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BACKGROUND: The aims of this cross-sectional study were to (a) assess actigraphy-based sleep parameters (total sample and gender differences), (b) assess differences in morphological parameters and physical function between short- versus normal-sleepers and poor- versus good-sleepers, and (c) assess the possible correlations between sleep variables and morphological and physical function parameters in older subjects. METHODS: This study enrolled 42 healthy older participants (60-80 years). Participants completed the following clinical evaluations: (1) whole-body dual-energy X-ray absorptiometry to assess the appendicular skeletal muscle mass index; (2) magnetic resonance imaging acquisition to determine the cross-sectional muscle area of thigh muscles and intermuscular adipose tissue; (3) risk of fall assessment through the mini-Balance Evaluation Systems Test; (4) strength assessment: (a) chair stand test and (b) handgrip strength test; (5) sleep monitoring by actigraphy to assess total sleep time, sleep efficiency, wake after sleep onset, sleep latency, fragmentation index, mobile time, and subjective sleep quality. RESULTS: 31.0% of subjects were short-sleepers (total sleep time < 6 hr), 19.1% were poor-sleepers (sleep efficiency < 85%), and gender differences were detected in mobile time (males: 15.8 ± 6.0 and females: 13.4 ± 6.8; p < .001) and fragmentation index (males: 35.3 ± 14.3 and females: 29.6 ± 14.6; p < .001); no significant differences were observed between groups (short- vs. normal-sleepers and poor- vs. good-sleepers) in morphological and physical function variables; correlation analysis showed that sleep latency negatively correlated with Mini-Balance Evaluation Systems Test (r = -.352; p = .022) and a positive correlation was detected between cross-sectional muscle area and mobile time (r = .349, p = .023). CONCLUSION: No differences were observed in morphological and function parameters between good- versus poor-sleepers, those subjects with worse sleep onset latency (i.e., longer time to fall asleep) registered higher for risk of fall. The potential role of sleep in the physiological mechanisms of muscular aging must be explored through cross-sectional cohort studies with a larger population.
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OBJECTIVES: To generate pseudo-CT (pCT) images of the pelvis from zero echo time (ZTE) MR sequences and compare them to conventional CT. METHODS: Ninety-one patients were prospectively scanned with CT and MRI including ZTE sequences of the pelvis. Eleven ZTE image volumes were excluded due to implants and severe B1 field inhomogeneity. Out of the 80 data sets, 60 were used to train and update a deep learning (DL) model for pCT image synthesis from ZTE sequences while the remaining 20 cases were selected as an evaluation cohort. CT and pCT images were assessed qualitatively and quantitatively by two readers. RESULTS: Mean pCT ratings of qualitative parameters were good to perfect (2-3 on a 4-point scale). Overall intermodality agreement between CT and pCT was good (ICC = 0.88 (95% CI: 0.85-0.90); p < 0.001) with excellent interreader agreements for pCT (ICC = 0.91 (95% CI: 0.88-0.93); p < 0.001). Most geometrical measurements did not show any significant difference between CT and pCT measurements (p > 0.05) with the exception of transverse pelvic diameter measurements and lateral center-edge angle measurements (p = 0.001 and p = 0.002, respectively). Image quality and tissue differentiation in CT and pCT were similar without significant differences between CT and pCT CNRs (all p > 0.05). CONCLUSIONS: Using a DL-based algorithm, it is possible to synthesize pCT images of the pelvis from ZTE sequences. The pCT images showed high bone depiction quality and accurate geometrical measurements compared to conventional CT. CRITICAL RELEVANCE STATEMENT: pCT images generated from MR sequences allow for high accuracy in evaluating bone without the need for radiation exposure. Radiological applications are broad and include assessment of inflammatory and degenerative bone disease or preoperative planning studies. KEY POINTS: pCT, based on DL-reconstructed ZTE MR images, may be comparable with true CT images. Overall, the intermodality agreement between CT and pCT was good with excellent interreader agreements for pCT. Geometrical measurements and tissue differentiation were similar in CT and pCT images.
