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Antúnez-Estudillo E, Riera Tur L, Caballero García A. Perichondritis and auricular cellulitis related to piercings as first manifestation of monkeypox. Acta Otorrinolaringol Esp (Engl Ed) 2024; 75:129-132. [PMID: 38220050 DOI: 10.1016/j.otoeng.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/29/2023] [Indexed: 01/16/2024]
Abstract
INTRODUCTION Pinna infections are usually due to Staphylococcus aureus infection. It is common for the patient to have had an earring in the area of infection. Monkeypox infection has gone from being an endemic infection to a worldwide health emergency. CASE SUMMARY In this article we present five cases of monkeypox earring infection of the pinna and what common features we have seen that differentiate them from Staphylococcus aureus infection. DISCUSSION Symptoms of monkeypox include general malaise, fever with uni- or bilateral lymphadenopathy, and then the appearance within one or two days of skin lesions, we want to alert he otolaryngologist and the medical society to the possibility the diagnostic possibility of monkeypox in patients with an auricular perichondritis.
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Affiliation(s)
- Encarnación Antúnez-Estudillo
- Department of Otolaryngology, Puerta del Mar University Hospital, Cádiz, Spain; Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain.
| | - Laura Riera Tur
- Department of Otolaryngology, Puerta del Mar University Hospital, Cádiz, Spain; Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
| | - Andrés Caballero García
- Department of Otolaryngology, Puerta del Mar University Hospital, Cádiz, Spain; Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
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Gris AH, Piva MM, Schwertz CI, Mori AP, Saremba C, Simon DM, Sonne L, Pavarini SP, Driemeier D. Auricular and laryngeal chondritis in nursery and finishing pigs. Vet Pathol 2024; 61:88-94. [PMID: 37470276 DOI: 10.1177/03009858231186101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
This work aimed to characterize the clinic-pathological presentation of an outbreak of auricular and laryngeal chondritis in pigs. Visits were made to pig farms, where the clinical history was obtained, and clinical and postmortem examinations were performed. In those farms, 3% to 4% of pigs presented otohematomas, which started in the nursery and extended to the finishing phase. Moreover, some finishing pigs presented with respiratory distress, initially characterized as inspiratory dyspnea, associated by an uncommon respiratory stridor and culminating in death. Grossly, nursery piglets had enlarged ears, and on the cut surface, the cartilage was fragmented and associated with blood clots. In the finishing phase, in addition to auricular lesions, the epiglottis and arytenoid cartilages were thickened and distorted, which partially occluded the lumen. Microscopically, the laryngeal and auricular cartilages were fragmented, displayed a loss of matrix basophilia, and were surrounded by lymphohistiocytic inflammatory infiltrate, with occasional multinucleated giant cells and fibrosis. The lesions exclusively affected elastic cartilages. The disease in finishing pigs led to increased mortality and was a differential diagnosis to respiratory challenges. It was not possible to determine the factor that triggered this condition; however, a nutritional association is suspected. To the authors' knowledge, this is the first report of primary auricular and laryngeal chondritis in pigs.
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Affiliation(s)
- Anderson H Gris
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Manoela M Piva
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Claiton I Schwertz
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Inata Produtos Biológicos, Uberlândia, Brazil
| | - Ana P Mori
- Inata Produtos Biológicos, Uberlândia, Brazil
| | | | | | - Luciana Sonne
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - David Driemeier
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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3
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Vater MR, Luo Y, Lawley MG, Graham TB. Clinical Image: Early Intervention With Etanercept to Prevent the Progression of Idiopathic Chondrolysis of the Hip. J Clin Rheumatol 2021; 27:S630-S631. [PMID: 33337803 DOI: 10.1097/rhu.0000000000001677] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- McKenzie R Vater
- From the Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN
| | - Yu Luo
- From the Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN
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Tanay G, Tanay A. "Cave Aurem"! Chondritis/Perichondritis in the Course of a Systemic Disease. Isr Med Assoc J 2021; 23:261. [PMID: 33899363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Galya Tanay
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
| | - Amir Tanay
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Darby S, Gomez DE, Hobbs K, Carrera-Justiz S, Grosso FV, MacKay R. Presumptive fibrocartilaginous embolic myelopathy in a pot-bellied pig. Can Vet J 2021; 62:167-172. [PMID: 33542556 PMCID: PMC7808203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A case of presumptive fibrocartilaginous embolic myelopathy in a pet pot-bellied pig is described in this report. This case, which was associated with a previous trauma, highlighted the importance of advanced diagnostic imaging in pigs with clinical signs consistent with a myelopathy.
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Affiliation(s)
- Shannon Darby
- Departments of Large Animal Clinical Sciences (Darby, Gomez, Hobbs, MacKay), and Small Animal Clinical Sciences (Carrera-Justiz, Vilaplana Grosso), College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA; Department of Large Animal Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario (Gomez)
| | - Diego E Gomez
- Departments of Large Animal Clinical Sciences (Darby, Gomez, Hobbs, MacKay), and Small Animal Clinical Sciences (Carrera-Justiz, Vilaplana Grosso), College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA; Department of Large Animal Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario (Gomez)
| | - Kallie Hobbs
- Departments of Large Animal Clinical Sciences (Darby, Gomez, Hobbs, MacKay), and Small Animal Clinical Sciences (Carrera-Justiz, Vilaplana Grosso), College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA; Department of Large Animal Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario (Gomez)
| | - Sheila Carrera-Justiz
- Departments of Large Animal Clinical Sciences (Darby, Gomez, Hobbs, MacKay), and Small Animal Clinical Sciences (Carrera-Justiz, Vilaplana Grosso), College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA; Department of Large Animal Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario (Gomez)
| | - Federico Vilaplana Grosso
- Departments of Large Animal Clinical Sciences (Darby, Gomez, Hobbs, MacKay), and Small Animal Clinical Sciences (Carrera-Justiz, Vilaplana Grosso), College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA; Department of Large Animal Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario (Gomez)
| | - Robert MacKay
- Departments of Large Animal Clinical Sciences (Darby, Gomez, Hobbs, MacKay), and Small Animal Clinical Sciences (Carrera-Justiz, Vilaplana Grosso), College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA; Department of Large Animal Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario (Gomez)
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Roguin Maor N, Zmiri P. Perichondritis after High Ear Piercing. Isr Med Assoc J 2021; 23:57-58. [PMID: 33443346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Noga Roguin Maor
- Clinical Research Unit, Clalit Health Services, Haifa and Western Galilee District, Israel
- Savion Clinic, Clalit Health Services, Rechasim, Israel
| | - Pnina Zmiri
- Department of Family Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Savion Clinic, Clalit Health Services, Rechasim, Israel
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Hartmann B, Marchi G, Alberton P, Farkas Z, Aszodi A, Roths J, Clausen-Schaumann H. Early Detection of Cartilage Degeneration: A Comparison of Histology, Fiber Bragg Grating-Based Micro-Indentation, and Atomic Force Microscopy-Based Nano-Indentation. Int J Mol Sci 2020; 21:ijms21197384. [PMID: 33036285 PMCID: PMC7582717 DOI: 10.3390/ijms21197384] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/29/2020] [Accepted: 10/04/2020] [Indexed: 12/27/2022] Open
Abstract
We have determined the sensitivity and detection limit of a new fiber Bragg grating (FBG)-based optoelectronic micro-indenter for biomechanical testing of cartilage and compared the results to indentation-type atomic force microscopy (IT-AFM) and histological staining. As test samples, we used bovine articular cartilage, which was enzymatically degraded ex vivo for five minutes using different concentrations of collagenase (5, 50, 100 and 500 µg/mL) to mimic moderate extracellular matrix deterioration seen in early-stage osteoarthritis (OA). Picrosirius Red staining and polarization microscopy demonstrated gradual, concentration-dependent disorganization of the collagen fibrillar network in the superficial zone of the explants. Osteoarthritis Research Society International (OARSI) grading of histopathological changes did not discriminate between undigested and enzymatically degraded explants. IT-AFM was the most sensitive method for detecting minute changes in cartilage biomechanics induced by the lowest collagenase concentration, however, it did not distinguish different levels of cartilage degeneration for collagenase concentrations higher than 5 µg/mL. The FBG micro-indenter provided a better and more precise assessment of the level of cartilage degeneration than the OARSI histological grading system but it was less sensitive at detecting mechanical changes than IT-AFM. The FBG-sensor allowed us to observe differences in cartilage biomechanics for collagenase concentrations of 100 and 500 µg/mL. Our results confirm that the FBG sensor is capable of detecting small changes in articular cartilage stiffness, which may be associated with initial cartilage degeneration caused by early OA.
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Affiliation(s)
- Bastian Hartmann
- Center for Applied Tissue Engineering and Regenerative Medicine–CANTER, Munich University of Applied Sciences, 80335 Munich, Germany; (B.H.); (A.A.)
- Laboratory of Experimental Surgery and Regenerative Medicine (ExperiMed), Clinic for General, Trauma and Reconstructive Surgery, University of Munich, 82152 Planegg, Germany; (P.A.); (Z.F.)
