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The Usefulness of Magnetic Resonance Imaging in the Diagnosis of Anterolateral Impingement of the Ankle 总被引:3,自引:0,他引:3
LCDR Doug Duncan MD CAPT Tim Mologne MD CDR Hans Hildebrand MD Mark Stanley MD LT Richard Schreckengaust MD CAPT Dave Sitler MD 《The Journal of foot and ankle surgery》2006,45(5):304-307
The purpose of this study is to assess the sensitivity and specificity of magnetic resonance imaging (MRI) in the diagnosis of anterolateral impingement of the ankle and to assess the most helpful sequence in making the diagnosis. Twenty-four patients who had undergone ankle arthroscopy were chosen. Twelve patients had arthroscopically documented anterolateral impingement, and 12 patients with no impingement on arthroscopy served as controls. Two musculoskeletal radiologists and an orthopedic surgeon, blinded to the operative diagnosis, retrospectively reviewed selective MRI images in the sagittal, axial, and coronal planes. The sensitivities and specificities were calculated for all 3 reviewers. The Kendall coefficient of concordance was calculated for overall agreement among reviewers. Sensitivities varied from 0.75 to 0.83, whereas specificities varied from 0.75 to 1.00. Using the Fisher exact test of contingency, the sensitivities and specificities showed that all reviewers' interpretations were statistically significant with P = .039, .001, and .012, respectively. The axial images were felt to be most helpful in making the diagnosis. The physicians felt that the sagittal images were helpful in 67%, 83%, and 100%, respectively. MRI is a useful tool that can aid the clinician in the diagnosis of anterolateral impingement of the ankle. T1 sagittal images demonstrating displacement of the normal fat signal anterior to the fibula by scar can be useful and help to confirm the diagnosis. 相似文献
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P. H. Sebrechts CAPT MC USN J. P. Anderson Jr. LCDR MC USN 《Diseases of the colon and rectum》1971,14(1):57-61
Summary The management of pilonidal cyst disease in a large military hospital is described. Of special interest to the military practice
is the “buddy” system, in which patients help one another to keep their wounds clean and dry. The specific objectives of our
technic are: 1) obtaining excellent hemostasis by the use of zinc peroxide paste; 2) avoiding recurrences by an open-wound
method of treatment; 3) preservation of a pad of subcutaneous tissue over the postsacral fascia, thus reducing long-term morbidity
by insuring a mobile scar; 4) decreasing the duration of hospitalization, achieved by frequently drying the wounds with warm
air.
Read at the meeting of the American Proctologic Society, Hollywood, Florida, April 12 to 16, 1970.
The opinions or assertions contained herein are those of the authors and are not to be construed as official or as reflecting
the views of the Navy Department. 相似文献
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Matthew T. Brigger MD LCDR MC USNR Christopher J. Hartnick MD MEpi 《The Laryngoscope》2009,119(1):176-179
Pediatric tracheostomy dependence is associated with a variety of sequelae. Vocalization delay is commonplace and may result in long‐term communication disability. Passy‐Muir speaking valves are routinely used to allow such children to vocalize. Unfortunately, not all tracheostomy dependent children can tolerate the placement of a speaking valve. Elevated transtracheal pressures are often associated with failure. We describe a method of modifying a standard Passy‐Muir valve to decrease transtracheal pressures and thus improve tolerance of the valve. In our practice, the modification allows a broader range of children experience the benefit of speaking valve placement. Laryngoscope, 119:176–179, 2009 相似文献
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L. D. Freeman MD LCDR MC USN D. S. Anderson MD R. B. Greaney MD T. S. Kilcheski MD S. A. McAdams MD 《Digestive diseases and sciences》1982,27(2):171-174
Due to the evidence that a splenectomized patient is at increased risk for serious infection, nonoperative management of splenic injury, as well as operations designed to preserve functioning splenic tissue, have been recently reported. Most experience in nonoperative management has been in the pediatric and young-adult age groups. We report a case of delayed rupture of the spleen in a middle-aged patient who was successfully managed nonoperatively and was followed with ultrasonography to resolution.Supported in part by the Bureau of Medicine and Surgery Clinical Investigation Program. 相似文献