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BACKGROUND: Skeletal muscle mass wasting almost invariably accompanies bone loss in elderly, and the coexistence of these two conditions depends on the tight endocrine crosstalk existing between the two organs, other than the biomechanical coupling. Since the current diagnostics limitation in this field, and given the progressive population aging, more effective tools are needed. The aim of this study was to identify circulating microRNAs (miRNAs) as potential biomarkers for muscle mass wasting in post-menopausal osteoporotic women. METHODS: One hundred seventy-nine miRNAs were assayed by quantitative real-time polymerase chain reaction in plasma samples from 28 otherwise healthy post-menopausal osteoporotic women (73.4 ± 6.6 years old). The cohort was divided in tertiles based on appendicular skeletal muscle mass index (ASMMI) to better highlight the differences on skeletal muscle mass (first tertile: n = 9, ASMMI = 4.88 ± 0.40 kg·m-2; second tertile: n = 10, ASMMI = 5.73 ± 0.23 kg·m-2; third tertile: n = 9, ASMMI = 6.40 ± 0.22 kg·m-2). Receiver operating characteristic (ROC) curves were calculated to estimate the diagnostic potential of miRNAs. miRNAs displaying a statistically significant fold change ≥ ±1.5 and area under the curve (AUC) > 0.800 (P < 0.05) between the first and third tertiles were considered. A linear regression model was applied to estimate the association between miRNA expression and ASMMI in the whole population, adjusting for body mass index, age, total fat (measured by total-body dual-energy X-ray absorptiometry [DXA]) and bone mineral density (measured by femur DXA). Circulating levels of adipo-myokines were evaluated by bead-based immunofluorescent assays and enzyme-linked immunosorbent assays. RESULTS: Five miRNAs (hsa-miR-221-3p, hsa-miR-374b-5p, hsa-miR-146a-5p, hsa-miR-126-5p and hsa-miR-425-5p) resulted down-regulated and two miRNAs (hsa-miR-145-5p and hsa-miR-25-3p) were up-regulated in the first tertile (relative-low ASMMI) compared with the third tertile (relative-high ASMMI) (fold change ≥ ±1.5; P-value < 0.05). All the corresponding ROC curves had AUC > 0.8 (P < 0.05). Two signatures hsa-miR-126-5p, hsa-miR-146a-5p and hsa-miR-425-5p; and hsa-miR-126-5p, hsa-miR-146a-5p, hsa-miR-145-5p and hsa-miR-25-3p showed the highest AUC, 0.914 (sensitivity = 77.78%; specificity = 100.00%) and 0.901 (sensitivity = 88.89%; specificity = 100.00%), respectively. CONCLUSIONS: In this study, we identified, for the first time, two miRNA signatures, hsa-miR-126-5p, hsa-miR-146a-5p and hsa-miR-425-5p; and hsa-miR-126-5p, hsa-miR-146a-5p, hsa-miR-145-5p and hsa-miR-25-3p, specifically associated with muscle mass wasting in post-menopausal osteoporotic women.
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MicroARN Circulante , MicroARNs , Humanos , Femenino , Anciano , Anciano de 80 o más Años , Posmenopausia , MicroARNs/metabolismo , Biomarcadores , Músculo Esquelético/metabolismoRESUMEN
OBJECTIVE: To assess the reliability and diagnostic accuracy of new radiographic imaging definitions developed by an international multidisciplinary working group for identification of calcium pyrophosphate deposition (CPPD). METHODS: Patients with knee osteoarthritis scheduled for knee replacement were enrolled. Two radiologists and 2 rheumatologists twice assessed radiographic images for presence or absence of CPPD in menisci, hyaline cartilage, tendons, joint capsule, or synovial membrane, using the new definitions. In case of disagreement, a consensus decision was made and considered for the assessment of diagnostic performance. Histologic examination of postsurgical specimens under compensated polarized light microscopy was the reference standard. Prevalence-adjusted bias-adjusted kappa values were used to assess reliability, and diagnostic performance statistics were calculated. RESULTS: Sixty-seven patients were enrolled for the reliability study. The interobserver reliability was substantial in most of the assessed structures when considering all 4 readers (κ range 0.59-0.90), substantial to almost perfect among radiologists (κ range 0.70-0.91), and moderate to almost perfect among rheumatologists (κ range 0.46-0.88). The intraobserver reliability was substantial to almost perfect for all the observers (κ range 0.70-1). Fifty-one patients were included in the accuracy study. Radiography demonstrated an overall specificity of 92% for CPPD, but sensitivity remained low for all sites and for the overall diagnosis (54%). CONCLUSION: The new radiographic definitions of CPPD are highly specific against the gold standard of histologic diagnosis. When the described radiographic findings are present, these definitions allow for a definitive diagnosis of CPPD, rather than other calcium-containing crystal depositions; however, a negative radiographic finding does not exclude the diagnosis.
