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麥淑嫻 and Suk-han Anna Mak. "Thumb base joints: comparison between standard and special radiographic projections." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1999. http://hub.hku.hk/bib/B31223187.
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Gunes, E. evren. "Computerized Test Procedure For Industrial Radiographic Examination Of Metallic Welded Joints." Master's thesis, METU, 2004. http://etd.lib.metu.edu.tr/upload/2/12605553/index.pdf.
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Radiography is an extensively used NDT method, especially in nuclear, aerospace and automotive industries where optimal designs call for greater reliability. The rules corresponding to industrial radiography are defined in a system of radiographic standards. The standards related to the radiographic testing of metallic welded joints had been harmonised in all over the Europe and at the end in 1997, the standard "EN 1435"
was established and published. Since then, this standard has become the most widely used standard where the radiographic applications are necessary. To eliminate the person based errors during application of the standard, moreover to save time, cost and effort in radiographic exposures, in this study it was aimed to write a computer program which is able to calculate all necessary parameters for a radiographic exposure related to this standard EN 1435. In the programming stage, Visual Basic 6.0 &
#61651
was used. The program consists of many windows, each giving and controlling separate parameters related to the exposure. Besides giving all the needed parameters, the evolved program is able to prepare a report with these parameters. So, both radiography technicians and experts can use it. It is believed that this study constructs a basis for developing other computerised test procedures for any kind of non-destructive testing methods used in industry today.
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Tandjaoui, Amina. "Solidification dirigée du silicium multi-cristallin pour les applications photovoltaïques : caractérisation in situ et en temps réel par imagerie X synchrotron." Thesis, Aix-Marseille, 2013. http://www.theses.fr/2013AIXM4319/document.
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Nous avons étudié in situ et en temps réel la structure de grains du silicium multi-cristallin issue de la solidification dirigée en utilisant l’imagerie X synchrotron. La radiographie X permet de suivre l’évolution de l’interface solide/liquide et de caractériser sa dynamique et sa morphologie. La topographie X nous donne des informations sur la structure de grains formée, les contraintes et les défauts issus de la solidification. Nous avons montré l’importance la préparation de l’état initial de la solidification en particulier pour les expériences de reprise sur germe. L’analyse de la morphologie de l’interface solide/liquide nous a permis de caractériser la surfusion cinétique du front de solidification, de comprendre l’évolution des sillons de joints de grains et d’analyser les mécanismes de compétition de grains ainsi que de révéler l’impact des impuretés sur la structure de grains formée à l’issue de la solidification. Le phénomène de maclage a aussi été observé dans nos expériences et nous avons démontré que les macles dans le silicium multi-cristallin peuvent être des macles de croissance. Deux types de macles ont été identifiés et le phénomène de compétition de grains en présence de macles étudiéWe studied in situ and real-time the grain structure of multi-crystalline silicon from directional solidification using synchrotron X-ray imaging techniques. X-ray Radiography gives information on the evolution, dynamics and morphology of the solid/liquid interface. X- ray Topography gives more information on the grain structure, strains and defects that occur during solidification step. We showed the importance of the preparation of the initial stage of solidification in particular in the experiments where solidification is initiated from seed. The analysis of the solid/liquid interface morphology allowed us to characterize the kinetic undercooling of the solidification front, to understand the evolution of the grains boundary grooves and to analyze the mechanisms of grain competition and also to reveal the impurities impact on the grain structure formed at the end of the solidification. We also observed twinning phenomenon in our experiments and we demonstrated that twins in multi-crystalline silicon can be growth twins. Two kinds of silicon twins have been identified and the grain competition phenomenon with twins studied
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Vitule, Luiz Fernando. "Avaliação da ressonância magnética da mão dominante na artrite reumatóide precoce: correlação com a radiologia convencional." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/5/5151/tde-19032007-112614/.
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A artrite reumatóide (AR) é uma patologia crônica e sistêmica de etiologia desconhecida provavelmente multifatorial na qual há um predomínio de acometimento da sinóvia. Afeta de 0,5 a 1 % da população com predomínio nas mulheres. O diagnóstico precoce e o inicio da terapêutica adequada são fundamentais e podem modificar a evolução da doença reduzindo as graves seqüelas. O custo do exame de ressonância magnética (RM) é a maior limitação neste método de diagnóstico. O objetivo deste estudo foi avaliar a especificidade e a sensibilidade da ressonância magnética (RM) da mão e do punho de pacientes com AR precoce de acordo com os parâmetros do OMERACT (comitê internacional para avaliação de medidas em reumatologia para análise da ressonância magnética) correlacionando com a radiologia convencional. Foram avaliados 19 pacientes com AR (idade: 22-64 anos) e um grupo controle composto por 10 indivíduos sem história de patologias prévias com idade de 26-46 anos. Foram realizados exames de radiografia (RX) e RM da mão e do punho dominante. Treze articulações foram avaliadas pelo RX convencional (radio-ulnar distal, radiocarpal, intercarpal e metacarpofalângicas do primeiro ao quinto dedo e articulação interfalângicas proximais do primeiro ao quinto dedo). As lesões ósseas no RX foram classificadas de acordo com o método de Van Der Heiidje com graduações de 0 a 4 para redução do espaço articular e de 0 a 5 para erosão óssea. Foram realizados exames de RM num equipamento marca GE 1,5 T Signa Horizon LX (General Eletric medical systems) utilizando T1, T2 eco de spin e T1 eco de Spin com saturação de gordura após a infusão do contraste paramagnético gadopentato dimegumina. O protocolo foi realizado de acordo com as padronizações do OMERACT. Como resultados obtivemos que a RM foi mais sensível na pesquisa de erosão óssea (94,7%) que o RX (78,9%). Somente as articulações intercarpais e metacarpo-falângicas do segundo dedo demonstraram correlação estatística entre os 2 métodos (r=0,47 p=0,04 e r=0,63 p=0,004). Para erosão óssea os compartimentos radiocarpal (73,7%) e intercarpal (84,2%) foram os mais sensíveis e com maior acurácia. Além disso, a RM foi muito sensível no estudo da sinovite presente em 100% dos pacientes com AR comparados com 20% do grupo controle. Quando estudados nos sítios anatômicos o carpo foi o local mais sensível para a sinovite (100%). O edema intra-ósseo foi mais detectado no punho com uma alta especificidade (90%), porém com baixa acurácia (50%) um achado importante é que a analise simultânea do punho e da mão não aumentou a detecção de um maior número de pacientes com AR. Concluindo, a RM foi mais sensível que o RX no estudo da AR precoce. Este trabalho demonstrou que o estudo do punho apresentou uma ótima sensibilidade e especificidade no diagnóstico precoce da AR e somente o estudo deste compartimento parece ser adequado com redução do custo do exame para os pacientes, portanto na análise do AR precoce o punho parece apresentar melhor desempenho.Rheumatoid arthritis (RA) is a chronic and systemic disease of unknown etiology probably multifactorial with a predominant involvement of synovial tissue. The disease prevalence is 0.5-1% and affects more often women. Early diagnosis and therapy are essential to modify the course of the disease and reduce the degree of severe late sequelae. The cost of MRI of this region is a major limitation for the use of this sensitive exam. We therefore decided to evaluate if the wrist magnetic resonance with a simultaneous reading of wrist and hand compartments according to the OMERACT parameters would be sensitive and accurate to diagnose early RA. We have evaluated 19 patients with RA (ages: 22-64 years) and 10 age-matched controls. X-ray and MRI evaluated the dominant wrist all subjects. Thirteen joints were evaluated by conventional radiography: radio-ulnar distal (DRU), radiocarpal joint (RC), intercarpal (IC), metacarpo-phalageal (first to fifth finger) and phalangophalangeal (first to fifth finger). The bone lesion in the radiograph was scored by the method of Van Der Heidje for joint damage and for joint narrowing space. Wrist MRI imaging was performed with 1,5 T GE Signa Horizon LX 8,2 (General Eletric medical systems) with multiplanar T1, T2 (spin echo and fast spin echo) and T1 fat sat after intravenous injection of gadopentetate dimeglumine, according to the definitions of OMERACT. The MRI was more sensitive to detect erosion (94.7%) than the conventional X-ray (78.9%), and only intercarpal and metacarpofalangic joints of the second finger showed statistic correlation in the two methods (r=0.47 p=0.04 e r= 0.63 p=0.004). Of interest, among the anatomic compartments evaluated the radiocarpal (73.7%) and intercarpal joints (84.2%) were the most sensitive and accurate to detect erosion. Moreover, the MRI was also very sensitive to detect synovitis, present in 100% of the AR compared 20% in the control group, p<0,001. With regards to the anatomic site, synovitis was uniformly observed in all carpal joints (100%). Edema was also more frequently detected in the wrist joints with a high specificity (90%) but low accuracy (50%). Importantly, the simultaneous reading of wrist and hands did not identify additional cases. MRI imaging was more sensitive than conventional radiography in detecting early lesion in RA Our data support the notion that wrist MRI has an excellent sensitivity and specificity to diagnose early RA, and therefore only this assessment seems to be adequate, with a reduced cost for the patients. Additionally, we have demonstrated that the reading may be restrict to the wrist compartment, overcoming the technical limitations of the hand anatomical site.
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Tompson, Carl G. "Radiographic determination of the lay-up influence on fatigue damage development under bearing/bypass conditions." Thesis, Atlanta, Ga. : Georgia Institute of Technology, 2009. http://hdl.handle.net/1853/29689.
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Thesis (M. S.)--Mechanical Engineering, Georgia Institute of Technology, 2009.Committee Chair: Dr. Steve Johnson; Committee Member: Dr. Andrew Makeev; Committee Member: Kyriaki Kalaitzidou. Part of the SMARTech Electronic Thesis and Dissertation Collection.
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Coombs, Malcolm Iain. "Diagnostic Imaging Of The Temporomandibular Joint." Thesis, The University of Sydney, 1986. http://hdl.handle.net/2123/4965.
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Sadan, Madeh Adel Abd Elrahiem. "Radiographic studies on the carpal joints in some small animals." Giessen VVB Laufersweiler, 2010. http://geb.uni-giessen.de/geb/volltexte/2010/7619/index.html.
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Mak, Suk-han Anna. "Thumb base joints : comparison between standard and special radiographic projections /." Hong Kong : University of Hong Kong, 1999. http://sunzi.lib.hku.hk/hkuto/record.jsp?B22079142.
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Charlesworth, Gregory C. "An Assessment Of The Accuracy Of Transcranial Radiographs Of The Temporomandibular Joint." Thesis, Faculty of Dentistry, 1986. http://hdl.handle.net/2123/4318.
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Sadan, Madeh A. A. [Verfasser]. "Radiographic studies on the carpal joints in some small animals / eingereicht von Madeh A. A. Sadan." Giessen : VVB Laufersweiler, 2010. http://d-nb.info/1004757735/34.
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Garnier, Ann-Sofi Johansson. "Temporomandibular joint internal derangement tissue reactions and topographical relations with implication on pain : a radiographic and histologic investigation /." Stockholm : Departments of Oral Radiology and Oral Pathology, School of Dentistry, Karolinska Institutet, 1990. http://catalog.hathitrust.org/api/volumes/oclc/22669079.html.
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Barton, Lucinda. "Degenerative Joint Disease in Captive Large Cats: the radiographic characteristics and clinical presentation of DJD in captive cheetahs (Acinonyx jubatus), lions (Panthera leo) and tigers (Panthera tigris)." Thesis, The University of Sydney, 2022. https://hdl.handle.net/2123/29741.
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Lions, tigers and cheetahs are commonly held in zoos, experiencing greater longevity in captivity than the wild. As a result, they are more likely to develop age-related diseases, including degenerative joint disease (DJD). However, the prevalence, distribution, severity and clinical presentation of DJD in these species is currently unclear. To address these knowledge gaps, 14 institutions provided radiographic studies and matched clinical records for all cheetahs, lions and tigers that underwent imaging between 1979-2019. Radiographic arthropathies were identified and the correlation between arthropathy status and a range of predictors was examined. Radiographic DJD status was then matched with clinical entries to investigate the presenting signs of DJD in these three species. Arthropathies were found to be common and almost exclusively degenerative in nature. Increasing age was the strongest predictor for joint disease, and a significantly lower prevalence of disease was recorded for the cheetah. Whilst all species showed unique patterns of disease, similarities existed between the lion and tiger, with severe axial DJD a feature. There was a conspicuous absence of appendicular DJD detected in older cheetahs, however axial DJD is reported in this species for the first time, with both increased prevalence and severity found in cheetahs from urban compared with open-range zoos. The meniscal ossicle and supinator sesamoid bone were identified as normal structures that become radiographically evident with skeletal maturation, with the supinator sesamoid bone reported in the tiger, and the meniscal ossicle in the Sumatran tiger, for the first time. A spectrum of DJD-associated presenting clinical signs was established for the three species. Combined, these findings will facilitate radiographic diagnosis of DJD and enhance understanding of the clinical impact of this disease in captive nondomestic felids, whilst also providing impetus for further research in this area.
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Lagacé, Pierre-yves. "Développement et validation d’une méthode d’évaluation destranslations glénohumérales 3d sous EOS(mc)." Thesis, Paris, ENSAM, 2012. http://www.theses.fr/2012ENAM0059/document.
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L'analyse morpho-fonctionnelle précise de l'épaule, notamment au niveau de l'articulation glénohumérale (GH), permettrait d'améliorer notre compréhension des dysfonctions de l'épaule associées aux ruptures de la coiffe des rotateurs. Cependant, des difficultés techniques compliquent l'analyse de la morphologie et du mouvement de l'épaule dans un contexte clinique. Dans le cadre de la présente thèse, une méthode d'analyse 3D des translations GH basée sur l'acquisition de séquences de radiographies biplanes sous EOS™ a été développée. Une étude pilote sur 10 sujets sains a d'abord permis de vérifier la facilité d'application d'un protocole d'acquisition des images et d'évaluer la répétabilité de l'identification des repères anatomiques de l'épaule sur les radiographies. La méthode proposée en dernier lieu permet, suite à l'acquisition de radiographies, de reconstruire un modèle personnalisé morpho-réaliste de la scapula et un modèle simplifié de l'humérus. Ces modèles sont ensuite recalés interactivement sur les images acquises à différentes positions du bras et utilisés pour décrire les translations GH à ces positions. La méthode a été validée en termes de précision et de répétabilité sur des images acquises d'épaules cadavériques et de patients ayant des ruptures de la coiffe des rotateurs. La dernière partie du travail présenté ici consiste à appliquer la méthode développée à 30 sujets (25 patients et 5 sujets sains) pour lesquels l'état de la coiffe des rotateurs et la fonction de l'épaule ont été évalués, puis à étudier les corrélations entre les translations GH et la fonction de l'épaulePrecise morpho-functional analysis of the shoulder, including of the glenohumeral (GH) joint, would allow improving our understanding of shoulder dysfunction associated to rotator cuff tears. However, technical difficulties make analysis of shoulder morphology and motion difficult in a clinical setting. The work carried out during this thesis allowed developing a method for 3D analysis of GH translations relying on the acquisition of sequences of biplanar radiographs with the EOS™ system. A pilot study carried out on 10 healthy subjects allowed verifying the ease of application of an image acquisition protocol and evaluating the repeatability of shoulder landmark identification on the radiographs. The final proposed method allows, following the acquisition of radiographs, obtaining a personalized morphologically realistic reconstruction of the scapula and a simplified model of the humerus. These models are then interactively registered to the images acquired at different arm positions and used to describe GH translations for these positions. The proposed method was validated in terms of precision and repeatability on images acquired of cadaveric shoulders and of patients with rotator cuff tears. The last part of the work presented here consists in applying the developed method to 30 subjects (25 patients and 5 asymptomatic subjects) for whom rotator cuff condition and shoulder function were assessed, and to study correlations between GH translations and shoulder function
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Hall, Michelle C. "An ultrasonographic study of knee joints : features of inflammation and their relationship to radiographic osteoarthritis and pain." Thesis, University of Nottingham, 2013. http://eprints.nottingham.ac.uk/13848/.