- Center for Nanoscience (CeNS), University of Munich, 80331 Munich, Germany
| | - Gabriele Marchi
- Photonics Laboratory, Department of Applied Sciences and Mechatronics, Munich University of Applied Sciences, 80335 Munich, Germany; (G.M.); (J.R.)
| | - Paolo Alberton
- Laboratory of Experimental Surgery and Regenerative Medicine (ExperiMed), Clinic for General, Trauma and Reconstructive Surgery, University of Munich, 82152 Planegg, Germany; (P.A.); (Z.F.)
| | - Zsuzsanna Farkas
- Laboratory of Experimental Surgery and Regenerative Medicine (ExperiMed), Clinic for General, Trauma and Reconstructive Surgery, University of Munich, 82152 Planegg, Germany; (P.A.); (Z.F.)
| | - Attila Aszodi
- Center for Applied Tissue Engineering and Regenerative Medicine–CANTER, Munich University of Applied Sciences, 80335 Munich, Germany; (B.H.); (A.A.)
- Laboratory of Experimental Surgery and Regenerative Medicine (ExperiMed), Clinic for General, Trauma and Reconstructive Surgery, University of Munich, 82152 Planegg, Germany; (P.A.); (Z.F.)
| | - Johannes Roths
- Photonics Laboratory, Department of Applied Sciences and Mechatronics, Munich University of Applied Sciences, 80335 Munich, Germany; (G.M.); (J.R.)
| | - Hauke Clausen-Schaumann
- Center for Applied Tissue Engineering and Regenerative Medicine–CANTER, Munich University of Applied Sciences, 80335 Munich, Germany; (B.H.); (A.A.)
- Center for Nanoscience (CeNS), University of Munich, 80331 Munich, Germany
- Correspondence: ; Tel.: +49-89-1265-1682
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Lehmer LM, Roseman VM, Lundquist KF. Chondrodermatitis nodularis helicis in an adolescent boy: not just for old men. Cutis 2019; 104:E6-E8. [PMID: 31886791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Chondrodermatitis nodularis helicis (CNH) is a solitary, chronic, painful, often ulcerated lesion on the upper portion of the ear, mostly in older men. We present an unusual case of CNH in a 17-year-old adolescent boy who was a lifeguard. Correlation between clinical and histopathologic characteristics of CNH is outlined in the context of the existing literature to increase awareness of this condition in younger patients as well as to guide appropriate management and surveillance.
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Affiliation(s)
| | - Victoria M Roseman
- Western Diagnostic Services Laboratories, San Luis Obispo, California, USA
| | - Kurt F Lundquist
- Western Diagnostic Services Laboratories, San Luis Obispo, California, USA
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Sachdev A, Chhawchharia R, Gupta D, Gupta N. Flexible Fiberoptic Bronchoscopy Directed Interventions in Neonatal Intensive Care Unit. Indian Pediatr 2019; 56:563-565. [PMID: 31333210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To describe the utility of flexible fiberoptic bronchoscopy for the diagnosis and management in the neonatal ICU. METHODS A retrospective, medical chart review was conducted in neonates who underwent flexible fiberoptic bronchoscopy over a period of 7 years. Besides demographic data and diagnostic findings, the results of medical and/or surgical interventions done by treating neonatologist were recorded. RESULTS 88 bronchoscopies were performed in 83 neonates, of which 37 were done through endotracheal tube. Indications included persistent need for mechanical ventilation (32), persistent atelectasis (21), and stridor (27). Most common airway anomalies diagnosed included tracheobronchomalacia (20), laryngomalacia (18), subglottic stenosis (7), choanal atresia (4), laryngeal cleft (4), and tracheoesophageal fistula (4). Surgical interventions were undertaken in 17 cases (9 tracheostomies and 2 cases of slide tracheoplasty). CONCLUSIONS Flexible fiberoptic bronchoscopy can be beneficial for the diagnosis and management of neonates with persistent or undiagnosed respiratory problems.
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Affiliation(s)
- Anil Sachdev
- Department of Pediatrics, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, India. Correspondence to: Dr Anil Sachdev, Department of Pediatrics, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi 110 060, India.
| | - Ritika Chhawchharia
- Department of Pediatrics, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, India
| | - Dhiren Gupta
- Department of Pediatrics, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, India
| | - Neeraj Gupta
- Department of Pediatrics, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, India
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Affiliation(s)
- Casey Slattery
- Department of Orthopaedics & Sports Medicine, University of Washington, Seattle, WA, USA
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Abstract
Hyaline cartilages, fibrocartilages and elastic cartilages play multiple roles in the human body including bearing loads in articular joints and intervertebral discs, providing joint lubrication, forming the external ears and nose, supporting the trachea, and forming the long bones during development and growth. The structure and organization of cartilage's extracellular matrix (ECM) are the primary determinants of normal function. Most diseases involving cartilage lead to dramatic changes in the ECM which can govern disease progression (e.g., in osteoarthritis), cause the main symptoms of the disease (e.g., dwarfism caused by genetically inherited mutations) or occur as collateral damage in pathological processes occurring in other nearby tissues (e.g., osteochondritis dissecans and inflammatory arthropathies). Challenges associated with cartilage diseases include poor understanding of the etiology and pathogenesis, delayed diagnoses due to the aneural nature of the tissue and drug delivery challenges due to the avascular nature of adult cartilages. This narrative review provides an overview of the clinical and pathological features as well as current treatment options available for various cartilage diseases. Late breaking advances are also described in the quest for development and delivery of effective disease modifying drugs for cartilage diseases including osteoarthritis, the most common form of arthritis that affects hundreds of millions of people worldwide.
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Affiliation(s)
- Yamini Krishnan
- Department of Chemical Engineering, MIT, Cambridge, MA 02139, USA
| | - Alan J Grodzinsky
- Department of Biological Engineering, MIT, Cambridge, MA 02139, USA; Department of Mechanical Engineering, MIT, Cambridge, MA 02139, USA; Department of Electrical Engineering and Computer Science, MIT, Cambridge, MA 02139, USA.
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D'Ambrosi R, Maccario C, Serra N, Ursino C, Usuelli FG. Relationship between symptomatic osteochondral lesions of the talus and quality of life, body mass index, age, size and anatomic location. Foot Ankle Surg 2018; 24:365-372. [PMID: 29409207 DOI: 10.1016/j.fas.2017.04.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Revised: 03/03/2017] [Accepted: 04/11/2017] [Indexed: 02/04/2023]
Abstract
INTRODUCTION The aim of the study was to assess the relationship between symptomatic osteochondral lesions of the talus (OLTs) and age, body mass index (BMI), quality of life (QOL), size and anatomic location. METHODS Fifty-two patients with chronic OLTs were analyzed including BMI, Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS), Short-Form Health Survey (SF-12 divided into Mental (MCS) and Physical (PCS) score) and the 12-Item General Health Questionnaire (GHQ-12). Every patient underwent magnetic resonance imaging (MRI) and computed tomography (CT) examinations. We carried out a sub-analysis by dividing the talus into 6 areas, 3 vertical (medial, central and lateral group) and 3 horizontal (anterior, middle and posterior group). RESULTS There were 31 (60%) male and 21 (40%) female patients. Mean MCS and PCS resulted respectively 43.9 and 35.2. OLTs were located as follows: medial 20 (38.50%); central 13 (24.0%); and lateral 19 (36.50%); anterior 24 (46.15%); middle 16 (30.77%); and posterior 12 (23.08%). No significant differences were found among different groups with the exception of the anterior and posterior group for MCS (p=0.021). In the central group we identified a negative correlation (R=-0.672) between aging and AOFAS and a positive correlation between BMI and lesion size. We found a positive correlation between CT and MRI in each group. CONCLUSIONS OLTs impact patients' quality of life particularly in the physical component. Additionally, in patients with central lesions we found a positive linear correlation between lesion size and BMI and a worsening of the ankle with increasing age.
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Affiliation(s)
- Riccardo D'Ambrosi
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, U.O. CASCO - Piede e Caviglia, Milan, Italy.
| | - Camilla Maccario
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, U.O. CASCO - Piede e Caviglia, Milan, Italy
| | - Nicola Serra
- Seconda Università di Napoli, Dipartimento di Radiologia, Naples, Italy
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Abstract
RATIONALE We report two rare cases of enchondroma protuberans originating from phalanxes. PATIENT CONCERNS The patients visited doctors for a palpable mass in their phalanx without any pain or discomfort. DIAGNOSES Biopsy is the gold standard for the diagnosis of enchondroma protuberans. Radiographs usually provide important imaging information, while studied on the ultrasound manifestation of enchondroma protuberans are still limited. In our cases, significant information about ultrasound manifestation of enchondroma protuberans were presented. Sonographic examination of enchondroma protuberans revealed a hypoechoic mass located in and beyond the medullary cavity of bone through the interrupted bone cortex, and blood flow signals were usually not abundant. INTERVENTIONS Patients were subsequently referred for surgical removal and the masses were confirmed by following pathological examination. OUTCOMES After surgery, the patients recovered well with no relapse within 2 years. LESSONS Enchondroma protuberans is a rare form of benign enchondroma. Enchondroma protuberans can present as an intramedullary hypoechoic mass extending to the surrounding soft tissue via the discontinuous cortex line on ultrasound. Ultrasound can provide important information for the diagnosis of enchondroma protuberans.
