The Experts below are selected from a list of 969 Experts worldwide ranked by ideXlab platform
Nicola Maffulli - One of the best experts on this subject based on the ideXlab platform.
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high resolution real time ultrasonography of the sural nerve after percutaneous repair of the achilles tendon
Foot and Ankle Surgery, 2017Co-Authors: Marcello Zappia, Daniela Berritto, Francesco Oliva, Nicola MaffulliAbstract:Abstract Background Percutaneous Achilles tendon repair has been developed to minimise soft tissue complications following treatment of tendon ruptures. However, there are concerns because of the risk of sural nerve injury. Few studies have investigated the relationship between the Achilles tendon, the sural nerve and its several anatomical course variants. Methods We studied 7 cadaveric limbs (7 Achilles tendons) in which a percutaneous repair of the Achilles tendon was performed. On each tendon, high resolution real time ultrasonography examination was performed by an experienced Musculoskeletal Radiologist before and after the procedure, with the surgeons blind to the results of the scan both before and after surgery. Results In two instances, high resolution real time ultrasonography examination revealed nerve entrapment at the level of most proximal lateral suture. Conclusions Since the sural nerve can be easily visualised using high-frequency high resolution real time ultrasonography, intraoperative ultrasound can be of assistance during percutaneous repair of Achilles tendon rupture. Clinical relevance The sural nerve can be readily visualised by high-frequency high resolution real time ultrasonography probes. It could be beneficial to use high resolution real time ultrasonography intraoperatively or perioperatively to minimise the risks of sural nerve injury when undertaking percutaneous repair of Achilles tendon tears.
Ali Guermazi - One of the best experts on this subject based on the ideXlab platform.
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reliability of a new scoring system for intraarticular mineralization of the knee bucks boston university calcium knee score
Osteoarthritis and Cartilage, 2019Co-Authors: Ali Guermazi, Michael C Nevitt, Mohamed Jarraya, J A Lynch, David T Felson, Margaret Clancy, Cora E Lewis, James C Torner, Tuhina NeogiAbstract:Summary BACKGROUND The role of intra-articular mineralization in osteoarthritis (OA) is unclear. Its understanding may potentially advance our knowledge of knee OA pathogenesis. We describe and assess the reliability of a novel computed tomography (CT) scoring system, the Boston University Calcium Knee Score (BUCKS) for evaluating intra-articular mineralization. METHODS We included subjects from the most recent study visit of the Multicenter Osteoarthritis Study (MOST) Study, a NIH-funded longitudinal cohort of community-dwelling older adults with or at risk of knee OA. All subjects underwent CT of bilateral knees. Each knee was scored at 28 scored locations (14 for cartilage, 6 for menisci, 6 for ligaments, 1 for joint capsule, and 1 popliteal-tibial vessels). A single Musculoskeletal Radiologist scored cartilage and meniscus subregions, as well as vascular calcifications assigning to each a score ranging from 0-3. The joint capsule, medial and lateral posterior meniscal roots, ACL/PCL and 2 collateral ligaments (MCL/LCL) were each scored 0 or 1 for absence or presence of mineralization. To assess reliability, 31 subject CTs were reread 12 weeks later by the same reader and by a second reader and agreement was evaluated using a weighted kappa. RESULTS The intra-reader reliability ranged from 0.92 for ligaments to 1.0 for joint capsule. The inter-reader reliability ranged from 0.94 for cartilage and ligaments, to 1.0 for joint capsule. CONCLUSION BUCKS demonstrated excellent reliability and is a potentially useful CT-based tool for studying the role of calcium crystals in knee OA.
