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Assessment of rotatory laxity in anterior cruciate ligament-deficient knees using magnetic resonance imaging with Porto-knee testing device.
Get PDFPURPOSE:
Objective evaluation of both antero-posterior translation and rotatory laxity of the knee remains a target to be accomplished. This is true for both preoperative planning and postoperative assessment of different ACL reconstruction emerging techniques. The ideal measurement tool should be simple, accurate and reproducible, while enabling to assess both ‘‘anatomy’’ and ‘‘function’’ during the same examination. The purpose of this study is to evaluate the clinical effectiveness of a new in-house developed testing device, the so-called Porto-knee testing device (PKTD). The PKTD is aimed to be used on the evaluation of both antero-posterior and rotatory laxity of the knee during MRI exams.
METHODS:
Between 2008 and 2010, 33 patients with ACLdeficient knees were enrolled for the purpose of this study. All patients were evaluated in the office and under anesthesia with Lachman test, lateral pivot-shift test and anterior drawer test. All cases were studied preoperatively with KT-1000 and MRI with PKTD, and examinations performed by independent observers blinded for clinical evaluation. During MRI, we have used a PKTD that applies antero-posterior translation and permits free tibial rotation through a standardized pressure (46.7 kPa) in the proximal posterior region of the leg. Measurements were taken for both knees and comparing side-to-side. Five patients with partial ruptures were excluded from the group of 33.
RESULTS:
For the 28 remaining patients, 3 women and 25 men, with mean age of 33.4 ± 9.4 years, 13 left and 15 right knees were tested. No significant correlation was noticed for Lachman test and PKTD results (n.s.). Pivot-shift had a strong positive correlation with the difference in anterior translation registered in lateral and medial tibia plateaus of injured knees (cor. coefficient = 0.80; p\0.05), and with the difference in this parameter as compared to side-to-side (cor. coefficient = 0.83; p\0.05). Considering the KT-1000 difference between injured and healthy knees, a very strong positive correlation was found for side-to-side difference in medial (cor. coefficient = 0.73; p\0.05) and lateral (cor. coefficient = 0.5; p\0.05) tibial plateau displacement using PKTD.
CONCLUSION:
The PKTD proved to be a reliable tool in assessment of antero-posterior translation (comparing with KT-1000) and rotatory laxity (compared with lateral pivotshift under anesthesia) of the ACL-deficient knee during MRI examination
Doença de Graves em Idade Pediátrica: Avaliação da eficácia dos antitiroideus – Resultados do Hospital de Braga
Get PDFGiant recurrent retroperitoneal liposarcoma initially presenting as inguinal hernia: Review of literature.
Get PDFINTRODUCTION: Liposarcomas comprise around 15% of soft tissue tumors.
These tumors of mesodermal origin arise as single tumors, present one
histologic type and diverse locations (including the retroperitoneum).
Diagnosis of liposarcomas of retroperitoneum is difficult because of
this unspecific presentation and in 50-100% of the cases there is
recurrence from residual tissue. PRESENTATION OF
CASE: An 86 year old male patient was admitted in 1996 due to a right
and voluminous inguinal hernia. During the herniaplasty, a right
paratesticular tumor was isolated and removed. The histologic exam
revealed a well-differentiated liposarcoma. A CT scan was performed
and a large abdominal mass was detected. The patient underwent a
laparotomy and an incomplete resection of the tumor was achieved.
After the surgery the patient remained asymptomatic during a long
period. Nine years later, the patient underwent another laparotomy
with partial removal of the giant recurrent retroperitoneal
liposarcoma.
CONCLUSION: The purpose of this publication is to report the
recurrence of giant retroperitoneal liposarcoma, which is an unusual
presentation in surgery today. Furthermore, we would like to emphasize
the long-term survival of this patient despite partial resection and
the possibility of performing a re-resection in this type of cases
Caseous calcification of the mitral annulus: A multi-modality imaging perspective.
Get PDFMitral annulus calcification is a common echocardiographic finding, particularly in the elderly and in end-stage renal disease patients under chronic dialysis. Caseous calcification or liquefaction necrosis of mitral annulus calcification is a rare evolution of mitral annular calcification. Early recognition of this entity avoids an invasive diagnostic approach, since it is benign and, unlike intracardiac tumors and abscesses, has a favorable prognosis. The authors present the case of an 84-year-old woman with a suspicious large, echodense mass at the level of the posterior mitral leaflet with associated severe mitral regurgitation. Cardiac magnetic resonance imaging demonstrated a hypoperfused mass with strong peripheral enhancement 10 minutes after gadolinium administration. Multislice computed tomography showed the calcified nature of the mass. A multi-modality imaging approach confirmed the diagnosis of caseous calcification of the posterior mitral annulus. The patient refused surgical treatment
