Radiographic evaluation of the acromioclavicular and sternoclavicular joints.

Plain radiography is useful for the initial assessment of suspected disorders of the sternoclavicular and acromioclavicular joints. Other modalities are often required to further assess more complex pathologies involving these joints, however. Ultrasound has been described as a screening tool to assess possible sternoclavicular joint dislocation; however, it is usually used only if CT and MRI are not readily available.

Osteochondral lesions of the talus: a new magnetic resonance grading system with arthroscopic correlation.

Purpose: The purpose of this study was to show that magnetic resonance imaging (MRI) can accurately and noninvasively evaluate the articular cartilage overlying osteochondral lesions of the talus, using arthroscopy as the standard, and provide information about lesion stability. A classification system applicable to both MRI and arthroscopy is proposed.

Type Of Study: Retrospective review with MRI and arthroscopy correlation.

T2 quantitation of articular cartilage at 1.5 T.

Purpose: To evaluate sources of error when using a multiecho sequence for quantitative T2 mapping of articular cartilage at 1.5 T.

Materials And Methods: Phantom measurements were used to assess the contribution of stimulated echoes to inaccuracy of T2 measurements in cartilage using a multiecho sequence.

Magnetic resonance imaging of total knee arthroplasty.

Evaluation of painful total knee arthroplasty can be clinically difficult, and traditional imaging techniques such as conventional radiographs, arthrography, and bone scintigraphy are limited by poor contrast resolution and specificity. Traditional magnetic resonance imaging techniques often are nondiagnostic because of significant metal artifact. Forty-one patients (46 knees) had magnetic resonance imaging, tailored to reduce metallic susceptibility artifact, after total knee arthroplasty, and the findings and clinical and surgical followup were reviewed.

Organising UK cancer nursing services: a review.

This article describes an NTResearch survey which outlines how UK cancer nursing services have evolved over the past seven years in response to changes in government policy.

Effect of mechanical compression on the prevalence of proximal deep venous thrombosis as assessed by magnetic resonance venography.

Background: Patients have been shown to be at greater risk for deep venous thrombosis, particularly proximal thrombosis, after total hip arthroplasty. Proximal thrombi are more likely to develop into pulmonary emboli than are distal thrombi. The purpose of this randomized, prospective study was to compare the prevalence of pelvic and proximal lower-extremity deep venous thrombosis after primary total hip arthroplasty between patients treated with an impulse mechanical compression device for prophylaxis and those treated with prophylactic stockings.

Developing, delivering, and evaluating cancer nursing services: searching for a United Kingdom evidence base for practice.

The drive toward evidence-based healthcare aims to promote effectiveness and thereby improve quality. The challenge for cancer nursing is to continually evaluate what it does, retaining effective interventions and working to develop new ones and refine those interventions that require improvement, thereby enhancing both practice and patient outcomes. The aim of the project was to assimilate an evidence base to support the development, delivery, and evaluation of cancer nursing services in the United Kingdom.

Impact of MRI on treatment plan and fracture classification of tibial plateau fractures.

Objective: To evaluate the interobserver agreement for both treatment plan and fracture classification of tibial plateau fractures using plain radiographs, computed tomography (CT) scan, and magnetic resonance imaging (MRI).

Design: Prospective study to assess the impact of an advanced radiographic study on the agreement of treatment plan and fracture classification of tibial plateau fractures among three orthopaedic surgeons.

Setting/participants: Patients presenting with tibial plateau fractures to a level I trauma center were evaluated with plain knee radiographs (anteroposterior, lateral, two oblique views), CT scan, and MRI.

A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache.

Study Design: A multicenter, randomized controlled trial with unblinded treatment and blinded outcome assessment was conducted. The treatment period was 6 weeks with follow-up assessment after treatment, then at 3, 6, and 12 months.

Objectives: To determine the effectiveness of manipulative therapy and a low-load exercise program for cervicogenic headache when used alone and in combination, as compared with a control group.

Magnetic resonance imaging of painful shoulder arthroplasty.

Specialized magnetic resonance imaging (MRI) was performed in 42 painful shoulder arthroplasties, 22 of which underwent subsequent revision surgery, allowing surgical confirmation of the pathology identified on MRI. One hemiarthroplasty was excluded because of motion artifact, leaving 21 studies (19 patients) to be correlated retrospectively to the surgical findings. At the time of revision surgery, there were full-thickness rotator cuff tears in 11 of 21 shoulders; MRI correctly predicted these in 10 of 11 shoulders.

Interosseous-lumbrical adhesions of the hand: contribution of magnetic resonance imaging to diagnosis and treatment planning.

Previous investigators have not found magnetic resonance imaging (MRI) to be helpful in the diagnosis of interosseous-lumbrical tendon adhesions of the hand. We present 2 cases in which preoperative magnetic resonance images correlated with the clinical diagnosis and intraoperative finding of adhesions between the interosseous-lumbrical tendons at the level of the metacarpal head. Because there are no specific signs for the diagnosis, no palpable lesion, and no specific provocative test, the MRI acted to confirm the diagnosis in the presence of vague, nonspecific symptoms and provide objective evidence of the source of the patient's discomfort.

Imaging of elbow injuries in the child and adult athlete.

Because of the often complex and sometimes poorly remembered history of trauma to the elbow, imaging beyond conventional plain film radiographs is often needed. Usually, this consists of high-resolution MR imaging to evaluate the articular cartilage, supporting ligaments, and tendons about the elbow. Sonography, however, can also be used, especially when there is a targeted clinical question as to the presence of epicondylitis, or to provide guidance for diagnostic or therapeutic injections.