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Background. Knee osteoarthritis (OA) can result in considerable pain and disability for some people. Inflammation within the joint may be partly responsible for the pain associated with OA and a link between inflammation and disease progression has been suggested. Ultrasound (US) imaging has been successfully employed in the evaluation of knee joint effusion, synovial hypertrophy and power doppler signal (PDS) which are said to represent joint inflammation. The associations between US features of inflammation, knee pain and radiographic OA have yet to be firmly established. Objectives. The objectives of this thesis were to compare the frequency of US features of inflammation in 4 groups from a community sample, [1] those with normal knees (controls) [2] knee pain - without radiographic OA (KP) [3] radiographic OA (without pain) (ROA) and [4] symptomatic OA (SOA). Associations between US features, knee pain, radiographic change and clinical signs of inflammation could then be explored. Secondary objectives were to determine if US features change in tandem with fluctuations in knee pain (1) over time and (2) with improved pain following a therapeutic intervention in people with SOA. Methods. In a cross-sectional multiple group comparison study, 243 participants were divided into 4 groups based on the presence of absence of knee pain and ROA. All underwent an US examination for effusion, synovial hypertrophy, peri-articular cysts and PDS. The presence or absence of features, absolute measures (millimetres) and grade of PDS (0-3) was recorded for both knees. Radiographs and clinical evaluation of knee pain, biomechanical stiffness and function were also undertaken. Follow-up examination of control and SOA groups was undertaken at 3 months. Participants with SOA were then invited to take part in a randomised placebo-controlled study of intra-articular (IA) cortico-steroid and a saline placebo. Results. The frequency of US features in the control group (effusions (29%) synovial hypertrophy (8%), popliteal cysts (12%) and PD signal (2%)) was not significantly different from those in the KP group. US features were more common in ROA and higher again in SOA (effusion 81% and 92% respectively, synovial hypertrophy 41% and 82%, popliteal cysts 22% and 39%). PDS was not significantly different between ROA (6.3%) and SOA (16%). Synovial hypertrophy was the only US feature independently associated with knee pain after adjusting for ROA (aOR 6.6; 95% CI 2.85, 15.11). All grey-scale features were strongly associated with ROA and remained so after adjusting for pain (effusion aOR 13.39, 95%CI 6.14, 29.02; synovial hypertrophy aOR 14.39, 95%CI 6.28, 32.94; popliteal cysts aOR 2.82, 95%CI 0.76, 10.43). PDS was not association with either knee pain or radiographic OA. Change in pain severity was not found to correlate with and change in US measures among the participants followed up at 3 months or following improved pain among participants in the intervention study. Conclusion. These findings show that US features suggestive of inflammation are higher in participants with SOA but was only significant for synovial hypertrophy. Synovial hypertrophy was confirmed as an independent risk factor for knee pain but was not found to be responsive to temporal changes in pain or improved pain following an IA cortico-steroid or placebo injection. Further studies to understand the contribution of US features of inflammation to pain in knee OA are warranted.
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Cortez, Andre Luis Vieira. "Avaliação radiografica da posição condilar em pacientes submetidos a osteotomia Le Fort I para avanço maxilar." [s.n.], 2005. http://repositorio.unicamp.br/jspui/handle/REPOSIP/289686.
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Orientador: Luis Augusto PasseriTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: Foi realizado um estudo radiográfico prospectivo avaliando a angulação e o posicionamento condilar, por meio da radiografia submento-vértice e da tomografia convencional da articulação temporomandibular (ATM). Para o estudo, foram selecionados onze pacientes, que procuraram atendimento na Área de Cirurgia e Traumatologia Buco-Maxilo-Faciais da Faculdade de Odontologia de Piracicaba ¿ Unicamp, para correção cirúrgica de deformidade dentofacial. Todos estavam em tratamento ortodôntico preparatório e possuíam o mesmo diagnóstico de deficiência ântero-posterior de maxila, sendo o planejamento cirúrgico definido, após análise facial, análise dos modelos de estudo e traçados cefalométricos, como a osteotomia Le Fort I para avanço maxilar. As imagens radiográficas foram obtidas nos períodos pré-operatório imediato, pós-operatório imediato (1-2 semanas) e pós-operatório tardio (mínimo de 6 meses). Foram mensuradas a angulação axial dos côndilos e a medida linear sobre os cortes tomográficos, dos espaços articulares posterior, superior e anterior para as posições de máxima intercuspidação habitual e repouso, e a máxima abertura bucal, nos três períodos. As imagens das tomografias, juntamente com os traçados, foram digitalizadas e mensuradas por meio de um programa de computador (UTHSCSA Image Tool 3.0), após a sua devida calibração. Os dados foram colhidos três vezes, com um intervalo de no mínimo 24 horas e, então, a média submetida à análise estatística (ANOVA ¿ nível de significância de 5%). Os resultados não foram significativos para as medidas lineares dos espaços articulares em nenhum período, bem como para a medida angular axial dos côndilos. Na máxima abertura bucal, ocorreu diferença significativa (diminuição da abertura) para o período pós-operatório imediato, em ambos os lados. Concluiu-se que a osteotomia Le Fort I para avanço maxilar não causou alterações significativas na posição condilar nesse grupo de pacientes avaliados
Abstract: It was realized a prospective radiographic study of the angulation and position of the mandibular condyle, by means of submento-vertex radiograph and conventional tomography of the temporomandibular joint (TMJ). For the study, it was selected eleven patients who were referred to the Division of Oral and Maxillofacial Surgery of Piracicaba School of Dentistry ¿ Unicamp, for surgical correction of dentofacial deformity. All patients were under preparatory orthodontist therapy to surgical procedure and had the same diagnoses of anterior-posterior deficiency of maxilla, in which the final surgical goal, after facial analysis, model analysis and predictive radiographic tracings, was the Le Fort I osteotomy to advance the maxilla. The radiographic images were taken at the immediate preoperative, immediate post-operative (1-2 weeks) and late post-operative (minimum of 6 months). It was measured the axial angulation of the condyles and the linear measurements for the tomographic images, over the posterior, superior and anterior articular spaces in the maximal intercuspation and rest position, and the maximal opening, for the three periods. Tomographic images with the tracings were digitized and measured by means of a computer software (UTHSCSA Image Tool 3.0), after its adequate calibration. Data analysis was collected three times, with a minimum of 24 hours between them and, after that, the mean value was submitted to statistical analysis (ANOVA ¿ 5% of significance). The results were not statistically significant for the linear measurements of the articular spaces in any of the periods, as well as for the axial angular measurements of the condyles. In the maximal opening, there was significant difference (decrease of opening) for the immediate post-operative period, for both sides. In conclusion, Le Fort I osteotomy for maxillary advancement did not cause any significant changes in this specific group of patients evaluated.
Doutorado
Cirurgia e Traumatologia Buco-Maxilo-Faciais
Doutor em Clínica Odontológica
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Önsten, Ingemar. "Fixation of total hip components in rheumatoid arthritis and srthrosis a radiographic, roentgen stereophotogrammetric, densitometric and histomorphometric study /." Lund : Dept. of Orthopaedics, University of Lund, Malmö General Hospital, 1994. http://books.google.com/books?id=mGVsAAAAMAAJ.
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Bryndahl, Fredrik. "Temporomandibular joint disk displacement and subsequent adverse mandibular growth : a radiographic, histologic and biomolecular experimental study." Doctoral thesis, Umeå : Oral and Maxillofacial Radiology, Umeå University, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1624.
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Nordahl, Silvi. "Pain and radiographic changes of the arthritic temporomandibular joint : relation to cytokines in synovial fluid and plasma /." Stockholm, 2000. http://diss.kib.ki.se/2000/91-628-4400-8/.
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Ward, Rupert John. "Assessment of radiographic tibio-femoral joint space width measurements : reproducibility and practicability for clinical trials in osteoarthritis." Thesis, King's College London (University of London), 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.412291.
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Starke, Andreas. "Quantifizierung und Klassifizierung der kaninen Ellbogeninkongruenz auf Grundlage einer standardisierten Röntgen- und Messmethode." Doctoral thesis, Universitätsbibliothek Leipzig, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-155312.
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Andreas Starke Quantifizierung und Klassifizierung der kaninen Ellbogeninkongruenz auf Grundlage einer standardisierten Röntgen- und Messmethode Klinik für Kleintiere der Veterinärmedizinischen Fakultät der Universität Leipzig (79 Seiten, 27 Abbildungen, 8 Tabellen, 132 Literaturangaben) Zielstellung: Ziel der vorliegenden Arbeit war die objektive Quantifizierung der knöchernen Konformation des Ellbogengelenkes gesunder und erkrankter Hunde unter standardisierten Bedingungen. Dazu sollte eine Methode entwickelt werden mit der Röntgenaufnahmen von Ellbogen unter Belastung angefertigt und anhand von Messungen an markanten Knochenstrukturen evaluiert werden können. Diese standardisierte Röntgen- und Messmethode sollte an einer Kontrollgruppe getestet werden, um die Eignung der Methodik zu untersuchen und Referenzwerte zu erstellen. Besonderer Schwerpunkt war die Überprüfung der Reliabilität der Messungen in Abhängigkeit von Lagerungsartefakten und Messwiederholungen. Danach sollten Ellbogengelenke klinisch erkrankter Hunde untersucht und mit den Ergebnissen der Kontrollgruppe verglichen werden, um herauszufinden, ob sich die Messergebnisse signifikant von gesunden Gelenken unterscheiden. Zudem wurde die Hypothese aufgestellt, dass sich die dysplastischen Ellbogengelenke anhand der röntgenologischen Messparameter in unterschiedliche Formen der humeroulnaren und humeroradialen Inkongruenz unterteilen lassen. Material und Methode: Bei 27 lahmheitsfreien Hunden wurden von 47 Ellbogengelenken Röntgenaufnahmen mit und ohne Belastung (mediolateral, kraniokaudal; Aufnahmen am liegenden, narkotisierten Tier) sowie Aufnahmen im Stehen (kraniokaudal) untersucht. Digital gemessen wurden subchondrale Gelenkspaltenabstände, subchondrale Knochenabstände und ein Winkel. Anschließend wurden 149 Hunde mit ED der Röntgen- und Messmethode unterzogen und mit den Ergebnissen der Kontrollgruppe verglichen. Anhand von gehäuft auftretenden Messwertabweichungen wurden die 149 Hunde in Untergruppen eingeteilt und erneut mit der Kontrollgruppe verglichen. Danach wurden 4 Gruppen mit jeweils unterschiedlicher Osteotomie an Radius bzw. Ulna zur zwei- und dreidimensionalen Gelenkumstellung erstellt (euthanasierte Hunde ohne Ellbogenerkrankung), der gleichen Röntgen- und Messprozedur unterzogen und mit der Kontrollgruppe und den Gruppen der kranken Hunde verglichen. Ergebnisse: Eine standardisierte und reliable Lagerung sowie Längen- und Winkelmessungen an definierten Knochenpunkten konnten mit und ohne Belastung bei gesunden und kranken Hunden etabliert werden. Mittels Normalisierung der Parameter der Längenmessungen gelang eine Vergleichbarkeit zwischen unterschiedlichen Gelenken und Projektionsebenen herzustellen. Messwerte von Aufnahmen im Stehen zeigten viele Lagerungsartefakte und eine geringe Reliabilität. Von den einzelnen Messparametern der Aufnahmen mit und ohne Belastung konnten aufgrund ihrer geringen Streuung Normwerte von der Kontrollgruppe abgeleitet werden. Eine deutliche Abgrenzung auf Grundlage signifikanter Unterschiede führte zur Bildung der Untergruppen Typ I (n=60), Typ II (n=40) und indiff (n=49) innerhalb der 149 Hunde mit ED. Unterscheidungskriterien für die Einteilung eines kranken Ellbogengelenkes in Typ I, Typ II und indiff waren 3 subchondrale Gelenkspaltenabstände (mp3, mp4, mp6), 3 aus Gelenkspaltenabständen errechnete Indizes (LI 3, LI 4, LI 6) und ein Winkel. Diese Parameter wiesen in der Kontrollgruppe eine hohe Reliabilität auf. Durch die Osteotomiemodelle konnten Parallelen zwischen Typ I und einer short ulna sowie zwischen Typ II und einem short radius ermittelt werden. Schlussfolgerungen: Röntgenaufnahmen am stehenden Hund sind nicht praktikabel, nur bedingt auswertbar und daher nicht geeignet. Anhand von Röntgenbildern mit und ohne Belastung lassen sich dagegen die Knochenverhältnisse im Gelenk beschreiben und Normwerte erstellen. Die untersuchte Methodik ist geeignet 67% erkrankter Tiere einem Inkongruenztyp (Typ I oder Typ II) zuzuordnen. Die Ergebnisse der dreidimensionalen Ulnaverkürzung und dreidimensionalen Radiusverkürzung weisen auf dreidimensionale Bewegungen der Knochenoberflächen bei Typ I bzw. Typ II im und am Gelenk hin. Ob Ellbogengelenke des Typ I (40%) von einer dreidimensionalen Osteotomie der proximalen Ulna und Ellbogengelenke des Typ II (27%) von einer Radiuselongation profitieren würden, müssen weitere Untersuchungen zeigen. Die Inkongruenz selbst konnte nicht näher quantifiziert werdenAndreas Starke Quantification and classification of canine elbow incongruency using a standardized method for radiography and measurement Department of Small Animal Medicine, Faculty of Veterinary Medicine, Universitiy of Leipzig (79 pages, 27 Figures, Tables, 132 references) Objective: Goal of this paper was the objective quantification of elbowjoint conformation for healthy and diseased dogs under standardized conditions. Therefor we developed a method for taking x-rays of the elbow joint under load to facilitate measurements using bone-landmarks. For this we aimed to test a standardized X-ray- and measurement methodology on a control group for evaluation of the developed methodology and to compile reference values. Emphasis has been placed on the validation of the reliability of the taken measurements especially were positioning artefacts and repeat measurements were concerned. Subsequently we examined elbow joints of clinically affected dogs and compared the results to that of the control group to determine whether signifikant differences can be found in the measurements compared to those taken in joints of healthy dogs. Additionally we formulated the hypothesis that displastic Elbow joints can be grouped into humero-ulnar and humero-radial incongruencies using the developed method of measurement. Material and methods: Plain x-rays and standardized stressed x-rays (medio-lateral, cranio-caudal taken under sedation; cranio-caudal views taken while standing) of 47 elbow-joints of 27 lameness free dogs were examined. We digitally measured subchondral jointgaps, subchondral bone gaps and an angle. Afterwards 149 dogs with ED were examined using our standardized X-ray method and we compared the results to the control group. The 149 dogs were divided into subgroups using frequent measurement deviances and the subgroups again compared to the control group. Afterwards we created 4 groups based on the kind of radial or ulnar osteotomy for two- and three- dimensional joint adjustment, took measurements based on our standardized X-ray method and compared the results to the control group and ED group. Results: A reliable standardized X-ray methodology as well as length and angle measurement on defined bone landmarks with and without load could be established on healthy dogs and those with ED. Using normalization of length-measurements we were able to establish comparability between different joints and projections. Measurements from x-rays taken in a standing position showed a lot of positioning related artefacts and low reliability. We were able to compile standard values from x-rays of the control group taken with- and without load due to the low deviation of the norm values. Due to marked delination based on significant differences we were able to establish subgroups Typ I (n=60), Typ II (n=40) and Group indiff (n=49) in the ED Group. Distinction Criterions to classify an ED elbow joint in Types I, II or indiff were 3 subchondral jointgaps (mp3, mp4, mp6), three indices calculated out of joint gaps (LI 3, LI 4 and LI 6) and an angle. In the control group these parameters showed a high reliability. Using an osteotomy model we were able to draw parallels between Typ I and a short Ulna, as well as Typ II and a short radius. Conclusions: X-rays taken in a standing position are not feasible. Using x-rays taken with and without load we were able to adequately describe bone-marker relations and could compile norm values. Using our developed method we have been able to assign 67% of the examined diseased joints to a type of incongruency (Type I or II). The results of three dimensional ulna and radius shortening indicate three dimensional movement of the bone surface in Typ I or II in the joint. Whether elbow joints of Typ I (40%) benefit of a three dimensional proximal ulna-osteotomy or joints of Typ II (27%) would benefit of a radial elongation needs to be shown in further studies
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Eksell, Per. "Imaging of bone spavin : a radiographic and scintigraphic study of degenerative joint disease in the distal tarsus in Icelandic horses /." Uppsala : Swedish Univ. of Agricultural Sciences (Sveriges lantbruksuniv.), 2000. http://epsilon.slu.se/avh/2000/91-576-5922-2.pdf.