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Taketomi S, Inui H, Yamagami R, Kawaguchi K, Nakazato K, Kono K, Kawata M, Nakagawa T, Tanaka S. Surgical timing of anterior cruciate ligament reconstruction to prevent associated meniscal and cartilage lesions. J Orthop Sci 2018; 23:546-551. [PMID: 29501276 DOI: 10.1016/j.jos.2018.02.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 01/26/2018] [Accepted: 02/12/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND The purpose of this study was to analyze the association between the prevalence of meniscal and chondral lesions and the timing of surgery in patients undergoing primary anterior cruciate ligament (ACL) reconstruction to determine a safe time for surgery. METHODS This retrospective study involved 226 patients (91 females and 135 males; median age, 29 years) undergoing primary ACL reconstruction. Time interval from ACL injury to surgery (median, 4 months; range, 1-420 months) and concomitant meniscal and cartilage lesions in ACL reconstruction were reviewed. Receiver operating characteristic (ROC) curve analysis was used to determine the precise threshold interval to surgery to prevent meniscal or cartilage lesions. The risk of lesion occurrence after each cutoff period was determined using odds ratio (OR). RESULTS The incidences of medial meniscus (MM), lateral meniscus (LM), and cartilage lesions were 43.8%, 32.7%, and 27.4%, respectively. ROC analysis revealed that patients who waited for more than 6, 4, and 5 months for ACL reconstruction had a significantly greater risk of associated MM, LM, and chondral lesions, respectively. Patients who underwent ACL reconstruction ≥7 months after injury had OR of 4.1 (p < 0.001) for the presence of MM lesion as compared with those who underwent reconstruction within 6 months. Similarly, patients who underwent ACL reconstruction ≥5 months after injury had OR of 1.9 (p = 0.023) for the presence of LM lesion as compared with those who underwent reconstruction within 4 months, and patients who underwent ACL reconstruction ≥6 months after injury had OR of 2.9 (p < 0.001) for chondral lesion as compared with those who underwent reconstruction within 6 months. CONCLUSION ACL reconstruction should be performed within approximately 6 months after the injury to prevent associated meniscal or chondral lesions.
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Affiliation(s)
- Shuji Taketomi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Hiroshi Inui
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryota Yamagami
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kohei Kawaguchi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Keiu Nakazato
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kenichi Kono
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Manabu Kawata
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takumi Nakagawa
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
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Papalia R, Papalia G, Russo F, Diaz LA, Bressi F, Sterzi S, Denaro V. Meniscal extrusion as booster of osteoarthritis. J BIOL REG HOMEOS AG 2017; 31:33-44. [PMID: 29202561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Meniscal extrusion (ME) has shown to play a critical but still unclear role in osteoarthritis (OA) development. ME has been described as an important risk factor in the progression of knee OA, as it is involved in the thinning of articular cartilage, joint space narrowing, spontaneous osteonecrosis of the knee and subchondral bone marrow lesions. Meniscal damage of any degree of severity could cause ME in both compartments, but it is commonly associated with severe meniscal tears or root tears mainly in the medial meniscus. Magnetic resonance imaging is the most commonly used imaging modality in the assessment of ME, while ultrasonography may represent a valid alternative with high sensitivity and specificity. Conservative treatment for ME includes physical therapy and rehabilitation to maintain range of motion, corticosteroid injections and intra-articular injections of hyaluronic acid to provide short-term relief of knee pain. The goal of this study is to review standards of current diagnosis and treatment of ME and its relationship to knee OA.
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Affiliation(s)
- R Papalia
- University Campus Bio-Medico of Rome, Department of Orthopedics and Traumatology
| | - G Papalia
- University Campus Bio-Medico of Rome, Department of Orthopedics and Traumatology
| | - F Russo
- University Campus Bio-Medico of Rome, Department of Orthopedics and Traumatology
| | - L A Diaz
- University Campus Bio-Medico of Rome, Department of Orthopedics and Traumatology
| | - F Bressi
- University Campus Bio-Medico of Rome, Physical and Rehabilitation Medicine
| | - S Sterzi
- University Campus Bio-Medico of Rome, Physical and Rehabilitation Medicine
| | - V Denaro
- University Campus Bio-Medico of Rome, Department of Orthopedics and Traumatology
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Warner E, Weston C, Barclay-Klingle N, Corbridge R. The swollen pinna. BMJ 2017; 359:j5073. [PMID: 29146730 DOI: 10.1136/bmj.j5073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- E Warner
- Royal Berkshire Hospital, Reading, UK
| | - C Weston
- Royal Berkshire Hospital, Reading, UK
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Décary S, Fallaha M, Frémont P, Martel-Pelletier J, Pelletier JP, Feldman DE, Sylvestre MP, Vendittoli PA, Desmeules F. Diagnostic Validity of Combining History Elements and Physical Examination Tests for Traumatic and Degenerative Symptomatic Meniscal Tears. PM R 2017; 10:472-482. [PMID: 29111463 DOI: 10.1016/j.pmrj.2017.10.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 09/19/2017] [Accepted: 10/21/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND The current approach to the clinical diagnosis of traumatic and degenerative symptomatic meniscal tears (SMTs) proposes combining history elements and physical examination tests without systematic prescription of imaging investigations, yet the evidence to support this diagnostic approach is scarce. OBJECTIVE To assess the validity of diagnostic clusters combining history elements and physical examination tests to diagnose or exclude traumatic and degenerative SMT compared with other knee disorders. DESIGN Prospective diagnostic accuracy study. SETTINGS Patients were recruited from 2 orthopedic clinics, 2 family medicine clinics, and from a university community. PATIENTS A total of 279 consecutive patients who underwent consultation for a new knee complaint. METHODS Each patient was assessed independently by 2 evaluators. History elements and standardized physical examination tests performed by a physiotherapist were compared with the reference standard: an expert physicians' composite diagnosis including a clinical examination and confirmatory magnetic resonance imaging. Participating expert physicians were orthopedic surgeons (n = 3) or sport medicine physicians (n = 2). Penalized logistic regression (least absolute shrinkage and selection operator) was used to identify history elements and physical examination tests associated with the diagnosis of SMT and recursive partitioning was used to develop diagnostic clusters. MAIN OUTCOME MEASURES Diagnostic accuracy measures were calculated including sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CIs). RESULTS Eighty patients had a diagnosis of SMT (28.7%), including 35 traumatic tears and 45 degenerative tears. The combination a history of trauma during a pivot, medial knee pain location, and a positive medial joint line tenderness test was able to diagnose (LR+ = 8.9; 95% CI 6.1-13.1) or exclude (LR- = 0.10; 95% CI 0.03-0.28) a traumatic SMT. Combining a history of progressive onset of pain, medial knee pain location, pain while pivoting, absence of valgus or varus knee misalignment, or full passive knee flexion was able to moderately diagnose (LR+ = 6.4; 95% CI 4.0-10.4) or exclude (LR- = 0.10; 95% CI 0.03-0.31) a degenerative SMT. Internal validation estimates were slightly lower for all clusters but demonstrated positive LR superior to 5 and negative LR inferior to 0.2 indicating moderate shift in posttest probability. CONCLUSION Diagnostic clusters combining history elements and physical examination tests can support the differential diagnosis of SMT. These results represent the initial derivation of the clusters and external validation is mandatory. LEVEL OF EVIDENCE I.
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Affiliation(s)
- Simon Décary
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec; and Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Department of Surgery, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec; and Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
- Osteoarthritis Research Unit, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
- University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec; and Department of Social Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada
- Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec; and Department of Surgery, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Michel Fallaha
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec; and Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Department of Surgery, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec; and Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
- Osteoarthritis Research Unit, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
- University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec; and Department of Social Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada
- Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec; and Department of Surgery, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Pierre Frémont
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec; and Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Department of Surgery, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec; and Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
- Osteoarthritis Research Unit, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
- University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec; and Department of Social Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada
- Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec; and Department of Surgery, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Johanne Martel-Pelletier
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec; and Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Department of Surgery, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec; and Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
- Osteoarthritis Research Unit, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
- University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec; and Department of Social Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada
- Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec; and Department of Surgery, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Jean-Pierre Pelletier
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec; and Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Department of Surgery, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec; and Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
- Osteoarthritis Research Unit, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
- University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec; and Department of Social Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada
- Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec; and Department of Surgery, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Debbie E Feldman
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec; and Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Department of Surgery, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec; and Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
- Osteoarthritis Research Unit, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
- University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec; and Department of Social Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada
- Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec; and Department of Surgery, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Marie-Pierre Sylvestre
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec; and Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Department of Surgery, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec; and Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
- Osteoarthritis Research Unit, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
- University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec; and Department of Social Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada
- Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec; and Department of Surgery, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Pascal-André Vendittoli
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec; and Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Department of Surgery, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec; and Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
- Osteoarthritis Research Unit, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
- University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec; and Department of Social Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada
- Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec; and Department of Surgery, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - François Desmeules
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec; and Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Department of Surgery, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec; and Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
- Osteoarthritis Research Unit, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
- University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec; and Department of Social Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada
- Orthopaedic Clinical Research Unit, Maisonneuve-Rosemont Hospital Research Center, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec; and Department of Surgery, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada, Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
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Wierzcholski K, Miszczak A. Magneto-therapy of human joint cartilage. Acta Bioeng Biomech 2017; 19:115-124. [PMID: 28552916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE The topic of the present paper concerns the human joint cartilage therapy performed by the magnetic induction field. There is proved the thesis that the applied magnetic field for concrete cartilage illness should depend on the proper relative and concrete values of applied magnetic induction, intensity as well the time of treatment duration. Additionally, very important are frequencies and amplitudes of magnetic field as well as magnetic permeability of the synovial fluid. MATERIAL AND METHODS The research methods used in this paper include: magnetic induction field produced by a new Polish and German magneto electronic devices for the therapy of human joint cartilage diseases, stationary and movable magnetic applicators, magnetic bandage, ferrofluid injections, author's experience gained in Germany research institutes and practical results after measurements and information from patients. RESULTS The results of this paper concern concrete parameters of time dependent electro-magnetic field administration during the joint cartilage therapy duration and additionally concern the corollaries which are implied from reading values gained on the magnetic induction devices. CONCLUSIONS The main conclusions obtained in this paper are as follows: Time dependent magnetic induction field increases the dynamic viscosity of movable synovial fluid and decreases symptoms of cartilage illness for concrete intensity of magnetic field and concrete field line architecture. The ferrofluid therapy and phospholipids bilayer simultaneously with the administrated external electromagnetic field, increases the dynamic viscosity of movable synovial fluid.
