RESUMEN
O prolapso uretral, o qual é incomum em cães, se caracteriza pela protusão da mucosa uretral além da extremidade do pênis e do orifício externo da uretra. Pode ocorrer por causas congênitas ou adquiridas, tendo maior incidência em animais jovens não castrados. O objetivo do presente trabalho é relatar um caso de prolapso uretral em um cão não castrado da raça American Bully Terrier, de dois anos, o qual foi atendido na Universidade Estácio de Sá localizada no Rio de Janeiro com histórico de lambedura excessiva do pênis, disúria, sangramento prepucial e protrusão da mucosa uretral após tentativa de cópula. Durante a avaliação física o animal apresentou todos os parâmetros clínicos dentro da normalidade, entretanto demonstrava agitação excessiva e dor na região afetada. Então, o diagnóstico foi definido por meio da inspeção direta da visualização da mucosa uretral protusa. Frente ao quadro clínico e físico do animal, foi adotado o procedimento cirúrgico de ressecção e anastomose da porção uretral prolapsada. Desta forma, conclui-se que esta técnica cirúrgica se mostrou eficaz, visto que o referido paciente apresentou ótima recuperação e cicatrização uretral, sem quaisquer sinais de complicações pós-cirúrgicas.
Urethral prolapse, which is uncommon in dogs, is characterized by protrusion of the urethral mucosa beyond the tip of the penis and the external orifice of the urethra. It can occur due to congenital or acquired causes, with a higher incidence in young animals not castrated. The present study aims to report a case of urethral prolapse in a non-castrated dog of 2 years old (American Bully Terrier), which was treated at the Estácio de Sá University located in Rio de Janeiro city, with a history of excessive penis licking, dysuria, prepucial bleeding, and protrusion of the urethral mucosa after an attempt of copulation. During the physical evaluation, the animal presented all clinical parameters within the normal range; however, it showed excessive agitation and pain in the affected region. Then, the diagnosis was defined through direct inspection of the visualization of the protruding urethral mucosa. Given the animal's clinical and physical condition, the surgical procedure of resection and anastomosis of the prolapsed urethral portion was adopted. Therefore, it is concluded that this surgical technique proved to be effective since the patient presented excellent recovery and urethral healing, without any signs of post-surgical complications.
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Animales , Masculino , Perros , Prolapso , Uretra/cirugía , Uretra/patología , Anastomosis Quirúrgica/veterinaria , Disuria/veterinariaRESUMEN
OBJECTIVE: To describe the occurrence of imaging-depicted sports-related injuries (bone, muscle, tendon, and ligament injuries) during the Rio 2016 Summer Paralympic Games. METHODS: Descriptive data on all imaging examinations by using radiography, ultrasonography (US), and MRI were collected and retrospectively analyzed centrally by five musculoskeletal radiologists according to imaging modality, country of origin of the athletes, type of sport, type of disability, and type and location of injury. RESULTS: We report 109 injuries in 4378 athletes. A total of 382 radiologic examinations were performed in 261 athletes, including 118 (31%) radiographic, 22 (6%) US, and 242 (63%) MRI examinations. Para athletes from Africa had the highest utilization rate (20.1%, 67 out of 333). Athletes from Europe underwent the most examinations with 29 radiographic, 12 US, and 66 MRI examinations. The highest utilization rate of imaging modalities by sport was among Judo para athletes (16.7%, 22 out of 132). Most injuries were reported in athletics discipline (37.6%, 41 out of 109). Most injuries were also reported among para athletes with visual impairment (40 injuries, 36.7% of all injuries). Bone stress injuries were most common among para athletes with visual impairment (6 out of 7). Para athletes with visual impairment were also more prone to bone stress injuries than traumatic fractures, unlike para athletes with neurologic and musculoskeletal impairments. CONCLUSIONS: Imaging was used in 6.0% of para athletes. MRI comprised 63% of imaging utilization. Identification of patterns of injuries may help building future prevention programs in elite para athletes. KEY POINTS: ⢠The highest imaging utilization rates were found among para athletes competing in Judo, sitting volleyball, powerlifting, and football. ⢠Utilization of diagnostic imaging at the Rio 2016 Paralympic Games demonstrated similar trends to what was observed at the Rio 2016 Olympic Games. ⢠Comparison of the rate of imaging-depicted injuries between Olympic and Paralympic athletes is limited due to inherent differences between the two athlete populations and the manner in which injury risk in the Paralympic athlete varies dependent on impairment type, which is not the case for the Olympic athlete.
