Magnetic resonance imaging evaluation of patients with clinically diagnosed medial Epicondylitis.

OBJECTIVE: We evaluated magnetic resonance imaging (MRI) findings in patients with clinically diagnosed medial epicondylitis (ME) and determined whether any of the MRI findings correlated with the follow-up pain level after nonoperative treatment. MATERIALS AND METHODS: We retrospectively reviewed 83 patients who had undergone elbow MRI examinations for clinically diagnosed ME and who were followed-up for more than 6 months. Five categories of MRI findings were selected for qualitative grading: common flexor tendon (CFT) origin signal changes, ulnar collateral ligament (UCL) insufficiency, ulnar neuritis, bony changes of the medial epicondyle, and calcification. The mean follow-up after MRI examination was 21 months. We performed multivariate regression analysis to analyze whether any of these MRI findings were associated with the follow-up pain level after nonoperative treatment. RESULTS: Positive MRI findings included CFT origin signal changes (66%), ulnar neuritis (40%), UCL insufficiency (30%), calcification (27%), and bony changes (18%). Multivariate analysis indicated that CFT origin signal changes were independently associated with the follow-up pain level (ß = 3.387; p = 0.004). CONCLUSION: In patients with clinically diagnosed ME, MRI demonstrated diverse abnormal findings in the CFT origin, ulnar collateral ligament, ulnar nerve, and bone. Among the findings, the severity CFT origin signal changes, which indicates the severity of tendon degeneration in ME, was associated with the follow-up pain level. This information can be helpful in consulting on the prognosis of nonoperative treatment in patients with clinically diagnosed ME.

Correction: Effects of walking speed and slope on pedobarographic findings in young healthy adults.

[This corrects the article DOI: 10.1371/journal.pone.0220073.].

Inverse Relationship Between Radiographic Lateral Ankle Instability and Osteochondral Lesions of the Talus in Patients With Ankle Inversion Injuries.

BACKGROUND: Insufficient or excessive bony constraint surrounding the talus might contribute to the occurrence of ligamentous injury or bone contusion, respectively, at the time of ankle inversion injuries. This study aimed to investigate the relationship between radiographic lateral ankle instability and osteochondral lesions of the talus (OLT) following ankle inversion injuries. METHODS: A total of 195 patients (113 men and 83 women; mean age, 38.7 years) with a history of ankle inversion injuries were included in this study. All patients underwent ankle magnetic resonance imaging (MRI) and stress radiography. The tibiotalar tilt angle on varus stress radiograph, anterior translation of the talus on anterior-drawer lateral radiographs, bimalleolar tilt angle, and fibular position were radiographically determined. The radiographic lateral ankle instability was defined as tibiotalar tilt angle ≥10 degrees, and the presence of OLT was confirmed on MR images. The relationship between the radiographic lateral ankle instability and the presence of OLT was statistically analyzed. RESULTS: The presence of radiographic lateral ankle instability (tibiotalar tilt angle ≥10 degrees) showed an inverse relationship with that of OLT in the chi-squared test (P = .003). An increased tibiotalar tilt angle was associated with lower incidence of OLT (P = .011) in the multiple regression analysis, and the presence of OLT was associated with a decreased tibiotalar tilt angle (P = .016) in the binary logistic regression analysis. CONCLUSIONS: This study showed an inverse relationship between lateral ankle instability and the development of OLT following ankle inversion injury. The role of bony constraint in the development of sports injuries in the ankle should be considered with these injuries. LEVEL OF EVIDENCE: Level III, diagnostic, comparative study.

Effects of walking speed and slope on pedobarographic findings in young healthy adults.

BACKGROUND: This study aimed to investigate the effects of walking speed and slope on foot pressure changes in young healthy adults. METHODS: Twenty young healthy adults (mean age 22.4 years, SD 1.2 years; 10 male and 10 female) participated in the study. Dynamic pedobarographic data during treadmill walking were obtained for combinations of three different walking speeds (3.2 km/hr, 4.3 km/hr, and 5.4 km/hr) and 5 different slopes (downhill 8 degrees, downhill 4 degrees, ground walking (0 degree), uphill 4 degrees, and uphill 8 degrees). Pedobarographic data such as the peak pressure and pressure-time integral were measured on five plantar segments: medial forefoot (MFF), lateral forefoot (LFF), medial midfoot (MMF), lateral midfoot (LMF), and heel. Maximum ankle dorsiflexion was also recorded using the Plug in Gait marker set. RESULTS: All participants maintained heel-toe gait in all walking conditions. The peak pressure on the MFF during downhill slope walking was lower than that during ground and uphill walking, whereas the peak pressure on the MFF during uphill slope walking was similar to that during ground walking at each walking speed. The peak pressures on the heel were similar for different walking slopes at each walking speed. The peak pressures on the MFF and heel increased with an increase in walking speed. The pressure-time integral of the MFF did not show significant changes at different walking speeds and slopes. The pressure-time integral of the heel increased with an increase in walking slope and decrease in walking speed. CONCLUSIONS: Different walking speeds and slopes affected the pedobarographic characteristics of young healthy adults. Downhill walking with slower speed appeared to be beneficial to reduce or optimize MFF pressures, while downhill walking at a comfortable speed would be helpful to reduce or optimize heel pressures. The findings of this study have clinical implications in recommending activities to patients with foot pressure-related symptoms and disorders.

