1,721,108 research outputs found
Occult fractures of tibial plateau detected employing magnetic resonance imaging
No full textWe describe two cases of spontaneous fracture at the tibial metaphysis not diagnosed by standard X-ray. In both cases, only magnetic resonance imaging supplied a precise diagnosis and allowed us to follow the evolution of the pathology. Scintigraphy is equally sensitive but unspecific. Osteoporosis was noted in all cases. Hypothetically, similar pathological situations could be present without being diagnosed since they are not always detected by standard X-rays
Efficacy and safety of eperisone in patients with low back pain : a double blind randomized study
No full textEperisone hydrochloride (4′-ethyl-2-methyl-3-piperidinopropiophenone hydrochloride) is an antispastic agent used for treatment of diseases characterized by muscle stiffness and pain. The aim of this research was to investigate the efficacy of eperisone in patients with acute low back pain and spasticity of spinal muscles. The study design was a randomized, double-blind (double-dummy) study in 160 patients with low back pain and no Rx finding of major spinal diseases, randomly assigned to a treatment with oral eperisone 100 mg three times daily (t.i.d.) or thiocolchicoside 8 mg twice daily (b.i.d.) for 12 consecutive days. Analgesic activity was evaluated by scoring "spontaneous pain" (VAS) and pain on movement and pression (4-digit scale), while muscle relaxant activity of the medication was evaluated by means of the "hand-to-floor" distance and the Lasegue's manoeuvre. All the measures were done at the inclusion day and after 3, 7 and 12 days of treatment. The two medications had comparable analgesic and muscle relaxant efficacy. Sponta-neous pain and pain on movement/pressure were significantly reduced by both treatments. Moreover, both eperisone- and thiocolchicoside-treated patients showed a clinically evident muscle relaxation as proved by a progressive reduction in the "hand-to-floor" distance and increase in the articular excursion (Lasegue's manoeuvre). Only 5% of eperisone-treated patients showed minor gastrointestinal side effects, while the incidence of side effects in the thiocolchicoside group was 21.25%. Moreover, in the thiocolchicoside-treated patients also diarrhoea was present, which reached a moderate intensity in some cases. In conclusions, eperisone represents a valuable and safer alternative to other muscle relaxant agents for treatment of low back pain
Monitoraggio ecografico del trattamento ortopedico della displasia congenita d'anca infantile entro i primi 6 mesi di vita
No full textObiettivo. L'utilizzo dell'ecografia nella diagnosi precoce della displasia congenita d'anca (DCA) infantile entro i primi sei mesi di vita è sicuramente ormai entrato nella routine degli esami di medicina preventiva.
L'ecografia consente di seguire, ad ogni momento, l'evolversi dello sviluppo dell'anca displasica neonatale, permettendo di dimostrare la sua responsività o meno al trattamento intrapreso, e in quest'ultimo caso di modificare il trattamento stesso al fine di giungere alla guarigione.
Metodi. In questo studio sono state considerate le anche patologiche studiate ecograficamente in 12 anni, onde valutare quanto i controlli ecografici durante il trattamento abbiano influito sulle scelte e le modifiche di quest'ultimo.
Per lo studio sono stati utilizzati differenti apparecchi ecografici sempre con sonde lineari da 5 o 7,5 MHz; la metodica di valutazione impiegata è stata quella proposta da Graf. La valutazione ecografica è sempre stata preceduta da quella clinica e seguita, a fine trattamento, da un controllo radiografico del bacino.
Risultati. Di 17.938 anche valutate ecograficamente dal 1 gennaio 1989 al 31 dicembre 2000 (59,5% femmine e 40,5% maschi, età media 3 mesi e 17 giorni), si sono osservate 1534 anche patologiche (IIC, IID, IIIA, IIIB); si è confermata la prevalenza dell'affezione nel sesso femminile e al lato sinistro.
In 35 casi pari al 2,19% si è modificato l'iter terapeutico ortopedico intrapreso all'inizio, sulla base dei controlli ecografici periodici eseguiti.
La normalizzazione dell'angolo a si è ottenuta mediamente in 51 giorni di trattamento con divaricatore; con tempo minimo di giorni 30 nelle anche di tipo IIC in pazienti di età inferiore ai tre mesi e tempo massimo di giorni 98 nelle anche di tipo IIIA in pazienti di più di 120 giorni di vita.
Conclusioni. La semplicità e facilità d'uso dell'ecografia, la sua economicità, rapidità, innocuità, e validità nonché sensibilità e specificità ne fanno un esame strumentale affidabile e sicuro, indispensabile nella pianificazione del trattamento di questa patologia.BACKGROUND: The use of ultrasound scanning in the early diagnosis of congenital hip dysplasia in infants within the first six months of life has become part of the routine in preventive medicine examinations. Ultrasound scanning makes it possible to monitor the development of the neonatal dysplasic hip at any moment and it also tells us whether or not it is responding to treatment and, if it is not, to modify the treatment in order to achieve cure.
METHODS: The present study considers pathological hips studied echographically over 12 years in order to assess to what extent ultrasound controls during treatment have influenced the choices and modifications of treatment. The study employed different echographic equipment always with 5 or 7.5 MHz linear probes; the evaluation technique employed was that proposed by Graf. Echography evaluation was always proceded by clinical assessment and followed at the end of treatment by X-ray control of the pelvis.
RESULTS: Of 17,938 hip cases assessed echographically from 1 January 1989 to 31 December 2000 (59.5% female and 40.5% male, average age 3 months 17 days) 1534 hips were pathological (IIC, IID, IIIA, IIIB); the prevalence of the condition in females and on the left-hand side was confirmed. In 35 cases (2.19%) the orthopaedic treatment approach undertaken at the beginning was changed on the basis of periodic scans. The normalisation of the alpha angle was achieved on average in 51 days of treatment with the harness; with a minimum time of 30 days in IIC type hips in patients below the age of three months and a maximum time of 98 days in hips of type IIIA in patients aged more than 120 days.
CONCLUSIONS: The simplicity and ease of use of ultrasound scanning, its cheapness, rapidity, harmlessness and validity not to mention its sensitivity and specificity make it a reliable, safe instrumental examination that is indispensable in planning the treatment of this pathology
Sonographic versus radiographic measurement of subacromial space width
No full textPURPOSE: It was the purpose of the study to compare the accuracy of sonographic and radiographic measurement of the subacromial space width, and to verify its variations in relation to the morphology of the acromion, to age, to sex and to pathologies of the rotator cuff.
MATERIALS AND METHODS: We compared the radiographic and sonographic examinations for 200 consecutive shoulders. The shoulders examined were divided into 4 groups based on age and pathology of the rotator cuff.
RESULTS: We observed that the results obtained in the two different methods of measurement were comparable and statistically significant (p = 0.8). Furthermore, they are corresponded to the morphology of the acromion. Measurement of the subacromial space was in relation to acromial morphology, female sex and pathology of the cuff, but not in relation to age.
CONCLUSIONS: Sonography proved to be safe, accurate and useful in measuring the subacromial space, and comparable to what is obtained when radiography is used. We believe that measurement may be the useful completion of the sonographic evaluation of the shoulder. Furthermore, we believe that it may also support the most diffused radiographic measurement and its completion and confirmation. Sonography is certainly useful because of its simplicity of execution, rapidity of use, and measurement of the subacromial space can easily be carried out during routine sonographic evaluation of the shoulder
Il dolore postoperatorio in chirurgia ortopedica : effetto sulla condotta fisiokinesiterapica
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