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Calcinosis , Condrocalcinosis , Humanos , Pirofosfato de Calcio , Condrocalcinosis/diagnóstico por imagen , Reproducibilidad de los Resultados , Articulación de la Rodilla/diagnóstico por imagen , RadiografíaRESUMEN
PURPOSE: Current conservative treatments for knee OA provide limited benefits, with symptoms relief for a short amount of time. Regenerative medicine approaches such as the use of microfragmented adipose tissue (mFAT) showed promising results in terms of durable effects and the possibility to enhance tissue healing and counteract the progression of the pathology. Nevertheless, up to today, the large part of clinical data about mFAT use refers to uncontrolled studies, especially in the surgical setting. The purpose of this study was to evaluate the effectiveness of mFAT applied in association with arthroscopic debridement (AD) for the treatment of knee OA, in terms of symptoms relief and tissue healing. METHODS: This study is a prospective, randomized controlled clinical trial. 78 patients affected by knee OA grade 3-4 according to KL classification were randomly assigned to AD or AD + mFAT treatment groups. Clinical, radiological and serological assessments were performed at 6 months after treatment. Additional clinical evaluation was performed at the end of the study with an average follow-up of 26.1 ± 9.5 months. VAS, KOOS, WOMAC and SF-12 were also collected at both timepoints, KSS only at 6 months. RESULTS: Treatment with AD + mFAT improved functional scores at both 6 months (KOOS-PS: + 11.7 ± 20.2 vs + 24.4 ± 22.5, in AD and AD + mFAT, respectively, p = 0.024; KSS: + 14.9 ± 15.9 vs + 24.8 ± 23.5, in AD and AD + mFAT, respectively, p = 0.046) and 24-month follow-ups (KOOS-PS Functional subscale: - 2.0 ± 3.5 vs - 4.7 ± 4.2, in AD and AD + mFAT, respectively, p = 0.012). Lower T2-mapping scores were obtained in AD + mFAT-treated group in medial and lateral condyle compartments (p < 0.001). Slight increase was observed in the levels of a serum biomarker of cartilage deposition (PIIINP) in both groups at 6-month follow-up (p = 0.037). CONCLUSION: mFAT improves functional outcome and MRI appearance when used in association with AD, therefore supporting its use in the treatment of knee OA in an arthroscopic setting.
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Osteoartritis de la Rodilla , Humanos , Desbridamiento/métodos , Estudios Prospectivos , Articulación de la Rodilla/cirugía , Tejido Adiposo , Resultado del TratamientoRESUMEN
OBJECTIVES: The current lack of agreement regarding standardized terminology in musculoskeletal and sports ultrasound presents challenges in education, clinical practice, and research. This consensus was developed to provide a reference to improve clarity and consistency in communication. METHODS: A multidisciplinary expert panel was convened consisting of 18 members representing multiple specialty societies identified as key stakeholders in musculoskeletal and sports ultrasound. A Delphi process was used to reach consensus which was defined as group level agreement >80%. RESULTS: Content was organized into seven general topics including: 1) General Definitions, 2) Equipment and Transducer Manipulation, 3) Anatomic and Descriptive Terminology, 4) Pathology, 5) Procedural Terminology, 6) Image Labeling, and 7) Documentation. Terms and definitions which reached consensus agreement are presented herein. CONCLUSIONS: The historic use of multiple similar terms in the absence of precise definitions has led to confusion when conveying information between colleagues, patients, and third-party payers. This multidisciplinary expert consensus addresses multiple areas of variability in diagnostic ultrasound imaging and ultrasound-guided procedures related to musculoskeletal and sports medicine.
