological treatment in the first case has been shown to prevent the development of other fractures and complications, while percutaneous treatments and various oncological therapies can be an alternative in the second case. Therefore, it is necessary to know the epidemiology and typical imaging findings of this type of fractures. The objective of this work is to review the imaging diagnosis of low-energy fractures, with special emphasis on the characteristics that should be outlined in the radiological report to guide a specific diagnosis that favours and optimizes the treatment of patients suffering of low energy fractures.(AU)


Assuntos
Humanos , Masculino , Feminino , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/prevenção & controle , Fraturas da Coluna Vertebral/terapia , Osteoporose , Fraturas da Coluna Vertebral/epidemiologia , Radiografia , Radiologia , Tomografia Computadorizada por Raios X , Espectroscopia de Ressonância Magnética
17.
Rev. chil. radiol ; 23(1): 7-14, 2017. ilus
Artigo em Espanhol | LILACS | ID: biblio-844630

RESUMO

Lumbar pain is a common and frequent chronic condition. It is estimated that facet joint pain represents 15-31% of all consultations for low back pain. In suspected facet joint pain, it is recommended to perform nerve blocks to establish the diagnosis. Percutaneous continuous radiofrequency is the most effective treatment to date. We describe the current evidence on the minimally invasive treatment of lumbar facet syndrome and our experience with image guidance with CT and fluoroscopy by means of rhizolysis of the medial branch of the dorsal primary ramus of the spinal nerve.


El dolor lumbar es una entidad común y frecuente crónica. Se estima que el dolor de causa articular facetaria representa el 15-31% de todas las consultas por dolor lumbar. En sospecha de dolor articular facetario se recomienda realización de bloqueos nerviosos para establecer el diagnóstico. La radiofrecuencia continua percutánea es el tratamiento más efectivo hasta la fecha. Se describe la evidencia actual en el tratamiento mínimamente invasivo del síndrome facetario lumbar y nuestra experiencia con las guías de imagen con TC y fluoroscopía mediante rizolisis de la rama medial del ramo primario dorsal del nervio espinal.


Assuntos
Humanos , Denervação/métodos , Dor Lombar/cirurgia , Tratamento por Radiofrequência Pulsada/métodos , Articulação Zigapofisária , Síndrome
18.
Radiologia ; 52(2): 126-37, 2010.
Artigo em Espanhol | MEDLINE | ID: mdl-20227735

RESUMO

The introduction of tomographic imaging techniques, fundamentally computed tomography and magnetic resonance imaging, has led to a gradual decrease in the indications for plain-film radiography, resulting in fewer patients studied and fewer projections for each patient. Consequently, plain-film studies of the spine have received less attention and radiologists are less familiar with the typical findings in normal and pathologic conditions of the spine. Nevertheless, plain-film radiography continues to be widely used in both primary and specialized care. Thus, radiologists still need to be aware of the normal radiologic anatomy of the spine and of the radiologic manifestations of the diverse pathological processes that can affect the spinal column and that can cause pain. The aim of this article is to review the manifestations on plain-film radiography of a wide variety of diseases that can cause back pain, including congenital, traumatic, degenerative, tumor-related, inflammatory, and infectious diseases and processes.


Assuntos
Dor nas Costas/diagnóstico por imagem , Doenças da Medula Espinal/diagnóstico por imagem , Dor nas Costas/etiologia , Humanos , Radiografia , Doenças da Medula Espinal/complicações
19.
Radiología (Madr., Ed. impr.) ; 60(6): 465-475, nov.-dic. 2018. ilus, tab
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-175323

RESUMO

El plasma rico en plaquetas (PRP) es un preparado con fines terapéuticos cada vez más aceptado en diversas patologías musculoesqueléticas, debido a su teórico potencial para reparar tejidos con baja capacidad curativa. Se han realizado diversos ensayos clínicos aleatorizados que investigan la capacidad del PRP para la reparación de tendones, ligamentos, músculos y cartílago. Hasta la fecha existe evidencia 1A que apoya su uso para la epicondilitis lateral, la osteoartritis de rodilla, la fascitis plantar y tendinopatías del manguito rotador, y evidencia 1B en la tendinopatía del tendón rotuliano y la osteoartritis de cadera. Estudios retrospectivos, de cohortes y series de casos describen resultados prometedores del PRP para el tratamiento de otras patologías musculoesqueléticas. Al ser sus efectos secundarios menores que los de los grupos controles hacen que sea un tratamiento considerado como prácticamente inocuo y cada vez más usado. Son necesarios nuevos ensayos clínicos aleatorizados para establecer futuras indicaciones y confirmar su efectividad y seguridad


Platelet-rich plasma (PRP) is a preparation for therapeutic purposes that is increasingly accepted for various musculoskeletal disorders, due to its theoretical potential to repair tissues with poor healing capacity. Several randomised clinical trials have investigated the capacity of PRP to repair tendons, ligaments, muscles and cartilage, and to date there is level 1a evidence to support its use for lateral epicondylitis, osteoarthritis of the knee, plantar fasciitis and rotator cuff tendinopathy; and level 1b for patellar tendinopathy and osteoarthritis of the hip. Retrospective cohort studies and case series describe promising results with PRP for treating other musculoskeletal disorders. Since its side effects are fewer than those of the control groups, the treatment is considered practically harmless and is being increasingly used. Further randomised clinical trials are necessary to establish future indications, and to confirm effectiveness and safety


Assuntos
Humanos , Plasma Rico em Plaquetas , Traumatismos dos Tendões/terapia , Entorses e Distensões/terapia , Fraturas de Cartilagem/terapia , Resultado do Tratamento , Tendinopatia/terapia , Lesões do Manguito Rotador/terapia , Fasciíte Plantar/terapia
SELEÇÃO DE REFERÊNCIAS
Detalhe da pesquisa