[Spinal infection with spinal cord/cauda equina affection requires emergency handling].

Seventeen cases of infections in spinal structures were reported 2010-2017 to the Swedish Health and Social Care Inspectorate (IVO), a government agency responsible for supervising health care, for missed or delayed diagnosis. All patient records were scrutinized in order to find underlying causes and common factors. The delayed diagnoses were equally found among men and women and most frequent in in the age-group 65 to 79 years of age.

[Lumbar spine radiography – unreliable diagnostic accuracy and negligible value for the patients].

Lumbar spine radiography - unreliable diagnostic accuracy and negligible value for the patients In 2016 140 000 lumbar spine radiographies were performed in Sweden (14 000 per million inhabitants) to a cost of about 85 million SEK (≈8.5 million Euro) and a negligible value for the patients with low back pain. In the work-up of low back pain, when imaging is indicated, lumbar spine radiography should be replaced by limited magnetic resonance imaging including a whole lower body coronal STIR sequence or computed tomography with radiation dose adapted to indication and patient age.

[Missed diagnosis of Achilles tendon ruptures most common in elderly patients].

We audited forty-six patients with a rupture of the Achilles tendon notified to the Swedish regulatory authority (the Health and Social Care Inspectorate) due to suspicion of malpractice. The patients' history and clinical presentation differed from those with a more classical acute rupture. The diagnostic errors were often found in patients older than 60 years, they were just as common in women as in men and the symptoms often had a subacute start.

[Failing primary clinical investigation is common in missed hip fractures].

Failing primary clinical investigation is common in missed hip fractures Diagnostic errors in 43 patients with hip fracture handled by the Swedish Health and Social Care Inspectorate were analyzed. Diagnostic errors were most likely a consequence of insufficient initial history, examination and/or radiologic examination. The most common isolated cause was delayed examination by a physician outside of a hospital setting.

[Diagnostic imaging no answer in the diagnosis of appendicitis].

Diagnostic errors in 49 patients with appendicitis handled by the Swedish Health and Social Care Inspectorate were analyzed. Diagnostic errors were more common in young or old patients, and among patients with atypical symptoms. Adjunct diagnostic tools, such as computerized tomography and/or ultrasound examination, also have limitations as regards diagnostic precision, and should therefore not be seen as golden standard.

[Systematic analysis of diagnostic errors in patients with myocardial infarction handled by the Swedish Health and Social Care Inspectorate​].

Systematic analysis of diagnostic errors in patients with myocardial infarction handled by the Swedish Health and Social Care Inspectorate​ Diagnostic errors in 51 patients with myocardial infarction handled by the Swedish Health and Social Care Inspectorate​ were analyzed. In more than half of the cases, the diagnostic errors occurred in health-care outside of hospitals. Diagnostic errors were more common when patients presented atypical symptoms, but atypical symptoms were equally common in male and female patients.

Knee rotation in healthy individuals related to age and gender.

An external device ("the Rottometer") was especially designed to measure passive knee rotation in vivo. The device had earlier been evaluated with respect to it's validity and reliability. In the present study, we evaluated knee rotation in knee-healthy individuals and studied possible age and gender related differences.

Measurements of knee rotation-reliability of an external device in vivo.

Background: Knee rotation plays an important part in knee kinematics during weight-bearing activities. An external device for measuring knee rotation (the Rottometer) has previously been evaluated for validity by simultaneous measurements of skeletal movements with Roentgen Stereometric Analysis (RSA). The aim of this study was to investigate the reliability of the device.

The influence of posterior-inferior tibial slope in ACL injury.

Purpose: To explore the effect of different posterior-inferior tibial slope (PITS) angles on ACL injury at non-contact sports, knee laxity and the need for ACL reconstruction.

Methods: One hundred patients with an acute, arthroscopically verified total ACL rupture were followed prospectively with the intention of treating the injury without reconstruction. Knee laxity was assessed with the Lachman and pivot shift tests with the patients under general anesthesia within 10 days of injury.

Clinically assessed knee joint laxity as a predictor for reconstruction after an anterior cruciate ligament injury: a prospective study of 100 patients treated with activity modification and rehabilitation.

Background: The association of early knee joint laxity with the need for later reconstruction of the anterior cruciate ligament has not been extensively studied.

Hypothesis: The grade of knee laxity can be used as an early predictor of the need for later reconstruction.

Study Design: Cohort study (prognosis); Level of evidence, 2.

Prevalence of tibiofemoral osteoarthritis 15 years after nonoperative treatment of anterior cruciate ligament injury: a prospective cohort study.

Background: The occurrence of osteoarthritis (OA), associated meniscal injuries, meniscectomy, and patient-related measures for patients treated nonoperatively after anterior cruciate ligament (ACL) injuries have not been well described in the literature in terms of natural history.

Hypothesis: Patients with ACL injury can achieve a low occurrence of tibiofemoral OA and good knee function when treated without ACL reconstruction.

Study Design: Cohort study (prognosis); Level of evidence, 2.

Normalized motor function but impaired sensory function after unilateral non-reconstructed ACL injury: patients compared with uninjured controls.

Improvement in motor function after anterior cruciate ligament (ACL) injury is achieved by appropriate rehabilitation. However, it has been questioned whether training after injury can lead to sensory improvement. We hypothesized that motor function can be restored after unilateral non-reconstructed ACL injury, whereas the sensory function cannot, i.

15-year follow-up of neuromuscular function in patients with unilateral nonreconstructed anterior cruciate ligament injury initially treated with rehabilitation and activity modification: a longitudinal prospective study.

Background: It has been suggested that neuromuscular function is of importance in the overall outcome after anterior cruciate ligament (ACL) injury.

Hypothesis: Good neuromuscular function can be achieved and maintained over time in subjects with ACL injury treated with rehabilitation and activity modification but without reconstructive surgery.

Study Design: Case series; Level of evidence, 4.

Activity level and subjective knee function 15 years after anterior cruciate ligament injury: a prospective, longitudinal study of nonreconstructed patients.

Background: The activity level and subjective knee function after an anterior cruciate ligament (ACL) injury treated without reconstruction have not been well elucidated.

Hypothesis: Patients with ACL injury can achieve good knee function and satisfactory long-term activity level when treated by early activity modification combined with rehabilitation.

Study Design: Cohort study (prognosis); Level of evidence, 2.

Balance in single-limb stance in patients with anterior cruciate ligament injury: relation to knee laxity, proprioception, muscle strength, and subjective function.

Background: It has been shown previously that an anterior cruciate ligament injury may affect postural control, measured by balance in single-limb stance. To our knowledge, no studies have reported the influence of measures of impairment on postural control after such an injury.

Purpose: To assess the influence of knee laxity, proprioception, and muscle strength on balance in single-limb stance and to study the correlation between balance in single-limb stance and subjective estimation of extremity function.

The effect of short-duration sub-maximal cycling on balance in single-limb stance in patients with anterior cruciate ligament injury: a cross-sectional study.

Background: It has previously been shown that an anterior cruciate ligament (ACL) injury may lead to impaired postural control, and that the ability to maintain postural control is decreased by fatigue in healthy subjects. To our knowledge, no studies have reported the effect of fatigue on postural control in subjects with ACL injury. This study was aimed at examining the effect of fatigue on balance in single-limb stance in subjects with ACL injury, and to compare the effects, and the ability to maintain balance, with that of a control group of uninjured subjects.