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Sistema Musculoesquelético , Deportes , Consenso , Técnica Delphi , Humanos , Sistema Musculoesquelético/diagnóstico por imagen , Ultrasonografía/métodosRESUMEN
BACKGROUND: Femoroacetabular impingement is characterized by an abnormal contact between the acetabulum and the femoral head-neck junction. Femoroacetabular impingement shows three main clinical frameworks: pincer-FAI, cam-FAI and cam-pincer mixed form. The aim of the study was to investigate the correlation between femoroacetabular impingement, imaging, activity and chondral damages. METHODS: Forty-one patients, undergoing arthroscopic chondroartroplasty for cam and cam-pincer mixed form were considered. All patients underwent an X-Ray hip evaluation (G1 group), while 15 patients also underwent a pelvis MRI evaluation (G2 subgroup). For G1 patients, the superior-inferior offset ratio and alpha angle were calculated from the X-Ray examinations. For G2 patients, the antero-posterior offset ratio was also calculated from pelvis MRI. Chondral damage was classified according to the Outerbridge Classification. RESULTS: The superior-inferior offset ratio and the antero-posterior offset ratio were respectively 0.50±0.23 and 0.33±0.19. The α angle predictive for a chondral damage of IV degree was 81.5°. The chondral damage of the patients suffering from cam-FAI and cam-pincer mixed form were respectively 3.53±0.80 and 3.00±1.41. CONCLUSIONS: From the results was possible to: 1) elaborate two tables providing a reliable indirect calculation of the alpha angle; 2) establish an alpha angle cut-off value indicative for a IV degree chondral damage; 3) show that pincer-FAI does not represent an aggravating factor for chondral damage; 4) show that the level of sports activity was related to the severity of chondral damage; and 5) show that a physically demanding occupation was not an aggravating factor for chondral damage.
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Pinzamiento Femoroacetabular , Acetábulo/cirugía , Pinzamiento Femoroacetabular/diagnóstico por imagen , Pinzamiento Femoroacetabular/cirugía , Fémur , Articulación de la Cadera , Humanos , Imagen por Resonancia Magnética , RadiografíaRESUMEN
Traumatic and non-traumatic tendon lesions are common at the wrist and hand. For the diagnosis, therapy management, and long-term prognosis of tendon lesions, a detailed understanding of the complex anatomy and knowledge of typical injury patterns is crucial for both radiologists and clinicians. Improvements in high-resolution ultrasound are producing high-quality images of the superficial tendinous and peritendinous structures. Thus, ultrasound is a valuable first-choice tool for visualizing traumatic, inflammatory, and degenerative conditions of the extensor and flexor tendons, particularly with the advantage of possible dynamic examination. The additional use of duplex-Doppler and power Doppler ultrasound imaging is recommended for detection of tenosynovitis in overuse injury, inflammatory disease, infection, and after traumatic conditions. In traumatic tendon injuries, knowing the precise injury zone is important for treatment decision-making. In cases of tendon rupture, the radiologist should report the tear type (i.e., complete or partial-thickness) and assess the degree of tendon retraction and associated avulsion injury, including the degree of fragment displacement. The function of intact flexor tendons may be impaired by thickening, strain, or rupture of corresponding annular pulleys. This review describes in detail the typical ultrasound imaging features of common pathologies of hand and wrist tendons, including annular pulley lesions.