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Affiliation(s)
- Krzysztof Wierzcholski
- Technical University of Koszalin, Institute of Technology and Education, ul. Śniadeckich 2, 75-453 Koszalin, Poland
| | - Andrzej Miszczak
- Gdynia Maritime University, ul. Morska 81-87, 81-225 Gdynia, Poland
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19
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Cavaignac É, Menetrey J, Hannouche D. [Update on the treatment of articular cartilage lesions in the knee]. Rev Med Suisse 2016; 12:2178-2184. [PMID: 28707834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Despite articular cartilage lesions being common, there is no evidence-based treatment protocol for them. The preoperative assessment must diagnose all of the concurrent pathologies that need to be treated at the same time. Several types of treatments exist, and each has its advantages and disadvantages. First-line therapy consists of well-conducted conservative treatment. Surgical treatment is the second choice. It is chosen according to the size of the lesion, its depth, damage to the subchondral bone, and the condition of the neighboring cartilage. The few studies that have compared the different methods used to treat these lesions have reported contradictory results.
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Affiliation(s)
- Étienne Cavaignac
- Service de chirurgie orthopédique et traumatologie de l'appareil moteur, HUG, 1211 Genève 14
| | - Jacques Menetrey
- Service de chirurgie orthopédique et traumatologie de l'appareil moteur, HUG, 1211 Genève 14
| | - Didier Hannouche
- Service de chirurgie orthopédique et traumatologie de l'appareil moteur, HUG, 1211 Genève 14
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20
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Kunzler E, Weaver J, Cernik C. Necrotic lesion of the ear. Cutis 2016; 98:293-302. [PMID: 28040810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Papalia R, Vadalà G, Torre G, Perna M, Saccone L, Cannata F, Denaro V. The cytokinome in osteoarthritis, a new paradigm in diagnosis and prognosis of cartilage disease. J BIOL REG HOMEOS AG 2016; 30:77-83. [PMID: 28002903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
At present, diagnosis and progression monitoring of osteoarthritis (OA) is made through radiological and clinical assessment. Several studies investigated the role of synovial fluid analysis, to find out whether joint disease could be characterized by the pattern of cytokines, which acts during the pathogenic process or in specific stages of it. Online PubMed-Medline search was performed in order to retrieve evidence concerning synovial fluid analysis of cytokines involved in OA degenerative process. Concerning pro-inflammatory cytokines, it has been shown that interleukin (IL)-6, TNF-α and IL-17 are mainly over-expressed in the synovial fluid of OA joints, as well as anti-inflammatory cytokine IL-10. Variations of cytokines levels occur with radiological and clinical progression. It was also reported that metalloproteinases are involved. Synovial fluid analysis may be helpful in defining stage and type of OA, but more research is needed, especially focusing on the variation of sets of cytokines during OA stages and correlating these patterns with clinical features.
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Affiliation(s)
- R Papalia
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - G Vadalà
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - G Torre
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - M Perna
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - L Saccone
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - F Cannata
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - V Denaro
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
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Chahla J, LaPrade RF, Mardones R, Huard J, Philippon MJ, Nho S, Mei-Dan O, Pascual-Garrido C. Biological Therapies for Cartilage Lesions in the Hip: A New Horizon. Orthopedics 2016; 39:e715-23. [PMID: 27359284 DOI: 10.3928/01477447-20160623-01] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 02/01/2016] [Indexed: 02/03/2023]
Abstract
Treatment of hip cartilage disease is challenging, and there is no clear algorithm to address this entity. Biomarkers are arising as promising diagnostic tools because they could play a role in the early assessment of the prearthritic joint and as a prognostic factor before and after treatment. The potential effect of biomarkers may be used to categorize individuals at risk of evolving to severe osteoarthritis, to develop new measures for clinical progression of the disease, and to develop new treatment options for the prevention of osteoarthritis progression. A trend toward a less invasive biological treatment will usher in a new treatment era. With the growth of surgical skills in hip arthroscopy, cartilage restoration techniques are evolving in a fast and exponential manner. Biological and surgical treatments have been proposed to treat these pathologies. Biological treatments include platelet-rich plasma, stem cells or bone marrow aspirate concentration, hyaluronic acid, losartan, and fish oil. Surgical treatments include microfracture alone or augmented, direct repair, autologous chondrocyte implantation, matrix-induced chondrocyte implantation, autologous matrix-induced chondrogenesis, mosaicplasty, osteochondral allograft transplantation, and stem cells implanted in matrix (stem cells in membranes/expanded stem cells). This article reviews new evidence available on treatment options for chondral lesions and early osteoarthritis of the hip. [Orthopedics. 2016; 39(4):e715-e723.].
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Ma YL, Zhou L, Wang RQ, Zhuang PY, Xu XL. [The role of acoustic analysis of fundamental frequency in differentiating arytenoid dislocation from vocal fold paralysis]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016; 30:780-783. [PMID: 29798052 DOI: 10.13201/j.issn.1001-1781.2016.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Indexed: 06/08/2023]
Abstract
Objective:Analysis of the sustained vowels of acoustic parameters in arytenoid dislocation and vocal fold paralysis. To investigate their acoustic characteristics and evaluate the role of this acoustic analysis method in differentiating arytenoid dislocation from vocal fold paralysis. Method:Thirty-three cases with unilateral vocal cord movement disorders were collected.All cases were divided into arytenoid dislocation group and vocal fold paralysis group through the laryngeal electromyography. Each group was further devided into male group and female group. The voice signals of sustained vowel of /a/ were measured using the software MDVP and obtain the acoustic parameters(Jitter, Shimmer, SPI and Fo). The acoustic characteristics between the two groups were observed and compared. Results were analyzed using Rank sum test for group design.Result:There were significant differences in Fo between arytenoid dislocation group and vocal fold paralysis group in both male and female group(P <0.05). And mean rank order of Fo in arytenoid dislocation group was greater than vocal fold paralysis group. There were no significant differences in jitter,shimmer and SPI between arytenoid dislocation group and vocal fold paralysis group(P >0.05).Conclusion:Mean rank order of Fo in arytenoid dislocation group is greater than vocal fold paralysis group in both the male and the female group. Fo is of value in differentiating arytenoid dislocation from vocal fold paralysis. This provides a theoretical basis for the acoustic analysis method to identify these two diseases.
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Affiliation(s)
- Y L Ma
- Department of Otorhinolaryngology, Zhongshan Hospital, Xiamen University, Xiamen, 361004, China
| | - L Zhou
- Department of Otorhinolaryngology, Zhongshan Hospital, Xiamen University, Xiamen, 361004, China
| | - R Q Wang
- Medical College of Xiamen University
| | - P Y Zhuang
- Department of Otorhinolaryngology, Zhongshan Hospital, Xiamen University, Xiamen, 361004, China
| | - X L Xu
- Department of Otorhinolaryngology, Zhongshan Hospital, Xiamen University, Xiamen, 361004, China
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Abstract
Achondroplasia is the most common skeletal dysplasia. This form of dwarfism is caused by a point mutation in the fibroblast growth factor receptor 3 (FGFR3) gene, leading to inhibition of endochondral ossification for these patients. This results in a normal trunk height but shortened limbs. The discoid meniscus may be an important associated finding to better understand the common complaints of leg pain for these patients. Although the incidence for a discoid meniscus is between 3% and 5% for the general population, it is unknown with achondroplasia. This case series includes 4 patients, with ages ranging from adolescence to early adulthood, with symptoms of knee pain that were not attributable to some of the more common findings seen in this patient population. Typically, patients with achondroplasia who experience knee pain are evaluated for more common and well-known etiologies such as genu varum, ligamentous instability, and neurogenic claudication. However, the authors propose that symptomatic discoid lateral meniscus should be added to the differential diagnosis for lower-extremity pain in the achondroplasia population. A thorough history and physical examination, in combination with magnetic resonance imaging, can aid in making the diagnosis. Treatment with arthroscopic debridement, saucerization of the meniscus, and repair for unstable injuries has yielded good outcomes for this patient population. [Orthopedics. 2016; 39(3):e498-e503.].
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Abstract
An 18-year-old man with no prior surgical history presented with left knee pain after sustaining a basketball injury and was diagnosed with transient patellar dislocation. Magnetic resonance imaging was ordered to further assess the extent of injury.