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Traumatismos en Atletas , Atletas , Traumatismos en Atletas/diagnóstico por imagen , Traumatismos en Atletas/epidemiología , Huesos , Brasil/epidemiología , Humanos , Estudios Retrospectivos , UltrasonografíaRESUMEN
ANTECEDENTES: La encefalopatía posterior reversible se relaciona con enfermedades hipertensivas del embarazo, con clínica inespecífica. El diagnóstico se realiza mediante resonancia magnética y electroencefalograma, y el tratamiento oportuno evita complicaciones. CASO CLÍNICO: Primigesta de 15 años con embarazo pretérmino, hipertensión arterial y convulsiones tónico-clónicas, que desarrolló encefalopatía posterior atípica con múltiples lesiones cerebrales. Se administraron antihipertensivos, sin mejoría de los síntomas neurológicos. El manejo de esta patología depende de la situación desencadenante, no existe evidencia suficiente del soporte con medidas antiedema preventivas en pacientes con factores de riesgo. El retraso en el tratamiento oportuno y la presentación atípica favorecen la progresión de las secuelas neurológicas. BACKGROUND: Reversible posterior encephalopathy is related to hypertensive diseases of pregnancy, with a nonspecific clinic. The diagnosis is made by magnetic resonance and electroencephalogram, appropriate treatment prevents complications. . CASE REPORT: 15-year-old primigesta with preterm pregnancy, arterial hypertension and tonic-clonic seizures, presents atypical posterior encephalopathy with multiple brain lesions, antihypertensives were administered without improvement of neurological symptoms. The management of this pathology depends on the triggering situation, there is insufficient evidence to support preventive anti-edema measures in patients with risk factors. The delay in timely treatment and atypical presentation favors the progression of neurological sequelae.
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Encefalopatías , Eclampsia , Hipertensión , Adolescente , Eclampsia/diagnóstico , Eclampsia/tratamiento farmacológico , Femenino , Humanos , Hipertensión/etiología , Recién Nacido , Embarazo , Factores de RiesgoRESUMEN
Background: This study analyzes the current and evolving physical rehabilitation needs of BRICS nations (Brazil, Russian Federation, India, China, South Africa), a coalition of large emergent economies increasingly important for global health. Methods: Secondary, cross-national analyses of data on Years Lived with Disability (YLDs) were extracted from the Global Burden of Disease Study 2017. Total physical rehabilitation needs, and those stratified per major condition groups are analyzed for the year 2017 (current needs), and for every year since 1990 (evolution over time). ANOVAs are used to detect significant yearly changes. Results: Total physical rehabilitation needs have increased significantly from 1990 to 2017 in each of the BRICS nations, in every metric analyzed (YLD Counts, YLDs per 100,000 people, and percentage of YLDs relevant to physical rehabilitation; all p < 0.01). Musculoskeletal & pain conditions were leading cause of physical rehabilitation needs across the BRICS nations but to varying degrees: from 36% in South Africa to 60% in Brazil. Country-specific trends include: 25% of South African needs were from HIV-related conditions (no other BRICS nation had more than 1%); India had both absolute and relative growths of pediatric rehabilitation needs (p < 0.01); China had an exponential growth in the per-capita needs from neurological and neoplastic conditions (p < 0.01; r2 = 0.97); Brazil had a both absolute and relative growth of needs coming from musculoskeletal & pain conditions (p < 0.01); and the Russian Federation had the highest neurological rehabilitation needs per capita in 2017 (over than three times those of India, South Africa or Brazil). Conclusions: total physical rehabilitation needs have been increasing in each of the BRICS nations, both in absolute and relative values. Apart from the common growing trend, each of the BRICS nations had own patterns for the amount, typology, and evolution of their physical rehabilitation needs, which must be taken into account while planning for health and physical rehabilitation programs, policies and resources.