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Pulmonary parenchymal and vascular damage are frequently reported in COVID-19 patients and can be assessed with unenhanced chest computed tomography (CT), widely used as a triaging exam. Integrating clinical data, chest CT features, and CT-derived vascular metrics, we aimed to build a predictive model of in-hospital mortality using univariate analysis (Mann-Whitney U test) and machine learning models (support vectors machines (SVM) and multilayer perceptrons (MLP)). Patients with RT-PCR-confirmed SARS-CoV-2 infection and unenhanced chest CT performed on emergency department admission were included after retrieving their outcome (discharge or death), with an 85/15% training/test dataset split. Out of 897 patients, the 229 (26%) patients who died during hospitalization had higher median pulmonary artery diameter (29.0 mm) than patients who survived (27.0 mm, p < 0.001) and higher median ascending aortic diameter (36.6 mm versus 34.0 mm, p < 0.001). SVM and MLP best models considered the same ten input features, yielding a 0.747 (precision 0.522, recall 0.800) and 0.844 (precision 0.680, recall 0.567) area under the curve, respectively. In this model integrating clinical and radiological data, pulmonary artery diameter was the third most important predictor after age and parenchymal involvement extent, contributing to reliable in-hospital mortality prediction, highlighting the value of vascular metrics in improving patient stratification.
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Tendon injuries represent the second most common injury of the hand (after fractures) and are a common scanning indication in radiology. Pulley injuries are very frequent in rock climbers with the A2 pulley the most commonly affected. Tendon and pulley injuries can be reliably evaluated using ultrasound (US) and magnetic resonance imaging (MRI). US can be postulated as a first-line imaging modality, allowing dynamic examination. MRI is essential for cases with ongoing diagnostic doubt post-US and also for preoperative pulley reconstruction assessment.
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Traumatismos de los Dedos , Montañismo , Traumatismos de los Tendones , Traumatismos de los Dedos/diagnóstico por imagen , Traumatismos de los Dedos/cirugía , Humanos , Rotura , Traumatismos de los Tendones/diagnóstico por imagen , Traumatismos de los Tendones/cirugía , Tendones/diagnóstico por imagen , Tendones/cirugíaRESUMEN
BACKGROUND: To diagnose periprosthetic joint infection (PJI) preoperatively, ultrasound-guided joint aspiration (US-JA) may not be performed when effusion is minimal or absent. We aimed to report and investigate the diagnostic performance of ultrasound-guided periprosthetic biopsy (US-PB) of synovial tissue to obtain joint samples in patients without fluid around the implants. METHODS: One-hundred nine patients (55 men; mean age: 68 ± 13 years) with failed total hip arthroplasty (THA) who underwent revision surgery performed preoperative US-JA or US-PB to rule out PJI. RESULTS: Sixty-nine of 109 patients had joint effusion and underwent US-JA, while the remaining 40 with dry joint required US-PB. Thirty-five of 109 patients (32.1%) had PJI, while 74/109 (67.9%) had aseptic THA failure. No immediate complications were observed in both groups. Technical success of US-PB was 100%, as the procedure was carried on as planned in all cases. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of US-JA were 52.2%, 97.8%, 92.3%, 80.3%, and 82.6%, while for US-PB, they were 41.7%, 100%, 100%, 80%, and 82.5%, respectively, with no significant difference (P = .779). Using the final diagnosis as reference standard, we observed a moderate agreement with both US-JA (k = 0.56) and US-PB (k = 0.50). CONCLUSION: We present a novel US-guided technique to biopsy periprosthetic synovial tissue of failed THA to rule out PJI. We found similar diagnostic performance as compared with traditional US-JA. This supports future larger studies on this procedure that might be applied in patients without joint effusion.