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Danieli MV, Guerreiro JPF, Queiroz AD, Pereira HD, Tagima S, Marini MG, Cataneo DC. Diagnosis and classification of chondral knee injuries: comparison between magnetic resonance imaging and arthroscopy. Knee Surg Sports Traumatol Arthrosc 2016; 24:1627-33. [PMID: 25957606 DOI: 10.1007/s00167-015-3622-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 04/27/2015] [Indexed: 02/07/2023]
Abstract
PURPOSE To compare the magnetic resonance imaging (MRI) findings of patients undergoing knee arthroscopy for chondral lesions. The hypothesis was that MRI displays low sensitivity in the diagnosis and classification of chondral injuries. METHODS A total of 83 knees were evaluated. The MRIs were performed using the same machine (GE SIGNA HDX 1.45 T). The MRI results were compared with the arthroscopy findings, and an agreement analysis was performed. Thirty-eight of the 83 MRI exams were evaluated by another radiologist for inter-observer agreement analysis. These analyses were performed using the kappa (κ) coefficient. RESULTS The highest incidence of chondral injury was in the patella (14.4 %). The κ coefficient was 0.31 for the patellar surface; 0.38 for the trochlea; 0.46 for the medial femoral condyle; 0.51 for the lateral femoral condyle; and 0.19 for the lateral plateau. After dividing the injuries into two groups (ICRS Grades 0-II and Grades III and IV), the following κ coefficients were obtained as follows: 0.49 (patella); 0.53 (trochlea); 0.46 (medial femoral condyle); 0.43 (medial plateau); 0.67 (lateral femoral condyle); and 0.51 (lateral plateau). The MRI sensitivity was 76.4 % (patella), 88.2 % (trochlea), 69.7 % (medial femoral condyle), 85.7 % (medial plateau), 81.8 % (lateral femoral condyle) and 75 % (lateral plateau). Comparing the radiologists' evaluations, the following κ coefficients were obtained as follows: 0.73 (patella); 0.63 (trochlea); 0.84 (medial femoral condyle); 0.72 (medial plateau); 0.77 (lateral femoral condyle); and 0.91 (lateral plateau). CONCLUSION Compared with arthroscopy, MRI displays moderate sensitivity for detecting and classifying chondral knee injuries. It is an important image method, but we must be careful in the assessment of patients with suspected chondral lesions. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Marcus Vinicius Danieli
- Uniorte - Hospital de Ortopedia, Antonio Pisicchio, 155, apto 1402, Londrina, PR, CEP 86040-482, Brazil.
- Faculdade de Medicina de Botucatu - UNESP, Botucatu, SP, Brazil.
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Rosique López L. Tracheal osteochondromas, accidental finding. Acta Otorrinolaringol Esp 2016; 67:e34-5. [PMID: 26775024 DOI: 10.1016/j.otorri.2015.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 09/22/2015] [Accepted: 09/27/2015] [Indexed: 11/17/2022]
Affiliation(s)
- Lina Rosique López
- Otorrinolaringología, Hospital Rafael Méndez Lorca, Lorca, Murcia, España.
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Dhollander A, Verdonk P, Almqvist KF, Verdonk R, Victor J. Clinical and MRI outcome of an osteochondral scaffold plug for the treatment of cartilage lesions in the knee. Acta Orthop Belg 2015; 81:629-638. [PMID: 26790784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Conflicting clinical outcomes have been reported recently with the use of an osteochondral scaffold plugs for cartilage repair in the knee. In this study, twenty patients were consecutively treated for their cartilage lesions with the synthetic plug technique. These patients were prospectively clinically evaluated with a mean follow-up of 34.15 months. Magnetic resonance imaging (MRI) was used for morphologic analysis of the cartilage repair. The patients included in this study showed a significant gradual clinical improvement after the osteochondral scaffold plug. However, this clinical improvement was not confirmed by the MRI findings of this cohort study. Subchondral bone changes were seen in all patients on MRI and deficient filling of the defect was noticed in in 30.7% of the cases at 24 months of follow-up. There was no evidence found to support osteoconductive bone ingrowth. Therefore, the use of this type of osteochondral scaffold plug in osteochondral repair is questionable. Level of evidence: IV.
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Bittersohl B, Kircher J, Miese FR, Dekkers C, Habermeyer P, Fröbel J, Antoch G, Krauspe R, Zilkens C. T2* mapping and delayed gadolinium-enhanced magnetic resonance imaging in cartilage (dGEMRIC) of humeral articular cartilage--a histologically controlled study. J Shoulder Elbow Surg 2015; 24:1644-52. [PMID: 25958213 DOI: 10.1016/j.jse.2015.03.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 02/27/2015] [Accepted: 03/07/2015] [Indexed: 02/01/2023]
Abstract
BACKGROUND Cartilage biochemical imaging modalities that include the magnetic resonance imaging (MRI) techniques of T2* mapping (sensitive to water content and collagen fiber network) and delayed gadolinium-enhanced MRI of cartilage (dGEMRIC, sensitive to the glycosaminoglycan content) can be effective instruments for early diagnosis and reliable follow-up of cartilage damage. The purpose of this study was to provide T2* mapping and dGEMRIC values in various histologic grades of cartilage degeneration in humeral articular cartilage. METHODS A histologically controlled in vitro study was conducted that included human humeral head cartilage specimens with various histologic grades of cartilage degeneration. High-resolution, 3-dimensional (3D) T2* mapping and dGEMRIC were performed that enabled the correlation of MRI and histology data. Cartilage degeneration was graded according to the Mankin score, which evaluates surface morphology, cellularity, toluidine blue staining, and tidemark integrity. SPSS software was used for statistical analyses. RESULTS Both MRI mapping values decreased significantly (P < .001) with increasing cartilage degeneration. Spearman rank analysis revealed a significant correlation (correlation coefficients ranging from -0.315 to 0.784; P < .001) between the various histologic parameters and the T2* and T1Gd mapping values. CONCLUSION This study demonstrates the feasibility of 3D T2* and dGEMRIC to identify various histologic grades of cartilage damage of humeral articular cartilage. With regard to the advantages of these mapping techniques with high image resolution and the ability to accomplish a 3D biochemically sensitive imaging, we consider that these imaging techniques can make a positive contribution to the currently evolving science and practice of cartilage biochemical imaging.
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Affiliation(s)
- Bernd Bittersohl
- Medical Faculty, Department of Orthopaedics, University Düsseldorf, Düsseldorf, Germany
| | - Jörn Kircher
- Klinik Fleetinsel Hamburg, Clinic for Orthopedic Surgery, Hamburg, Germany.
| | - Falk R Miese
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Düsseldorf, Düsseldorf, Germany
| | - Christin Dekkers
- Medical Faculty, Department of Orthopaedics, University Düsseldorf, Düsseldorf, Germany
| | - Peter Habermeyer
- ATOS-Klinik Heidelberg, Department of Shoulder and Elbow Surgery, Heidelberg, Germany
| | - Julia Fröbel
- Medical Faculty, Department of Orthopaedics, University Düsseldorf, Düsseldorf, Germany
| | - Gerald Antoch
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Düsseldorf, Düsseldorf, Germany
| | - Rüdiger Krauspe
- Medical Faculty, Department of Orthopaedics, University Düsseldorf, Düsseldorf, Germany
| | - Christoph Zilkens
- Medical Faculty, Department of Orthopaedics, University Düsseldorf, Düsseldorf, Germany
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Wierzcholski K. Acoustic emission diagnosis for human joint cartilage diseases. Acta Bioeng Biomech 2015; 17:139-148. [PMID: 26899013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE The topic of the presented paper concerns the diagnosis of the wear and diseases of human joint cartilage performed by the acoustic waves emission. The aim of this paper is the determining of the necessary parameters for the diagnosis about the wear and diseases of human joint cartilage. MATERIAL AND METHOD To the research methods used in this paper belong the evaluation of measurement results of the cartilage surface samples obtained by means of laser and mechanical sensor and acoustic emission wave might or voltage gained from the AE apparatus during the treatments performed for normal and pathological used and not used human knee and hip joints. RESULTS The results concern with the corollaries which are implied from reading values gained by virtue of the acoustic emission Apparatus, and from observations from cartilage surface pictures obtained from laser and mechanical sensors. The diagnose of concrete cartilage illness depends on the proper relative values of obtained strongest of generated AE wave as well as the shapes and amplitudes of acoustic waves and wave frequencies. CONCLUSIONS The main conclusions obtained in this paper are as follows: connections between synovial fluid dynamic viscosity or friction forces and intensity of acoustic emission values, the determination of the type of lesions and deformations of the human joint cartilage surface by means of the shapes architecture of the acoustic emission waves. Moreover are indicated the necessary conditions for the diagnosis of the such dieses as: pathological cartilage with arthritic or osteoporosis or rheumatology changes.