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Carga Global de Enfermedades , Brasil/epidemiología , Niño , China/epidemiología , Humanos , India , Federación de Rusia , Sudáfrica/epidemiologíaRESUMEN
Foot-and-mouth disease (FMD) is one of the most contagious veterinary viral diseases known, having economic, social and potentially devastating environmental impacts. The vaccines currently being marketed/sold around the world for disease control and prevention in bovines do not stimulate the production of antibodies having crossed reactions to different serotypes. This means that if an animal becomes infected by a serotype which has not been included in a vaccine then it will develop the disease. Synthetic peptide vaccines represent a safer option and (depending on the design) can stimulate antibodies protecting against different variants. Based on the forgoing, this work was aimed at evaluating FMDV VP1, VP2 and VP3 protein-derived, modified and chemically-synthesised peptides' ability to induce an immune response for developing a vaccine contributing towards controlling the disease. VP1, VP2 and VP3 proteins' conserved regions were selected for this. Peptides from these regions were chemically synthesised; binding assays were then carried out for ascertaining whether they were involved in BHK-21 cell binding. Selected peptides' structure and location were studied. Peptides which did bind were modified and formulated with Montanide ISA 70 adjuvant; 17 animals were immunised twice with the formulation. The animals were genotyped by amplifying the BoLA-DRB3.2 gene. Blood samples were taken from 17 cattle on day 43 post-first immunisation for studying the formulation's immunogenicity. The sera were used in ELISA, immunofluorescence, flow cytometry, immunoadsorption and seroneutralisation assays. The A24 Cruzeiro and O1 Campos virus serotypes were used for these assays. The results revealed that even though protein exposure and 3D structure might be different amongst serotypes, the antibodies so produced could inhibit virus entry to cells, thereby showing the selected peptides' in vitro protection-inducing ability.
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Virus de la Fiebre Aftosa , Fiebre Aftosa , Péptidos , Vacunas Virales , Animales , Anticuerpos Antivirales , Proteínas de la Cápside/genética , Bovinos , Fiebre Aftosa/prevención & control , Virus de la Fiebre Aftosa/inmunologíaRESUMEN
OBJECTIVE: To describe the frequency and the distribution of degenerative disc disease (DDD) detected in athletes who underwent spine MRI in the 2016 Summer Olympic Games in Rio de Janeiro. METHODS: Data on spine MRI examinations from the 2016 Summer Olympics were retrospectively analyzed. We assessed the frequency of DDD of the cervical (Cs), thoracic (Ts), and lumbar (Ls) spine using Pfirrmann's classification. Grade II and III were considered as mild, grade IV as moderate, and grade V as severe disc degeneration. Data were analyzed according to the location of the degenerative disc, type of sport, age-groups, and gender of the athletes. RESULTS: One hundred out of 11,274 athletes underwent 108 spine MRI's (21 C, 6 T, and 81 L) (53% Females (F), 47% Males (M)). The frequency of DDD was 40% (42% F, 58% M) over the entire spine (28% mild, 9% moderate and 3% severe). There were 58% (12%F, 88%M) of the cervical spine discs that showed some degree of degeneration (44% mild, 13.5% moderate and 1% severe). Athletics, Boxing, and Swimming were the sports most affected by DDD in the Cs. There were 12.5% of the thoracic discs that showed some degree of degeneration, all were mild DDD and were exclusively seen in female athletes. There were 39% (53% F, 47% M) of the lumbar discs with DDD (26% mild, 9% moderate, and 4% severe). CONCLUSION: Athletes who underwent spine MRI during the 2016 Summer Olympic Games show a high frequency of DDD of cervical and lumbar spines. Recognition of these conditions is important to develop training techniques that may minimize the development of degenerative pathology of the spine.
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Traumatismos en Atletas/diagnóstico por imagen , Traumatismos en Atletas/epidemiología , Degeneración del Disco Intervertebral/diagnóstico por imagen , Degeneración del Disco Intervertebral/epidemiología , Imagen por Resonancia Magnética/métodos , Deportes , Adulto , Atletas , Brasil/epidemiología , Vértebras Cervicales/diagnóstico por imagen , Femenino , Humanos , Vértebras Lumbares/diagnóstico por imagen , Masculino , Estudios Retrospectivos , Vértebras Torácicas/diagnóstico por imagen , Adulto JovenRESUMEN
We collected 729 Hypanus guttatus from the northern coast of the state of Rio Grande do Norte (RN), of which 196 were used to estimate age and growth. Ninety-five were male (12.7 to 57.0 cm disc width; WD ) and 101 were female (13.0 to 88.5 cm WD ); females were significantly larger than males. Cross sections of vertebrae showed band-pairs ranging from 0 to > 14 in females and from 0 to 9 in males. New-borns presented an opaque edge at birth in vertebrae without a birthmark. The average percentage of error (APE; %E) for the entire sample provided evidence that ages were repeatable. The mean monthly marginal increment (IM ) indicates annual band-pair formation from August to November. The annual cycle model for one band-pair deposition provided the best fit to data based on the AIC, with peaks between August and October, similar to that found in the IM analysis, suggesting an annual formation pattern. A multi-model approach that included four models based on the observed mean WD at age indicated a modified von Bertalanffy growth model as the best for describing the species growth: W0 (WD at birth) = 14.6 cm for both sexes; females W∞ = 98.61 cm (95% CI = 87.34-114.61 cm); k = 0.112 year-1 (CI = 0.086-0.148 year-1 ); males W∞ = 60.22 cm (CI = 55.66-65.35 cm); k = 0.219 year-1 (CI = 0.185-0.276 year-1 ). The age-at-maturity in males and females is 5 years and 7 years, respectively. The age composition shows that most (84%) specimens were aged 0 to 2 years. The information provided here is essential for analytical assessments of H. guttatus, which is subject to significant fishing pressure mainly on new-borns and juveniles.