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Lamb, Megan Murphy. "Comparison of radiographic guidance to magnetic resonance imaging guidance for injection of the collateral ligaments of the distal interphalangeal joint in an equine cadaver model." Thesis, Virginia Tech, 2013. http://hdl.handle.net/10919/51166.
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Desmopathy of the collateral ligament of the distal interphalangeal joint is a common cause of lameness in the horse and carries a poor prognosis for soundness. Intralesional treatment has been suggested as a way to improve outcome; however, limited reports describe methods for injecting this ligament. This study compares the accuracy of injecting the collateral ligament of the distal interphalangeal joint using magnetic resonance imaging (MRI) versus radiographic guidance. Equine cadaver digit pairs (n=10) were divided by random assignment to injection of the ligament by either technique and assessed using post-injection MRI or gross sections. Images from the proximal, middle, and distal portions of the ligament were blindly evaluated for successful injection. McNemar\'s test was performed to determine statistical difference between injection techniques. Fisher\'s exact test was used to evaluate number of injection attempts and injection of the medial or lateral collateral ligament. MRI-guided injection was successful more frequently than radiographic-guided injection on post-injection MRI (24 of 30 versus 9 of 30; p=0.0006) and gross sections (26 of 30 versus 13 of 30; p=0.0008). At each level of the ligament (proximal, middle, and distal), MRI-guided injection resulted in more successful injections than radiographic guidance. Statistical significance occurred at the proximal aspect of the collateral ligament based on post-injection MRI (p=0.0143) and the middle portion of the ligament based on gross sections (p=0.0253). Based on these results, injection guided by standing, low-field MRI should be considered an option for delivering intralesional regenerative therapy to horses with desmopathy of these collateral ligaments.Master of Science
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Menezes, Alynne Vieira de. "Comparação entre radiografias transcranianas e imagens por ressonancia magnetica." [s.n.], 2007. http://repositorio.unicamp.br/jspui/handle/REPOSIP/288875.
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Orientador: Flavio Ricardo ManziDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
Made available in DSpace on 2018-08-08T11:29:55Z (GMT). No. of bitstreams: 1 Menezes_AlynneVieirade_M.pdf: 1180811 bytes, checksum: 64bc1d26cd02bd7f68780d09d85349aa (MD5) Previous issue date: 2007
Resumo: Inúmeras são as imagens propostas para determinar a posição condilar na fossa mandibular. No entanto, apesar do desenvolvimento de técnicas mais avançadas para a obtenção da imagem da articulação temporomandibular, a projeção transcraniana permanece popular até os dias de hoje. A realização deste trabalho teve como objetivo avaliar a posição condilar em radiografias transcranianas (TRANS) comparando-as com o resultado obtido nas imagens por ressonância magnética (IRM). Foram estudados 35 pares de TRANS e IRM, perfazendo um total de 70 articulações. As TRANS foram comparadas com as imagens dos pólos lateral, central e medial da IRM. Para isso foram realizadas análises subjetivas e objetivas tanto em máxima intercuspidação habitual (MIH) como em máxima abertura, objetivando a determinação da posição condilar. Valores de sensibilidade, especificidade e acurácia foram calculados e os dados analisados estatisticamente pelo teste de Bowker, não sendo verificada diferenças estatísticas entre TRANS e IRM (p>0,05). Apesar de não ter sido observada diferença estatisticamente significante e ntre os valores, as comparações entre a TRANS e a imagem do pólo lateral da IRM apresentaram valores mais altos do que comparações realizadas com os pólos central e medial, visto que a imagem observada na TRANS é considerada a projeção do pólo lateral da ATM. Concluise então que a TRANS mostrou-se como um método aceitável, não podendo ser descartada sua aplicabilidade quanto ao poder de diagnóstico complementar na determinação da posição do côndilo
Abstract: Several image modalities have been used to access the condylar position in the glenoid fossa. However, despite the development of more advanced techniques for imaging of the temporomandibular joint, the transcranial projection remains widely used in dentistry. The purpose of this study was to compare the condylar position from transcranial projection (TRANS) and magnetic resonance imaging (MRI). Thirty five matched pairs of TRANS and MRI were evaluated. The TRANS were compared with the lateral, central and medial cuts of the MRI and the condylar position was accessed in the closed and opened mouth position, according to subjective and objective methods. Bowker¿s test was used to analyze the data and there was no statistical significance between TRANS and MRI (p>0.05). The sensitivity, specificity and accuracy values were calculated for each group. Although a similar mean values between them, the comparison with the lateral cut showed higher values, which might be due to the fact that the TRANS represents the lateral one third of the condyle. It can be concluded that the TRANS seems to be an acceptable method, and its applicability as adjunctive method in the condylar position should not be rejected.
Mestrado
Radiologia Odontologica
Mestre em Radiologia Odontológica
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Taranto, Michael Joseph. "An investigation of the dynamic angle of gait and radiographic characteristics of the first metatarsophalangeal joint in subjects with hallux limitus." University of Western Australia. School of Surgery and Pathology, 2005. http://theses.library.uwa.edu.au/adt-WU2005.0048.
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[Truncated abstract] Limitation of sagittal plane dorsiflexion, or hallux limitus (HL), represents the second most commonly encountered pathomechanical disorder affecting the first metatarsophalangeal joint, after hallux valgus (HV). The kinematic role of the first metatarsophalangeal joint represents an integral component of the gait cycle. It has often been reported that for adequate leverage and propulsion to occur during normal gait, the hallux must be able to dorsiflex approximately 65° on the head of the first metatarsal. Secondary gait compensation mechanisms have often been observed clinically as a result of HL. The effect of HL on gait can be reflected in transverse plane alteration of the foot in relation to the line of progression during gait, defined as the angle of gait (AOG). The first purpose of this study served to investigate potential differences in dynamic angle of gait AOG in subjects with HL compared to a control group. A validated technique using coloured powdered footprints was used to quantify AOG. Furthermore, it was required to establish whether the relative amount of transverse plane motion observed in the AOG was related to factors intrinsic or extrinsic to the foot. Intrinsic factors such as the amount of forefoot to rearfoot abduction was considered, and achieved by measuring the rearfoot to forefoot axis (RFA) angle using a weight bearing composite (COMP) view radiograph. The remaining objectives of the study served to investigate other common aetiological factors associated with HL and their potential influence on AOG in subjects with HL ... Results further indicated that the amount of first metatarsophalangeal joint dorsiflexion did not appear to influence AOG in the two groups, and that AOG did not reflect the iii amount of forefoot to rearfoot abduction in a foot with HL compared to the control group. When comparing foot type, as indicated by CIA, it appeared AOG did not significantly alter between the HL and control groups. Finally, the results indicated AOG did not differ significantly between subjects with unilateral HL. This thesis study indicated that with the current sample population, the wide variability in AOG prevented detection of any subtle differences that may exist in subjects with HL. Results also emphasised the need to incorporate other variables such as symptomology and foot dominance when considering the effects first metatarsophalangeal joint pathology might have on HL, such as AOG.
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Suzuki, Yusuke. "Home exercise therapy to improve muscle strength and joint flexibility effectively treats pre-radiographic knee OA in community-dwelling elderly: a randomized controlled trial." Kyoto University, 2019. http://hdl.handle.net/2433/242660.
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Abreu, Marcos Petto Nunes de. "Pneumatização do tubérculo articular do osso temporal." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/23/23139/tde-02012008-121507/.
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A pneumatização do tubérculo articular do osso temporal (PTA) é uma variação anatômica, observada radiograficamente como uma área radiolúcida uni ou multilocular, similar às observadas nas células aéreas do processo mastóide do osso temporal, não expansiva ou destrutiva, e não se estendendo além da sutura zigomático-temporal. No presente trabalho nos propusemos a conhecer, por meio do levantamento epidemiológico de 3823 radiografias panorâmicas, a incidência e as características da PTA em pacientes atendidos pelo Serviço de Radiologia da Clínica de Odontologia da Faculdade de Odontologia da Universidade de São Paulo. A PTA foi encontrada em 68 pacientes (1,78%) com idade cronológica média de 40 anos (±20,85) em intervalo etário de 8 a 87 anos; sendo que destes casos, 39 (57,4%) ocorreram no gênero feminino e 29 (42,6%) no gênero masculino. A PTA ocorreu unilateralmente em 42 casos (61,8%) e bilateralmente em 26 casos (38,2%). Radiograficamente 42 (44,6%) eram de padrão unilocular e 52 (55,4%) de padrão multilocular. O reconhecimento da PTA é de suma importância para se evitar interpretações incorretas com afecções e avaliar sua influência na evolução de processos sépticos, na reparação tecidual e no planejamento cirúrgico na região da articulação têmporo-mandibular.The temporal bone pneumatized articular tubercule (PAT) is a anatomical variant, seen on radiographs as a unilocular or multilocular radiolucency, similar to those in mastoid process, noexpansile or nondestructive, and do not extend beyond the zygomatictemporal suture. The purpose of this study was to know, by a epidemilogical analysis of 3823 panoramic radiographs, the incidence and characteristics of the PAT, in dental patients from the Dental Clinic, at the Radiology service in University of São Paulo. The PAT was found in 68 patients (1,78%) with mean cronological age of 40 years (± 20,85) with a range of 8 to 87 years; while 39 (57,4%) occured in females and 29 (42,6%) in male. Unilateral PAT was found in 42 cases (44,6%) and bilateral in 26 cases (38,2%). Radiography aspects showed 42 cases (44,6%) as unilocular and 52 cases (55,4%) as multilocular. The knowledge of the PAT is very important to avoid misdiagnosis within other diases ocorring in the area, and avaliate her influency in the evolution of septic process, realing process, and at the cirurgical management of the temporomandibular joint.
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Ji, Xiang. "The association of variations in hip and pelvic geometry with pregnancy-related sacroiliac joint pain based on a longitudinal analysis." Kyoto University, 2019. http://hdl.handle.net/2433/242658.
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Pina, Augusto Taborda Monteiro de Calça e. "Associação entre alterações radiológicas e ecográficas em casos de desmite do ligamento colateral da articulação interfalângica distal." Master's thesis, Universidade de Lisboa, Faculdade de Medicina Veterinária, 2019. http://hdl.handle.net/10400.5/18580.
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Dissertação de Mestrado Integrado em Medicina VeterináriaDesmite dos ligamentos colaterais da articulação interfalângica distal é uma afeção que tem vindo a ser estudada ao longo dos tempos. Anteriormente, com os métodos complementares de diagnósticos disponíveis, era uma afeção que muitas vezes era subdiagnosticada. Assim, desenvolveu-se um estudo em que o objectivo era determinar a relação entre alterações visíveis no local de inserção dos ligamentos colaterais da articulação interfalângica distal no estudo radiográfico com base na projecção Dorsoproximal-Palmarodistal Oblíqua a 65º e a presença de lesões nos ligamentos colaterais diagnosticadas com base em ecografia. Este estudo incluía uma amostra de 8 cavalos dos quais se avaliaram 13 membros. Este é um estudo retrospectivo, sendo que os dados foram recolhidos da base de dados da CVME. Os membros relativos a este estudo, eram membros torácicos. Destes 8 cavalos, foram definidos dois grupos, 1 e 2, em que: Grupo 1 (G1) – (controlo) cavalos positivos ao bloqueio digital palmar sem alterações dos LC’s visíveis á ecografia; Grupo 2 (G2) – cavalos positivos ao bloqueio digital palmar com alterações dos LC’s visíveis á ecografia. Na comparação da avaliação de radiolucência entre o local de inserção dos ligamentos colaterais lateral e medial os resultados demonstraram não existir diferenças significativas para a amostra deste estudo. Isto é, foi encontrada associação entre o lado da alteração radiográfica (lateral/medial) e o lado do ligamento lesionado no G2. Contudo, no G1 houve casos em que estavam presentes alterações radiográficas mas não eram casos de desmite, admitindo que as mesmas não são específicas para o lesões de ligamentos colaterais. Com os resultados obtidos na amostra representada neste estudo, conclui-se que as alterações radiográficas visualizadas na projeção Dorsoproximal-Palmarodistal Oblíqua a 65º e a sua relação com lesões nos ligamentos colaterais, não auxiliam no diagnóstico de lesões nos ligamentos colaterais da articulação interfalângica distal.
ABSTRACT - ASSOCIATION BETWEEN RADIOGRAPHIC AND ECOGRAPHIC CHANGES IN CASE OF COLLATERAL LIGAMENT DESMITIS OF DISTAL INTERPHALANGEAL JOINT - The collateral ligaments desmitis of the distal interphalangeal joint is an affection that has been studied over time. Previously, with the complementary diagnostic methods available, it was an affection that was often underdiagnosed. Thus, a study was developed in which the objective was to determine the relationship between visible changes at the insertion site of the collateral ligaments of the distal interphalangeal joint in the radiographic study based on the dorsoproximal-palmarodistal oblique projection at 65º and the presence of collateral ligament injuries diagnosed by ultrasound technique. This study included a sample of 8 horses of which 13 members were evaluated. This is a retrospective study, and data were collected from the CVME database.The limbs related to this study were thoracic limbs. Of these 8 horses, two groups were defined, 1 and 2, in which: Group 1 (G1) - (control) horses positive for palmar digital block without alterations of the LCs visible on ultrasound; Group 2 (G2) - horses positive to palmar digital block with alterations of LCs visible on ultrasound. Comparing the radiolucency evaluation between the lateral and medial collateral ligament insertion site, the results showed no significant differences for the sample of this study. That is, an association was found between the radiographic alteration side (lateral / medial) and the injured ligament side in G2. However, in G1 there were cases where radiographic changes were present but not cases of dismissal, admitting that they are not specific for collateral ligament injuries. With the results obtained in the sample represented in this study, it can be concluded that the radiographic alterations visualized in the Dorsoproximal-Palmarodistal Oblique projection at 65º and its relation with collateral ligament injuries do not help in the diagnosis of lesions in the distal interphalangeal joint collateral ligaments.
N/A
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Björnsdóttir, Sigrídur. "Bone spavin in Icelandic horses : aspects of predisposition, pathogenesis and prognosis /." Uppsala : Dept. of Clinical Radiology, Swedish Univ. of Agricultural Sciences ([Institutionen för klinisk radiologi], Sveriges lantbruksuniv, 2002. http://epsilon.slu.se/avh/2002/91-576-6382-3.pdf.
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Doering, Bettina. "Vergleichende Darstellung röntgenologischer Befunde am Strahlbein und Hufgelenk des Pferdes gemäß dem Röntgenleitfaden 2007 und computertomographischen Befunden." Doctoral thesis, Universitätsbibliothek Leipzig, 2017. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-217275.
