RESUMEN
PURPOSE: To characterize the magnetic resonance (MR) imaging features of patellar tendinitis. MATERIALS AND METHODS: Fifteen patients with a clinical diagnosis of patellar tendinitis underwent gadolinium-enhanced MR imaging of the knee. RESULTS: Grades of patellar abnormality, based on findings in the enthesial region at MR imaging, correlated with signs of increasing fibrovascular repair: grade 1 (n = 4), enhancing area adjacent to patellar apex, with marginal zone of intermediate signal intensity, and a patellar apical chondral-bone avulsion; grade 2 (n = 5), same signs as grade 1 damage but without avulsion; grade 3 (n = 6), homogeneous, nonenhancing area of intermediate signal intensity adjacent to the patellar apex seen on all images. Changes were most obvious posteriorly and involved the central and medial thirds of the tendon. Chronic injury to the medial retinaculum was a common associated finding. CONCLUSION: Patellar tendinitis demonstrates a consistent spectrum of changes at MR imaging that can aid understanding of the origin and treatment of damage.
Asunto(s)
Traumatismos en Atletas/patología , Imagen por Resonancia Magnética , Rótula , Tendinopatía/patología , Adolescente , Adulto , Traumatismos en Atletas/clasificación , Traumatismos en Atletas/etiología , Cartílago Articular/lesiones , Cartílago Articular/patología , Enfermedad Crónica , Medios de Contraste , Femenino , Fracturas Óseas/clasificación , Fracturas Óseas/etiología , Fracturas Óseas/patología , Fracturas del Cartílago , Gadolinio , Gadolinio DTPA , Humanos , Luxaciones Articulares/clasificación , Luxaciones Articulares/etiología , Luxaciones Articulares/patología , Masculino , Persona de Mediana Edad , Compuestos Organometálicos , Rótula/lesiones , Rótula/patología , Ligamento Rotuliano/lesiones , Ligamento Rotuliano/patología , Ácido Pentético/análogos & derivados , Rotura , Tendinopatía/clasificación , Tendinopatía/etiologíaRESUMEN
PURPOSE: To estimate 30-day mortality after vena caval filter insertion and assess the usefulness of a severity of disease score in predicting postprocedure 30-day survival. PATIENTS AND METHODS: Records of 40 consecutive patients undergoing inferior vena caval filter insertion over a 2 1/2-year period were retrospectively reviewed. A severity of illness score for each patient was calculated based on the weighting system described for the APACHE (Acute Physiology and Chronic Health Evaluation) II system. In addition, 30-day postprocedure survival was determined. RESULTS: Seven patients died within 30 days of the procedure (18%). The use of a severity of disease score of greater than 15 as a predictor of postprocedure 30-day mortality had a sensitivity of 50%, specificity of 97%, positive predictive value of 75%, a negative predictive value of 91.4%, and accuracy of 90%. CONCLUSIONS: The 30-day mortality after caval filter insertion is significant. A severity of disease score is a useful predictor of patients likely to survive following caval filter insertion. On this basis it may be possible to establish criteria for more beneficial use of vena caval filters.