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Distribución por Edad , Explotaciones Pesqueras/estadística & datos numéricos , Rajidae/crecimiento & desarrollo , Determinación de la Edad por el Esqueleto , Animales , Tamaño Corporal , Brasil , Femenino , Masculino , Periodicidad , Columna Vertebral/crecimiento & desarrolloRESUMEN
OBJECTIVE: The purpose of this article is to describe knee abnormalities and the occurrence of MRI-detected sports-related knee abnormalities by evaluating MRI examinations performed during the Rio de Janeiro Olympic Games held in August 2016. CONCLUSION: There were 11,274 athletes at the Rio 2016 Olympic Games, and 113 of them underwent at least one knee MRI in the Olympic Village. Cartilage abnormalities, followed by meniscal tears and ligament sprains, were the most frequent abnormalities.
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Traumatismos en Atletas/diagnóstico por imagen , Traumatismos de la Rodilla/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Deportes/estadística & datos numéricos , Adulto , Traumatismos en Atletas/epidemiología , Brasil/epidemiología , Femenino , Humanos , Traumatismos de la Rodilla/epidemiología , MasculinoRESUMEN
BACKGROUND: To use Magnetic Resonance Imaging (MRI) to characterize the severity, location, prevalence, and demographics of shoulder injuries in athletes at the Rio de Janeiro 2016 Summer Olympic Games. METHODS: This was a retrospective analysis of all routine shoulder MRIs obtained from the Olympic Village Polyclinic during the Rio 2016 Summer Olympics. Imaging was performed on 1.5 T and 3 T MRI, and interpretation was centrally performed by a board-certified musculoskeletal radiologist. Images were assessed for tendon, muscle, bone, bursal, joint capsule, labral, and chondral abnormality. RESULTS: A total of 11,274 athletes participated in the Games, of which 55 (5%) were referred for a routine shoulder MRI. Fifty-three (96%) had at least two abnormal findings. Seven (13%) had evidence of an acute or chronic anterior shoulder dislocation. Forty-nine (89%) had a rotator cuff partial tear and / or tendinosis. Subacromial / subdeltoid bursitis was present in 29 (40%). Thirty (55%) had a tear of the superior labrum anterior posterior (SLAP). CONCLUSION: Our study demonstrated a high prevalence of both acute and chronic shoulder injuries in the Olympic athletes receiving shoulder MRI. The high rates of bursal, rotator cuff, and labral pathology found in these patients implies that some degree of glenohumeral instability and impingement is occurring, likely due to fatigue and overuse of the dynamic stabilizers. Future studies are needed to better evaluate sport-specific trends of injury.
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Atletas , Traumatismos en Atletas/diagnóstico por imagen , Traumatismos en Atletas/epidemiología , Imagen por Resonancia Magnética , Lesiones del Hombro/diagnóstico por imagen , Lesiones del Hombro/epidemiología , Adolescente , Adulto , Traumatismos en Atletas/fisiopatología , Brasil , Humanos , Valor Predictivo de las Pruebas , Prevalencia , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Lesiones del Hombro/fisiopatología , Factores de Tiempo , Adulto JovenRESUMEN
Purpose To describe the occurrence of imaging-depicted sports-related stress injuries, fractures, and muscle and tendon disorders during the 2016 Summer Olympic Games in Rio de Janeiro, Brazil. Materials and Methods Data on radiologic examinations were collected and retrospectively analyzed centrally by two board-certified musculoskeletal radiologists (with a third musculoskeletal radiologist acting as an adjudicator in case of discrepancies). Descriptive data on all imaging examinations by using radiography, ultrasonography (US), and magnetic resonance (MR) imaging were collected and analyzed according to imaging modality, country of origin of the athletes, type of sport, and type and location of injury. Results There were 1101 injuries that occurred in 11 274 (9.8%) athletes. A total of 1015 radiologic examinations were performed, including 304 (30.0%) radiographic, 104 (10.2%) US, and 607 (59.8%) MR examinations. Excluding 10 athletes categorized as refugees, athletes from Africa had the highest utilization rate (14.8%, 148 of 1001). Athletes from Europe underwent the most examinations with 103 radiographic, 39 US, and 254 MR examinations. Gymnastics (artistic) had the highest percentage of athletes who underwent imaging (15.5%, 30 of 194). Athletics (track and field) had the most examinations (293, including 53 radiographic, 50 US, and 190 MR examinations). Conclusion The overall occurrence of imaging used to help diagnose sports-related injuries at the Rio de Janeiro 2016 Summer Olympics was 6.4% of athletes. In these cases, MR imaging comprised 60% of imaging utilization. © RSNA, 2018 Online supplemental material is available for this article.