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a longitudinal study of disc height narrowing and facet joint osteoarthritis at the thoracic and lumbar spine evaluated by computed tomography the framingham study
The Spine Journal, 2018Co-Authors: Mohamed Jarraya, Ali Guermazi, Amanda L Lorbergs, Elana Brochin, Douglas P Kiel, Mary L Bouxsein, Adrienne L Cupples, Elizabeth J SamelsonAbstract:Abstract Background Context Prevalence and progression of disc height narrowing (DHN) and facet joint osteoarthritis (FJOA) in the thoracic and lumbar regions in non-clinical populations are not well established. Purpose The present study aimed to use computed tomography (CT) images to determine the prevalence and progression of DHN and FJOA according to age, sex, and spinal region. Study Design This is a 6-year longitudinal study. Sample A total of 1,195 members of the Framingham Study (mean baseline age 61±9 years) were included in the study. Outcome Measures We compared the prevalence and progression (new or worsening) of moderate-to-severe DHN and FJOA by age, sex, and spinal region. Methods A Musculoskeletal Radiologist evaluated DHN and FJOA from T4/T5 to L4/L5 on baseline and follow-up CT images using a semi-quantitative scale: 0=normal, 1=mild, 2=moderate, and 3=severe. Results One-third or more of women and men ages 40–59 years at baseline had imaged-based evidence of prevalent DHN, more than half had prevalent FJOA, and DHN and FJOA prevalence increased approximately two- to fourfold in those age 60–69 and 70–89 years at baseline, respectively (p Conclusions Prevalence and progression of moderate-to-severe DHN and FJOA are common in non-clinical populations of older adults. The high frequency of spinal degeneration observed on CTs in this community-based study may contribute to challenges in interpreting the clinical significance of imaging evidence of DHN and FJOA. Future studies investigating the association of CT-based spinal degenerative features with pain and functional impairments in population-based samples are needed to help determine the clinical significance of imaged-based findings of DHN and FJOA.
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The epidemiology of MRI detected shoulder injuries in athletes participating in the Rio de Janeiro 2016 Summer Olympics
BMC Musculoskeletal Disorders, 2018Co-Authors: Akira M. Murakami, Daichi Hayashi, Andrew Kompel, Lars Engebretsen, Bruce Forster, Michel Crema, Mohamed Jarraya, Frank Roemer, Ali GuermaziAbstract:Background: To use Magnetic Resonance Imaging (MRI) to characterize the severity, location, prevalence, and demographics of shoulder injuries in athletes at the Rio de Janeiro 2016 Summer Olympic Games. Methods: This was a retrospective analysis of all routine shoulder MRIs obtained from the Olympic Village Polyclinic during the Rio 2016 Summer Olympics. Imaging was performed on 1.5 T and 3 T MRI, and interpretation was centrally performed by a board-certified Musculoskeletal Radiologist. Images were assessed for tendon, muscle, bone, bursal, joint capsule, labral, and chondral abnormality. Results: A total of 11,274 athletes participated in the Games, of which 55 (5%) were referred for a routine shoulder MRI. Fifty-three (96%) had at least two abnormal findings. Seven (13%) had evidence of an acute or chronic anterior shoulder dislocation. Forty-nine (89%) had a rotator cuff partial tear and / or tendinosis. Subacromial / subdeltoid bursitis was present in 29 (40%). Thirty (55%) had a tear of the superior labrum anterior posterior (SLAP). Conclusion: Our study demonstrated a high prevalence of both acute and chronic shoulder injuries in the Olympic athletes receiving shoulder MRI. The high rates of bursal, rotator cuff, and labral pathology found in these patients implies that some degree of glenohumeral instability and impingement is occurring, likely due to fatigue and overuse of the dynamic stabilizers. Future studies are needed to better evaluate sport-specific trends of injury.
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prevalence of radiographic and symptomatic hip osteoarthritis in an urban united states community the framingham osteoarthritis study
Arthritis & Rheumatism, 2014Co-Authors: Chan Kim, Ali Guermazi, David T Felson, Katherine Linsenmeyer, Steven C Vlad, Mary M Clancy, Jingbo NiuAbstract:Objectives. The last prevalence survey encompassing urban populations was part of the nationwide Health and Nutrition examination survey (NHANES I) in the 1970's. We carried out a prevalence survey for hip osteoarthritis (OA) in the Framingham Study Community cohort. Methods. Persons age 50 and older living in Framingham in 2002 - 2005 were recruited by random digit dialing without respect to joint pain or arthritis. Anteroposterior standing long-limb radiographs of the lower extremities including the pelvis were obtained and read for radiographic hip OA (ROA) by two trained physicians with all possible cases of ROA confirmed by an experienced Musculoskeletal Radiologist. ROA was defined as Kellgren-Lawrence score ? 2. Using a homunculus in which the hip joint was depicted, participants were asked whether they had hip pain on most days. Those who said 'yes' were defined as having hip pain. Symptomatic hip OA (SxOA) was defined as radiographic OA with ipsilateral hip pain. We defined a person as having hip OA if at least one of their hip joints was affected. Results. Of 978 subjects studied (mean age 63.5 years; 56% women), age-standardized prevalence of ROA was 19.6% (95% CI 16.7%-23.0%) and SxOA was 4.2% (95% CI 2.9%-6.1%%). Overall, we found that men had higher prevalence of ROA (p<0.0001) compared to women, but men did not have a higher prevalence of SxOA compared to women (5.2% vs 3%, p=0.08). Conclusion. In conclusion, hip osteoarthritis is a common condition in middle aged and older persons in urban and suburban U.S. � 2014 American College of Rheumatology.
