脊柱结核的影像学诊断

目的：评价X线平片、CT、MRI在脊柱结核的诊断价值。方法：回顾40例经手术病理或临床结果证实为脊柱结核病人的X线平片、CT、MRI影像表现。结果：X线平片可了解椎体破坏、塌陷、椎间隙变窄情况，及脊柱是否后凸畸形。40例CT均可较清楚显示椎体骨质破坏的数目（有21例分别两个椎体受累）、范围及病变是否进入椎管，其中19例形成寒性脓疡。9例行MRI均可显示椎体骨质破坏，周围软组织肿胀、寒性脓疡范围，及椎管、脊髓情况。结论：X线平片结合CT平扫可对脊柱结核进行较全面细致的观察并做出诊断。与肿瘤不易鉴别时需加CT增强扫描。若有神经症状时应补充MRI检查。     

脊柱结核MRI表现

脊柱结核多发生于儿童，但青壮年和老年人也可以发病．男女发病无明显差异，一般病例X线即可显示脊柱的骨破坏的形态改变，也可对病变作出分型，CT对显示寒性脓疡较X线平片敏感，MRI既可以显示骨破坏、冷脓肿的形态和范围，又能显示病变对椎管硬膜囊和脊髓的压迫及侵犯的情况，故可以作为脊柱结核检查的最佳手段。     

脊柱结核的影像学诊断及病理对照分析

目的　研究正侧位X线平片和CT诊断脊柱结核的意义。方法　对经病理确诊且均有正侧位X线片及CT片的 2 0 7例病人进行回顾性分析。结果　 (1)脊柱正侧位X线片、CT对脊柱结核的诊断符合率分别为 93 .7%、98%。 (2 )正侧位X线片、CT对椎体骨质破坏、椎间隙狭窄的敏感性分别为 74.4%、89.9%。 (3 )凭椎体骨质破坏、椎间隙狭窄便可确诊 90 %。 (4 )对死骨形成、椎旁软组织肿块和腰大肌肿胀、骨性椎管受累、附件破坏的显示CT优于X线平片 ,差异有显著性 (Ρ <0 .0 1)。结论　 (1)脊柱正侧位X线平片是诊断脊柱结核的基础方法。 (2 )如需进一步了解死骨、椎旁软组织肿胀、脓肿、附件 ,特别是了解骨性椎管内的情况以指导手术时 ,须CT检查     

脊柱外伤的平片、CT和MRI诊断价值对比

目的 探讨平片、CT、MRI对脊柱外伤不同的诊断价值.方法 对比分析47例脊柱外伤的X线平片、CT、MRI图像,对椎体附件骨折检出率、脊柱曲度改变、碎骨片移位、椎管容积改变、椎间盘损伤、韧带损伤、脊髓损伤、神经根损伤、椎旁软组织损伤的诊断效果进行评价.结果 平片、CT、MRI检出压缩骨折椎体均为46个,分辨出椎体碎骨片分别是47、134、84块.MRI还检出12个单纯骨挫伤的椎体.CT、MRI显示34块碎骨片压迫脊髓、51个椎间盘形态改变.结论 对脊柱外伤,X线平片诊断价值有限;CT对骨折线、碎骨片移位显示最佳;MRI能显示骨折、骨挫伤、脊髓、椎间盘、神经根、韧带、软组织损伤.     

脊柱结核的CT诊断

目的探讨脊柱结核的CT表现及脊柱结核CT检查的重要意义。方法对30例临床和病理确诊的脊柱结核病例的CT表现进行回顾性分析。结果脊柱结核的CT表现包括:(1)椎体及附件不规则虫蚀样和囊状骨质破坏。(2)沙砾样和斑片样死骨形成。(3)椎间盘坏死及椎间隙狭窄、消失。(4)椎旁脓肿、纵隔脓肿、腰大肌脓肿。(5)椎体后部的骨质破坏产生的碎骨片和坏死物质可进入椎管压迫硬膜囊和神经根。(6)椎体塌陷呈楔形。结论CT对脊柱结核的诊断和鉴别诊断有重要价值,尤其脊柱结核对椎体附件和椎管的累及范围、程度可清楚地显示,对指导手术治疗和判断预后有重要意义。     