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Traumatismos en Atletas/diagnóstico por imagen , Trastornos de Traumas Acumulados/diagnóstico por imagen , Diagnóstico por Imagen/métodos , Fracturas Óseas/diagnóstico por imagen , Enfermedades Musculares/diagnóstico por imagen , Traumatismos de los Tendones/diagnóstico por imagen , Brasil , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Radiografía , Estudios Retrospectivos , UltrasonografíaRESUMEN
OBJECTIVE: To assess the differences in morphology and alignment of the knee between patients with proximal patellar tendinopathy (PPT) and a control group, using MRI and focusing on the patellofemoral joint. METHODS: We retrospectively included 35 patients with clinically diagnosed and unequivocal findings of PPT on knee MRI, the case group. For the control group, we included 70 patients who underwent knee MRI for other reasons, with no clinical or MRI evidence of PPT. Patients and controls were matched for age and gender, with all subjects reporting frequent physical activity. MRIs were evaluated by two musculoskeletal radiologists, who assessed parameters of patellar morphology, trochlear morphology, patellofemoral alignment, and tibiofemoral alignment. The differences in parameters between cases and controls were assessed using Student's t test. Logistic regression was applied to assess the associations between the MRI parameters and the presence of PPT. RESULTS: The patellar height Insall-Salvati ratio was different between cases and controls (1.37 ± 0.21 vs. 1.24 ± 0.19; p = 0.003). The subchondral Wiberg angle was higher in cases than controls (136.8 ± 7.4 vs. 131.7 ± 8.8; p = 0.004). After applying logistic regression, significant associations with PPT were found [odds ratios (95% CI)] for patellar morphology [1.1 (1.0, 1.2)] and patellar height [1.3 (1.0, 1.7)]. CONCLUSIONS: Patellar height and the subchondral patellar Wiberg angle were greater in patients with PPT and significantly associated with PPT.
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Imagen por Resonancia Magnética/métodos , Ligamento Rotuliano/diagnóstico por imagen , Ligamento Rotuliano/patología , Articulación Patelofemoral/diagnóstico por imagen , Articulación Patelofemoral/patología , Tendinopatía/diagnóstico por imagen , Tendinopatía/patología , Adolescente , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
BACKGROUND: Discrepancies exist in the literature regarding the association of the extent of injuries assessed on magnetic resonance imaging (MRI) with recovery times. HYPOTHESIS: MRI-detected edema in grade 1 hamstring injuries does not affect the return to play (RTP). STUDY DESIGN: Retrospective cohort study. LEVEL OF EVIDENCE: Level 4. METHODS: Grade 1 hamstring injuries from 22 professional soccer players were retrospectively reviewed. The extent of edema-like changes on fluid-sensitive sequences from 1.5-T MRI were evaluated using craniocaudal length, percentage of cross-sectional area, and volume. The time needed to RTP was the outcome. Negative binomial regression analysis tested the measurements of MRI-detected edema-like changes as prognostic factors. RESULTS: The mean craniocaudal length was 7.6 cm (SD, 4.9 cm; range, 0.9-19.1 cm), the mean percentage of cross-sectional area was 23.6% (SD, 20%; range, 4.4%-89.6%), and the mean volume was 33.1 cm3 (SD, 42.6 cm3; range, 1.1-161.3 cm3). The mean time needed to RTP was 13.6 days (SD, 8.9 days; range, 3-32 days). None of the parameters of extent was associated with RTP. CONCLUSION: The extent of MRI edema in hamstring injuries does not have prognostic value. CLINICAL RELEVANCE: Measuring the extent of edema in hamstring injuries using MRI does not add prognostic value in clinical practice.