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Artroplastia de Reemplazo de Cadera , Prótesis de Cadera , Infecciones Relacionadas con Prótesis , Anciano , Anciano de 80 o más Años , Artroplastia de Reemplazo de Cadera/efectos adversos , Biomarcadores , Biopsia , Prótesis de Cadera/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Infecciones Relacionadas con Prótesis/diagnóstico , Infecciones Relacionadas con Prótesis/etiología , Infecciones Relacionadas con Prótesis/cirugía , Reoperación , Sensibilidad y Especificidad , Líquido Sinovial , Ultrasonografía IntervencionalRESUMEN
Background Lower muscle mass is a known predictor of unfavorable outcomes, but its prognostic impact on patients with COVID-19 is unknown. Purpose To investigate the contribution of CT-derived muscle status in predicting clinical outcomes in patients with COVID-19. Materials and Methods Clinical or laboratory data and outcomes (intensive care unit [ICU] admission and death) were retrospectively retrieved for patients with reverse transcriptase polymerase chain reaction-confirmed SARS-CoV-2 infection, who underwent chest CT on admission in four hospitals in Northern Italy from February 21 to April 30, 2020. The extent and type of pulmonary involvement, mediastinal lymphadenopathy, and pleural effusion were assessed. Cross-sectional areas and attenuation by paravertebral muscles were measured on axial CT images at the T5 and T12 vertebral level. Multivariable linear and binary logistic regression, including calculation of odds ratios (ORs) with 95% CIs, were used to build four models to predict ICU admission and death, which were tested and compared by using receiver operating characteristic curve analysis. Results A total of 552 patients (364 men and 188 women; median age, 65 years [interquartile range, 54-75 years]) were included. In a CT-based model, lower-than-median T5 paravertebral muscle areas showed the highest ORs for ICU admission (OR, 4.8; 95% CI: 2.7, 8.5; P < .001) and death (OR, 2.3; 95% CI: 1.0, 2.9; P = .03). When clinical variables were included in the model, lower-than-median T5 paravertebral muscle areas still showed the highest ORs for both ICU admission (OR, 4.3; 95%: CI: 2.5, 7.7; P < .001) and death (OR, 2.3; 95% CI: 1.3, 3.7; P = .001). At receiver operating characteristic analysis, the CT-based model and the model including clinical variables showed the same area under the receiver operating characteristic curve (AUC) for ICU admission prediction (AUC, 0.83; P = .38) and were not different in terms of predicting death (AUC, 0.86 vs AUC, 0.87, respectively; P = .28). Conclusion In hospitalized patients with COVID-19, lower muscle mass on CT images was independently associated with intensive care unit admission and in-hospital mortality. © RSNA, 2021 Online supplemental material is available for this article.
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COVID-19/complicaciones , Radiografía Torácica/métodos , Sarcopenia/complicaciones , Sarcopenia/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Anciano , Femenino , Humanos , Italia , Masculino , Persona de Mediana Edad , Músculo Esquelético/diagnóstico por imagen , Valor Predictivo de las Pruebas , Estudios Retrospectivos , SARS-CoV-2RESUMEN
BACKGROUND: Very little has been published about the diagnostic performance of MRI in total hip arthroplasty (THA) infection. PURPOSE: To determine the diagnostic performance of conventional MRI features and of new lymph nodal indices to identify infection in patients with failed THA. STUDY TYPE: Retrospective. POPULATION: In all, 119 patients (66 females; age 66.9 ± 12.4 years) with failed THA. FIELD STRENGTH/SEQUENCES: Metal artifact reduction sequence (MARS) protocol including short tau inversion recovery and turbo spin-echo T1 - and T2 -weighted sequences at 1.5T. ASSESSMENT: Patients underwent pelvis MRI prior to failed THA revision. MRIs were reviewed to identify periprosthetic bone destruction, soft-tissue mass, effusion, synovitis, lamellated synovitis, extracapsular edema, fibrous periprosthetic membrane, bone edema, and extracapsular collection/sinus tract. The number and maximum diameter of inguinal, obturator and iliac lymph nodes of the affected hip were assessed and normalized to those of the unaffected hip to calculate the ratio of nodal size (RNS), ratio of node number (RNN), difference of nodal size (DNS), and difference of node number (DNN). STATISTICAL TESTS: The Mann-Whitney U-and chi-square test were used. Diagnostic performance of indices and odds ratios (OR) were calculated. RESULTS: RNS, RNN, DNS, and DNN indices were significantly different (P = 0.000) between infected and noninfected THA, with accuracies ranging from 84.8% (RNS) and 93.1% (RNN). All other MRI features were significantly more prevalent in infected THA (P ≤ 0.002), except bone destruction, periarticular soft-tissue mass, and fibrous membrane (P ≥ 0.031). Sensitivities ranged from 7.9% (soft-tissue mass) to 76.3% (effusion/bone edema), specificity from 45.7% (bone destruction) to 97.5% (synovitis/lamellated synovitis), accuracy from 49.6% (bone destruction) to 81.5% (synovitis), OR from 0.261 (soft-tissue mass) to 35.550 (synovitis). DATA CONCLUSION: Conventional MRI features have limited accuracy to differentiate septic and aseptic THA failure. Lymph nodal indices, particularly those related to nodal number, may represent biomarkers of THA infection. EVIDENCE LEVEL: 3 TECHNICAL EFFICACY STAGE: 2.