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Zusammenfassung
Vergleichende Darstellung röntgenologischer Befunde am Strahlbein und Hufgelenk des Pferdes gemäß dem Röntgenleitfaden 2007 und computertomographischen Befunden
Die vorliegende Arbeit befasst sich mit der röntgenologischen und computertomographischen Untersuchung an der distalen Gliedmaße des Pferdes.
Ziel der Arbeit ist es, die in Kaufuntersuchungen verwendeten röntgenologischen Standardaufnahmen des RöLF 2007 im Hinblick auf ihre Darstellbarkeit von Veränderungen im Hufgelenk- und Strahlbeinbereich und die folgliche Klassifizierung der Pferde in Röntgenklassen gemäß dem RöLF 2007 zu überprüfen.
Material und Methoden
Das Untersuchungsmaterial setzte sich aus 100 distalen Gliedmaßenpaaren 51 getöteter Warmblutpferde aus einem niedersächsischen Schlachthof im Bremer Raum zusammen. Es wurden die Hufgelenke und Strahlbeine von 102 Vorder- und 98 Hinterextremitäten röntgenologisch und computertomographisch untersucht. Anschließend wurden die erhobenen Befunde makroskopisch anhand von Frisch-und Knochenpräparaten überprüft.
Die Pferde wurden mittels der Befunde der lateromedialen Übersichtsaufnahme der Zehe und der 0°-Aufnahme („Oxspingaufnahme“) des Strahlbeins gemäß dem RöLF 2007 in Röntgenklassen eingeteilt. Nach der anschließenden computertomographischen Untersuchung erfolgte eine erneute, korrigierte Einteilung in die entsprechende Röntgenklasse in Anlehnung an den RöLF 2007. Computertomographische Befunde, für die kein entsprechendes Äquivalent im RöLF 2007 zu finden war, wurden gesondert hervorgehoben. In einer weiteren Auswertung wurde der Einfluss einer hypothetischen Erweiterung des Röntgenstandards um Zusatzprojektionen wie eine Strahlbeintangentialaufnahme an den Vorderbeinen und die Oxspringaufnahme an den Hinterbeinen auf die Gesamtbeurteilung eines Pferdes untersucht. Mit den Sekundärrekonstruktionen der Spiral-CT sollten die Befunde dargestellt werden, die durch die röntgenologischen Zusatzprojektionen hypothetisch hätten detektiert werden können. Im Anschluss wurden die bildgebenden Befunde durch eine Präparation und Mazeration der veränderten Gliedmaßen letztlich in Beziehung zu den pathomorphologischen Veränderungen im Hufgelenk- und Strahlbeinbereich gesetzt und überprüft.
Die Röntgenuntersuchung erfolgte nach den einzelnen Kriterien der lateromedialen Übersichtsaufnahme der Zehe und der 0°-Aufnahme des Strahlbeins gemäß dem RöLF 2007. Zum Einsatz kam das mobile DR-System „Scope X“ der Gierth international GmbH sowie eine dicomPACS® vet gestützte Dokumentations- und Befundungssoftware.
Die Akquirierung der CT-Datensätze erfolgte anhand eines Toshiba Aquilon 16-zeiligen Spiral-CT der 3. Generation mit einer stationären Gantry der TOMOVET® GmbH und einer integrierten VITREA®-Workstation zur Erstellung multiplanarer Reformatierungen (MPRs).
Ergebnisse
Es stellte sich heraus, dass sich die Röntgenklasse bei 82,36 % der untersuchten Pferde nach der computertomographischen Untersuchung nicht oder nur um eine halbe Röntgenklasse veränderte, wenn die gesamte distale Gliedmaße betrachtet wurde. In der gesonderten Betrachtung des Hufgelenk- und Strahlbeinbereichs waren dies sogar 88,24 %.
Dies zeigt, dass durch die Darstellbarkeit von Veränderungen im Hufgelenk-/Strahlbeinbereich mittels der röntgenologischen Standardaufnahmen eine relativ sichere und korrekte Zuordnung der Pferde in die entsprechende Röntgenklasse ermöglicht wird.
Eine hypothetisch zusätzlich angefertigte Strahlbeintangentialaufnahme an den Vordergliedmaßen sowie eine Oxspringaufnahme an den Hintergliedmaßen haben entgegen der Erwartungen keinen wesentlichen Einfluss auf die Gesamtklassifizierung der einzelnen Pferde.
Schlussfolgerung
Die Ergebnisse der vorliegenden Arbeit zeigen, dass ein Großteil der Befunde im HG/SB mittels der lateromedialen Übersichtsaufnahme und der 0°-Aufnahme des Strahlbeins gemäß dem RöLF 2007 dargestellt werden können. Der zusätzlich erreichte Informationsgehalt durch eine reguläre Erweiterung der Standardaufnahmen um eine Strahlbeintangentialaufnahme an den Vordergliedmaßen sowie eine Oxspringaufnahme an den Hintergliedmaßen rechtfertigt nicht den technischen und finanziellen Mehraufwand und die zusätzliche Strahlenbelastung des Untersuchers sowie der an der Untersuchung beteiligten Personen.
Bei zweifelhaften Befunden ist eine Erweiterung des Standards um entsprechende Zusatzaufnahmen aber natürlich weiterhin obligat. Im wissenschaftlichen Interesse wären weitere Untersuchungen mit einem röntgenologisch insgesamt besser klassifizierten Pferdematerial und Informationen über die klinische Verfassung sowie die Beschaffenheitsvereinbarung des untersuchten Pferdes zum Untersuchungszeitpunkt wünschenswert.
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Costa, Emanuel Dias. "Prevalência de alterações radiográficas associadas à doença articular degenerativa no gato doméstico : estudo retrospetivo de 100 casos." Master's thesis, Universidade de Lisboa, Faculdade de Medicina Veterinária, 2018. http://hdl.handle.net/10400.5/16330.
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Dissertação de Mestrado Integrado em Medicina VeterináriaA doença articular degenerativa (DAD) apresenta uma etiologia multifatorial, envolvendo fatores genéticos, biomecânicos e bioquímicos, caracterizando-se pela existência de degeneração da cartilagem articular com produção de novo tecido ósseo. A sua prevalência na população felina parece aumentar com a idade, sendo o seu diagnóstico feito com base na associação de sinais clínicos e alterações ao exame radiográfico. O presente estudo teve por base uma amostra de 100 pacientes felinos (N=100) com exame radiográfico e anamnese disponíveis. Os objetivos principais foram calcular a prevalência de DAD na presente amostra e avaliar a frequência e a gravidade das lesões no esqueleto axial e apendicular. Para isto, os exames radiográficos dos 100 animais foram avaliados por dois observadores quanto à existência de sinais radiográficos compatíveis com DAD e respetivo grau de gravidade. Na população avaliada, a prevalência de sinais radiográficos compatíveis com DAD foi de 38%. Os esqueletos apendicular e axial apresentaram alterações em 24% e 25% dos animais, respetivamente. Existiam lesões simultaneamente na coluna e nas articulações apendiculares em 11% dos animais avaliados. A articulação do esqueleto apendicular mais frequentemente afetada foi a articulação úmero-rádio-ulnar, e a que apresentou lesões de maior gravidade foi a articulação femoro-tíbio-patelar. No esqueleto axial, o segmento da coluna com maior frequência de alterações compatíveis com DAD foi a região torácica. Já a região lombar apresentou scores de gravidade mais elevados quando comparado com os restantes segmentos. Não foi encontrada uma associação estatisticamente significativa entre a presença de sinais radiográficos e o sexo ou a idade. No entanto, foi encontrada uma relação estatisticamente significativa entre a raça do animal e a presença de DAD (p<0,05). A prevalência encontrada (38%) é largamente superior ao número de animais da amostra em que se suspeitava da existência de doença articular (3%). Além de frequente, a DAD é sub-diagnosticada na prática clínica, sendo responsável por provocar dor crónica nos pacientes felinos passando muitas vezes desapercebida quando a avaliação se baseia na anamnese e nos sinais clínicos. Sendo assim, o exame radiográfico e sua correta apreciação reveste-se de extrema importância de modo a identificar e possibilitar o tratamento desta doença.
ABSTRACT - Prevalence of radiographic changes associated with degenerative joint disease in the domestic cat – retrospective study of 100 cases - Degenerative joint disease (DJD) has a multifactorial etiology that involves genetics, biomechanics and biochemistry factors and it is characterized by the degeneration of the cartilage with production of new bone tissue. Its prevalence in the feline population increases with age and its diagnosis takes in consideration the clinical signs as well the radiographic chances. The present study used a sample of 100 feline patients (N=100) with radiographic exams and anamnesis available. The main objective was to calculate DJD prevalence in the sample as well as determine the frequency and severity of these lesions in the axial and appendicular skeleton. To accomplish this, radiographic exams from 100 patients were observed and evaluated by two different observers, who assessed them for the presence of radiographic signs compatible with DJD and respective degree of severity. In the evaluated population, the prevalence of radiographic signs compatible with DJD was 38%. The appendicular and axial skeleton had shown changes in 24% and 25% of the animals, respectively. There were lesions in both spine and appendicular joints in 11% of the population. The most frequently affected joint of the appendicular skeleton was the elbow, and the one that presented with the most severe lesions was the knee. In what concerns to the axial skeleton, the segment of the spine with the highest frequency of compatible with DJD was the thoracic region. The lumbar region presented higher severity scores when compared to the other segments. No statistically significant association was found between the presence of radiographic signs and sex or age. However, a statistically significant relationship was found between the patient’s breed and the presence of DJD (p<0,05. The prevalence of DJD determined (38%) is significantly higher than the number of patients in which it was suspected (3%). DJD is not only frequent and responsible for causing chronic pain in feline patients, but also under-diagnosed in the clinical practice, going unnoticed when the evaluation is based on anamnesis and clinical signs. Therefore, the radiographic examination and its correct evaluation is of extreme importance to identify and make the treatment of this disease possible.
info:eu-repo/semantics/publishedVersion
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Lemos, Fernando de Aguiar. "Desenvolvimento de um programa de análise de imagens radiológicas de membros inferiores com osteoartrite de joelho a partir de parâmetros biomecânicos funcionais." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2010. http://hdl.handle.net/10183/29252.
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A osteoartrite (OA) de joelho é uma doença multifatorial que acomete pessoas a partir da terceira década de vida, mas com maior incidência em idosos. Sua classificação é feita baseado em parâmetros clínicos e qualitativos durante uma intervenção médica. Nos casos mais avançados, a cirurgia de artroplastia de joelho envolve não apenas a substituição da articulação por uma prótese, mas também o realinhamento dos segmentos do membro inferior. Nesse caso há a necessidade de uma abordagem mais quantitativa na busca do reposicionamento desta articulação em relação ao eixo de suporte da carga corporal (ESCC). O objetivo deste estudo foi desenvolver uma metodologia de análise que possibilitasse quantificar uma série de parâmetros estruturais e funcionais a partir de imagens da raios-X em sujeitos saudáveis, assintomáticos para OA e em sujeitos com diagnóstico de OA de joelho. Este estudo utilizou-se da classificação adotada por Dejour (1991) para a classificação dos sujeitos em grupos com diferentes graus de OA. A amostra foi constituída de sujeitos de 25 a 80 anos com níveis de grau 1, grau 2 e grau 3 de OA. Além da classificação nos graus, os sujeitos foram separados pela presença ou não de dor em assintomáticos (OA sem dor) e sintomáticos (OA com dor). Imagens de raios-X foram obtidas do membro inferior dos sujeitos. Previamente à obtenção das imagens, um sistema de calibração foi construído com o objetivo de identificar possíveis erros de medidas e corrigi-los. Além disso, o sistema de calibração também foi utilizado na definição exata da metodologia a ser utilizada na obtenção dos exames radiográficos a fim de que a quantificação dos parâmetros estruturais e funcionais de cada membro inferior não apresentasse fatores intervenientes que pudessem mascarar os resultados obtidos de cada imagem digital, possibilitando também a comparação entre os indivíduos. Após a identificação dos fatores de correção das imagens digitais, um programa foi desenvolvido na plataforma Matlab para a identificação das variáveis geométricas dos membros inferiores. Além disso, também foi desenvolvida uma rotina matemática que permitiu calcular, por meio da de decomposição de vetores de força, as cargas que atravessavam cada articulação do joelho. Com estas informações foi possível comparar as variáveis geométricas dos membros inferiores entre os diferentes níveis de OA e também observar por meio de três modelos matemáticos qual a influência destas variáveis no mínimo espaço intra-articular medial (MEIAM), na força no compartimento medial (FCM) e nas estruturas contra-laterais a este compartimento, como o ligamento colateral lateral e trato iliotibial, neste trabalho denominados de força P. Os principais resultados obtidos no presente estudo foram: (1) o desenvolvimento de uma metodologia de calibração de imagens digitais capaz de reduzir os efeitos da ampliação da imagem, corrigindo os valores ampliados aproximando-os dos valores reais; (2) Foi observado que o desalinhamento dos membros inferiores avaliado pelo ângulo que representa a relação entre o quadril, joelho e tornozelo (QJT) tem influência na OA de joelho, assim como o ângulo entre os platôs condilares do fêmur e da tíbia (PC). Visto que quanto maior estes ângulos, menor o mínimo espaço intra - articular medial (MEIAM) e maior os graus de OA. 3) Quando avaliado as variáveis geométricas dos membros inferiores em um teste de regressão linear múltipla, para saber a influência na força do compartimento medial (FCM), na força do ligamento colateral lateral e tracto iliotibial (força P) e no MEIAM, o QJT teve maior poder explicativo tanto para as cargas como o MEIA, confirmando a teoria mecânica. Entretanto o ângulo do colo do fêmur (ACF), apesar de uma baixa participação (6%) que mostrou um grau de importância significativo nos modelos de carga do compartimento e do MEIAM. Assim, embora nós saibamos que os segmentos inferiors ajustam-se mecanicamente em relação a carga, foi observado que o desalinhamento dos membros inferiores é um fator de risco mais importante entre todas as variáveis para o desenvolvimento da OA.Knee osteoarthritis (OA) is a multifactorial disease that affects people from the third decade of life, but with higher incidence in the elderly. Its classification is based on clinical and qualitative parameters during a medical intervention. In more advanced cases of OA, knee arthroplasty involves not only joint replacement with prosthesis, but also the realignment of the lower limb segments. In this case, there is a need for a more quantitative approach in the pursuit of the joint repositioning in relation to the load bearing axis (LBA). The aim of this study was to develop a methodology that would enable the quantification of a number of structural and functional parameters, using X-ray images, in healthy subjects, asymptomatic for OA and subjects diagnosed with knee OA. This study used the classification adopted by Dejour (1991) to classify the subjects into groups with different degrees of OA. The sample consisted of subjects between 25 and 80 years old, classified with levels 1, 2 and 3 of OA. Besides this classification, subjects were separated by the presence or absence of pain into asymptomatic (OA without pain) and symptomatic (OA with pain). Radiographic images of the lower limb were obtained of the subjects. Prior to obtaining the images, a calibration system was built to identify possible measurement errors and correct them. In addition, the calibration system was also used to define the exact methodology to be used to obtain the images, so that the quantification of structural and functional parameters of each lower limb did not present intervening factors that might mask the results, allowing also the comparison between individuals. After identifying the correction factors of the digital images, a Matlab routine was developed to identify the geometric variables of the lower limbs. In addition, this routine also allowed the calculation, through the decomposition of force vectors, of the loads that cross each knee joint. With this information, it was possible to compare the geometric variables of the lower limbs between different levels of OA and also observe, by means of three mathematical models, the influence of these variables on the medial intra-articular minimum space, on the force in the medial compartment (FMC) and on the contra-lateral structures in this compartment, such as the lateral collateral ligament and the iliotibial tract, called, in this work, P force. The main results of this study were: (1) the development of a calibration methodology for digital images capable of reducing the effects of image magnification, adjusting the values closer to real values; (2) the observation that the misalignment of the lower extremities, evaluated by the angle that represents the relationship between hip, knee and ankle (HKA), has an influence on knee OA, as well as the angle between the condyle plateaus of the femur and the tibia. The larger this angle is, smaller is the medial intra-articular minimum space, and higher are the levels of OA; (3) when evaluating the geometric variables of the lower limbs in a multiple linear regression test, to identify the influence of these variables on the force of the medial compartment (FMC), on the force of the lateral collateral ligament and the iliotibial tract (indicated here as P force) and on the MIAMS it was possible to observe that the HKA showed larger explanatory power for the loads as the MIAMS, confirming the mechanical theory. However, for the angle of the femoral neck (AFN), despite a lower power to explain the dependant variables (only 6%), it still showed a significant importance in the load compartment models and MIAMS. Thus, although we know that the segments adapt or mechanically adjust in response to load, it seems that the lower limb segments alignment is the most important factor amongst all variables as a risk factor for the development of knee OA.
