ABSTRACT
Shoulder disorders are common in the general populationâ: they occur in about 25 of every 1000 patients per year. A rather large majority are caused by cuff disorders. Differentiating between impingement and cuff rupture is essential to adequate treatment. Clinical tests have been developed, but their accuracy is limited. This study was performed to improve clinical accuracy by combining single tests and adding a subacromial injection. We postulated that the empty can and drop arm tests would result in higher sensitivity and specificity after subacromial injection. METHOD: We prospectively assessed 49 patients with the empty can and drop arm tests and used ultrasound to compare the individual and combined results. RESULT: The ultrasound found six cuff ruptures. Specificity improved and sensitivity decreased after subacromial injection. CONCLUSION: Only specificity improved after subacromial injection. Combining the test results led to an increase in both sensitivity and specificity without injection.
Subject(s)
Adrenal Cortex Hormones/administration & dosage , Physical Examination/methods , Rotator Cuff Injuries/diagnosis , Rotator Cuff Injuries/drug therapy , Shoulder Impingement Syndrome/diagnosis , Shoulder Impingement Syndrome/drug therapy , Adult , Aged , Aged, 80 and over , Female , Humans , Injections , Male , Middle Aged , Rotator Cuff Injuries/diagnostic imaging , Rupture , Sensitivity and Specificity , Shoulder Impingement Syndrome/diagnostic imaging , UltrasonographyABSTRACT
BACKGROUND: The histologic composition of prostate adenoma seems related to the development of clinical benign prostatic hyperplasia (BPH). Therefore, a new noninvasive prediction model as an alternative for biopsies was investigated. METHODS: In 19 patients, the data of a routine preoperative workup for transurethral resection (TURP) and of an additional MRI-examination were related to the results of morphometry on TURP-tissue. RESULTS: Statistical analysis identified age of the patient and MRI-volumetrics of the prostate adenoma as best predictors of the epithelial fraction, with a 95% confidence interval of at least 5% (range, 9-14%) (R2 = 50%). CONCLUSIONS: This prediction model is sufficiently accurate to categorize a population of patients into histologic subgroups. It seems very likely that this method will be of use as an investigative tool in medical trials to provide insight into the pathogenesis of clinical BPH and into treatment strategies for the individual patient.
Subject(s)
Models, Biological , Models, Statistical , Prostate/pathology , Prostatic Hyperplasia/pathology , Aged , Aged, 80 and over , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Predictive Value of Tests , Prostate/diagnostic imaging , Prostatic Hyperplasia/diagnosis , Prostatic Hyperplasia/diagnostic imaging , Regression Analysis , UltrasonographyABSTRACT
A patient with infantile cortical hyperostosis (ICH) is presented. Common features in all reported patients include: onset in the early part of the 1st year, tender swellings in more than one site and multiple scattered hyperostoses shown by radiography, but no previous study has determined the cause or origin of ICH. Biopsy of bony lesions only reveals hyperplasia of the lamellar cortical bone, without inflammation or subperiosteal haemorrhage. Although MRI resulted in excellent images for differentiation between bony and soft tissue structures and for evaluation of the extent of soft tissue involvement, it had no additional value in the management of the patient. Only in questionable cases can MRI provide additional information about the presence of a subperiosteal haemorrhage. Radiographic examination, in addition to clinical history and physical examination, is considered sufficient with regard to differential diagnosis and follow up of ICH.
Subject(s)
Hyperostosis, Cortical, Congenital/diagnosis , Bone and Bones/pathology , Female , Humans , Hyperostosis, Cortical, Congenital/diagnostic imaging , Infant , Magnetic Resonance Imaging , RadiographyABSTRACT
The clinical and radiological findings in chronic radiation enteritis are described in a group of 18 patients. The patients presented with malabsorption, diarrhoea, chronic intermittent obstruction or a combination of these signs. Eventually all patients developed an ileus. The radiologist plays an important role in determining the cause of the clinical signs. The single-contrast barium infusion technique was used. In the jejunum no changes were found except bowel dilatation as a sign of an obstruction more distally. In the ileum there was evidence of submucosal thickening, adhesions and single or multiple stenoses. These changes are described in relation to the pathogenesis of chronic radiation enteritis.