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Artroplastia de Reemplazo de Cadera , Linfadenopatía , Anciano , Artroplastia de Reemplazo de Cadera/efectos adversos , Femenino , Articulación de la Cadera , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
Joint motion and postnatal stress of weight bearing are the principal factors that determine the phenotypical and architectural changes that characterize the maturation process of the meniscus. In this study, the effect of compressive forces on the meniscus will be evaluated in a litter of 12 Dobermann Pinschers, of approximately 2 months of age, euthanized as affected by the quadriceps contracture muscle syndrome of a single limb focusing on extracellular matrix remodeling and cell-extracellular matrix interaction (i.e., meniscal cells maturation, collagen fibers typology and arrangement). The affected limbs were considered as models of continuous compression while the physiologic loaded limbs were considered as controls. The results of this study suggest that a compressive continuous force, applied to the native meniscal cells, triggers an early maturation of the cellular phenotype, at the expense of the proper organization of collagen fibers. Nevertheless, an application of a compressive force could be useful in the engineering process of meniscal tissue in order to induce a faster achievement of the mature cellular phenotype and, consequently, the earlier production of the fundamental extracellular matrix (ECM), in order to improve cellular viability and adhesion of the cells within a hypothetical synthetic scaffold.
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Fuerza Compresiva/fisiología , Matriz Extracelular/fisiología , Menisco/fisiología , Animales , Fenómenos Biomecánicos , ADN/metabolismo , Perros , Módulo de Elasticidad , Glicosaminoglicanos/metabolismo , Imagen por Resonancia Magnética , Menisco/diagnóstico por imagenRESUMEN
Several radiological indices were introduced to evaluate cast adequacy for paediatric distal forearm fractures: cast, gap, padding, Canterbury (reflecting the cast shape and the amount of padding) and three-point indices, and second metacarpal-radius angle (measuring cast ulnar-moulding). The aim of this study is to define which index is most reliable in assessing cast adequacy and predicting redisplacements. Hundred twenty-four consecutive patients (age 5-18) affected by distal both-bone forearm or radius fractures treated with casting were included. These indices and the displacement angles were calculated on the initial radiograph after reduction. Radiographs at 7 and 30 days were taken to assess if the loss of reduction occurred, and measure the displacement deltas (displacement angle at day 30 - displacement angle at day 0). Student's t-test, Chi-square test and Pearson's correlation were used for the statistical analysis. High padding (P = 0.034), Canterbury (P = 0.002) and Cast (P < 0.001) indices showed an association with redisplacements in distal forearm fractures. Both-bone forearm fractures have a higher risk of loss of reduction than radius fractures [odds ratio (OR = 4.99, 95% confidence interval (CI) = 2.21-11.3, P < 0.001]. A higher displacement delta in antero-posterior (Pearson's r = 0.418, P = 0.037) and lateral (P = 0.045) views for both-bone fractures showed an association with a high gap Index. Regarding radius fractures, a high cast index is associated with a higher displacement delta in antero-posterior (P = 0.035). The three-point index and the second metacarpal-radius angle did not show any association with the redisplacement risk. Cast oval moulding without excessive padding may prevent redisplacements in paediatric distal forearm fractures, while casts ulnar-moulding does not.