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Pavão, Rogério Fávaro. "Avaliação eletromiográfica dos músculos da mastigação, da movimentação mandibular e do posicionamento condilar de pacientes desdentados totais com disfunção temporomandibular, antes e após a instalação de próteses totais com pistas deslizantes de Nóbilo." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/58/58131/tde-23102007-142231/.
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O objetivo deste trabalho foi estudar as medidas dos movimentos da mandíbula, o posicionamento dos côndilos nas fossas mandibulares, os sinais e sintomas de disfunção temporomandibular e a atividade eletromiográfica em pacientes desdentados totais, antes e após a instalação das próteses totais com pistas deslizantes de Nóbilo. Foram selecionados nove pacientes portadores de próteses totais superior e inferior, com presença de sinais e sintomas de disfunção temporomandibular e com comprometimento da dimensão vertical da face. Os pacientes foram submetidos a mensurações dos movimentos mandibulares, análise da sintomatologia dolorosa, medidas de posicionamento condilar em radiografias transcranianas e exames eletromiográficos, antes e após a instalação das próteses. Os resultados obtidos foram analisados estatisticamente e mostraram significância estatística nos movimentos mandibulares (p<=0,05) de lateralidade direita, lateralidade esquerda e protrusão. Com relação a sintomatologia dolorosa posterior ao tratamento com as próteses, os resultados mostraram significância estatística (p<=0,05) nos músculos temporal esquerdo, pterigóideo lateral direito e esquerdo, pterigóideo medial direito e esquerdo e também nas articulações temporomandibulares direita e esquerda. Quanto ao posicionamento condilar os resultados mostraram-se não-significantes (p>=0,05) para os ângulos e módulos de deslocamentos. O exame eletromiográfico dos músculos masseteres e temporais foram significantes nas situações de repouso para o masseter e temporal direito e na protrusão para o masseter esquerdo. Baseado nos resultados obtidos pode-se concluir que as próteses totais com pistas deslizantes de Nóbilo promoveram alterações significativas no aumento dos movimentos mandibulares e melhora da sintomatologia dolorosa; não promoveram alterações significativas na posição dos côndilos nas fossas mandibulares e promoveram alterações significativas na atividade muscular em repouso e protrusão.The purpose of this work was to study the measurements of jaw movements, the condyles position into the mandibular fossas, signs and symptoms of temporomandibular dysfunction and electromyographic activity in edentulous subjects, before and after using complete dentures with Nóbilo\'s sliding plates. Nine subjects were selected with upper and lower complete denture, with signs and symptoms of temporomandibular dysfunction and vertical dimension of the face were modified. The subjects were submitted to measurements of the mandibular movements, analysis of painful symptoms, and evaluation of condyle position in transcranians radiograph and electromyographic recordings before and after using dentures. The findings in this study showed statistical significances in mandibular movements (p<=0,05) lateral movement to the right and left side and protrusion. The painful symptoms after treatment showed statistical significance (p<=0,05) in left temporalis, right and left lateral pterygoid, right and left medial pterygoid and in the temporomandibular joints. Whatever the condylar position there were no significance (p>=0,05) for sliding angles and modulus. The electromyographic activity of the masseter and temporalis muscles was significantly in rest position for right masseter and right temporalis and left masseter for protrusion. In conclusion, it has been found that complete dentures with sliding plates occlusal splint enable to increase the mandibular movements, improve painful symptoms, however showed no changes in condylar position, and promote significantly change the activity in of the muscle in rest protrusion.
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Sposeto, Rafael Barban. "Estudo radiográfico axial do antepé para a avaliação do alinhamento da cabeça dos metatarsais no plano coronal." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/5/5140/tde-05062018-134557/.
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INTRODUÇÃO: As alterações do comprimento relativo dos metatarsais no plano axial são consideradas por muitos autores uma causa de distribuição inadequada da carga durante a marcha, sobrecarregando as estruturas plantares do antepé, culminando com a metatarsalgia. A meta do tratamento cirúrgico dessa síndrome é estabelecer o alinhamento da fórmula metatarsal. Porém, muitos estudos evidenciam uma taxa de 15% de recidiva da metatarsalgia após a reconstrução do formato preconizado no plano axial, conduzindo a um questionamento sobre a importância do alinhamento das cabeças dos metatarsais no plano coronal. OBJETIVO: Esse estudo tem como objetivo avaliar o padrão de alinhamento das cabeças dos metatarsais no plano coronal com carga, em indivíduos sem e com metatarsalgia. MÉTODO: Estudo transversal, avaliou 106 indivíduos entre 30 a 65 anos, dividindo-os em dois grupos de 106 pés cada, um sem dor, deformidades e calosidades nos pés e outro grupo com metatarsalgia entre os 2º, 3º e 4º metatarsais. O recrutamento dos indivíduaos foi realizado no Pronto Socorro do IOT e no ambulatório do IOT HC FMUSP, respeitando os critérios de inclusão, exclusão e aplicando o Termo de Consentimento Livre e Esclarecido. Indivíduos com deformidades no mediopé, retropé e tornozelo, pacientes com cirurgias ou fraturas prévias no pé, doenças reumatológicas e síndromes osteoneuromusculares, não foram incluídos. Após a seleção, os indivíduos foram submetidos a duas radiografias, uma axial do antepé com carga, avaliando o plano coronal de modo a aferir as alturas das cabeças dos metatarsais, e uma anteroposterior dos pés com carga, determinando o comprimento de cada raio. A análise estatística foi realizada, comparando as medidas entre os grupos. RESULTADOS: Foram avaliados 106 indivíduos, divididos em dois grupos com 106 pés cada. No grupo com metatarsalgia, 34 pés (32%) eram de pacientes do sexo masculino, apresentando uma média de idade de 49,5 anos. Foram identificados 33 pés com hálux valgo no grupo com metatarsalgia. No grupo sem patologia 54 pés (51%) eram de pacientes do sexo masculino, apresentando uma média de idade de 44,6 anos. As variáveis antropométricas como tamanho do pé, peso, altura e IMC, entre os grupos, não apresentaram diferença estatística. As cabeças dos metatarsais em ambos grupos se distribuíram em formato não retilíneo no plano coronal, seguindo a fórmula M1 M3 > M4=M5. O apoio distal do 1º raio apresentou uma posição mais plantar no grupo com metatarsalgia (p=0,000). CONCLUSÃO: As cabeças dos metatarsais em indivíduos com metatarsalgia e sem deformidade em valgo do 1º dedo, se alinharam no plano coronal de modo que M1 M3 > M4=M5, sendo M1 < M3, M1 < M4 e o M1 < M5. As cabeças dos metatarsais em indivíduos sem dor, calosidades e deformidades no antepé, se alinharam no plano coronal de modo que M1 M3 > M4=M5, sendo M1 < M3 e M1=M4=M5. No plano coronal o ponto de apoio do M1 se posicionou mais plantar nos pés de indivíduos com metatarsalgiaINTRODUCTION: Many authors consider the differences in the relative length of metatarsals in the axial plane, the cause of inadequate load distribution during the gait, overloading the forefoot plantar structures, culminating with metatarsalgia. The realignment of the metatarsal formula is the goal of surgical treatment of this syndrome. However, many studies have shown a 15% rate of metatarsalgia recurrence after the reconstruction in the axial plane, questioning the importance of the metatarsal heads alignment in the coronal plane. OBJECTIVE: This study aims to evaluate the alignment pattern of metatarsal heads in the coronal plane in individuals with and without metatarsalgia. METHODS: A cross-sectional study evaluated 106 individuals between 30 and 65 years old. They were divided in two groups of 106 feet each, one without foot pathologies and another group with metatarsalgia between the 2nd, 3rd and 4th metatarsals. The recruitment was performed at the IOT HC FMUSP for both groups, respecting the criteria of inclusion, exclusion and applying the Informed Consent Term. Individuals with midfoot, hindfoot and ankle deformities, patients with previous surgeries or fractures in the foot, rheumatologic diseases and osteoneuromuscular syndromes were not included. After the selection, the subjects were submitted to one weightbearing forefoot axial radiograph, evaluating the coronal plane in order to verify the heights of the metatarsals heads, and other weightbearing anteroposterior foot radiograph, determining the length of each ray. Statistical analysis was performed comparing the measurements between groups. RESULTS: A hundred six individuals were evaluated, forming two groups with 106 feet each. The group with metatarsalgia presented 34 male patients feet (32%), with a mean age of 49.5 years. Thirty-three feet with hallux valgus were identified in the metatarsalgia group. In the non-pathological group were found 54 male patients feet (51%), with a mean age of 44.6 years. Anthropometric variables such as foot size, body weight, height and BMI between the groups did not present statistical difference. The metatarsal heads in both groups were distributed in curved line in the coronal plane, following the formula M1 M3 > M4 = M5. The distal support of the 1st ray was positioned more plantar in the metatarsalgia group (p = 0.000). CONCLUSION: The metatarsal heads in individuals with metatarsalgia and no hallux valgus, were aligned in the coronal plane following this formula M1 M3 > M4 = M5, with M1 < M3, M1 < M4 and M1 < M5. The metatarsal heads in individuals without pain, callosities and forefoot deformities, were aligned in the coronal plane following the position M1 M3 > M4 = M5, with M1 < M3 and M1 = M4 = M5. In the coronal plane, the M1 weightbearing point was more plantar in the feet of individuals with metatarsalgia
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Hirvasniemi, J. (Jukka). "Novel X-ray-based methods for diagnostics of osteoarthritis." Doctoral thesis, Oulun yliopisto, 2015. http://urn.fi/urn:isbn:9789526210384.
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Abstract Osteoarthritis (OA) is the commonest joint disease in the world, and it has a major socioeconomic impact. OA causes progressive degenerative changes in the composition and structure of articular cartilage and subchondral bone. Clinical diagnosis of OA is based on physical examination and qualitative evaluation of changes on plain radiographs. Current clinical imaging methods are subjective or insensitive to early OA changes. Therefore, new methods are needed so as to quantify composition of the cartilage and characteristics of the subchondral bone. The aim of this thesis was to evaluate the potential of clinically applicable X-ray-based methods for the assessment of the cartilage proteoglycan content as well as the structure and density of subchondral bone in a knee joint. Subchondral bone density and structure (local binary patterns, Laplacian, and fractal-based algorithms) analysis methods for two-dimensional (2-D) plain radiographs were validated against three-dimensional (3-D) bone microarchitecture obtained from micro-computed tomography ex vivo and applied to plain radiographs in vivo. Furthermore, a method developed for the evaluation of articular cartilage proteoglycan content from computed tomography (CT) was validated against a delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC), which is widely used as a proteoglycan sensitive method, in subjects referred for an arthroscopy of the knee joint. Subchondral bone density and structure evaluated from 2-D radiographs were significantly related to the bone volume fraction and true 3-D microarchitecture of bone, respectively. In addition, bone density- and structure-related parameters from radiographs were significantly different among subjects with different stages of OA. Cartilage proteoglycan content evaluated from CT was significantly related to dGEMRIC method. Furthermore, dGEMRIC was associated with bone structure from a 2-D radiograph. In conclusion, analysis of bone structure and density is feasible from clinically available 2-D radiographs. A novel CT method sensitive to proteoglycan content should be considered when a 3-D view of cartilage quality is neededTiivistelmä Nivelrikko on maailman yleisin nivelsairaus. Se aiheuttaa merkittävää kärsimystä potilaille, ja sillä on suuri taloudellinen vaikutus yhteiskuntaan. Nivelrikko aiheuttaa palautumattomia muutoksia nivelrustokudoksen ja rustonalaisen luun koostumukseen ja rakenteeseen. Nivelrikon diagnoosi perustuu kliiniseen tutkimukseen ja röntgenkuvien silmämääräiseen arviointiin. Nykyiset nivelrikon kliiniset kuvantamismenetelmät ovat subjektiivisia eivätkä riittävän tarkkoja nivelrikon varhaisten muutosten osoittamiseen, minkä vuoksi rustokudoksen koostumuksen ja rustonalaisen luun muutosten arviointiin tarvitaan uusia menetelmiä. Tämän väitöskirjantyön tarkoituksena oli tutkia uusien röntgensäteilyyn perustuvien menetelmien soveltuvuutta polvinivelen rustokudoksen proteoglykaanipitoisuuden sekä luun tiheyden ja rakenteen arviointiin. Rustonalaisen luun tiheyttä ja rakennetta arvioitiin digitaalisesta röntgenkuvasta tietokonepohjaisilla menetelmillä ja tuloksia verrattiin mikrotietokonetomografiassa nähtävään luun kolmiulotteiseen rakenteeseen. Röntgenkuvasta laskettavia muuttujia verrattiin myös eriasteisesta nivelrikosta kärsivien henkilöiden välillä. Rustokudoksen proteoglykaanipitoisuutta epäsuorasti mittaavaa tietokonetomografiamenetelmää verrattiin vastaavaan magneettikuvausmenetelmään henkilöillä, jotka olivat menossa polven niveltähystykseen. Röntgenkuvasta laskettu rustonalaisen luun tiheys ja rakenne olivat tilastollisesti selkeästi yhteydessä luun tilavuusmäärään ja mikrorakenteeseen, ja ne erosivat eriasteisesta nivelrikosta kärsivien henkilöiden välillä. Proteoglykaanipitoisuutta arvioivien tietokonetomografia- ja magneettikuvausmenetelmien välillä oli tilastollisesti merkitsevä korrelaatio. Ruston proteoglykaanipitoisuutta arvioivan magneettikuvausmenetelmän ja röntgenkuvasta laskettavan luun rakenteen välillä oli myös tilastollinen yhteys. Loppupäätelmänä voidaan todeta, että luun tiheyttä ja rakennetta on mahdollista arvioida kliinisesti saatavilla olevista röntgenkuvista. Tietokonetomografiamenetelmän käyttöä tulee harkita tutkimuksissa silloin, kun rustokudoksen tilasta halutaan kolmiulotteista tietoa
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Soares, Henrique Nogueira. "Detecção por raios-x de trincas de fadiga em juntas rebitadas de Glare®." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/88/88131/tde-09042008-150513/.
