ABSTRACT
Objetivo: Evaluar el grado de concordancia entre la manometría anorrectal y la ecografía dinámica del piso pelviano (ecodefecografía) mediante la medición del índice kappa, en la detección de la contracción paradojal del haz puborrectal en pacientes que presentan dificultad evacuatoria (DE) ocasionada por pujo disinergico. Material y Método: Se efectuaron manometría anorrectal y ecodefecografía, en 89 pacientes (9 hombres y 80 mujeres) en un centro ambulatorio de coloproctología, a pacientes que presentaban síntomas de obstrucción defecatoria en el período comprendido entre mayo 2011 y mayo 2014. Se reportó la presencia de contracción paradojal del haz puborrectal durante el pujo en las manometrías. En la ecodefecografía se analizó el movimiento del músculo puborrectal, comparando el ángulo anorrectal. durante el reposo y pujo. En caso de constatarse una disminución del mismo durante el esfuerzo evacuatorio se interpreto como contracción paradojal del haz puborrectal. Resultados:. Se obtuvo un índice kappa de 0.87 (IC 95% 0,73-0,97), dando un muy buen grado de acuerdo entre los resultados de ambos estudios, con resultados estadísticamente significativos (p=0,05). Conclusión: La ecodefecografía es una herramienta útil que puede confirmar casos de disinergia demostrada por manometría, pero si bien ambos métodos presentan muy buen grado de acuerdo entre sí, ningún estudio puede reemplazar al otro ya que ambos métodos tienen sus resultados falsos positivos.
Objective: To assess the degree of agreement between anorectal manometry and dynamic pelvic floor ultrasound (echodefecography) by calculating kappa index in patients with symptoms of obstructed defecation. Material and Methods: Anorectal manometry and echodefecography were performed in patients with obstructed defecation symtpoms between May 2011 and May 2014. When the anorectal manometry was performed, the pressures during attempted defecation were recorded. Dyssinergic pattern was defined if a rise in pressures was noted. When the echodefecography was performed, the angle between the internal edges of the puborectalis with a vertical line according to the anal canal axis was calcultated at rest and during straining. Results: Anorectal manometry and echodefecography was performed in 89 patients with defecatory disturbances symptoms. Male:female 9male, the mean age of patients was 57 years old (range 25-78). The assessment of the degree of agreement or concordance between dynamic ultrasound and anorectal manometry yielded a kappa index of 0.87 (very good agreement) with statistically significant results (p=0.05). Conclusion: Ultrasonography may be used to assess patients with obstructed defecation, as it is able to detect the same anorrectal dysfuntions found by another pelvic floor studies. It is a minimally invasive, well tolerated method, and avoids exposure to radiation. Although both methods shows very good agreement with each other, they cannot replace them since both methods have false positive results.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Constipation/diagnosis , Constipation/physiopathology , Defecography/methods , Manometry/methods , Anal Canal/diagnostic imaging , Anal Canal/physiopathology , Pelvic Floor/physiopathology , Rectum/physiopathologyABSTRACT
PURPOSE: Snapping triceps syndrome is dynamic condition in which medial head of triceps snaps (dislocates) over the medial epicondyle as the elbow is flexed. MATERIALS AND METHODS: The symptoms are pain or snapping at the medial aspect of the elbow and/or symptoms from coexisting ulnar nerve irritation. The diagnosis can be made by dynamic ultrasonography. RESULTS AND CONCLUSION: And successful outcome can be archived by operative treatment, which are ulnar nerve anterior transposition and tenotomy of medial head of triceps.
Subject(s)
Joint Dislocations , Elbow , Head , Tenotomy , Ulnar NerveABSTRACT
The term muscle herniation represents focal muscular protrusions through an acquired or congenital fascial defect. The anterior tibialis muscle is the most common site of herniation. Dynamic ultrasonography has become an important tool in dermatology for diagnosing suspected muscle herniation because it is a non-invasive, highly accurate, readily available and cost-effective imaging technique. We present here the case of a 21-year-old male Korean soldier who underwent dynamic ultrasonography to confirm the diagnosis of anterior tibialis muscle herniation.
Subject(s)
Humans , Male , Young Adult , Dermatology , Leg , Military Personnel , MusclesABSTRACT
Muscle herniation is a relatively common disorder in the extremities, particularly in the lower extremity where the tibialis anteior muscle is the most commonly affected. Usually muscle herniation is asymptomatic or mild but a few patients complain of cramping or severe pain. We report a case of a bilateral hernia of the tibialis anterior muscle that was confirmed by dynamic ultrasonography.
Subject(s)
Humans , Diagnosis , Extremities , Hernia , Lower Extremity , Muscle Cramp , UltrasonographyABSTRACT
To evaluate the usefulness of dynamic ultrasonography in documenting treatment efficacy and expecting prognosis in developmental dysplasia of the hip (DDH), 49 DDH hips in 32 patients, who had serial dynamic ultrasonographic examinations by Harcke's method during Pavlik harness treatment, were studied as for the progression of ultrasound findings. Grafs alpha and beta angle were measured in coronal flexion view of dynamic ultrasonography. Among 49 hips, on follow-up radiographs, 44 hips showed normal hip development and 5 hips showed dysplasia. In 44 normal hips, 43 hips had alpha angle of more than 50 degrees and stability on dynamic sonogram at the time of weaning of harness. In contrast, all five hips with residual dysplasia exhibited instability on dynamic stress with comparable alpha angle to that of normal hips. This finding suggests that when the hip matures beyond "delayed ossification"(alpha angle more than 50 degrees) with stability on dynamic sonogram, normal hip development can be expected. But if the hip is continuously unstable, regardless of alpha angle, there can be a possibility of residual dysplasia.