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Affiliation(s)
- Krzysztof Wierzcholski
- Koszalin University of Technology, Institute of Technology and Education, Koszalin, Poland
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Flanigan DC, Harris JD, Jia G, Choi S, Siston RA, Randazzo JL, Knopp M. Effect of chondral defect size, shape, and location on MRI diagnostic performance in the porcine knee. Orthopedics 2014; 37:e322-7. [PMID: 24762834 DOI: 10.3928/01477447-20140401-50] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 09/26/2013] [Indexed: 02/03/2023]
Abstract
The purpose of this study was to determine the sensitivity and positive predictive value of magnetic resonance imaging (MRI) in the identification of full-thickness articular cartilage defects in the porcine knee. Seventy-two full-thickness chondral defects (small or large; circular, oval, or triangular) were created in 12 porcine knees. The authors used 3.0-T MRI with 3-dimensional gradient echo water-selective/fluid (WATSf) sequences acquired in axial, coronal, and sagittal planes. Sensitivity and positive predictive value parameters were calculated for 2 readers. Magnetic resonance imaging was highly sensitive for detection of full-thickness defects in the knee (85%). The highest sensitivity was observed at the medial femoral condyle (93%), while the lowest was observed at the medial patella (71%). The sensitivities for detecting different shapes were unique to each shape, with oval lesions identified with greatest sensitivity (93%). Small lesions (86%) were detected at a similar sensitivity as large lesions (83%). The positive predictive values for accurate true-positive reads were low for all lesion shapes (18%-57%) and moderate for small (69%) and large (59%) sizes, with significant differences observed between the 2 readers. Magnetic resonance imaging has a high sensitivity in the detection of full-thickness articular cartilage defects in the porcine knee. Variability in defect shape and intra-articular location affects MRI sensitivity, while size does not. Magnetic resonance imaging was not effective in describing lesion shape or size. Further, there was subjectivity in reading defect shape and size between 2 radiologists.
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Caruso AM, Camacho M, Brietzke S. Recurrent auricular perichondritis in a child as the initial manifestation of insulin-dependent diabetes mellitus: a case report. Ear Nose Throat J 2014; 93:E4-E5. [PMID: 24526489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
An 8-year-old boy presented to our otolaryngology clinic three times in a 3-month period for treatment of acute auricular perichondritis. At each visit he was treated with an antibiotic, and he responded quickly in each case, with a complete resolution of his infection. The results of standard autoimmune laboratory tests were negative. Three months after his initial presentation, the patient developed the classic signs and symptoms of diabetes mellitus, including polydipsia, polyuria, and weight loss. He was diagnosed with and treated for type 1 (insulin-dependent) diabetes, and his recurrent infections ceased. There has been no recurrence over a 4-year follow-up period. This case report serves to illustrate the fact that recurrent infections may be the first sign of diabetes. Since diabetes and perichondritis are known to be associated, we recommend that for patients who present with recurrent episodes of perichondritis, a basic metabolic panel and measurement of the glycosylated hemoglobin level be added to standard autoimmune laboratory testing to possibly identify undiagnosed diabetes.
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Affiliation(s)
- Andria M Caruso
- Department of Otolaryngology, Walter Reed National Military Medical Center, 8901 Wisconsin Ave., Bethesda, MD 20814.
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Flatz KM, Glaser C, Flatz WH, Reiser MF, Matis U. [Detection and evaluation of cartilage defects in the canine stifle joint - an ex vivo study using high-field magnetic resonance imaging]. Tierarztl Prax Ausg K Kleintiere Heimtiere 2014; 42:291-296. [PMID: 25323210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 04/24/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The aim of our study was to implement and test an imaging protocol for the detection and evaluation of standardised cartilage defects using high-field magnetic resonance imaging (MRI) and to determine its limitations. MATERIAL AND METHOD A total of 84 cartilage defects were created in the femoral condyles of euthanized dogs with a minimum body mass of 25 kg. The cartilage defects had a depth of 0.3 to 1.0 mm and a diameter of 1 to 5 mm. T1-FLASH-3D-WE-sequences with an isotropic voxel size of 0.5 x 0.5 x 0.5 mm and an anisotropic voxel size of 0.3 x 0.3 x 0.8 mm were used. In addition to quantitative evaluation of the cartilage defects, the sig- nal intensities, signal-to-noise ratios and contrast-to-noise ratios of the cartilage were determined. Of special interest were the limita- tions in identifying and delineating the standardised cartilage defects. RESULTS With the anisotropic voxel size, more cartilage defects were detectable. Our results demonstrated that cartilage defects as small as 3.0 mm in diameter and 0.4 mm in depth were reliably detected using anisotropic settings. Cartilage defects below this size were not reliably detected. CONCLUSION AND CLINICAL RELEVANCE We found that for optimal delineation of the joint cartilage and associated defects, a higher in-plane resolution with a larger slice thickness should be used, corresponding to the anisotropic settings employed in this study. For the delineation of larger cartilage defects, both the anisotropic and isotropic imaging methods can be used.
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Affiliation(s)
- K M Flatz
- Dr. Katharina Flatz, Chirurgische und Gynäkologische Kleintierklinik der Ludwig-Maximilians-Universität München, Radiologie, Veterinärstraße 13, 80539 München, E-Mail:
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Sun LF, Ju YF, Fu GJ, Wang JR, Feng YZ, Chen X. [Keutel syndrome with tracheal stenosis as the major symptom: case report and literature review]. Zhonghua Er Ke Za Zhi 2013; 51:527-530. [PMID: 24267135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To investigate the clinical characteristics, diagnosis and therapy of Keutel syndrome, and thereby to minimize the misdiagnosis. METHOD Data of a case of Keutel syndrome diagnosed at the Provincial Hospital Affiliated to Shandong University were analyzed and related literature were reviewed. RESULT An 8-month-26-day-old boy was presented with inspiratory and expiratory stridor and wheezing after movement on lung auscultation. His craniofacial appearance was characterized by midfacial hypoplasia with a broad depressed nasal bridge. The nose was small and flat. A grade 2-3/6 systolic murmur was heard between the second and third ribs at left edge of the sternum. The end phalanges of his fingers were thickened. Chest radiograph showed tracheobronchial cartilage calcification and tracheobronchial stenosis. Echocardiographic examination revealed the right pulmonary stenosis. With endoscopic surgery, antiobstructive and antibiotic therapy clinical symptoms were improved. Three weeks later he died of lung reinfection after he was discharged from our hospital. English literature search with "Keutel syndrome" as the key word at "PubMed" showed 22 articles covering 26 patients, and the clinical symptoms were hearing loss (91%), persistent respiratory symptoms (68%), recurrent otitis media/sinusitis (67%), growth development delay (52%) in turn, and signs were brachytelephalangism (100%), low nasal bridge (95%), midfacial hypoplasia (93%), cardiac murmur (69%), and auxiliary examinations showed abnormal cartilage calcification (100%), pulmonary arterial stenosis (72%), tracheobronchial stenosis (50%). CONCLUSION The diagnosis of Keutel syndrome should be considered in patients with brachytelephalangism, abnormal cartilage calcification, peripheral pulmonary stenosis, and midfacial hypoplasia. Tracheal stenosis was main clinical manifestation in part of patients.
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Affiliation(s)
- Li-feng Sun
- Department of Pediatrics, Provincial Hospital Affiliated to Shandong University, Jinan
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Gungor S, Kamali G, Canat D, Gokdemir G. Soft tissue chondroma of the index finger: clinical, histological and radiological findings in a unique case. Dermatol Online J 2013; 19:18176. [PMID: 24011276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 05/14/2013] [Indexed: 06/02/2023] Open
Abstract
A chondroma is a benign, slow-growing cartilaginous tumor. When arising in the medullary cavity of a bone it is referred to as an enchondroma-a very common bone tumor. When occurring in soft tissue without any connection to bone, which is extremely rare, it is known as a soft-tissue chondroma (STC). A 38-year-old female presented with a 2- year history of right index finger pulp swelling in the absence of trauma. On physical examination a firm, immobile nodule, approximately 1 cm in diameter, was observed on the palmar side of the right index finger. The overlying skin was normal. Plain X-ray showed a dense, soft tissue shadow without calcification in the right index finger pulp, but the adjacent bones were intact. MRI showed a 1-cm diameter, well-demarcated lesion with intermediate signal intensity on T1-weighted images and high signal intensity on T2-weighted images. MRI also showed that the tumor had no bony involvement and that the adjacent bones were normal. Histopathological examination of the biopsy specimen showed lobules of mature hyaline cartilage with chondrocytes in the lacunae in the dermal and subdermal layers. Mitotic figures and an increase in cellular atypism were not observed. Based on the histopathological and radiological findings, the mass was thought to be an STC and total excision was performed. Examination of the excised mass confirmed the diagnosis of STC. STC should be considered in patients with a slowly growing, mildly painful cutaneous mass.
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Affiliation(s)
- Sule Gungor
- Okmeydani Training and Research Hospital, Istanbul, Turkey
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Kim DS, Yi CH, Kwon KY, Oh JR. Relationship between the extent of labral lesions and the frequency of glenohumeral dislocation in shoulder instability. Knee Surg Sports Traumatol Arthrosc 2013; 21:430-7. [PMID: 22584911 DOI: 10.1007/s00167-012-2045-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Accepted: 04/23/2012] [Indexed: 01/02/2023]
Abstract
PURPOSE This study aimed to evaluate the relationship between the extent of the labral lesion and the frequency of glenohumeral dislocation in patients with shoulder instability. METHODS Ninety-three patients, who underwent surgical treatment at our clinic for chronic anterior shoulder dislocation, were selected and divided into 3 groups (group I: only Bankart lesion; group II: Bankart and SLAP lesions; group III: circumferential-labral lesion). The pre-operative frequency of dislocation, intraoperative findings, operation time, post-operative clinical score, and range of motion 2 years after surgery were analysed and compared among the 3 groups. RESULTS The time interval from the initial dislocation to operation was significantly shorter in group III than in groups I and II (P = 0.034 and P = 0.046, respectively). The median number of preoperative dislocations was also significantly less in group III than in groups I and II (P = 0.025 and P = 0.044, respectively). In all groups, the clinical scores (Constant, Rowe, and visual analogue scale) improved significantly post-operatively, and there were no significant differences in the scores between the different groups. All patients returned to work, and most patients returned to their preoperative sports activity levels. CONCLUSION The extent of the labral lesion is not always related to the number of dislocations; therefore, treatment should not be based on this. LEVEL OF EVIDENCE Retrospective comparative study, Level III.