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Foi realizado um estudo comparativo da capacidade de duas variantes do método de radiografia por raios- X em detectar trincas de fadiga em juntas sobrepostas rebitadas de laminado híbrido metal-fibra Glare® de uso aeronáutico. Durante os ensaios mecânicos de fadiga sob amplitude constante de tensão, diversos corpos de prova rebitados foram periodicamente inspecionados por raios-X, em ambas as modalidades convencional e digital. Raios-X em filmes convencionais digital. Raios-X em filmes convencionais proporcionaram ótimo detalhamento de trincas nas juntas mecânicas, enquanto que as imagens geradas pela modalidade digital apresentaram qualidade muito inferior, prejudicando ou até mesmo impedindo a avaliação do grau de integridade estrutural das juntas rebitadas.A comparison is performed on the ability of two modalities of nondestructive X-ray radiography method in detecting fatigue cracks in riveted lap joints of aeronautical grade fiber-metal laminate Glare™. During constant amplitude loading in fatigue testing riveted specimens were periodically inspected using both the conventional and digital X-ray methodology. Conventional film X-ray modality provided high quality images of growing cracks in the mechanical joints, whereas digital radiography generated faulty images, which impaired or even prevented the structural integrity assessment of the riveted joints.
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Oliveira, Rafaela Andreia Crespo de. "O uso do soro autólogo condicionado -IRAP- no tratamento de lesões articulares em equinos : estudo preliminar." Master's thesis, Universidade de Lisboa. Faculdade de Medicina Veterinária, 2015. http://hdl.handle.net/10400.5/9421.
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Dissertação de Mestrado Integrado em Medicina VeterináriaVários estudos têm mostrado o impacto das lesões articulares ao nível do desempenho desportivo dos equinos, bem como as suas repercussões a nível económico, associadas aos custos relacionados com tratamentos, mas também com o abandono precoce das competições. De entre as afecções articulares, a osteoartrite é a doença articular mais frequente em equinos de desporto. O objectivo principal desta dissertação é dar a conhecer a terapia regenerativa do soro autólogo condicionado, relatando três casos clínicos submetidos a este tratamento. O exame radiográfico, apesar de ser o método complementar imagiológico mais utilizado para a detecção de lesões a nível articular, mostrou ser uma ferramenta limitada, não revelando alterações significativas. Por outro lado, a realização das ressonâncias magnéticas em dois dos casos clínicos mostrou-se importante, possibilitando a observação de lesões não observadas nas radiografias. Os tratamentos realizados com o soro autólogo condicionado foram executados com sucesso, tendo sido obtidas melhorias significativas, que até então não tinham sido atingidas com os tratamentos anteriores. Apesar da reduzida casuísta, o presente trabalho possibilitou o relato e análise dos casos clínicos acompanhados durante o estágio curricular. É ainda necessário, no futuro, a realização de mais estudos ao nível dos tratamentos com o recurso ao soro autólogo condicionado, para promover a divulgação da terapêutica e obtenção de mais informação associadas ao mesmo.
ABSTRACT - The use of autologous conditioned serum for articular lesions treatment in horses: a preliminary study - Several studies have demonstrated the impact of joint damage on the performance of sports horses and the economic repercussions associated with treatment costs, generally leading to the early withdrawal of the animals from competitions. Osteoarthritis is the most common joint disease in sport horses. The main objective of this dissertation in to present a regenerative therapy ACS/IRAP, reporting three clinical cases in wich this treatment was used. Despite being the most commonly used method for detecting joint lesions, radiographic examination seems to be a limited diagnostic tool as it is sometimes unable to detect significant joint changes. However, the use of magnetic resonance in two of the three clinical cases was important, since it enabled the observation of lesions that were not evidence on radiographs. The treatments performed with autologous conditioned serum were successfully implemented, and significant improvements were achieved, which was not the case with the previously applied traditional treatments. Despite the low number of clinical cases, this preliminary study may be useful in reporting and analyzing the field use of autologous conditioned serum. In the future, it is necessary to promote further studies regarding this treatment, to broaden its use of this and hopefully to obtain more information and knowledge about it.
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Fernandes, Tiago Lazzaretti. "Relação entre o posicionamento dos túneis na reconstrução do ligamento cruzado anterior e as avaliações funcionais em atletas." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/5/5140/tde-06122012-124436/.
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INTRODUÇÃO: A incidência de rotura do LCA aumentou, principalmente, entre atletas jovens. Além disso, esta população possui compromissos esportivos e necessidade de retornar às atividades em curto prazo. O posicionamento dos túneis é uma das variáveis mais importantes no sucesso da reconstrução do LCA em que o cirurgião pode intervir. Apesar de existirem trabalhos sobre reconstrução do LCA e avaliações funcionais, poucos estudos prospectivos avaliam a relação entre o posicionamento radiográfico dos túneis e os resultados clínicos. Portanto, o objetivo do presente estudo é avaliar a relação entre o posicionamento radiográfico dos túneis na reconstrução do LCA e as avaliações funcionais de atletas no período de retorno ao esporte. MÉTODOS: O estudo foi conduzido prospectivamente em 86 atletas (23 ± 5,9 anos, 63 homens) com lesão do LCA submetidos à reconstrução artroscópica pela técnica transtibial no Grupo de Medicina do Esporte do IOT HC-FMUSP, de 2008 a 2010. Realizadas radiografias digitais (aparelho Duo Diagnost InRad) nos planos coronal, sagital e incidência de túnel e mensurações no sistema iSite PACS HC-FMUSP (Philips). Coletados protocolos de Tegner, Lysholm, IKDC objetivo, IKDC subjetivo e retorno ao esporte aos seis e 12 meses (m). Avaliada força de associação pelo teste de correlação de Pearson, regressão logística e ANOVA, p<0,05 (STATA 10). RESULTADOS: Radiografias projeção plano coronal (fêmur 38 ± 4%; tíbia 43 ± 3%), projeção plano sagital (fêmur Amis 62 ± 7%; fêmur Harner 74 ± 8%; tíbia 39 ± 6%), inclinação do enxerto (plano coronal 190 ± 40; incidência túnel 190 ± 50). Avaliações funcionais: Lysholm (6m = 87 ± 10,7; 12m = 91 ± 12,2), Tegner (6m = 5 ± 1,4; 12m = 7 ± 1,8), IKDC subjetivo (6m = 75 ± 13,8; 12m = 85 ± 14,5), retorno ao esporte em 12m (66,7%). Projeções sagitais de túneis femorais por sobre a linha de Blumensaat ( de Pearson = -0,33, p = 0,02), assim como túneis tibiais no plano coronal ( de Pearson = 0,35, p = 0,01) e sagital (F = 3,36, p = 0,04) possuem associações significativas com as escalas funcionais. Estas relações não puderam ser explicadas por fatores basais ou demográficos. CONCLUSÃO: Nos atletas, as projeções dos túneis femorais mais posteriores, assim como projeções dos túneis tibiais mais mediais e posteriores, estão relacionadas a menores valores de avaliações funcionais.There has been an increase of ACL injuries occurring in young athletes. Aside from this increase, athletes have intensive scheduling and must resume physical activity shortly after injury. Tunnel positioning is one of the most important variables in ACL reconstruction success in which surgeons can interfere. Although there are many studies on ACL reconstruction and functional assessments, few studies have prospectively investigated the relationship between radiographic tunnel positioning and clinical outcomes. PURPOSE: The aim of this study is to evaluate the relationship between tunnel positioning and functional assessments in athletes during return to sports. METHODS: A prospective study was conducted with 86 athletes (23 ± 5.9 years, 63 males) who underwent transtibial ACL reconstruction in the Sports Medicine Group (IOT-HC FMUSP) from 2008 to 2010. Digital radiographs were acquired (Duo diagnostic InRad) in coronal, sagittal and tunnel incidence and analyzed at iSite PACS HC-FMUSP (Philips). Tegner, Lysholm, IKDC form and return to sports were collected at six and 12 months (m). Task force was assessed by Pearson correlation test, logistic regression and ANOVA, p<0.05 (STATA 10). RESULTS: Radiographic coronal view (femur 38 ± 4%, tibia 43 ± 3%), sagittal view (femur Amis 62 ± 7%; femur Harner 74 ± 8%, tibia 39 ± 6%), graft inclination (coronal 190 ± 40; tunnel 190 ± 50). Functional outcomes: Lysholm (6 m = 87 ± 10.7, 12 m = 91 ± 12.2), Tegner (6 m = 5 ± 1.4, 12 m = 7 ± 1.8), IKDC subjective (6m = 75 ± 13.8; 12m = 85 ± 14.5), return to sports (66.7%). Femoral tunnel projections along Blumensaat line on sagittal view (PCC = -0.33, p = 0.02) and tibial tunnels on coronal view (PCC = 0.35, p = 0.01) and sagittal view (F = 3.36, p = 0.04) are statistically correlated to functional outcomes. These correlations between tunnel positioning on functional outcomes could not be explained by demographic or baseline characteristics. CONCLUSION: Athlete population has lower values of functional outcomes related to more posterior femoral tunnel projections and more medial and posterior tibial tunnel projections.
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Miguel, Omar Ferreira. "Avaliação radiográfica comparativa de quadris dolorosos e sem dor em indivíduos adultos." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5140/tde-04112010-151612/.
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O objetivo do estudo foi correlacionar a presença de alterações radiográficas em quadris de pacientes portadores de dor no quadril a um grupo de pacientes sem dor no quadril. Foram avaliados 122 pacientes com dor no quadril, e 100 pacientes sem dor no quadril. Todos com idade entre 20 e 50 anos. Os pacientes foram submetidos a exames radiográficos, nas incidências AP de pelve ortostático, falso perfil de Lequesne, Dunn, Dunn 45° e Ducroquet. Os parâmetros avaliados foram inclinação e versão acetabular, ângulo CE de Wiberg, espaço articular superolateral, ângulo , ângulo de Lequesne, ângulo VCA, diferença entre o raio da cabeça e do colo femorais (off set), esfericidade da cabeça femoral e a presença de ressalto na transição da cabeça com o colo femoral. Concluiu-se que as melhores incidências para o diagnóstico de impacto femoroacetabular são AP de pelve ortostático, Dunn 45° e Ducroquet, e que as seguintes alterações estão correlacionadas com dor nos quadris: off set diminuído, ângulo aumentado, ângulo de Lequesne aumentado, ângulo CE de Wiberg diminuído, espaço articular diminuído e presença de ressalto na transição cabeça-colo femoralThis study aimed to compare two groups of patients, with and with out hip pain, and correlate them with the existence of radiograph alterations. Weve studied 122 patients with hip pain and 100 asymptomatic; the ages were between 20 to 50 years old in both groups. All patients were roentnographicaly studied in anteroposterior pelvis in orthostatic position, Lequesne false profile, Dunns, Dunns 45° and Ducroquets view. The radiograph parameters analized were the acetabular inclination and vertion, Wiberg CE angle, Lequesne VCA angle, Lequesnes antevertion angle (), angle, superior and lateral joint space, femoral off set, nonspherical of the femoral head and the presence of a bump on the head-neck transition. We conclude that the best incidences to diagnosis of femoroacetabular impingement are AP pelvis orthostatic, Dunn 45° and Ducroquet. The following alterations are correlate with hip pain: lower off set, higher angle, higher Lequesne angle, lower CE angle of Wiberg, lower articular space and bump in the femoral head-neck transition
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Almeida, Margarida Grave de. "Contribuição para o estudo do diagnóstico imagiológico de desmite dos ligamentos colaterais da articulação interfalângica distal em equinos." Master's thesis, Universidade Técnica de Lisboa. Faculdade de Medicina Veterinária, 2012. http://hdl.handle.net/10400.5/4983.
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Dissertação de Mestrado Integrado em Medicina VeterináriaÉ difícil obter um diagnóstico definitivo de desmite dos ligamentos colaterais (LC) da articulação interfalângica distal (AIFD) em equinos através das técnicas imagiológicas convencionais, sendo muitas vezes necessário recorrer à ressonância magnética (RM). Devido às dificuldades logísticas impostas por este exame seria importante determinar o significado dos sinais radiográficos que possam auxiliar o diagnóstico em casos em que a RM não seja uma opção. Para isso desenvolveu-se um estudo cujo objectivo foi determinar a associação entre as alterações radiográficas na inserção (presença versus ausência; esclerose versus radiotransparência; lado lateral versus medial) dos LC da AIFD observadas na projecção dorsoproximal-palmarodistal oblíqua (DPPDO) e a presença de lesão nos mesmos. Foram incluídos casos de membros com dor isolada na zona do casco e que tinham exames radiográficos e de RM, tendo sido divididos em dois grupos (G1-com lesão nos LC, 19 membros; G2- sem lesão nos LC, 8 membros). Não houve diferenças estatisticamente significativas entre os dois grupos (p>0,05), sugerindo portanto que não existe associação entre a presença de alterações radiográficas assim como o tipo (esclerose versus radiotransparência) e o lado (lateral versus medial) na projecção DPPDO e a presença de lesão nos LC na RM. Concluiu-se portanto que estas alterações radiográficas na inserção do ligamento não auxiliam o diagnóstico de lesões nos ligamentos colaterais da articulação interfalângica distal em equinos. O segundo objectivo do mesmo estudo foi descrever e comparar os sinais clínicos e imagiológicos dos equinos com o diagnóstico desta afecção por RM (G1). Foram incluídos 33 membros com lesão dos LC. Foi observada calcificação das cartilagens complementares em 57,6% dos membros. Os LC medial e lateral encontraram-se afectados em igual número (14/14) e 5 membros tinham ambos os ligamentos afectados. A maioria (57,5%) tinham lesões noutras estruturas do casco em simultâneo e foram encontradas alterações ósseas relacionadas directamente com a lesão na RM em 24,2% membros. Pôde-se ainda concluir que a RM foi mais sensível e específica tanto em alterações da origem/inserção dos LC da AIFD como no diagnóstico de alterações de tecidos moles do casco do que qualquer outra técnica utilizada, incluindo a ecografia.
ABSTRACT - Contribution to the study of diagnostic imaging of collateral ligament desmitis of the equine distal interphalangeal joint - A definitive diagnosis of collateral ligament (CL) desmitis of the distal interphalangeal joint (DIPJ) in horses through conventional imaging techniques is difficult and it is often necessary to use magnetic resonance imaging (MRI). Due to the logistical difficulties in the use of this technique it is important to determine the significance of radiographic findings which might aid the diagnosis in cases for which MRI is not an option. This study aims to contribute the understanding of the association between radiographic changes in the insertion (presence versus absence; sclerosis versus radiolucency; medial versus lateral side) of the CL of the DIPJ observed in a dorsoproximal-palmarodistal oblique projection (DPPDO) and presence of pathology. Cases with pain localised to the foot and with radiological and MRI exams were included and were divided into two groups (G1-LC lesion, 19 limbs; G2 without LC injury, 8 limbs). There were no statistically significant differences between the two groups (p> 0.05), suggesting that there is no association between the presence of radiographic changes and the type (sclerosis versus radiolucency) and side (lateral versus medial) in the DPPDO projection and the presence of CL injury in MRI. It was concluded that these radiographic changes in the ligament insertion do not aid the diagnosis of CL injury in horses. The second objective of the study was to describe and compare the clinical and imaging findings of horses with this diagnosis by MRI (G1). 33 limbs with CL injury were included. Cartilage calcification was observed in 57.6% of limbs. The medial and lateral CL were equally injured (14/14) and 5 had both ligaments affected. The majority (57.5%) had lesions in other structures within the foot simultaneously and osseous changes directly related to desmitis were found in 24.2% limbs in MRI. MRI was more sensitive and specific in origin/insertion changes of the CL of the DIPJ and in the diagnosis of other soft tissue injuries of the foot than any other technique, including ultrasonography.
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Vinnars, Bertil. "Scaphoid fractures : Studies on diagnosis and treatment." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-8845.
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Hinckel, Betina Bremer. "Estudo anatômico, radiográfico e biomecânico dos estabilizadores mediais da patela: ligamento patelofemoral medial, ligamento patelotibial medial e ligamento patelomeniscal medial." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/5/5140/tde-05102016-132557/.