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Traumatismos en Atletas/diagnóstico por imagen , Edema/diagnóstico por imagen , Músculos Isquiosurales/lesiones , Traumatismos de la Pierna/diagnóstico por imagen , Fútbol/lesiones , Adulto , Atletas , Traumatismos en Atletas/patología , Humanos , Traumatismos de la Pierna/patología , Imagen por Resonancia Magnética , Masculino , Estudios Retrospectivos , Volver al Deporte , Adulto JovenRESUMEN
BACKGROUND: Acute muscle injuries in elite athletes are responsible for a large portion of time loss injuries. AIM: To describe the frequency, the anatomic distribution, and severity of imaging-detected acute muscle injuries among athletes who competed in the Rio de Janeiro 2016 Summer Olympics. METHODS: We recorded all sports injuries reported by the National Olympic Committee medical teams and the Organising Committee medical staff during the 2016 Summer Olympics. Imaging of acute muscle injuries was performed at the IOC's polyclinic within the Olympic Village using ultrasound and 3.0 T and 1.5 T MRI scanners. The assessment of images was performed centrally by three musculoskeletal radiologists. The distribution of injuries by anatomic location and sports discipline and the severity of injuries were recorded. RESULTS: In total, 11 274 athletes from 207 teams were included. A total of 1101 injuries were reported. Central review of radiological images revealed 81 acute muscle injuries in 77 athletes (66% male, mean age: 25.4 years, range 18-38 years). Athletics (track and field) athletes were the most commonly affected (n=39, 48%), followed by football players (n=9, 11%). The majority of injuries affected muscles from lower limbs (n=68, 84%), with the hamstring being the most commonly involved. Most injuries were grade 2 injuries according to the Peetrons classification (n=44, 54%), and we found 18 injuries exhibiting intramuscular tendon involvement on MRI. CONCLUSION: Imaging-detected acute muscle injuries during the 2016 Summer Olympics affected mainly thigh muscles in athletics disciplines.
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Traumatismos en Atletas/diagnóstico por imagen , Músculo Esquelético/lesiones , Adolescente , Adulto , Aniversarios y Eventos Especiales , Atletas , Brasil , Femenino , Humanos , Incidencia , Masculino , Estudios Retrospectivos , Adulto JovenRESUMEN
BACKGROUND: Tendon abnormalities are prevalent among both elite and non-elite athletes. Cross-sectional imaging modalities are used to confirm and evaluate the severity of such lesions. AIM: To describe the demographics, prevalence, anatomical location and characteristics of tendon abnormalities in athletes who participated in the Rio de Janeiro 2016 Summer Olympic Games. METHODS: We recorded all sports injuries reported by the National Olympic Committee (NOC) medical teams and the Organizing Committee medical staff during the Rio 2016 Summer Olympics. Diagnostic imaging was performed through the official IOC clinic within the Olympic Village, using digital ultrasound machines and 3T and 1.5T MR scanners. Image interpretation was performed centrally by board-certified musculoskeletal radiologists with expertise in sports injuries. RESULTS: In total, 11 274 athletes (5089 women (45%), 6185 men (55%)) from 207 NOCs were included. NOC and Rio de Janeiro 2016 medical staff reported 1101 injuries. Central review of radiological images revealed 156 tendon abnormalities in 109 athletes (51.2% male, mean age: 26.8, range 18-39). The supraspinatus tendon was the most commonly involved tendon (31 cases, 19.9%), followed by the Achilles tendon (20 cases, 12.8%) and patellar and infraspinatus tendons (12 cases, 7.7%). Tendon abnormalities were most commonly seen in track and field athletes (54 abnormalities, 34.6%). CONCLUSION: 156 tendon abnormalities were reported, most commonly in track and field athletes, and involving mainly the shoulder tendons, as well as Achilles and patellar tendons.
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Traumatismos en Atletas/epidemiología , Traumatismos de los Tendones/diagnóstico por imagen , Adolescente , Adulto , Aniversarios y Eventos Especiales , Atletas , Brasil , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Prevalencia , Atletismo , Ultrasonografía , Adulto JovenRESUMEN
OBJECTIVE: The objective of our study was to assess the diagnostic performance and associations of the direct and indirect MRI features of the metatarsophalangeal (MTP) joint that are thought to be related to tears of the plantar plate (PP) using surgical findings as the reference standard. MATERIALS AND METHODS: We retrospectively included 23 patients with symptomatic instability of lesser MTP joints who had undergone preoperative 1.5-T MRI and surgical assessment. The MRI examinations were independently assessed by two musculoskeletal radiologists. Using the surgical data as the reference standard, we calculated the sensitivity, specificity, and accuracy of each MRI feature in the detection of PP tears. Multivariate logistic regression analysis was performed to identify which MRI features were independently associated with PP tears. Interobserver reliability was assessed using kappa statistics. RESULTS: Forty-five lesser MTP joints were included. The presence of pericapsular fibrosis was highly sensitive (91.2%), specific (90.9%), and accurate (91.1%) for the diagnosis of PP tears. With a cutoff value of 0.275 cm, the PP-proximal phalanx distance had a sensitivity of 64.7%, specificity of 90.9%, and accuracy of 71.1% in diagnosing PP tears. CONCLUSION: In patients with clinical features indicating lesser MTP joint instability, some direct and indirect MRI features exhibited good to excellent diagnostic performance in detecting the presence of PP tears.