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Moldes Quirúrgicos , Fracturas del Radio/cirugía , Fracturas del Cúbito/cirugía , Adolescente , Niño , Preescolar , Femenino , Fijación de Fractura , Curación de Fractura , Humanos , Masculino , Complicaciones Posoperatorias , Fracturas del Radio/diagnóstico por imagen , Rango del Movimiento Articular , Estudios Retrospectivos , Fracturas del Cúbito/diagnóstico por imagenRESUMEN
The aims of this paper are to illustrate the trend towards data sharing, i.e. the regulated availability of the original patient-level data obtained during a study, and to discuss the expected advantages (pros) and disadvantages (cons) of data sharing in radiological research. Expected pros include the potential for verification of original results with alternative or supplementary analyses (including estimation of reproducibility), advancement of knowledge by providing new results by testing new hypotheses (not explored by the original authors) on pre-existing databases, larger scale analyses based on individual-patient data, enhanced multidisciplinary cooperation, reduced publication of false studies, improved clinical practice, and reduced cost and time for clinical research. Expected cons are outlined as the risk that the original authors could not exploit the entire potential of the data they obtained, possible failures in patients' privacy protection, technical barriers such as the lack of standard formats, and possible data misinterpretation. Finally, open issues regarding data ownership, the role of individual patients, advocacy groups and funding institutions in decision making about sharing of data and images are discussed. KEY POINTS: ⢠Regulated availability of patient-level data of published clinical studies (data-sharing) is expected. ⢠Expected benefits include verification/advancement of knowledge, reduced cost/time of research, clinical improvement. ⢠Potential drawbacks include faults in patients' identity protection and data misinterpretation.
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Investigación Biomédica/métodos , Difusión de la Información/métodos , Radiología/tendencias , Investigación Biomédica/tendencias , Confidencialidad , Bases de Datos Factuales , Femenino , Humanos , Publicación de Acceso Abierto , Reproducibilidad de los ResultadosRESUMEN
This review article highlights the role of radiological and nuclear medicine techniques in diagnosis of musculoskeletal infections with particular regard to hybrid imaging of osteomyelitis, prosthetic joint infections, sternal infections and spine infections. Authors conclude on the complementary role of the several techniques with indications for an appropriate diagnostic flow chart, in the light of the recent European Association of Nuclear Medicine guidelines on infection.
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Infecciones/diagnóstico por imagen , Imagen Multimodal/métodos , Enfermedades Musculoesqueléticas/diagnóstico por imagen , Humanos , Medicina NuclearRESUMEN
Vernillo, G, Pisoni, C, Sconfienza, LM, Thiébat, G, and Longo, S. Changes in muscle architecture of vastus lateralis muscle after an alpine snowboarding race. J Strength Cond Res 31(1): 254-259, 2017-This study aimed to assess acute changes of vastus lateralis (VL) muscle architecture after an alpine snowboarding simulated race and to compare architecture characteristics between the front and rear legs on elite alpine snowboarders. Using ultrasonography, VL muscle thickness (MT), pennation angles (θ), and fascicle lengths (Lf) were assessed in 8 elite alpine snowboarders (25.6 ± 4.4 years; stature: 178.4 ± 9.8 cm; body mass: 78.1 ± 12.1 kg) before and directly after an alpine snowboarding simulated race under competition rules. Muscle thickness, θ, and Lf showed no meaningful changes (P > 0.05, differences reported as trivial) after the race for both legs. The rear leg tended to have a 14.0% lower θ (P = 0.04, differences rated as moderate) and a 13.6% higher Lf (P = 0.04, differences rated as moderate) compared with the front leg. Changes in muscle architecture are not observable immediately after an alpine snowboarding simulated race. The â¼14.0% difference in muscle architecture between the front and the rear leg suggests the presence of a morphological asymmetry in elite alpine snowboarders with direct implications for injury prevention and training prescription.