Arthroscopic surgery: a historical perspective.

The most commonly performed orthopaedic procedure today, arthroscopy, has its origins in the 19th century. Considered as one of the three greatest improvements in orthopedic care, arthroscopic visualization can be performed in every joint of the human body. Beginning with the use of the cystoscope in cadaver knees through the development of sophisticated arthroscopic equipment, arthroscopy has become an invaluable component of modern orthopedic care.

Risks associated with exposure to surgical smoke plume: a review of the literature.

Electrosurgery, laser ablation, and ultrasonic scalpel dissection create a gaseous by-product commonly referred to as surgical smoke or plume. Smoke evacuation devices have been shown to be effective in limiting exposure to the noxious odor and potential health hazards of smoke and plume; however, these devices have not been used routinely and consistently in many ORs. This article reviews five quantitative research studies that explore the characteristics of smoke plume produced during surgery and presents the evidence of the need for consistent use of smoke evacuation systems.

An example of Lambl's excrescences by transesophageal echocardiogram: a commonly misinterpreted lesion.

Lambl's excrescences are thin, mobile, filiform structures, often referred to as valvular strands in the echocardiography literature. These valvular strands may occur as a single strand, in rows, or clusters. The differential diagnosis for these excrescences includes fibroelastoma, myxoma, thrombi, vegetations, and cardiac neoplasms and metastases.

The role of echocardiography in mitral valve dysfunction after repair.

The echocardiographer responsible for the intraoperative evaluation should be familiar with the transesophageal echocardiography (TEE) views of mitral valve morphology as well as the the repair procedure(s) in order to assess postoperative results. The most frequent immediate mitral valve repair failures are a result of extensive valve disease, calcification, suture dehiscence, ischemia, technical misadventures, stenosis, or systolic anterior motion. Systolic anterior motion with left ventricular outflow tract obstruction and an associated posteriorly directed jet of mitral regurgitation is the most common cause of immediate failure after mitral valve repair.

Botulinum toxin in primary care medicine.

Clostridium botulinum, a gram-positive anaerobic bacterium, produces a potent neurotoxin that causes muscle paralysis. The therapeutic use of botulinum toxin was discovered in the 1970s and has since been used to treat patients with a broad range of medical complaints. Botulinum toxin (BTX) is used in the primary care setting to treat conditions such as allergic rhinitis, hyperhidrosis, lichen simplex chronicus, migraine, myofascial pain syndrome, and certain task-specific idiopathic focal dystonias (eg, writer's cramp)--in addition to its more publicized use for cosmetic enhancement of the face.

Unsuspected lower extremity deep venous thrombosis simulating musculoskeletal pathology.

Objective: The purpose of this study was to highlight the critical role that MRI may play in diagnosing unsuspected lower extremity deep venous thrombosis and to stress the importance of scrutinizing MRI studies of the lower extremity showing apparently non-specific muscle edema for any evidence of intramuscular venous thrombosis.

Design And Patients: The imaging studies of four patients in whom deep venous thrombosis was unsuspected on clinical grounds, and first diagnosed on the basis of MRI findings, were reviewed by two musculoskeletal radiologists in consensus. In all four patients the initial clinical suspicion was within the scope of musculoskeletal injuries (gastrocnemius strain, n=3; ruptured Baker cyst, n=1), explaining the choice of MRI over ultrasound as the first diagnostic modality.