Validation of Ottawa ankle rules protocol in Greek athletes: study in the emergency departments of a district general hospital and a sports injuries clinic.
(25/471)
OBJECTIVE: To validate the Ottawa ankle rules protocol for predicting ankle and midfoot fractures in Greek athletes. METHOD: A prospective survey in the emergency departments of a district general hospital and a sports injury clinic in Greece over nine months. A clinical evaluation was made of 122 patients with acute ankle and/or midfoot injury, and then radiographs were taken. RESULTS: Nine ankle and eight midfoot fractures were detected. The sensitivity of the Ottawa ankle rules protocol in predicting fractures in both the malleolar and midfoot zones was 100%. The negative predictive value for each of these areas was also 1.0. Specificity was estimated to be 0.3 for ankle fractures and 0.4 for midfoot fractures. Positive predictive values were 0.16 and 0.28 respectively. A possible reduction of up to 28.7% was found in the need for radiography. CONCLUSIONS: Use of the Ottawa ankle rules protocol in evaluating injured Greek athletes resulted in 100% sensitivity when performed by orthopaedic residents or sports medicine doctors, and had the potential to reduce the use of radiography. (+info)
Classification of radiological appearance and the derivation of a numerical score.
(26/471)
Approaches to the use of the International Labour Office U/C Classification of radiological appearances are considered in the context of multiple readers recording different degrees of abnormality. The Panel on Survey Radiology has been set up to provide a basis for standardization. An example of how the panel may be used in this role is given. The approach will depend on the standards maintained by the panel and on a greater understanding of the appearances associated with differing exposures. (+info)
Breast cancer mortality among female radiologic technologists in the United States.
(27/471)
We evaluated breast cancer mortality through 1997 among 69 525 female radiologic technologists who were certified in the United States from 1926 through 1982 and who responded to our questionnaire. Risk of breast cancer mortality was examined according to work history and practices and was adjusted for known risk factors. Breast cancer mortality risk was highest among women who were first employed as radiologic technologists prior to 1940 (relative risk [RR] = 2.92, 95% confidence interval [CI] = 1.22 to 7.00) compared with risk of those first employed in 1960 or later and declined with more recent calendar year of first employment (P for trend =.002). Breast cancer mortality risk increased with increasing number of years of employment as a technologist prior to 1950 (P for trend =.018). However, risk was not associated with the total number of years a woman worked as a technologist. Technologists who first performed fluoroscopy (RR = 1.69, 95% CI = 1.02 to 3.11) and multifilm procedures (RR = 1.87, 95% CI = 1.04 to 3.34) before 1950 had statistically significantly elevated risks compared with technologists who first performed these procedures in 1960 or later. The high risks of breast cancer mortality for women exposed to occupational radiation prior to 1950 and the subsequent decline in risk are consistent with the dramatic reduction in recommended radiation exposure limits over time. (+info)
Meniscal and articular cartilage changes in knee osteoarthritis: a cross-sectional double-contrast macroradiographic study.
(28/471)
OBJECTIVE: In knee osteoarthritis (OA) damage to meniscal cartilage is associated with the changes in articular cartilage. Using double-contrast macroradiographs we determined whether the degree of meniscal cartilage damage was similar to or different from that at the corresponding regions of the articular cartilage on the tibia and femur. DESIGN: Double-contrast microfocal macroradiographs,x7-x9 magnification, were obtained of the tibio-femoral joint in 20 osteoarthritic knee patients with medial compartment disease (Kellgren and Lawrence grades I-III). The appearance of the meniscus and the femoral and tibial articular cartilage were graded separately using a 5-point scale. RESULTS: In the medial diseased compartment, articular cartilage damage on the tibia was similar to that of the meniscus, which had significantly greater (P<0.02) degenerative changes than the cartilage on the femur. In the lateral compartment, meniscal damage was significantly worse than in either tibial (P<0.04) or femoral articular cartilages (P<0.01), respectively; none was as severe as that in the medial osteoarthritic compartment. CONCLUSION: Although the cross-sectional nature of this study precluded definite aetiological inferences, this study showed that degenerative changes in the meniscal and articular cartilages were not totally variable. Because of its larger articular surface, changes in the medial femoral cartilage were less marked than at the meniscal and tibial cartilages in the osteoarthritic compartment. In the lateral compartment, meniscal damage precedes tibial and femoral articular cartilage changes. In knees with medial compartment OA, combined meniscal and articular cartilage damage would account for detection of radiographic joint space loss and not meniscal extrusion only. (+info)
Evaluation of radiography, ultrasonography and endoscopy for detection of shell lesions in live abalone Haliotis iris (Mollusca: Gastropoda).
(29/471)
Radiography, ultrasonography and endoscopy were examined for their efficacy as non-destructive techniques for the detection of shell lesions in the marine gastropod Haliotis iris Gmelin. X-rays provided 69% correct diagnoses, with detection being restricted to those lesions which were mineralised. Ultrasound also showed potential to reliably detect lesions (83% correct diagnoses), but only where the lesions demonstrated a clear 3-dimensional relief. Lesion dimensions were underestimated using ultrasound. Endoscopy, applied to anaesthetised individuals, provided the most accurate method (92% correct diagnoses) for lesion detection and, although invasive, had no discernible effect on survival of the abalone 8 mo after screening. (+info)
The Ionising Radiation (Medical Exposure) regulations (IRME) 2000--radiological considerations.
(30/471)
1) IRME regulations apply to the trust and not to the individual clinician. 2) Each trust must have written regulations outlining how the IRME regulations are to be applied locally. 3) The IRME regulations and, almost certainly, the local directions, have the force of the law and breaches may be dealt with by both the criminal and the civil courts. 4) All radiological examinations using ionising radiation must be reported either by a radiologist or a clinician, and the report must be filed in the patient's case notes. 5) It is unlawful to request a radiological examination if it is not to be reported. 6) No regulation mentions the quality or timeliness of the radiological report. (+info)
True aneurysm of a thumb digital artery in a radiographer: a case report.
(31/471)
True aneurysms of the digital artery are very rare. We report a case of true aneurysm of a proper digital artery of the right thumb in a radiographer. Treatment by ligation and excision resulted in complete relief of symptoms. (+info)
Congenital dislocation of the hip.
(32/471)
Congenital dislocation or subluxation of the hip (congenital acetabular dysplasia) is a complete or partial displacement of the femoral head out of the acetabulum. The physical signs essential for diagnosis are age related. In newborns the tests for instability are the most sensitive. After the neonatal period, and until the age of walking, tightness of the adductor muscles is the most reliable sign. Early diagnosis is vital for successful treatment of this partially genetically determined condition. Various therapeutic measures, ranging from abduction splinting to open reduction and osteotomy, may be required. Following diagnosis in the first month of life, the average treatment time in one recent series was only 2.3 months from initiation of therapy to attainment of a normal hip. When the diagnosis was not made until 3 to 6 months of age, ten months of treatment was required to achieve the same outcome. When the diagnosis is not made, or the treatment is not begun until after the age of 6, a normal hip will probably not develop in any patient. (+info)