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Artropatías/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Metatarsalgia/diagnóstico por imagen , Articulación Metatarsofalángica/diagnóstico por imagen , Articulación Metatarsofalángica/lesiones , Placa Plantar/diagnóstico por imagen , Placa Plantar/lesiones , Adulto , Femenino , Humanos , Aumento de la Imagen/métodos , Artropatías/cirugía , Masculino , Metatarsalgia/cirugía , Articulación Metatarsofalángica/cirugía , Persona de Mediana Edad , Variaciones Dependientes del Observador , Placa Plantar/cirugía , Estudios RetrospectivosRESUMEN
INTRODUCTION: We sought to compare median nerve elasticity between leprosy patients (LPs) and healthy volunteers (HVs) using ultrasound elastography (UE). METHODS: Two radiologists independently measured the strain ratio of the median nerve/flexor digitorum superficialis muscle (MN/FDSM) of 18 LP and 18 HV using real-time freehand UE. Statistical analysis included intra-class correlation coefficients (ICC) and Mann-Whitney test. RESULTS: The MN/FDSM strain ratios of the LP and HV were 2.66 ± 1.30 and 3.52 ± 0.93, respectively (P < 0.05). We observed a significantly lower MN/FDSM strain ratio in LP with reactions (types 1 and 2 cutaneous reactions associated with or without neuritis) (2.30 ± 0.91) compared with LP without reactions (3.60 ± 1.70). We found no significant differences between HV and LP without reactions. The intra- and inter-observer ICCs were 0.50 (95% confidence interval [CI], 0.11-0.72) and 0.34 (95% CI, 0.28-0.52), respectively. CONCLUSIONS: MN/FDSM strain ratios were significantly lower in LP with reactions. UE may be useful for nerve elasticity evaluation in leprosy. Muscle Nerve 56: 393-398, 2017.
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Diagnóstico por Imagen de Elasticidad/métodos , Lepra/diagnóstico por imagen , Nervio Mediano/diagnóstico por imagen , Músculo Esquelético/diagnóstico por imagen , Ultrasonografía/métodos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Antebrazo/diagnóstico por imagen , Antebrazo/inervación , Antebrazo/fisiopatología , Humanos , Lepra/fisiopatología , Masculino , Nervio Mediano/fisiopatología , Persona de Mediana Edad , Músculo Esquelético/fisiopatología , Estudios Prospectivos , Adulto JovenRESUMEN
OBJECTIVES: To describe in detail the anatomic distribution of acute hamstring injuries in football players, and to assess the relationship between location and extent of edema and tears, all based on findings from MRI. DESIGN: Retrospective observational study. METHODS: We included 275 consecutive male football players who had sustained acute hamstring injuries and had positive findings on MRI. For each subject, lesions were recorded at specific locations of the hamstring muscles, which were divided into proximal or distal: free tendon, myotendinous junction, muscle belly, and myofascial junction locations. For each lesion, we assessed the largest cross-sectional area of edema and/or tears. We calculated the prevalence of injuries by location. The relationships between locations and extent of edema and tears were assessed using a one-sample t-test, with significance set at p<0.05. RESULTS: The long head of biceps femoris (LHBF) was most commonly affected (56.5%). Overall, injuries were most common in the myotendinous junction and in proximal locations. The proximal myotendinous junction was associated with a greater extent of edema in the LHBF and semitendinosus (ST) muscles (p<0.05). Proximal locations in the LHBF had larger edema than distal locations (p<0.05). Distal locations in the ST muscle had larger tears than proximal locations (p<0.05). CONCLUSIONS: The proximal myotendinous junction (LHBF and ST muscles) and proximal locations (LHBF muscle) are more commonly affected and are associated with a greater extent of edema in acute hamstring muscle injury. Distal locations (ST muscle), however, seem to be more commonly associated with larger tears.