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Affiliation(s)
- Doo-Sup Kim
- Department of Orthopaedic Surgery, Wonju College of Medicine, Yonsei University, Wonju Christian Hospital, 162 Ilsan-dong, Wonju-si, Gangwon-do, 220-701, Korea
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Petri M, Broese M, Simon A, Liodakis E, Ettinger M, Guenther D, Zeichen J, Krettek C, Jagodzinski M, Haasper C. CaReS (MACT) versus microfracture in treating symptomatic patellofemoral cartilage defects: a retrospective matched-pair analysis. J Orthop Sci 2013; 18:38-44. [PMID: 23001127 DOI: 10.1007/s00776-012-0305-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 08/17/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Treating patellofemoral articular cartilage lesions remains a challenging task in orthopedic surgery. Whereas microfracture and autologous chondrocyte implantation yield good results on femoral condyles, the therapeutic state of the art for treating patellofemoral lesions is yet to be determined. In this study, we compared the CaReS technique, which is a matrix-associated autologous chondrocyte implantation technique, to microfracture for treating patellofemoral articular cartilage lesions. METHODS Between May 2003 and December 2005, 17 patients with an isolated patellofemoral cartilage defect (International Cartilage Repair Society III/IV) were treated with the CaReS technique at our department. After adjusting for inclusion and exclusion criteria, ten of these patients could be included in this study; ten patients treated with microfracture were chosen as a matched-pair group. Clinical outcome was evaluated 3 years after surgery by the 36-item Short Form Health Survey Questionnaire (SF-36), International Knee Documentation Committee (IKDC) subjective evaluation of the knee, Lysholm Score, and Cincinnati Modified Rating Scale scores. RESULTS Patients treated with CaReS had statistically significantly improved IKDC, Lysholm, and Cincinnati scores 36 months after surgery compared with preoperatively. When comparing outcome between groups 36 months after surgery, there was no statistically difference in IKDC, Lysholm, and Cincinnati scores. CONCLUSIONS This is the first trial comparing the CaReS technique and microfracture for treating patellofemoral articular cartilage lesions, and results show that CaReS(®) yields comparable results to microfracture. The small number of patients is a limiting factor of the study, leading to results without statistical significance. A multicentric prospective randomized study comparing the two procedures is desirable.
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Affiliation(s)
- Maximilian Petri
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany.
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Abstract
INTRODUCTION Chondral and osteochondral lesions of the knee are notoriously difficult to treat due to the poor healing capacity of articular cartilage and the hostile environment of moving joints, ultimately causing disabling pain and early osteoarthritis. There are many different reconstructive techniques used currently but few are proven to be of value. However, some have been shown to produce a better repair with hyaline-like cartilage rather than fibrocartilage. METHODS A systematic search of all available online databases including PubMed, MEDLINE(®) and Embase™ was undertaken using several keywords. All the multiple treatment options and methods available were considered. These were summarised, and the evidence for and against them was scrutinised. RESULTS A total of 460 articles were identified after cross-referencing the database searches using the keywords. These revealed that autologous and matrix assisted chondrocyte implantation demonstrated both 'good to excellent' histological results and significant improvement in clinical outcomes. CONCLUSIONS Autologous and matrix assisted chondrocyte implantation have been shown to treat symptomatic lesions successfully with significant histological and clinical improvement. There is, however, still a need for further randomised clinical trials, perfecting the type of scaffold and the use of adjuncts such as growth factors. A list of recommendations for treatment and the potential future trends of managing these lesions are given.
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Affiliation(s)
- J R Perera
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex HA7 4LP, UK.
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Xu L, Xia Z, Liu X, Huang S. [A case of Keutel syndrome in child (review the literature)]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2012; 26:793-794. [PMID: 23259292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE The purpose is to report a calcification of the cartilaginous of the tracheobronchial case in child, and to recognize the clinical and imaging features on Keutel syndrome. METHOD A comprehensive analysis of the clinical data and X-ray,CT. Some literatures involving some symptoms of this child were reviewed. RESULT This patient diagnosed with Keutel syndrome finally. CONCLUSION When we meet calcification of the cartilaginous of the tracheobronchial patient in clinic, it may be Keutel syndrome.
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Affiliation(s)
- Liangbo Xu
- Imaging Center, Wuhan Medical Health Center for Women and Children, Wuhan 430016, China
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Demirel G, Oguz SS, Celik IH, Erdeve O, Uras N, Dilmen U. A case of Keutel syndrome diagnosed in the neonatal period: associated with Binder phenotype. Genet Couns 2012; 23:25-30. [PMID: 22611639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Keutel syndrome is a rare autosomal recessive disorder, characterized by brachytelephalangia (short, broad distal phalanges), midfacial hypoplasia, abnormal cartilage calcifications, peripheral pulmonary stenosis and hearing loss. Binder profile is a well known maxillonasal dysplasia composed of midfacial hypoplasia with absence of anterior nasal spine and facial dysmophism (short nose, flat nasal bridge, perialar flatness, convex upper lip). Here we report a Keutel syndrome presenting with Binder phenotype, abnormal calcifications, hearing loss and respiratory insufficiency in the newborn period. Keutel syndrome should be considered in the differential diagnosis of children with tracheobronchial calcifications, midfacial hypoplasia and stippled epiphysis.
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Affiliation(s)
- G Demirel
- Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.
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Baird K, Kaplan KM. Shoulder chondrolysis. Adv NPs PAs 2011; 2:33-42. [PMID: 22128680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Kimberly Baird
- Jacksonville Pediatric Associates, Jacksonville, Fl, USA
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Abstract
MR imaging is one of the most commonly used imaging techniques to evaluate patients with hip pain. Intra-articular abnormalities of the hip joint are better assessed with recent advances in MR imaging technology, such as high-field strength scanners, improved coils, and more signal-to-noise ratio-efficient sequences. This article discusses the causes of early hip joint degeneration and the current use of morphologic and physiologic MR imaging techniques for evaluating the articular cartilage of the hip joint. The article also discusses the role of MR arthrography in clinical cartilage imaging.
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Affiliation(s)
- Donna G Blankenbaker
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, E3/366 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792-3252, USA.
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Botter SM, Zar M, van Osch GJVM, van Steeg H, Dollé MET, Hoeijmakers JHJ, Weinans H, van Leeuwen JPTM. Analysis of osteoarthritis in a mouse model of the progeroid human DNA repair syndrome trichothiodystrophy. Age (Dordr) 2011; 33:247-260. [PMID: 20820927 PMCID: PMC3168596 DOI: 10.1007/s11357-010-9175-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Accepted: 08/18/2010] [Indexed: 05/29/2023]
Abstract
The increasing average age in developed societies is paralleled by an increase in the prevalence of many age-related diseases such as osteoarthritis (OA), which is characterized by deformation of the joint due to cartilage damage and increased turnover of subchondral bone. Consequently, deficiency in DNA repair, often associated with premature aging, may lead to increased pathology of these two tissues. To examine this possibility, we analyzed the bone and cartilage phenotype of male and female knee joints derived from 52- to 104-week-old WT C57Bl/6 and trichothiodystrophy (TTD) mice, who carry a defect in the nucleotide excision repair pathway and display many features of premature aging. Using micro-CT, we found bone loss in all groups of 104-week-old compared to 52-week-old mice. Cartilage damage was mild to moderate in all mice. Surprisingly, female TTD mice had less cartilage damage, proteoglycan depletion, and osteophytosis compared to WT controls. OA severity in males did not significantly differ between genotypes, although TTD males had less osteophytosis. These results indicate that in premature aging TTD mice age-related changes in cartilage were not more severe compared to WT mice, in striking contrast with bone and many other tissues. This segmental aging character may be explained by a difference in vasculature and thereby oxygen load in cartilage and bone. Alternatively, a difference in impact of an anti-aging response, previously found to be triggered by accumulation of DNA damage, might help explain why female mice were protected from cartilage damage. These findings underline the exceptional segmental nature of progeroid conditions and provide an explanation for pro- and anti-aging features occurring in the same individual.
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Affiliation(s)
- Sander M. Botter
- Department of Internal Medicine, Erasmus MC, University Medical Centre Rotterdam, EE585, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
- Department of Orthopaedics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Michel Zar
- Department of Orthopaedics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Gerjo J. V. M van Osch
- Department of Orthopaedics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
- Department of Otorhinolaryngology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Harry van Steeg
- National Institute of Public Health and the Environment, Laboratory for Health Protection Research, Bilthoven, The Netherlands
| | - Martijn E. T. Dollé
- National Institute of Public Health and the Environment, Laboratory for Health Protection Research, Bilthoven, The Netherlands
| | - Jan H. J. Hoeijmakers
- Department of Cell biology and Genetics, Medical Genetics Centre, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Harrie Weinans
- Department of Orthopaedics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Johannes P. T. M. van Leeuwen
- Department of Internal Medicine, Erasmus MC, University Medical Centre Rotterdam, EE585, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
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Oni DB, Jeyapalan K, Oni OOA. An observational study on MR images of the effect of the discoid meniscus on articular cartilage thickness. Knee 2011; 18:202-4. [PMID: 20542700 DOI: 10.1016/j.knee.2010.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2009] [Revised: 05/06/2010] [Accepted: 05/07/2010] [Indexed: 02/02/2023]
Abstract
The discoid meniscus is known to affect the morphology and mechanics of the knee compartment in which it is housed. To determine whether it also is determinative of the articular cartilage thickness, measurements were made on MR images. There was no statistically significant difference in femoral or tibial articular cartilage thickness between compartments with normal meniscus and compartments with discoid meniscus. These findings suggest that mechanical disturbances wrought by the discoid shape do not have a 'Wolff law' effect.
