Update on sports imaging

Sports Imaging has dramatically increased in the past decade with increasing number of adolescents, young and middle-aged adults participating in non-competitive/hobby sports. Therefore, sports injuries are no longer confined to elite athletes. Furthermore, newer forms of sports such as mountain climbing, pickle ball and curling etc. are gaining popularity. Majority of the injuries in sports medicine are from musculoskeletal trauma. Therefore, it is imperative that the musculoskeletal radiologist becomes familiar with various sports related injury patterns as these are commonly encountered in daily practice. This update aims to briefly encapsulate the major aspects of sports imaging. It includes the imaging manifestations of various types of musculoskeletal injuries on different modalities (commonly US and MRI) and briefly mentions the various image guided interventions, performed both on the sports field and in the hospital setting.     

Out of the boxes,out of the silos: The need of interdisciplinary collaboration to reduce poor-quality medical products in the supply chain

In this paper, we argue that understanding and addressing the problem of poor-quality medical products requires a more interdisciplinary approach than has been evident to date. While prospective studies based on rigorous standardized methodologies are the gold standard for measuring the prevalence of poor-quality medical products and understanding their distribution nationally and internationally, they should be complemented by social science research to unpack the complex set of social, economic, and governance factors that underlie these patterns. In the following sections, we discuss specific examples of prospective quality surveys and of social science studies, highlighting the value of cross-sector partnerships in driving high-quality, policy-relevant research in this area.     

Tears at the myotendinous junction of the infraspinatus: Ultrasound findings

PurposeTears involving the myotendinous junction (MTJ) of the infraspinatus (IS) have been recently described on MRI. These occur centrally in the muscle belly, and are not associated with full thickness tears of the distal infraspinatus tendon. They also induce a rapidly progressive fatty infiltration of the muscles and amyotrophy. The purpose of this study is to assess the accuracy of ultrasonography in diagnosing MTJ tears of the infraspinatus and to describe the usual ultrasonographic appearance compared with MRI.Materials and methodsRetrospective study of 2403 US examinations of the shoulder (over 5 years). Fifteen patients with a reported suspicion of infraspinatus MTJ tears were included. MRI examination was available in all cases, CT arthrography in 13 cases, and one patient underwent surgical confirmation.ResultsAll patients were sent for an ultrasound for suspect lesion of the tendons of the rotator cuff, with posterior pain in the infraspinatus fossa. All cases seen on ultrasonography were confirmed on MRI. CT arthrography confirmed the absence of tear of the IS tendon in all cases and did not reveal the MTJ tears. Two signs appeared to us as being of special interest: the “tadpole sign” on longitudinal views, and the “black eye sign” on sagittal views. The proximal retraction of the tendon at the MTJ is the anatomical explanation of both signs.ConclusionTears at the myotendinous junction of the infraspinatus are rare but can be diagnosed on US examination, provided that the sonographer pays attention to the infraspinatus fossa especially in cases of normality of the distal tendinous cuff.     

Linguistic Validation of the US Spanish Work Productivity and Activity Impairment Questionnaire, General Health Version

INTRODUCTION: There are no measures of health-related absenteeism and presenteeism validated for use in the large and increasing US Spanish-speaking population. Before using a Spanish translation of an available English-language questionnaire, the linguistic validity of the Spanish version must be established to ensure its conceptual equivalence to the original and its cultural appropriateness. OBJECTIVE: The objective of this study was to evaluate the linguistic validity of the US Spanish version of the Work Productivity and Activity Impairment questionnaire, General Health Version (WPAI:GH). METHODS: A US Spanish translation of the US English WPAI:GH was created through a reiterative process of creating harmonized forward and back translations by independent translators. Spanish-speaking and English-speaking subjects residing in the US self-administered the WPAI:GH in their primary language and were subsequently debriefed by a bilingual (Spanish-English) interviewer. RESULTS: US Spanish subjects (N = 31) and English subjects (N = 35), stratified equally by educational level, with and without a high school degree participated in the study. The WPAI-GH item comprehension rate was 98.6% for Spanish and 99.6% for English. Response revision rates during debriefing were 1.6% for Spanish and 0.5% for English. Responses to hypothetical scenarios indicated that both language versions adequately differentiate sick time taken for health and non-health reasons and between absenteeism and presenteeism. CONCLUSION: Linguistic validity of the US Spanish translation of the WPAI:GH was established among a diverse US Spanish-speaking population, including those with minimal education.     

Diagnostic sonography of the fetal genitourinary tract

Fetal diagnosis has vastly improved over the last decade. Ultrasound has become the imaging modality of choice. As real-time equipment has improved technologically, the ability to deduce subtle abnormalities has greatly increased. The fetal genitourinary tract may be evaluated for renal dysplasias, anomalies, or obstruction. Points of obstruction and, at times, the exact cause of obstruction may be deduced. Abnormalities of the ureter, bladder, urethra, scrotum, or reproductive system can be detected.     