骨关节结核影像学检查临床对比分析

目的探讨不同影像学方法诊断骨关节结核的临床效果。方法对36例骨关节结核患者分别采用X线、CT及MRI等三种方法进行检查,比较三种检查方法的对骨关节结核各征象的显示情况及诊断敏感性。结果 MRI在椎体骨质破坏、关节腔积液、椎间盘破坏、椎管狭窄等征象显示方面明显优于CT和X线平片,且差异具有统计学意义。X线平片、CT、MRI等三种影像学检查方法对骨关节结核患椎的诊断敏感性比较存在明显差异;进行两两比较发现,MRI诊断敏感性明显优于X线平片和CT;而CT的诊断敏感性又明显优于X线平片,且差异具有统计学意义。结论 MRI在骨关节结核早期诊断敏感性方面明显优于X线平片和CT。     

骨肉瘤X线平片、CT和MRI征象对比分析

目的 探讨骨肉瘤X线平片、CT和MRI的表现及其对骨肉瘤的诊断价值.方法 回顾性分析34例影像学资料完整并经病理证实的骨肉瘤,对骨肉瘤同一征象在不同检查方法的表现进行界定、观察、记录及统计学分析.结果 ①X线平片和CT显示瘤骨呈高密度,MRI显示絮状瘤骨6例.2例针状瘤骨在X线和CT不能显示,MRI呈长T1短T2信号.②MRI能显示X线平片和CT不能显示的骨膜反应和骨膜三角9例和4例.③骨皮质破坏:X线平片和CT显示骨皮质破坏的形态.MRI能显示骨皮质破坏的病理基础.④干骺端或骨端松质骨在X线平片和CT呈溶骨、成骨或混合性改变,MRI呈长T1长T2和(或)长T1短T2信号.⑤骨干髓腔病变:X线平片能显示肿瘤骨,CT显示液-液平面3例,MR上,19例能分清肿瘤实质与瘤周水肿.⑥骺板(痕)及骨骺侵犯:X线平片和CT能显示骨质破坏和肿瘤骨,MRI还能显示骺板(痕)及骨骺瘤周水肿.⑦肿块与软组织肿胀:X线平片显示3例有钙化的软组织肿块边缘清楚,而CT和MRI显示软组织肿块均边缘清楚,分别为28例和32例;X线平片不能显示软组织肿胀.结论 X线、CT和MRI在显示骨肉瘤的征象方面各具特点,三者互补可提高诊断的正确率.     

CT扫描对脊柱结核早期诊断的意义

目的:评价CT在脊柱结核早期诊断中的应用价值。材料与方法:10例早期脊柱结核患者,其中男性7例,女性3例,年龄为5～30岁,平均25岁,于发病后5个月至1年内经CT扫描后确诊。结果:CT扫描1、能清晰显示椎体的微小骨质破坏、死骨的大小与数目,以及死骨周围干酪样物的形成状况2、可清晰显示椎间盘的破坏程度、及相邻间盘及椎体软骨板的破坏状况,3、还可较早地发现双侧或单侧肿胀的腰大肌、腰小肌、髂腰肌及其脓肿等。CT确诊脊柱结核的中心型6例,边缘型3例,混合型1例。结论:CT可以显示X线上所不能显示的种种微小病变,它是脊柱结核早期诊断的重要工具。     

MRI在脊柱结核诊断中的应用价值

目的 探讨MRI在脊柱结核诊断中的价值. 资料与方法 对34例临床疑脊柱结核者,术前行X线平片、MRI平扫及增强检查,并分别与手术病理结果 对比. 结果 34例中,最终诊断结核者33例,另1例为慢性化脓性炎. 33例结核X线平片诊断正确24例(72.7%),MRI均正确诊断(100%);1例慢性化脓性炎平片及MRI 均误诊为结核. 结论 MRI可清楚显示脊柱结核的骨髓水肿、椎体破坏、椎旁脓肿、间盘受累和椎管内改变,诊断准确率高,评价细致全面,并且能早期诊断.     

Ewing肉瘤的X线平片、CT与MRI影像学分析

本文对36例Ewing肉瘤的X线平片、CT与MRI影像学表现进行了回顾性分析，认为X线平片在Ewing肉瘤的病变部位、骨质破坏、瘤骨、骨膜反应及软组织肿块等方面有一定特殊性。CT对显示髓腔内及软组织肿块等方面较X线平片清晰，但X线平片与CT常常低估病变的范围，MRI对早期检出病变致确定病变范围有明显优势。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）