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Abdel-Aziz M, Azab NA, Bassyouni IH, Hamdy G. Laryngeal involvement in juvenile idiopathic arthritis patients. Clin Rheumatol 2011; 30:1251-6. [PMID: 21614473 DOI: 10.1007/s10067-011-1781-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Accepted: 05/11/2011] [Indexed: 11/26/2022]
Abstract
Juvenile idiopathic arthritis (JIA) is an autoimmune diseases characterized by chronic arthritis and systemic manifestations. Autoimmune diseases can affect the upper airways including the larynx. The aim of this study was to investigate laryngeal involvement in JIA patients and its possible association with JIA disease parameters. Fifty consecutive JIA patients were screened for laryngeal abnormalities using flexible fiberoptic laryngoscope and laryngeal computerized tomography. Laryngeal abnormalities were detected in nine (18%) of our cases, with cricoarytenoiditis in six cases (12%) and a rheumatoid nodule in the pyriform fossa in only one case (2%). Diffuse congestion and edema of the posterior part of the larynx with normal vocal cord mobility was detected in two cases (4%). In our study, laryngeal abnormalities were significantly higher in patients with polyarticular seropositive disease subtype and also were significantly higher in patients with longer disease duration, higher disease activity scores, and those with erosive disease. JIA may affect the larynx. Laryngeal involvement in JIA patients is more in polyarticular seropositive cases. JIA patients have to be subjected to thorough otolaryngologic examination for early diagnosis and prompt management.
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Affiliation(s)
- Mosaad Abdel-Aziz
- Department of Otolaryngology, Faculty of Medicine, Cairo University, Cairo, Egypt
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Yao-Lee A, Ryan M, Rajaram V. Nasal chondromesenchymal hamartoma: correlation of typical MR, CT and pathological findings. Pediatr Radiol 2011; 41:675-7. [PMID: 21400084 DOI: 10.1007/s00247-011-2034-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Accepted: 02/10/2011] [Indexed: 11/26/2022]
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McCarty WJ, Luan A, Sundaramurthy P, Urbanczyk C, Patel A, Hahr J, Sotoudeh M, Ratcliffe A, Sah RL. An arthroscopic device to assess articular cartilage defects and treatment with a hydrogel. Ann Biomed Eng 2011; 39:1306-12. [PMID: 21107696 PMCID: PMC3069304 DOI: 10.1007/s10439-010-0209-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2010] [Accepted: 11/12/2010] [Indexed: 10/28/2022]
Abstract
The hydraulic resistance R across osteochondral tissue, especially articular cartilage, decreases with degeneration and erosion. Clinically useful measures to quantify and diagnose the extent of cartilage degeneration and efficacy of repair strategies, especially with regard to pressure maintenance, are still developing. The hypothesis of this study was that hydraulic resistance provides a quantitative measure of osteochondral tissue that could be used to evaluate the state of cartilage damage and repair. The aims were to (1) develop a device to measure R in an arthroscopic setting, (2) determine whether the device could detect differences in R for cartilage, an osteochondral defect, and cartilage treated using a hydrogel ex vivo, and (3) determine how quickly such differences could be discerned. The apparent hydraulic resistance of defect samples was ~35% less than intact cartilage controls, while the resistance of hydrogel-filled groups was not statistically different than controls, suggesting some restoration of fluid pressurization in the defect region by the hydrogel. Differences in hydraulic resistance between control and defect groups were apparent after 4 s. The results indicate that the measurement of R is feasible for rapid and quantitative functional assessment of the extent of osteochondral defects and repair. The arthroscopic compatibility of the device demonstrates the potential for this measurement to be made in a clinical setting.
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Affiliation(s)
- William J. McCarty
- Department of Bioengineering, University of California-San Diego, 9500 Gilman Drive, Mail Code 0412, La Jolla, CA 92093-0412 USA
| | - Anna Luan
- Department of Bioengineering, University of California-San Diego, 9500 Gilman Drive, Mail Code 0412, La Jolla, CA 92093-0412 USA
| | - Priya Sundaramurthy
- Department of Bioengineering, University of California-San Diego, 9500 Gilman Drive, Mail Code 0412, La Jolla, CA 92093-0412 USA
| | - Caryn Urbanczyk
- Department of Bioengineering, University of California-San Diego, 9500 Gilman Drive, Mail Code 0412, La Jolla, CA 92093-0412 USA
| | - Atal Patel
- Department of Bioengineering, University of California-San Diego, 9500 Gilman Drive, Mail Code 0412, La Jolla, CA 92093-0412 USA
| | - Jacob Hahr
- Department of Bioengineering, University of California-San Diego, 9500 Gilman Drive, Mail Code 0412, La Jolla, CA 92093-0412 USA
| | | | | | - Robert L. Sah
- Department of Bioengineering, University of California-San Diego, 9500 Gilman Drive, Mail Code 0412, La Jolla, CA 92093-0412 USA
- Institute of Engineering in Medicine, University of California-San Diego, La Jolla, CA USA
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Abstract
Magnetic resonance imaging (MRI) remains the imaging modality of choice for morphological and compositional evaluation of the articular cartilage. Accurate detection and characterization of cartilage lesions are necessary to guide the medical and surgical therapy and are also critical for longitudinal studies of the cartilage. Recent work using 3.0-T MRI systems shows promise in improving detection and characterization of the cartilage lesions, particularly with increasing use of high-resolution and high-contrast 3-dimensional sequences, which allow detailed morphological assessment of cartilage in arbitrary imaging planes. In addition, implementation of biochemical sequences in clinically feasible scan times has a potential in the early detection of cartilage lesions before they become morphologically apparent. This article discusses relative advantages and disadvantages of various commonly used as well as experimental MRI techniques to directly assess the morphology and indirectly evaluate the biochemical composition of the articular cartilage.
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Affiliation(s)
- Rashmi S Thakkar
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University-School of Medicine, Baltimore, MD 21287, USA
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Lim NSJ, Hamed Z, Yeow CH, Chan C, Huang Z. Early detection of biomolecular changes in disrupted porcine cartilage using polarized Raman spectroscopy. J Biomed Opt 2011; 16:017003. [PMID: 21280924 DOI: 10.1117/1.3528006] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
We evaluate the feasibility of applying polarized Raman spectroscopy in probing the early biochemical compositions and orientation changes in impacted porcine cartilage explants. We divide 100 fresh tibial cartilage explants into four groups: control (unimpacted) and 3 groups of single impact at 15, 20, and 25 MPa. Each group is examined for biochemical changes using Raman microscopy, cell viability changes using confocal fluorescence microscopy, and histological changes using the modified Mankin score. For the 15-MPa impact group, the modified Mankin score (p>0.05, n=15) and cell viability test (p>0.05, n=5) reveal no significant changes when compared to the control, but polarized Raman spectroscopy detects significant biochemical changes. A significant decrease in the parallel polarized intensity of the pyranose ring band at 1126 cm(-1) suggests a possible decrease in the glycoaminoglycan content in early cartilage damage (one-way analysis of variance with a post hoc Bonferonni test, p<0.05, n=10). For impacts greater than 15 MPa, cell viability and modified Mankin score are consistent with the changes in the observed polarized Raman signals. This suggests that the polarized Raman spectroscopy technique has potential for diagnosis and detection of early cartilage damage at the molecular level.
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Affiliation(s)
- Natalie Sheng Jie Lim
- National University of Singapore, Faculty of Engineering, Department of Bioengineering, Optical Bioimaging Laboratory, Yong Loo Lin School of Medicine, Singapore 119074
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Zhao C, Bi Q, Xia B, Di XB, Zhu DJ, Zheng J, Hong JF, Qiu BS, Zhang SJ, Gu HF. [Application value of FS-3D-FISP sequence in the diagnosis of ankle cartilage injury]. Zhonghua Yi Xue Za Zhi 2010; 90:1752-1755. [PMID: 20979892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To compare several sequences of MRI and arthroscopy for detecting the ankle articular cartilage lesions and to evaluate the clinical outcome of special sequence of FS-3D-FISP. METHODS Forty patients (41 ankles) with iterative ankle pain who were scheduled for arthroscopy underwent MR scanning, including FS-3D-FISP, FSE T2WI and FSE PDWI sequences. The results of each sequence were then compared with the arthroscopic findings. RESULTS Using arthroscopic results as the standard of reference, the FS-3D-FISP images had the higher sensitivity (92.86%) than the other two sequences. The FS-3D-FISP sequence was well consistent with the result of arthroscopy. Kappa value (0.7590) was higher than the other two sequences (P < 0.01). CONCLUSION As a favorable scanning sequence, FS-3D-FISP imaging can show the early-stage pathological changes of articular cartilage and it has an excellent correlation with the arthroscopic findings. A 3-D reconstruction is helpful to determine the location and the degree of lesion and obtain a more accurate classification to guide clinical decisions.
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Affiliation(s)
- Chen Zhao
- Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou 310014, China
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