强直性脊柱炎的影像学诊断

目的：探讨强直性脊柱炎的影像学表现特点，分析其早期影像学表现，比较X线与CT对强直性脊柱炎的诊断价值。方法：回顾性分析临床确诊的43例强直性脊柱炎的影像学资料，总结其影像学表现特点。结果：骶髂关节炎影像学表现为骶髂关节关节面硬化、骨侵蚀、破坏，关节间隙模糊、狭窄、消失．脊椎骨质疏松、竹节样改变，外周关节间隙变窄、关节强直等。CT对早期骶髂关节病变显示明显优于X线摄影。结论：骶髂关节骨质侵蚀、破坏、囊变、骨质硬化是强直性脊柱炎的早期征象，CT检查对病变细节显示更清楚，对早期病变更具敏感性，能对强直性脊柱炎做出正确分期，对临床诊断及治疗预后有较高的准确性，优于X线平片。     

强直性脊柱炎的影像学诊断及护理

目的：探讨强直性脊柱炎的影像学表现,提高影像学对强直性脊柱炎的诊断价值及强直性脊柱炎患者的护理质量。方法：回顾性分析临床确诊的90例强直性脊柱炎的影像学资料,总结其影像学表现及护理。结果：强直性脊柱炎X线影像学表现为骶髂关节间隙正常、关节变毛糙、模糊、硬化、关节融合,病情进一步发展,关节软骨和关节面破坏,关节间隙不规则,晚期出现关节间隙完全消失;CT征象为骶髂关节毛糙、模糊、受侵蚀出现率最高,其他如关节硬化、关节间隙变窄、关节融合,髋关节受损等;MRI显示骨突关节滑膜炎,关节间隙模糊,骨突骨髓水肿,增强后可见强化表现,棘突韧带水肿,棘突骨髓亦可见水肿表现。通过对强直性脊柱炎早期护理,延缓或减少了畸形的发生。结论：强直性脊柱炎x线早期主要表现骶髂关节骨质侵蚀、破坏、囊变、骨质硬化是强直性脊柱炎的早期征象;CT检查对病变细节显示更清楚,对早期病变更具敏感性,CT对早期骶髂关节病变显示明显优于X线摄影,对疗效观察更为有利;MRI能显示强直性脊柱炎骶髂关节早期病理改变。CT和MRI为强直性脊柱炎早期诊断及护理提供重要帮助。     

强直性脊柱炎骶髂关节病变CT扫描的诊断价值

目的 分析强直性脊柱炎(AS)之骶髂关节病变的影像学表现，评价CT对AS骶髂关节病变的诊断价值方法分析研究30例成人临床肯定的AS骶髂关节病变的影像学表现。结果 AS骶髂关节病变的早期影像学表现是首发于骶髂关节前下方滑膜处的骨质侵蚀。对此处病变的检出率CT明显高于平片。平片可疑病变CT基本可以确诊，同时分级更为精确。结论 CT能清晰显示骶髂关节的微细结构，对AS的早期征象敏感性较平片高，CT检查对早期病变的诊断有较高的价值。     

影像学对强直性脊柱炎骶髂关节病变的诊断价值

目的探讨强直性脊柱炎(AS)骶髂关节改变的影像学诊断价值。方法回顾性分析98例经临床证实的AS患者的骶髂关节CR、CT及MRI表现特点,包括分级、部位和数量、钙化、关节间隙变化及关节面下骨质改变等。结果AS骶髂关节病变的CR正位及斜位片显示:骶髂关节间隙变窄67例,关节面致密硬化22例,囊变15例,关节强直17例,钙化38例;CT显示:病变主要累及骶髂关节滑膜部髂骨侧,软骨钙化55例,关节间隙变窄42例,关节面及面下骨质结构囊变43例,硬化65例,骶髂韧带钙化52例;MRI显示:关节软骨破坏40例,病变区周围水肿57例,骨内脂肪沉积15例。结论对AS骶髂关节的检查,CR为最基本的方法,CT对AS的分级较准确,而MRI对AS骶髂关节病变可做出早期诊断。     

多层螺旋CT在强直性脊柱炎骶髂关节病变中的应用价值

目的:探讨多层螺旋CT在强直性脊柱炎(AS)骶髂关节病变的应用价值。方法:56例临床确诊为强直性脊柱炎患者行骶髂关节多层螺旋CT检查,观察骶髂关节病变的CT表现及影像学特征。结果:强直性脊柱炎骶髂关节病变的多层螺旋CT表现特征为病变主要累及骶髂关节的髂骨侧,表现为关节软骨钙化、关节面毛糙、骨性关节面下多发小囊状骨质吸收、破坏伴不同程度骨质增生硬化,骶髂关节间隙狭窄、消失、关节骨性融合及骶髂韧带钙化等。结论:多层螺旋CT对强直性脊柱炎(AS)骶髂关节病变的诊断与鉴别诊断具有重要的应用价值。     