MRI assessment of the posterior acetabular wall fracture in traumatic dislocation of the hip in children.

Traumatic hip dislocations associated with posterior wall fractures of the acetabulum in the pediatric population are in general a consequence of high-energy trauma. After expeditious reduction, instability mandates for further diagnosis and intervention. Plain radiographs or computerized tomography (CT) scans can misjudge the involvement of the posterior wall of the acetabulum due to the partially calcified nature of the pediatric bone.

Contrast-enhanced MR angiography of the hand.

Contrast material-enhanced magnetic resonance (MR) angiography of the hand noninvasively provides information comparable to that provided by conventional angiography. It is a quick and easy examination that takes less than 5 minutes to perform and produces high-quality images with use of a dedicated surface coil that provides a high signal-to-noise ratio, allowing small pixel size and high spatial resolution. Contrast-enhanced MR angiography requires intravenous injection of gadopentetate dimeglumine and acquisition of a volumetric slab of image data from the hand.

Magnetic resonance imaging of the multiple-ligament injured knee.

Objective: To evaluate magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) in detecting soft tissue, neurovascular, and bony injury after multiple ligament knee injury, including knee dislocation.

Materials And Methods: A retrospective search was performed for patients presenting with reported knee dislocation from May 1993 through May 2000 who underwent both MRI and surgical reconstruction. Twenty-one patients met these criteria (15 men and six women; age range 14 to 75 years; mean 32.

MR imaging of joint arthroplasty.

Imaging evaluation of the painful total joint arthroplasty has, in the past, been limited to conventional radiographs, arthrography, and nuclear scintigraphy. All three modalities provide some clinical information regarding the status of the prosthesis, adjacent bone, and surrounding soft tissues but are hampered by poor specificity, particularly nuclear scintigraphy. Magnetic resonance imaging, using optimized pulse sequences to reduce the susceptibility artifact generated by the arthroplasty, can provide clinically relevant information regarding the prosthesis as well as the surrounding bone, soft tissues, and neurovascular structures.

Haemoglobin Pierre-Benite--a high affinity variant associated with relative polycythaemia.

This is the second reported example of Hb Pierre--Benite (beta90 Glu-->Asp). This mutation is associated with increased oxygen affinity and polycythaemia. No instability was found and there was no charge shift detected by cellulose acetate electrophoresis at pH 8.

The inflammation-induced pathological chaperones ACT and apo-E are necessary catalysts of Alzheimer amyloid formation.

Biochemical, genetic, and epidemiological evidence indicates that inflammation is an essential part of the pathogenesis of Alzheimer's disease. Over the last decade, we and others have focused on the mechanism by which specific inflammatory molecules contribute to the Alzheimer pathogenic pathway. In particular, we have learned that several acute phase/inflammatory molecules, specifically alpha(1)-antichymotrypsin (ACT) and apolipoprotein E (apoE) that are overproduced in the AD brain can promote the formation of, and are associated with, the neurotoxic amyloid deposits that are a key pathological hallmark of the disease.

The relationship of the femoral origin of the anterior cruciate ligament and the distal femoral physeal plate in the skeletally immature knee. An anatomic study.

We defined the anatomic relationship of the anterior cruciate ligament femoral origin to the distal femoral physis in the skeletally immature knee with use of 12 fresh-frozen human fetal specimens (ages, 20 to 36 weeks). Each specimen underwent magnetic resonance imaging, was dissected free of soft tissue, sectioned in the sagittal plane, and stained. The spatial relationship of 1) the epiphyseal side of the physeal proliferative zone to the nearest point of bony attachment of the anterior cruciate ligament and 2) the origin of the anterior cruciate ligament to the over-the-top position were measured.

Augmentation of tendon healing in an intraarticular bone tunnel with use of a bone growth factor.

We hypothesized that an exogenous bone growth factor could augment healing of a tendon graft in a bone tunnel in a rabbit anterior cruciate ligament-reconstruction model. Seventy rabbits underwent bilateral anterior cruciate ligament reconstructions with a semitendinosus tendon graft. One limb received a collagen sponge carrier vehicle containing a mixture of bone-derived proteins while the contralateral limb was treated with either no sponge or a sponge without bone-derived proteins.

Magnetic resonance imaging of the wrist.

Optimal magnetic resonance (MR) imaging of the wrist requires a high field strength magnet and a dedicated wrist coil to achieve high-resolution images. Using current MR sequences, detailed images of articular cartilage and the supporting ligaments and tendons can be obtained. Evaluation of the triangular fibrocartilage as well as the extrinsic and intrinsic ligaments of the wrist is possible with thin-slice three-dimensional volumetric gradient recalled sequences.

Effect of cytokines, dexamethasone and the A/T-signal peptide polymorphism on the expression of alpha(1)-antichymotrypsin in astrocytes: significance for Alzheimer's disease.

Proinflammatory cytokines and acute phase proteins, such as alpha(1)-antichymotrypsin, are over expressed in microglia and astrocytes in brain regions with abundant mature amyloid plaques, suggesting a glial cell-led brain acute phase response in the Alzheimer neuropathology. In this paper, we show that alpha(1)-antichymotrypsin gene expression in human astrocytes is elevated by interleukin-1 and interleukin-6, and further enhanced by glucocorticoid, while the homologous contrapsin gene in rat astrocytes is unaffected by these cytokines. These distinct gene regulation mechanisms might help to explain the differential susceptibility of humans and rodents to amyloid formation of the Alzheimer's type.