Asunto(s)
Fútbol Americano/lesiones , Músculo Esquelético/lesiones , Muslo/lesiones , Adolescente , Adulto , Atletas , Edema/diagnóstico por imagen , Edema/fisiopatología , Humanos , Imagen por Resonancia Magnética , Masculino , Músculo Esquelético/diagnóstico por imagen , Estudios Retrospectivos , Traumatismos de los Tejidos Blandos/diagnóstico por imagen , Muslo/diagnóstico por imagen , Adulto JovenRESUMEN
OBJECTIVE. The purpose of this article is to validate both semiquantitative and quantitative ultrasound assessment of medial meniscal extrusion using MRI assessment as the reference standard. SUBJECTS AND METHODS. Ninety-three consecutive patients with chronic knee pain referred for knee MRI were evaluated by ultrasound and MRI on the same day. Two musculoskeletal radiologists assessed meniscal extrusion on ultrasound and MRI separately and independently and graded it semiquantitatively as follows: 0 (< 2 mm), 1 (≥ 2 mm and < 4 mm), and 2 (≥ 4 mm). Agreement between the ultrasound and MRI evaluations was determined using weighted kappa statistics. Intraclass correlation coefficients were used to evaluate agreement using the absolute values of extrusion (quantitative assessment). We further evaluated the diagnostic performance of ultrasound for the detection of medial meniscal extrusion using MRI as the reference standard. RESULTS. For semiquantitative grading, agreement between ultrasound and MRI was moderate for reader 1 (κ = 0.57) and substantial for reader 2 (κ = 0.64). Substantial agreement was found for both readers (intraclass correlation coefficients, 0.73 and 0.70) when comparing quantitative assessment of meniscal extrusion between ultrasound and MRI. Ultrasound showed excellent sensitivity (95% and 96% for each reader) and good specificity (82% and 70% for each reader) in the detection of meniscal extrusion. CONCLUSION. Ultrasound assessment of meniscal extrusion is reliable and can be used for both quantitative and semiquantitative assessment, exhibiting excellent diagnostic performance for the detection of meniscal extrusion compared with MRI.
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Luxación de la Rodilla/diagnóstico por imagen , Imagen por Resonancia Magnética/normas , Meniscos Tibiales/diagnóstico por imagen , Lesiones de Menisco Tibial , Adolescente , Adulto , Anciano , Femenino , Humanos , Luxación de la Rodilla/diagnóstico , Masculino , Meniscos Tibiales/patología , Persona de Mediana Edad , Estándares de Referencia , Ultrasonografía , Adulto JovenRESUMEN
Osseous alterations adjacent to the posteromedial tubercle of the talus that lead to posterior ankle impingement and their imaging findings have been much less well described than alterations of the posterolateral tubercle. We present 5 cases of osseous abnormalities at the posteromedial tubercle of the talus depicted on magnetic resonance imaging in subjects with chronic symptoms at this location, with no history of local trauma, who had presented with posteromedial mechanical pain and/or tarsal tunnel syndrome. The symptoms were related to mechanical changes of the bony and soft tissue structures, leading to posterior impingement, and to neurovascular bundle entrapment at the tarsal tunnel, leading to tarsal tunnel syndrome.
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Corticoesteroides/administración & dosificación , Articulación del Tobillo/patología , Imagen por Resonancia Magnética/métodos , Osteofito/patología , Astrágalo/anomalías , Adulto , Articulación del Tobillo/fisiopatología , Artralgia/diagnóstico , Artralgia/terapia , Dolor Crónico , Femenino , Estudios de Seguimiento , Humanos , Inyecciones Intraarticulares , Masculino , Procedimientos Ortopédicos/métodos , Osteofito/terapia , Dimensión del Dolor , Medición de Riesgo , Muestreo , Astrágalo/patología , Resultado del Tratamiento , Adulto JovenRESUMEN
Specific missense mutations in the CACNA1A gene, which encodes a subunit of voltage-gated CaV2.1 channels, are associated with familial hemiplegic migraine type 1 (FHM1), a rare monogenic subtype of common migraine with aura. We used transgenic knock-in (KI) mice harboring the human pathogenic FHM1 mutation S218L to study presynaptic Ca(2+) currents, EPSCs, and in vivo activity at the calyx of Held synapse. Whole-cell patch-clamp recordings of presynaptic terminals from S218L KI mice showed a strong shift of the calcium current I-V curve to more negative potentials, leading to an increase in basal [Ca(2+)]i, increased levels of spontaneous transmitter release, faster recovery from synaptic depression, and enhanced synaptic strength despite smaller action-potential-elicited Ca(2+) currents. The gain-of-function of transmitter release of the S218L mutant was reproduced in vivo, including evidence for an increased release probability, demonstrating its relevance for glutamatergic transmission. This synaptic phenotype may explain the misbalance between excitation and inhibition in neuronal circuits resulting in a persistent hyperexcitability state and other migraine-relevant mechanisms such as an increased susceptibility to cortical spreading depression.