强直性脊柱炎骶髂关节CT诊断价值

目的探讨强直性脊柱炎(AS)骶髂关节CT表现,协助临床评估病变程度,以提高AS的早期诊断。方法对65例强直性脊柱炎骶髂关节的病例进行CT扫描。其中男52例,女13例,年龄16~52岁,平均23.6岁。结果65例强直性脊柱炎(AS)骶髂关节CT表现的患者中,Ⅰ级11例(16.9%),Ⅱ级22例(33.8%),Ⅲ级24例(36.9%),Ⅳ级8例(12.3%)。骶髂关节双侧同时受累54例(83.1%),单侧受累11例(16.9%)。早期CT表现为关节面毛糙、关节面皮质中断、皮质白线消失,软骨下骨质微小侵蚀、囊变,关节面轻度硬化,但关节间隙正常。进展期CT主要表现为关节面不光整、局部骨皮质呈锯齿状或波浪状改变,软骨下骨质囊状破坏,局部骨质硬化明显,关节间隙增宽。稳定期CT主要表现为关节骨性强直,关节间隙消失。结论骶髂关节CT检查有利于AS的早期诊断。     

CT和MRI在早期强直性脊柱炎骶髂关节病变中的诊断价值

目的探讨CT和MRI在早期强直性脊柱炎骶髂关节病变诊断中的应用价值。方法对接受诊治的强直性脊柱炎患者分别采用CT和MRI进行检查,比较两种检查方法的诊断效果。结果 MRI在强直性脊柱炎骶髂关节病变分级诊断中对0级和I级病变患者的诊断率明显高于CT检查,且差异具有统计学意义。而两种检查方法在其他级别的强直性脊柱炎骶髂关节病变分级诊断率比较则无明显差异。MRI检查对关节面下骨质囊变、腰5骶1关节突病变及骨髓水肿的检出率明显高于CT检查,且差异具有统计学意义。而CT检查在关节侵蚀和关节面增生硬化检出率方面明显高于MRI检查,且差异具有统计学意义。两种检查方法对关节间隙狭窄或增宽的检出率无明显差异。结论 MRI检查方法敏感,无放射性,CT检查强直性脊柱炎骶骼关节病变具有更高的空间分辨率,对关节侵蚀和关节面增生硬化等早期症状的检出率高于MRI,所以MRI检查应作为AS早期诊断的优选检查方法,但对一些显示不清楚的病情变化,要结合CT扫描来确诊。     

强直性脊柱炎早期骶髂关节病变的MRI研究

骶髂关节(SIJ)受累是强直性脊柱炎(ankylosing spondylitis,AS)主要的特征性改变。99%的AS病人最初表现为骶髂关节病变。影像学特征为AS诊断提供依据,但常晚于临床症状出现6~7年,核磁共振(MRI)能可靠的显示骶髂关节慢性(骨侵蚀、硬化、骨桥)和急性期(滑膜炎、骨炎、关节囊炎)炎性病变,并能分别对急慢性病变量化分级。MRI可早于放射线表现显示病变,随着新的有效的治疗药物(如生物制剂)的出现,强直性脊柱炎的早期诊断更加重要,本文综述了近年来AS的早期SIJ炎的病理、MRI特征,序列应用和评分系统。     

强直性脊柱炎骶髂关节的CT诊断价值

目的探讨强直性脊柱炎（AS）患者骶髂关节病变的CT表现,并评价其对早期诊断的意义。方法对46例经临床证实AS患者骶髂天节病变的CT表现进行了回顾性分析,并参照修订的AS纽约标准（5级分类法）对全部患者的骶髂关节病变进行了分级。结果研究证实,本组46例均有异常CT表现。其中,Ⅱ级（早期,7例）CT表现为骶髂关节受累,关节面轻度硬化、毛糙,皮质白线消失,关节面细小囊变,但关节间隙仍正常;Ⅲ级（进展期,35例）CT表现为骶髂关节面呈虫蚀状侵蚀,软骨钙化,关节面骨质增生硬化,关节间隙略增宽或不均匀变窄;Ⅳ级（晚期,4例）CT表现为关节骨性强直,关节间隙消失。结论CT能清晰显示骶髂关节的微细结构及其病理改变,极有利于诊断AS患者早期骶髂关节病变。     

强直性脊柱炎骶髂关节病变的CT表现

目的：通过对40例强直性脊柱炎（AS）骶髂关节CT扫描，以提高其鉴别诊断水平。方法：分析40例AS患者的骶髂关节CT表现特点。结果：骶髂关节早期CT表现为关节间隙正常，骨性关节面侵蚀破坏，基本呈对称性，关节面骨皮质毛糙不整，局限性微小皮质破坏或局限性硬化：进展期为双侧骶髂关节面广泛骨皮质破坏，呈锯齿状或毛刷状，局部骨质硬化明显，关节间隙不规则变窄或增宽：晚期为关节骨性强直和普遍性骨质疏松。骶髂关节韧带部也可发生骨侵蚀和囊变；结论：AS骶髂关节的CT表现特点，有助于临床的早期诊断，提高诊断准确率。     

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.     

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）     

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.