Objectives: To investigate the differences in findings from magnetic resonance imaging (MRI) in the neutral and provocative positions, and to examine the relationship between these differences and the results of physical examination tests in patients with thoracic outlet syndrome (TOS).
Design: Prospective.
Setting: University physical medicine and rehabilitation outpatient and radiology clinics.
Participants: Twenty-nine patients and 12 healthy controls. All of the patients had positive bilateral TOS stress tests; control group participants were symptom free and had negative TOS stress tests bilaterally.
Interventions: Not applicable.
Main Outcome Measures: All participants underwent Adson's test, the Halsted maneuver, and a hyperabduction test. All were evaluated with MRI while in 2 positions: the neutral position (upper extremities adducted) and in a provocative position. Measurements were obtained at the interscalene triangle, at the costoclavicular space, and at the retropectoralis minor space.
Results: There was a significant difference in MRI findings between the neutral and provocative position in the patients (P<.05), but there were no significant differences in the control group. There was a significant difference in the positional change values in MRI between the patients and the control subjects (P<.05). The difference was found in the minimum costoclavicular distance between patients with a positive Halsted maneuver and a negative Halsted maneuver (P<.05).
Conclusions: Our findings indicate that MRI findings in patients in a provocative position are more valuable in the diagnosis of TOS, and these findings are in accord with findings from the physical evaluation tests.
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http://dx.doi.org/10.1016/j.apmr.2007.03.015 | DOI Listing |
Am J Sports Med
January 2025
Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
Background: Knee injuries resulting in purely cartilaginous defects are rare, and controversy remains regarding the reliability of chondral-only fixation.
Purpose: To systematically review the literature for fixation methods and outcomes after primary fixation of chondral-only defects within the knee.
Study Design: Systematic review; Level of evidence, 5.
Am J Sports Med
January 2025
Department of Orthopaedic Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea.
Background: Studies are still limited on the isolated effect of retear after arthroscopic rotator cuff repair (ARCR) on functional outcomes after the midterm period.
Purpose: To assess the effect of retear at midterm follow-up after ARCR and to identify factors associated with the need for revision surgery.
Study Design: Cohort study; Level of evidence, 3.
Eur J Hum Genet
January 2025
Institute of Bioinformatics, International Technology Park, Bangalore, 560066, India.
Mitochondrial membrane protein-associated neurodegeneration (MPAN) is a rare neurodegenerative disorder characterized by spastic paraplegia, parkinsonism and psychiatric and/or behavioral symptoms caused by variants in gene encoding chromosome-19 open reading frame-12 (C19orf12). We present here seven patients from six unrelated families with detailed clinical, radiological, and genetic investigations. Childhood-onset patients predominantly had a spastic ataxic phenotype with optic atrophy, while adult-onset patients were presented with cognitive, behavioral, and parkinsonian symptoms.
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January 2025
Division of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Myocyte disarray and fibrosis are underlying pathologies of hypertrophic cardiomyopathy (HCM) caused by genetic mutations. However, the extent of their contributions has not been extensively evaluated. In this study, we investigated the effects of genetic mutations on myofiber function and fibrosis patterns in HCM.
View Article and Find Full Text PDFSci Rep
January 2025
Cardiovascular Research Center, Rajaie Cardiovascular, Medical, and Research Center, University of Medical Sciences, Tehran, Iran.
Assessing myocardial viability is crucial for managing ischemic heart disease. While late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) is the gold standard for viability evaluation, it has limitations, including contraindications in patients with renal dysfunction and lengthy scan times. This study investigates the potential of non-contrast CMR techniques-feature tracking strain analysis and T1/T2 mapping-combined with machine learning (ML) models, as an alternative to LGE-CMR for myocardial viability assessment.
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