Is Redo Vertebroplasty an Effective Treatment on the Same Vertebra?

OBJECTIVE: Redo vertebroplasty is rarely reported. Previous studies on redo vertebroplasty included a small number of patients and lacked radiographic analysis. The purpose of this study was to assess the radiographic outcomes (restoration of vertebral body) and clinical outcomes (pain relief) in patients with recurrent or unrelieved pain after vertebroplasty with a minimum follow-up duration of 12 months. MATERIALS AND METHODS: The records of 22 patients (23 cases), who underwent redo vertebroplasty between March 2001 and February 2014, were analyzed. Vertebral height loss (VHL) and wedge angle (WA) were measured before and after redo vertebroplasty. Subjective back pain was assessed via the numeric rating scale (NRS) score. RESULTS: VHL after the initial vertebroplasty was 18.7%. Preoperative and final VHL of redo vertebroplasty were 32.3 and 18.3%, respectively. WA after initial vertebroplasty was 9.5°. Preoperative and final WA of redo vertebroplasty was 13.9° and 9°, respectively. Changes of VHL and WA values at each time point were significant (p < 0.01). The change of NRS pain score at each time point, including the period between post-initial vertebroplasty and final follow-up, was statistically significant (p < 0.01); 18 patients (82%) showed marked pain relief and 4 patients (18%) showed partial pain relief. CONCLUSIONS: Redo vertebroplasty seems to be an effective way to achieve pain relief and vertebral body height restorations without major complications in patients with unrelieved or recurrent back pain after vertebroplasty. LEVEL OF EVIDENCE: Level 4, case series.

G-Channel Restoration for RWB CFA with Double-Exposed W Channel.

In this paper, we propose a green (G)-channel restoration for a red-white-blue (RWB) color filter array (CFA) image sensor using the dual sampling technique. By using white (W) pixels instead of G pixels, the RWB CFA provides high-sensitivity imaging and an improved signal-to-noise ratio compared to the Bayer CFA. However, owing to this high sensitivity, the W pixel values become rapidly over-saturated before the red-blue (RB) pixel values reach the appropriate levels. Because the missing G color information included in the W channel cannot be restored with a saturated W, multiple captures with dual sampling are necessary to solve this early W-pixel saturation problem. Each W pixel has a different exposure time when compared to those of the R and B pixels, because the W pixels are double-exposed. Therefore, a RWB-to-RGB color conversion method is required in order to restore the G color information, using a double-exposed W channel. The proposed G-channel restoration algorithm restores G color information from the W channel by considering the energy difference caused by the different exposure times. Using the proposed method, the RGB full-color image can be obtained while maintaining the high-sensitivity characteristic of the W pixels.

Color Restoration of RGBN Multispectral Filter Array Sensor Images Based on Spectral Decomposition.

A multispectral filter array (MSFA) image sensor with red, green, blue and near-infrared (NIR) filters is useful for various imaging applications with the advantages that it obtains color information and NIR information simultaneously. Because the MSFA image sensor needs to acquire invisible band information, it is necessary to remove the IR cut-offfilter (IRCF). However, without the IRCF, the color of the image is desaturated by the interference of the additional NIR component of each RGB color channel. To overcome color degradation, a signal processing approach is required to restore natural color by removing the unwanted NIR contribution to the RGB color channels while the additional NIR information remains in the N channel. Thus, in this paper, we propose a color restoration method for an imaging system based on the MSFA image sensor with RGBN filters. To remove the unnecessary NIR component in each RGB color channel, spectral estimation and spectral decomposition are performed based on the spectral characteristics of the MSFA sensor. The proposed color restoration method estimates the spectral intensity in NIR band and recovers hue and color saturation by decomposing the visible band component and the NIR band component in each RGB color channel. The experimental results show that the proposed method effectively restores natural color and minimizes angular errors.