Comparison of mri & direct mr arthrography with arthroscopy in diagnosing ligament injuries of wrist.

The objective of this study was to assess the value of MRI &direct magnetic resonance arthrography (MRA) of the wrist for detecting &evaluating tears of the triangular fibrocartilage complex (TFCC) &scapholunate &luno triquetral interosseous ligament(LTIL &SLIL) injuries in comparison with arthroscopy of the wrist .Materials &MethodsAll patients presenting with chronic wrist pain of more than 3 months duration with suspected ligament injuries were included . MRI was performed with 8 channel wrist coil on 1.5 Tesla machine. (PHILIPS, Netherlands). MRA was performed after obtaining consent. Retrospective MR findings were then correlated with results in those patients who underwent arthroscopy. Arthroscopic correlation was obtained in 22 (46.8 %) cases out of the 45 patients who underwent both MRI &MRA.RESULTSThe gold standard arthroscopic procedure diagnosed 15 peripheral &6 central TFCC tears in 22 patients. 4 scapholunate ligament tears were also identified. MRI diagnosed 16 peripheral &5 central TFCC tears in these 22 patients . MRA identified 9 central tears and 14 peripheral tears. The sensitivity in diagnosing an overall TFCC tears with MRI as well as MRA was 94.4 &100 %. The specificity of the MRI and MRA in diagnosing an overall TFCC tear was 100 % &75 % respectively .Discussion &conclusionsDirect MRA has better sensitivity in detecting TFCC central tears . In view of ‘substantial’ agreement between MRI &MR...
Source: Journal of Orthopaedics - Category: Orthopaedics Source Type: research

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CONCLUSION: This is the first study which shows that PAIS is a clinically misdiagnosed cause of posterior ankle pain in pediatric and adolescent population; an increased awareness about this diagnosis is needed amongst providers treating young patients. PMID: 31750084 [PubMed]
Source: World Journal of Orthopaedics - Category: Orthopaedics Tags: World J Orthop Source Type: research
ConclusionsUsing non-irradiated allografts for one-stage reconstructions of all the injured ligaments in MLKIs is effective and safe. Anteroposterior stability was difficult to restore, but patients returned to their daily activities and sometimes to their sports activity at the same preinjury level.Level of evidenceLevel IV, case series.
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research
In this study, 38 OCLs in 32 patients were identified. Median patient age was 35  years of which (68.8%) were male. Median length of follow-up was 36.7 months (range 12–64 months). (83%) returned to playing sport. Twenty-three patients underwent MAST in the setting of a failed previous operative attempt, with just nine having MAST as a first option. Nine patients out of 32 had a further procedure. Improvements were seen in all domains of the FAOS (p 
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
CONCLUSIONS The findings presented by the authors provide a new perspective on the causes of chronic problems such as the "posterior heel pain" and tend to give preference to the active endoscopic approach in patients with persisting problems, not responding to conservative treatment, predisposed based on the radiological examination and with a positive finding on ultrasound or MRI scan. Key words:retrocalcaneal bursitis, endoscopic calcaneoplasty, arthroscopy. PMID: 30257781 [PubMed - in process]
Source: Acta Orthopaedica - Category: Orthopaedics Authors: Tags: Acta Chir Orthop Traumatol Cech Source Type: research
Publication date: Available online 20 September 2018Source: The Journal of Foot and Ankle SurgeryAuthor(s): Tomoyuki Nakasa, Jiro Nakashiro, MD, PhD, Nobuo Adachi, MD, PhDAbstractArthroscopic repair of the lateral ankle ligament using the anchor system has been increasingly reported. We treated a 39-year-old woman who suffered from pain and instability in her left ankle joint. She was diagnosed with chronic ankle instability and an osteochondral lesion of the talar dome. For this patient, arthroscopic repair of the anterior talofibular ligament (ATFL) was performed. Standard anteromedial and anterolateral portals were plac...
Source: The Journal of Foot and Ankle Surgery - Category: Orthopaedics Source Type: research
CONCLUSION: Our study reproduces the known association between OA and degenerative meniscal changes in older patients. We have found a surprising underuse of the standing anteroposterior view on radiography. Most patients in our cohort could have been appropriately diagnosed and treated based on such radiographic information, as demonstrated by pre-MRI findings, thus avoiding the MRI and subsequent evaluation by an orthopedic surgeon. Meniscectomy was rarely performed, particularly in patients with advanced OA. Educational and pragmatic measures must be emphasized to encourage the use of radiography and to limit the inappr...
Source: Canadian Family Physician Medecin de Famille Canadien - Category: Primary Care Authors: Tags: Can Fam Physician Source Type: research
Publication date: Available online 25 September 2017 Source:Arthroscopy Techniques Author(s): Nicholas I. Kennedy, Márcio B. Ferrari, Jonathan A. Godin, George Sanchez, Matthew T. Provencher Coracoid fractures are rare injuries, which may occur in isolation or in association with other shoulder pathology. The mechanism of trauma consists of a strong contraction of the conjoint tendon as a result of direct trauma. The diagnosis is usually difficult and many times overlooked, thereby requiring a high level of suspicion. In many cases, standard trauma series shoulder radiographs are unable to provide a definitive and ...
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
Authors: DaSilva MF, Goodman AD, Gil JA, Akelman E Abstract Determining the etiology of ulnar-sided wrist pain is often challenging. The condition may be acute or chronic, and differential diagnoses include injuries to the ulnar carpal bones, ligament tears, tendinitis, vascular conditions, osteoarthritis and systemic arthritis, and ulnar nerve compression. An anatomically based, methodical physical examination coupled with provocative maneuvers, including piano key, ulnar impaction, shuck, foveal stress, and extensor carpi ulnaris synergy tests, further defines the differential diagnosis. Diagnostic imaging used i...
Source: The Journal of the American Academy of Orthopaedic Surgeons - Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research
Conclusions: The sex ratio of 2 males:30 females was startling. Nevertheless, this therapeutic level 3 study supports a thorough search for pathology in any patient with persistent wrist symptoms because pathology was identified in 32 of the 33 wrists at arthroscopy. Level of Evidence: Level III—Therapeutic.
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Hand Source Type: research
Patients with early osteoarthritis (OA) have been reported to have inferior outcomes with an increased prevalence of early failure after cartilage procedures. The underlying reasons for this failure are likely multifactorial, including a chronic synovial and chondrogenic process, which is confounded by persistent muscle weakness and altered pain processing for those with increased preoperative symptom duration. Pain, radiographic changes, patient-reported outcomes, and macroscopic changes on arthroscopic evaluation or MRI can assist clinicians in identifying the early OA knee to both aid in clinical decision making and cre...
Source: Clinics in Sports Medicine - Category: Sports Medicine Authors: Source Type: research
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