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INTRODUÇÃO: Os ligamentos mediais responsáveis pela manutenção da estabilidade da articulação patelofemoral (PF) são o ligamento patelofemoral medial (LPFM), o ligamento patelotibial medial (LPTM) e o ligamento patelomeniscal medial (LPMM). Sobre o LPFM, existem vários estudos anatômicos, radiológicos, biomecânicos, e a evolução clínica de sua lesão e reconstrução; no entanto, pouco se sabe sobre o LPTM e o LPMM. MÉTODOS: O LPFM, o LPTM e o LPMM foram dissecados em 9 joelhos. Todos os ligamentos foram enviados para avaliação histológica, corados pelo método de hematoxilina e eosina (HE), após o teste biomecânico. Foram medidos o comprimento e a largura bem como a relação das inserções com referências anatômicas (epicôndilo medial do fêmur, tubérculo dos adutores no fêmur, linha articular, tendão patelar e menisco medial). Esferas metálicas foram introduzidas nas inserções e radiografias em ântero-posterior (AP) e perfil (P) realizadas. Foram medidas as distâncias entre as inserções e as linhas de base (na tíbia, linha do planalto, borda medial do planalto e borda medial da espinha medial; e na patela, linha da cortical posterior e bordas proximal e distal da patela). Os ensaios de tração dos ligamentos foram executados em uma máquina de ensaios mecânicos KRATOS. RESULTADOS: Todos os materiais apresentaram tecido conjuntivo denso característico de tecido ligamentar. Com o estudo anatômico verificamos que o LPFM se encontrou na camada 2, com comprimento de 60.6 mm e largura de 15,3 mm no fêmur e 20,7 mm na patela. Inseriu-se entre o tubérculo dos adutores e o epicôndilo medial no fêmur e no pólo proximal da patela. O LPTM tinha um comprimento de 36,4 mm e largura de 7,1 mm. Sua inserção tibial se encontrou 13,7 mm distal a articulação e 11,6 mm medial ao tendão patelar formando um ângulo de 18,5o com este. A inserção na patela foi 3,6 mm proximal a sua borda distal. O LPMM se encontrou na camada 3 e seu comprimento foi de 33,7 mm e largura de 8,3 mm. Com uma inserção meniscal no corno anterior, 26,6 mm medial ao tendão patelar e formando ângulo com tendão patelar de 42,8o. Sobre os parâmetros radiográficos, a inserção tibial do LPTM se encontrou 9,4 mm, na incidência AP, e 13,5 mm, na incidência P, distal a articulação. Quanto ao posicionamento médio lateral a inserção se encontrou a 30% do comprimento do planalto de medial para lateral e na borda medial da espinha medial. A inserção patelar era 4,8 mm proximal a sua borda distal. Na análise biomecânica verificamos que o LPTM era mais rígido que o LPFM (médias de 17,0 N/mm versus 8,0 N/mm, respectivamente) e apresentou menor deformação no limite de resistência máxima (8,6 mm Resumo Betina Bremer Hinckel versus 19,3 mm). CONCLUSÃO: Os ligamentos foram identificados em todos os joelhos. Os parâmetros anatômicos e radiográficos das inserções foram bem definidos. Os enxertos comumente utilizados para as reconstruções ligamentares do joelho são suficientes para a reconstrução do LPFM e do LPTMINTRODUCTION: The medial ligaments responsible for maintaining the stability of the patellofemoral (PF) joint are the medial patellofemoral ligament (MPFL), the medial patellotibial ligament (MPTL) and the medial patellomeniscal ligament (MPML). There are several studies on the anatomical, imaging, and biomechanical characteristics of the MPFL, and clinical outcome of its injury and reconstruction; however, little is known about the MPTL and MPML. METHODS: The MPFL, MPTL and MPML were dissected in 9 knees. All ligaments underwent histological evaluation by hematoxylin eosin stain after the biomechanical test. The length and width and the insertions relationship with anatomical references (medial epicondyle of the femur, adductor tubercle of the femur, joint line, patellar tendon and medial meniscus) were measured. Steel balls were introduced at the insertions and radiographs in anteroposterior (AP) and profile (P) views were performed. The distance between the insertions to baselines were measured (in the tibia, the plateau line, the medial plateau border and the medial border of the medial tibial spine; and in the patella the posterior cortical line and the proximal and distal patellar borders). The tensile tests of the ligaments were performed on a mechanical testing machine KRATOS. RESULTS: All materials showed dense connective tissue characteristic of ligaments. With the anatomical study we found that the MPFL was in layer 2, it has length of 60.6 mm and width of 15,3 mm in the femur and 20,7 mm in the patella. Inserting between the adductor tubercle and the medial epicondyle on the femur and in the inferior pole of the patella. The MPTL was found in layer 2, its length was 36.4 mm and width of 7.1 mm. Its tibial insertion was found 13.7 mm distal to the joint line and 11.6 mm medial to the patellar tendon at an angle of 18,5o with it. On the patella it was 3.6 mm proximal to its distal border. The MPML was in layer 3 and its length was 33.7 mm and width of 8.3 mm. The meniscal insertion was in the anterior horn, 26.6 mm medial to the patellar tendon and a 42,8o angle with it. In regards to the radiographic parameters the tibial insertion of LPTM was 9.4 mm, in the AP, and 13.5 mm, in the P, distal to the joint line. The medial lateral position was at 30% from medial to lateral on the tibial plateau and on the medial edge of the medial spine. The patellar insertion was 4.8 mm proximal to the distal border of the patella. In the biomechanical analysis we verified that the MPTL was more rigid then the MPFL (average of 17.0 N / mm versus 8.0 N / mm, respectively) and showed less deformation in the maximum tensile strength (8,6 mm versus 19,3 mm). CONCLUSION: The ligaments were identified in all knees. The anatomical and radiographic insertion parameters were well
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Lahkar, Bhrigu. "Contribution à la modélisation musculosquelettique personnalisée du membre inférieur par éléments finis." Thesis, Paris, HESAM, 2020. http://www.theses.fr/2020HESAE070.
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Le trouble musculosquelettique du membre inférieur est l'un des fardeaux de santé les plus courants pouvant entraîner une déficience fonctionnelle chez un individu. Bien que diverses options de gestion opérationnelle soient disponibles, il ne semble pas y avoir unanimité sur une procédure particulière qui servirait au mieux les intérêts de tous. Pour évaluer objectivement les troubles et planifier efficacement les interventions chirurgicales, il est essentiel de comprendre la biomécanique des membres inférieurs dans des conditions de charge physiologique. Avec cette motivation, ce travail de thèse vise à développer un cadre complet de modélisation musculosquelettique du membre inférieur basé sur les éléments finis. La première phase du travail de thèse est axée sur le développement et l'évaluation de modèles personnalisés d'éléments finis en flexion passive. De nouvelles approches sont proposées et évaluées pour le développement rapide de modèles axés sur la géométrie et les propriétés des ligaments. Dans la deuxième phase, une nouvelle approche basée sur les éléments finis pour la compensation des artefacts des tissus mous est proposée et évaluée. Cette contribution a permis de compenser efficacement les artefacts des tissus mous dans l'analyse du mouvement en tenant compte de la spécificité du sujet. La troisième phase du travail de thèse est consacrée à l'application clinique, où l'utilité du système radiographique biplan dans l'évaluation de l'alignement des implants de l'arthroplastie totale du genou est brièvement explorée. Dans l'ensemble, ce travail de thèse peut aider à estimer et à comprendre avec précision la biomécanique des membres inférieurs dans des conditions de charge cliniquement pertinentes, et à rapprocher le modèle de la routine cliniqueMusculoskeletal disorder of the lower limb is one of the most common health burdens that may lead to functional impairment in an individual. Although various operative management options are available, there seems no unanimity on a particular procedure that serves the best. To objectively assess disorders and effectively plan surgeries, it is essential to understand lower limb biomechanics under physiological loading conditions. With that motivation, this PhD aims to develop a comprehensive finite element based musculoskeletal modeling framework of the lower limb. The first phase of the PhD focuses on the development and evaluation of subject-specific finite element models under passive flexion. Novel approaches are proposed and evaluated for fast model development focusing on geometry and ligament properties. In the second phase, a novel finite element based approach for soft tissue artifact compensation is proposed and evaluated. This contribution allowed to effectively compensate for soft tissue artifact in motion analysis by taking subject specificity into account. The third phase of the PhD is dedicated to clinical application, where the utility of the biplanar X-ray system in evaluating Total Knee Arthroplasty implant alignment is briefly explored. Overall, this PhD may help to accurately estimate and understand lower limb biomechanics under clinically relevant loading conditions, and bring the model a step closer to clinical routine
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"Development of diffraction enhanced computed tomography for imaging joints." Thesis, 2015. http://hdl.handle.net/10388/ETD-2015-09-2239.
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This research was inspired by a need to discover more refined technologies for imaging growing joints to facilitate research in childhood arthritis, which is among the most common chronic conditions of childhood.
The objective of this project was to develop and test a new technology for imaging growing joints using diffraction enhanced imaging (DEI) combined with computed tomography (CT) using a synchrotron radiation source. DEI is a modality that derives contrast from x-ray refraction, extinction (an extreme form of scatter rejection), and absorption (as in conventional radiography). The ability to add to an image’s contrast from the refraction of x-rays, rather than that solely from absorption, generates more detailed visualization of soft tissue and of interfaces between tissues. Additionally, refraction-based imaging allows reduction of absorbed radiation dose by the sample tissue.
For this research, stifle joints from four-week piglet joints were imaged by DEI-CT using the BioMedical Imaging and Therapy (BMIT) beamline at the Canadian Light Source (CLS) synchrotron facility. This new modality for imaging growing joints incorporated a novel feedback control to maintain precise alignment of the analyzer crystal, which is used to re- diffract the beam that passes through the object, throughout the scanning procedure.
Results showed that high-resolution DEI-CT provided three-dimensional images of the bone and soft tissue of growing joints at a resolution on the order of microns. Fine detail within and between all joint structures and tissues, including striking detail of cartilage vasculature, a
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characteristic of growing but not mature joints, was demonstrated. This report documents for the first time that DEI combined with CT and using a synchrotron radiation source can generate more detailed images of intact, growing joints than is currently available from conventional imaging modalities. The development of this high resolution imaging system, which provides excellent contrast for both hard and soft tissues, fills an important gap in the suite of imaging modalities available for joint research, particularly during growth.
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Lin, Wen-Shan, and 林妏珊. "using panoramic radiography to evaluate internal derangement of temporomandibular joint." Thesis, 2008. http://ndltd.ncl.edu.tw/handle/82719084079418653730.
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碩士國立臺灣大學
臨床牙醫學研究所
96
Introduction: Clinically images prescribed for diagnosis of TMJ problems are mostly related to the internal derangement (ID) and its consequences. It is of no doubt that MRI is the image modality of choice for such purpose. However, a cheap and easily available image option, such as the orthopantomogram (OPT), is still valuable especially used for screening, if its diagnostic power can be promoted. The value of OPT assisting in diagnosis of TMJ ID has been criticized. Its limitations might be attributed to projection distortion, lack of clearly defined criteria, and the fact that TMJ ID is not necessary to be associated with obvious bony changes. It has been proposed that sequential structural changes, namely from erosion to re-cortication, might occur along with natural course of TMJ ID. Interestingly, such bony changes are frequently occurred near lateral condylar pole, which is often clearly depicted on the OPT. The aim of this study was thus to explore a possible gain of diagnostic value of TMJ ID by assessing the cortex on the orthopantomogram. Materials & Methods: Both sagittal serial TMJ MR images and OPT of 117 female subjects (18 years to 28 years , mean age 22.19, SD 2.85) were used for this analysis. The existence of TMJ ID of every single joint was diagnosed based on TMJ MRI by an experienced dentist. The reading of OPT was done by a TMD specialist and a radiological technician. The 2 readers read the OPT with discussion to achieve an agreement on diagnosis, but blind to MRI gold standard. Since there’s no general consensus on norms of TMJ condyle shown on OPT, we defined normal condyle should be convexly round in shape and covered with thin and even-thickened cortex . If the condylar morphology was deviated from the norms, it was then diagnosed to have internal derangement . If the cortical bone near the lateral condylar pole was missing or became thickened, it would also be diagnosed to have internal derangement. The sensitivity and specificity of using OPT with different diagnostic criteria diagnosis to diagnose the existence of TMJ ID were then calculated Results: 39 TMJs were excluded from the analysis because severe overlapping of condyle to its surrounding bony structures. For the 198 TMJ, 57 were with normal disc/condyle relationship, 50 were with disk displacement with reduction (DDwR) and 88 were with disk displacement without reduction (DDw/oNR). By using condylar shape alone, only 48% were corrected diagnosed. The sensitivity and specificity were 30% and 95%, respectively. By considering the additional information of cortical bone, the correct diagnosis was still remained as 48%, the sensitivity slightly raised to 35%, but the specificity fell down to 84%. MRI indicated that 2 of the 50 DDwR TMJ and 67 of the 88 DDw/oR TMJ, their condyles were with obvious bony deformation. For those 69 TMJ with bony deformation, 78% can be revealed by using condylar shape alone (sensitivity and specificity were 50% and 92%). If the cortical bone was taken into consideration, 75% can be correctly diagnosed, the sensitivity became 56% and specificity was 84%. Conclusion: With the limitation of this study, the following conclusions might be drawn: 1. Only severe TMJ ID would be often associated with obvious bony changes. 2. Most of the condylar deformation can be revealed by the OPT. Therefore, OPT seems to be suitable only for screening severe TMJ ID. 3. TMJ showing cortical bone seems to be also have morphological changes. Therefore, the information of cortical changes don’t promote too much on diagnostic power.
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Chen, Hsiang-ju, and 陳薌如. "Radiographic features of atlantoaxial joint in dogs." Thesis, 2010. http://ndltd.ncl.edu.tw/handle/14384011079433783983.
Full textAbstract:
碩士國立臺灣大學
臨床動物醫學研究所
98
英文摘要 Atlantoaxial instability (AAI) refers to the instability of the atlantoaxial joint (AAJ) that leads to dorsal displacement of the axis relative to the atlas, causing spinal cord compression. Diagnosis is based on clinical signs, signalment, history and imaging findings. Definitive diagnosis is made by demonstrating the consequence of atlantoaxial instability, such as the apparent increase in space between the dorsal spinous process of the axis and the dorsal arch of the atlas in the survey lateral radiographs, atlantoaxial misalignment causing spinal cord compression in myelography or magnetic resonance imaging (MRI), and the abnormal position of atlantoaxial joint in computed tomography (CT). In some patients, the radiographic findings are not obvious and further investigations with advanced imaging would be required to achieve the diagnosis. However, the availability of the advanced imaging facilities, higher expense for the owner and the risk of general anesthesia would all potentially be the owner’s concern regarding the further investigations. To our knowledge, there are only few studies describing the motility of the atlantoaxial joint in dogs. The objective of this study include: 1) to establish the reference of the distance of the AAJ of predisposed breed dogs in three lateral projections (extended, neutral and flexed), 2) to demonstrate the motility of the AAJ of predisposed breed dogs and non-predisposed breed dogs, 3) to compare radiographic findings in dogs without AAI and clinically affected dogs, and 4) to establish a diagnostic criteria of AAI based on radiographic findings. In total, 46 dogs were included in study one and were divided into three groups. Group one included 26 AAI-predisposed breed dogs which were not affected by AAI (six Yorkshire terriers, seven Pomeranian dogs, seven Chihuahua dogs and six Maltese terriers). Group two included 14 AAI-non-predisposed breed dogs which were not affected by AAI (seven miniature Dachshunds and seven beagles). Six AAI clinically affected dogs of predisposed breed were included in Group three (one Yorkshire terrier, one Pomeranian dog, two Chihuahua dogs and two Maltese dogs). Cervical spine radiographs were obtained in neutral, extended and flexed lateral projections and ventrodorsal projection. Five methods including the distance of atlantoaxial joint (AAD), horizontal movement (HM), vertical movement (VM), cranial to cranial (Cr’-Cr’) and caudal to cranial (Cd’-Cr’) were used to measure the distance between the atlas and the axis in three lateral views. The length of dens and axis were measured in the ventrodorsal view. In Group one, the distance of the atlantoaxial joint significantly changed between three lateral projections (p<0.05), and no significant changes were found in Group two. In all three lateral projections, VM and Cd’-Cr’ of the atlantoaxial joint in Group two was significantly increased compared to that in Group one (p<0.05). In neutral and flexed lateral projections, AAD and Cr’-Cr’ of the atlantaoxial joint in Group three were significantly increased compared to that in Group one (p<0.05). In study two, based on the data analysis of study one, a diagnostic criteria of AAI was generated. Twelve veterinarians were asked to interpret radiographs of 12 dogs (six dogs in Group one and six dogs in Group three) based on their own experience (first stage) and based on the AAI diagnostic criteria (second stage). The diagnostic rate based on the AAI diagnostic criteria was significantly higher. In conclusion, the study demonstrated that the motility of the AAJ exists in several AAI-predisposed breed dogs. The reference range of the distance between atlas and axis in several breed dogs were also established. The AAI diagnostic criteria generated from the study is user friendly, and its application would increase the diagnostic rate of AAI.