人巨细胞病毒pUS28分子结构及其对宿主细胞的作用

人巨细胞病毒活化过程中编码产生pUS28等G蛋白偶联受体,该受体表现出吞没趋化因子和改变宿主细胞信号转导途径等多种生物学功能,从而使病毒自身及其所处微环境的多个行为环节向有利于病毒复制的方向进行.本文对pUS28分子结构及其对宿主细胞的作用研究进展作一综述.     

Benign liver lesions: implications of detection in cancer patients

A review of liver sonograms obtained for cancer patients (excluding primary liver cancers) over a 12 year period found 829 benign lesions: non-parasitic cysts (427 cases), hemangiomas (216 cases), solitary calcifications (79 cases), focal fatty infiltration (62 cases), and miscellaneous lesions (45 cases). These benign pathologies represented 41.8% of the focal hepatic lesions observed during this period in this population; hepatic metastases accounted for the remaining 58.2%. Marked female predilection was noted for the nonparasitic cysts, hemangiomas, and focal fatty infiltration; 63–78.7% of these lesions were solitary, and first-line imaging by US was sufficient for diagnosis of 66.1–98.2% of cases. Analysis of lesion evolution over more than 5 years revealed modifications in 17% of hemangiomas, 23.9% of nonparasitic cysts, and 75% of cases of focal fatty infiltration. Systematic pretherapy liver sonography can be proposed owing to the high frequency of benign liver lesions that can create diagnostic problems during follow-up of cancer patients. Correspondence to: J. N. Bruneton     

One-shot percutaneous ethanol injection of liver tumors under general anesthesia: Preliminary data on efficacy and complications

Purpose: To verify the efficacy of ultrasound (US)-guided injection of large amounts of ethanol into large or multiple liver lesions, in a single session under general anesthesia (one-shot PEI) for percutaneous ablation of hepatic tumors. Methods: Twenty-nine patients (27 with 51 hepatocellular carcinoma (HCC) nodules on cirrhosis, diameter range 1.0<+>–<+>9.0 cm; two patients with a single metastasis from the gastroenteric tract, 5.0 and 9.0 cm, respectively, in diameter) were treated with one-shot PEI. Results: The total volume of alcohol delivered per patient ranged from 16 to 210 ml. Mean ethanol volume in all patients was 49 ml. Dynamic computed tomography (CT) examination showed complete necrosis in 41 of 50 lesions. Two patients died of hypovolemic shock due to massive upper gastrointestinal bleeding, 3 and 7 days, respectively, after the interventional procedure. All the remaining patients are alive (follow-up 5<+>–<+>14 months) except one who died of liver failure 5 months after. New HCC nodules occurred in six patients within 6 months and one intralesional relapse was recorded. Conclusion: In this preliminary experience, one-shot PEI is as effective in inducing liver tumor necrosis as traditional PEI; its advantages are shorter treatment time and the capability of treating larger and multiple liver lesions.     

Hyperreactio luteinalis in a normal pregnancy: Sonographic and MRI findings

A case of hyperreactio luteinalis in an otherwise normal pregnancy is reported. Ascites was present, but no peritoneal implants or adenopathy were seen. Findings that would have suggested the correct diagnosis are the symmetrical and bilateral pattern of the mass, as well as the rather uniform size of the loculi, which were 1 to 3 cm in diameter.     

Skin Conductance Response Conditioning with High CS Intensities: Additional Evidence with New Controls

In an effort to determine whether or not conditioning is possible when CS intensity is at least as high as US intensity, nine groups of human subjects were employed in a skin conductance conditioning study. White noise CS and US intensities of 95- and 115-dB were varied orthogonally in the experimental groups, while control groups were incorporated to control for overall signal frequency and differences in habituation rates attributable to differences in intertrial interval. By conventional contrasts first interval response (FIR) conditioning was observed, but when controls for differential habituation rates were incorporated in the contrasts there was no evidence of FIR conditioning. Second interval response (SIR) conditioning was obtained, but it was manifest as an anticipatory response to the higher of two US intensities rather than in conventional conditioning vs control group comparisons. It was also shown that high CS intensities induce suppression of SIR levels, with greater suppression associated with the higher intensity. Several conclusions were made: 1) in a simple trace conditioning paradigm with skin conductance responding as the measure, it is not clear that what we have typically called a conditioning effect is separable from an habituation effect; 2) conditioning is possible even when CS intensity is as high as or higher than US intensity; and 3) the use of time sample measurement in the absence of signals provides a useful baseline for determining overall increases and decreases in SIR level.