ABSTRACT
Bone bruising demonstrated by MRI is discussed with histological findings and proposed classifications. The effects of the mechanism of injury on bone bruising at the knee and the natural history of the process are reviewed. The relationship of bone bruising to osteochondral sequelae and to osteoarthritis are considered.
Subject(s)
Bone and Bones/pathology , Contusions/diagnosis , Knee Injuries/diagnosis , Magnetic Resonance Imaging , Anterior Cruciate Ligament/pathology , Humans , Medial Collateral Ligament, Knee/immunology , Medial Collateral Ligament, Knee/pathology , Menisci, Tibial/pathology , Osteoarthritis/etiology , Time FactorsABSTRACT
Using a new method published by the first author, this article shows how direct explanations can be provided to interpret the classification of any input case by a standard multilayer perceptron (MLP) network. The method is demonstrated for a real-world MLP that classifies low-back-pain patients into three diagnostic classes. The application of the method leads to the discovery of a number of mis-diagnosed training and test cases and to the development of a more optimal low-back-pain MLP network.
Subject(s)
Low Back Pain/classification , Neural Networks, Computer , HumansABSTRACT
Previous studies have looked at early follow-up of the Graf ligament stabilisation system. We present mid- to long-term results of this procedure. A retrospective review of Graf ligaments inserted since 1993 was undertaken. A total of 51 patients were reviewed. Pre-operative Oswestry Disability Index scores were compared to post-operative scores recorded via a postal questionnaire. There were 28 men and 23 women. The average age was 41 years (range, 2267 years). The mean pre-operative score was 46 (range, 22-78), the mean follow-up time was 51 months (range, 23-84 months) and the mean post-operative score was 40 (range, 0-82). There were 12 complications (4 requiring further surgery), and seven patients went on to require bony fusion procedures. Forty one per cent of the group would choose not to have the operation again. Longer-term results of this technique are not as encouraging as earlier studies. The continued use of this procedure should be viewed with caution.
Subject(s)
Joint Instability/surgery , Orthopedic Fixation Devices , Spinal Diseases/surgery , Adult , Aged , Equipment Failure , Female , Follow-Up Studies , Humans , Male , Middle Aged , Orthopedic Fixation Devices/adverse effects , Reoperation , Retrospective StudiesABSTRACT
STUDY DESIGN: A prospective cohort study assessing the responsiveness of two disease-specific questionnaires and a generic health questionnaire for patients with low back pain and sciatica. OBJECTIVES: To compare the responsiveness of the eight scales and two summery scales of the SF-36 questionnaire with that of the Oswestry Disability Index and Low Back Outcome Score questionnaires. SUMMARY OF BACKGROUND DATA: Evaluation of treatment outcome is being determined more frequently from a patient's perspective, particularly the impact treatment has on current health status. METHODS: Patients were recruited from two orthopedic back pain clinics in a tertiary hospital. Patients completed the pretreatment questionnaire 1 month before treatment and follow-up questionnaires a minimum of 2-6 months after treatment. Patients undergoing surgery were also observed for a minimum of 2 years. RESULTS: Overall, the Oswestry Disability Index was most responsive; however, individual scales from the SF-36 questionnaire showed equal or greater sensitivity to change than the Oswestry Disability Index in each of the patient subgroups. The SF-36 Role Physical scale was prone to floor effects (a high percentage of respondents score zero), and the change scores from the SF-36 Role Emotional scale varied by 100 points in either direction in each of the patient subgroups. CONCLUSION: Responsiveness varied according to which method was used in its calculation. The responsiveness of the SF-36 questionnaire shows that it can be a useful adjunct in the assessment of patients with low back pain when combined with disease-specific questionnaires.
Subject(s)
Disability Evaluation , Health Status , Low Back Pain/diagnosis , Pain Measurement/methods , Surveys and Questionnaires , Female , Humans , Longitudinal Studies , Low Back Pain/psychology , Male , Middle Aged , Prospective Studies , Reproducibility of Results , Sciatica/diagnosis , Sciatica/psychologyABSTRACT
Over a six-year period, 166 shoulder arthroscopies were performed in 153 patients with symptoms of subluxation, but no firm evidence of dislocation and no clear-cut clinical diagnosis. Arthroscopy confirmed the working diagnosis in 133 shoulders (80%), but changed it in 33 (20%). In 26 shoulders the presumed direction of instability was changed and in seven a different diagnosis was made. Arthroscopy was particularly helpful for patients with shoulder instability of uncertain type or direction.