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FANG, YI-TING, and 方薏婷. "Fabrication of Multi-angle and Adjustable Knee Joint Radiographic Support." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/29jr7r.
Full textAbstract:
碩士中臺科技大學
醫學影像暨放射科學系暨研究所
106
The sulcus angle of the femoral trochlea is particularly important for evaluating the patellofemoral joint（PFJ）. The location and configuration of the intercondylar groove of the distal femur is clinically significant in the mechanics and pathomechanics of the PFJ. The aged society brings elder people in the tendency of increment of this disease. The imaging of PFJ has been becoming more important in the radiology department for the sulcus angle. The auxiliary frame adopts aluminum alloy and adopts multi-stage adjustment function to facilitate the bending of patients with different angles. The design of the base and hidden height can be adjusted according with the height of the examination table. The handles are easy to accommodate and designated fashionally. Composed of small parts, a total of 22 parts were cut. After metal cutting, the parts were anodized and black, and the instrument wheel was added to the base to allow the user to move easily. The positioning bar can also be adjusted in length. The length of the positioning bar is 22～37.5 cm and the hidden handle. The cassette positioning bar and the calf placing frame can be folded without occupying space, and can provide accommodating features. The knee bending angle was designed with five angles. In order to meet the increasing demand for photography in the clinic, a convenient, easy-to-store and angle-changing knee assist frame that can be used at angles of 30°, 35°, 40°, 45°, and 50° in order to meet the increasing demand for clinical photography. The use of patients with impaired joints that are difficult to bend will increase the convenience of clinical photography and benefit patients with knee discomfort.
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Cerva, Deborah Gillian. "A radiographic study to determine a relationship between leg length inequality and temporomandibular joint pain dysfunction syndrome." Thesis, 2009. http://hdl.handle.net/10210/2683.
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Martins, João Manuel Cardoso. "Analysis of the influence of animal positioning on the radiographic study of the coxofemural joint." Doctoral thesis, 2018. http://hdl.handle.net/10348/8454.
Full textAbstract:
A displasia da anca (DA) é uma das doenças ortopédicas mais comuns na espécie
canina. O controlo desta doença assenta essencialmente na prevenção. Apesar da
investigação desenvolvida nas últimas décadas, os resultados obtidos na sua erradicação
são ainda insatisfatórios, existindo a necessidade de aprofundar a investigação sobre os
atuais e novos métodos de diagnóstico. Na origem da dificuldade em controlar e
erradicar a DA está a sua natureza hereditária e poligénica extremamente complexa que
impossibilita que na atualidade e num futuro próximo se desenvolvam técnicas eficazes
de despiste genético. Na atualidade o despiste e classificação da DA praticado na
espécie canina pelas principais organizações mundiais (OFA, FCI, BVA/KC) assentam
os seus métodos na análise e classificação de radiografias obtidas na projeção
ventrodorsal convencional. As técnicas baseadas na lassidão articular e as novas
técnicas de imagem como a tomografia computorizada (TC) e a ressonância magnética
(RM), não são ainda usadas de forma rotineira quer devido à necessidade de maior
investigação para a sua validação, quer no caso da TC e RM também devido aos seus
elevados custos. Apesar das críticas apontadas à projeção ventrodorsal convencional,
esta continua a ser a técnica mais utilizada na atualidade para despiste de DA em grande
escala. Um dos fatores que é apontado como responsável pela falta de eficácia deste
método para reduzir a incidência da DA na espécie canina é o mau posicionamento
radiográfico, nomeadamente a rotação pélvica ao longo do eixo corporal longitudinal e
a rotação femoral. Baseado nesta problemática estabeleceram-se como objetivos desta
tese: criar e validar parâmetros que possam ser usados na identificação de rotação
pélvica e femoral na projeção ventrodorsal convencional; analisar de forma objetiva
qual o efeito da rotação pélvica e femoral sobre alguns parâmetros usados pelas
principais organizações internacionais, nomeadamente o ângulo de Norberg (AN).
No desenvolvimento deste trabalho, numa primeira fase foram utilizados cadáveres de
raças médias e grandes (> 20Kg), sem atender a critérios de raça ou sexo. Foi criado um
suporte especial para estabilização e rotação do terço posterior destes animais. A
rotação pélvica ao longo do eixo corporal longitudinal ficou compreendida entre 0 e 6
graus. Para o estudo da rotação femoral, foram obtidas projeções radiográficas com
rotação interna e externa tendo esta ficado compreendida entre 6 a 32 graus e 7 a 32
graus, respetivamenteOs resultados obtidos mostram que os parâmetros diâmetro horizontal do íleo (DHI),
largura do forâmen obturador (LFO) são critérios uteis para a identificação de rotação
pélvica e o parâmetro índice de deslocamento patelar (IDP) para identificação de
rotação femoral. A medição do AN e a distância cabeça femoral- acetábulo (DFA) não
são influenciados por reduzidos valores de rotação pélvica. No entanto, a medição dos
parâmetros índice de subluxação da cabeça femoral (IS), categorias de subluxação da
cabeça femoral (CS) e espessura pélvica (EP) são afetados por baixos valores de rotação
pélvica, sendo sobrevalorizados no lado ipsilateral à rotação e subvalorizados no lado
contralateral à rotação. A rotação femoral interna beneficia os parâmetros AN, IS e CS
ao aumentar a congruência articular entre a cabeça femoral e o acetábulo, por outro lado
a rotação femoral externa afeta negativamente o AN, IS e CS ao reduzir a congruência
articular entre a cabeça femoral e o acetábulo. Numa segunda fase deste trabalho foi usada uma base de dados de 68 animais vivos de raças médias e grandes (> 20Kg), radiografados para despiste e classificação de displasia da anca de acordo com as normas da FCI, foram incluídos neste trabalho animais que apresentavam uma radiografia com correto posicionamento e pelo menos
uma radiografia com rotação pélvica ou rotação femoral. A deteção e quantificação da rotação pélvica e femoral foram efetuadas através dos parâmetros DHI e IDP. Secundariamente avaliou-se o efeito da rotação sobre os parâmetros AN, IS e CS. Este trabalho permitiu a criação e validação dos parâmetros DHI e IDP, que podem ser uteis quando utilizados como forma de controlo e padronização do posicionamento radiográfico na projeção ventrodorsal convencional. Por outro lado, foi possível esclarecer a influência da rotação pélvica e femoral sobre a medição e obtenção de importantes parâmetros utilizados pelas principais organizações mundiais. De acordo
com conhecimento dos autores, este é o primeiro trabalho realizado sobre critérios de
identificação objetiva e efeitos de rotação pélvica ao longo do eixo corporal longitudinal
e rotação femoral na projeção ventrodorsal convencional.Hip dysplasia (HD) is one of the most common orthopedic diseases in the canine species. This disease control is essentially based on prevention. Despite the research carried out in the last decades, the results obtained in its eradication are still unsatisfactory, and there is a need to deepen research on current and new diagnostic methods. In the source of the difficulty to control and eradicate HD is its extremely complex hereditary and polygenic nature, which probably makes impossible the development of effective genetic screening techniques in the near future. Actually HD screening and classification made in the canine species by the main world organizations (OFA, FCI, BVA / KC) are based on the analysis and classification of radiographs obtained in the standard ventrodorsal projection. Techniques based on joint laxity and new imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) are not routinely used either because of the need for further investigation for their validation, or in the case of CT and MRI also due to their high costs. Despite the critics to the standard ventrodorsal projection, this remains the most widely used technique for large scale HD screening. One of the factors responsible for the lack of effectiveness of this method to reduce the incidence of HD in the canine species is the poor radiographic positioning, namely pelvic rotation along the longitudinal axis of the body and femoral rotation. Based on this problem, the objectives of this thesis were: to create and validate parameters that can be used in the identification of pelvic and femoral rotation in the standard ventrodorsal projection; to analyze objectively the effects of pelvic and femoral rotation on some parameters used by the main international organizations, namely Norberg angle (NA). In the development of this work, cadavers of medium and large breeds (> 20 kg) were used. There was no gender or breed criteria. A special support was created to stabilize and rotate the pelvis and hind limbs of these animals. The pelvic rotation along the longitudinal body axis ranged from 0 to 6 degrees. For the study of femoral rotation, radiographic projections were obtained with internal and external rotation, the femoral rotation ranged between 6 to 32 degrees and 7 to 32 degrees respectively. The results show that iliac horizontal diameter (IHD) and maximum obturator foramen width (OFW) are useful for pelvic rotation identification and the patella displacement index (PDI) to identify femoral rotation. The NA and the femoral head-acetabular distance (FAD) parameters measurement are not affected by slight pelvic rotations. However the pelvic thickness at the level of the cranial effective acetabular rim (PT), femoral head subluxation index (SI) and the femoral head subluxation categories (SC) are affected, being overvalued on the ipsilateral side of rotation and undervalued on the contralateral side of rotation. The internal femoral rotation benefits the NA, SI and SC parameters by increasing joint congruence between the femoral head and the acetabulum. On the other hand, external femoral rotation affects negatively NA, SI, reducing joint congruence between the femoral head and the acetabulum. In a second phase of this work we used a live animal database of 68 dogs from medium and large breeds (> 20 kg), radiographed for HD screening and classification purposes according to FCI recommendations. Each animal selected should have at least a normal radiography and at least another with pelvic or femoral rotation. Detection and quantification of pelvic and femoral rotation were performed using the IHD and PDI parameters. Secondarily the rotation effect on the AN, IS and CS parameters was evaluated. This work allowed the creation and validation of the IHD and PDI parameters, which may be useful when used for radiographic positioning control and standardization in the standard ventrodorsal projection. On the other hand, it was possible to clarify the effects of pelvic and femoral rotation on important parameters measurement used by the main world organizations. According to the authors' knowledge, this is the first work performed on criteria for objective identification and effects of pelvic rotation along the longitudinal body axis and femoral rotation in the standard ventrodorsal projection.
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Khan, HI. "Determinants of structural changes in the knee joint in a middle-aged cohort with a low prevalence of osteoarthritis." Thesis, 2017. https://eprints.utas.edu.au/23854/1/Khan_whole_thesis_ex-pub_mat.pdf.
Full textAbstract:
Osteoarthritis (OA) is the most common joint disorder in adults around the world. Knee OA is the most common form of OA in weight-bearing joints and results in deterioration of knee structures and function in older adults for which there is no cost-effective treatment currently available. The natural history of knee OA is highly variable and can involve any part of the joint including the articular cartilage, meniscus, sub-chondral bone and synovium. Use of MRI has revolutionised the understanding of knee OA disease process but there is limited long-term data available in middle-aged adults with early disease changes, as most studies have focused on older adults with established disease. Identifying modifiable risk factors early in life has the potential to prevent or delay the development of knee OA in later life. This thesis aims to investigate the long-term knee structural natural history data in middleaged adults and subsequent correlations with frequent knee symptoms.
A population-based sample of middle-aged adults (mean age 45(26–61) years; 58% females participated at baseline and approximately 2 and 10 years later. Matched sampling was used to recruit the study participants. Half of the participants were the adult offspring of patients who had a knee replacement performed for idiopathic knee OA at any Hobart hospital from 1996 to 2000. The other half were age and sex matched controls, randomly selected from the population (using electoral rolls) with no history of knee OA in either parent. Cartilage volume, cartilage defects, bone area, bone marrow lesions (BMLs), meniscal tears, meniscal extrusion and effusion were determined using magnetic resonance imaging (MRI). X-ray was used to assess radiographic OA [joint space narrowing (JSN) and osteophytes]. Multiple questionnaires were used to assess pain, function, history of knee joint injury/surgery and physical activity.
The first study examined the cross-sectional association between history of knee injury and knee structural damage assessed on MRI in middle-aged adults from the Offspring study and in a random community based sample of older adults. In middle-aged adults, BML presence, tibial bone area and meniscal extrusion presence were significantly higher in those with knee injury, whereas in older adults, cartilage defect presence, cartilage volume, BML presence and tibial bone area were significantly associated with knee injury. This was the first study to look at the association between history of knee injury and knee joint structural changes assessed on MRI and found that the association between knee injury and MRI-assessed structural pathology in the knee joint is moderate and appears to be stronger in older adults compared to middle-aged adults.
In the second study, a family history of knee joint replacement due to OA increased the risk of radiographic OA (JSN and osteophytes) and medial tibial cartilage volume loss over 10 years compared to community acquired controls with no family history of OA. Most of these changes were mediated by differences in baseline characteristics of offspring and controls except for increase in medial JSN.
Third study looked at the natural history of BMLs in middle-aged adults and found that the natural history of knee BMLs was unstable. BMLs were common in middle-aged adults at baseline. 24% of these BMLs at baseline increased in size, 55% remained stable and 21% decreased in size or resolved completely over 8 years. Change in BMLs was predicted by BMI and strenuous physical activity. An increase in BML size or a new BML resulted in an increase in pain especially in males and those with a family history of OA.
Fourth study looked at the natural history of meniscal tears. Only 22% of the participants had a meniscal tear at baseline. Over 8 years, 16 % of the participants had an increase in severity of meniscal tears while none improved. Change in meniscal tears shared common risk factors with knee OA and was independently associated with worsening knee pain and structural damage suggesting that meniscal tears are on the knee OA causal pathway and not just a result of mechanical factors.
Fifth study looked at the natural history of cartilage defects. 44% of the participants had at least one cartilage defect at any site at baseline. Most of these defects remained stable, whereas 26% increased and 13% decreased in severity over 10 years. Cartilage defects independently predicted cartilage volume loss in the lateral compartment only. Change in cartilage defects on the other hand was associated with changes in BMI and structural changes/symptoms mostly in the lateral compartment, suggesting a more crucial role of cartilage defects in the development of lateral compartment knee OA.
Sixth study examined the correlation between changes in structural abnormalities assessed on MRI and change in radiographic OA over 10 years. Change in JSN was correlated with change in meniscal tears and, to a lesser extent, with meniscal extrusion and cartilage defects. In this sample, change in JSN was a composite measure that did not reflect cartilage volume loss prompting the review of the use of JSN as an outcome measure in chondro-protective drug trials.
In conclusion, this series of related studies detail the natural history of knee structural progression in middle-aged adults. Structural changes such as BMLs and cartilage defects have the potential of reversibility in early disease and should be targeted in disease modifying clinical trials. Meniscal tears and BMLs should be targeted in symptom modifying clinical trials especially in those with a family history of OA. Lastly findings from this thesis suggest that the use of JSN as an outcome measure in chondro-protective trial should be reviewed.