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different thresholds for detecting osteophytes and joint space narrowing exist between the site investigators and the centralized reader in a multicenter knee osteoarthritis study data from the osteoarthritis initiative
Skeletal Radiology, 2012Co-Authors: Ali Guermazi, David J Hunter, O Benichou, F Eckstein, Kent C Kwoh, Michael C Nevitt, Daichi HayashiAbstract:Objective To evaluate how the reading of knee radiographs by site investigators differs from that by an expert Musculoskeletal Radiologist who trained and validated them in a multicenter knee osteoarthritis (OA) study.
J Arrie - One of the best experts on this subject based on the ideXlab platform.
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plantar plate imaging correlating ultrasound arthrography and surgical findings
Orthopaedic Proceedings, 2018Co-Authors: Jane Vine, R Jugdey, A Zubairy, Saifullah Kha, J ArrieAbstract:Introduction:Instability and synovitis of the lesser metatarsalphalangeal (MTP) joints is a significant cause of forefoot pain. Plantar plate imaging traditionally has been through MRI and fluoroscopic arthrography. We have described ultrasound arthrography as a less resource-intensive technique without radiation exposure. We report the correlation between ultrasound arthographic and surgical findings.Methods:Patients with lesser MTP joint instability and pain underwent ultrasound arthrography by a consultant Musculoskeletal Radiologist. The main finding was the presence of a full or partial tear of the plantar plate. In some patients the location of the tear along with its size in the long and short axis was also reported.Authors who were not involved in the imaging or surgery reviewed the operation notes of patients who underwent surgery to identifyWhether a partial or full thickness tear was identifiedSize and location of the tearThe accuracy of ultrasound arthrography was calculated using surgical fin...
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plantar plate imaging correlating ultrasound arthrography and surgical findings
Journal of Bone and Joint Surgery-british Volume, 2014Co-Authors: Jane Vine, R Jugdey, A Zubairy, Saifullah Kha, J ArrieAbstract:Introduction: Instability and synovitis of the lesser metatarsalphalangeal (MTP) joints is a significant cause of forefoot pain. Plantar plate imaging traditionally has been through MRI and fluoroscopic arthrography. We have described ultrasound arthrography as a less resource-intensive technique without radiation exposure. We report the correlation between ultrasound arthographic and surgical findings. Methods: Patients with lesser MTP joint instability and pain underwent ultrasound arthrography by a consultant Musculoskeletal Radiologist. The main finding was the presence of a full or partial tear of the plantar plate. In some patients the location of the tear along with its size in the long and short axis was also reported. Authors who were not involved in the imaging or surgery reviewed the operation notes of patients who underwent surgery to identify Whether a partial or full thickness tear was identified Size and location of the tear The accuracy of ultrasound arthrography was calculated using surgical findings as the standard. Results: 53 patients with 55 joints underwent ultrasound arthrography, and of these 34 went on to have surgery. 23 patients had adequate documentation of surgical and ultrasound findings. Surgery confirmed plantar plate tears in 21 patients (91.3%) with 9 full thickness tears and 7 partial thickness tears confirmed both operatively and with ultrasound (in 5 patients the operation note did not specify completeness of tear). In 2 patients, in whom ultrasound demonstrated a partial thickness tear, no tear was found at surgery. The sensitivity of ultrasound arthrography for plantar plate tears is 100%, specificity is 0% (although based on few patients), and positive predictive value of 91.3%. Conclusion: Ultrasound arthrography has a high sensitivity, but low specificity for plantar plate tears, comparable with ultrasound in previous studies. It allows differentiation of partial and full thickness tears which may be important for treatment.
S Golla - One of the best experts on this subject based on the ideXlab platform.
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ute t2 mapping detects sub clinical meniscus injury after anterior cruciate ligament tear
Osteoarthritis and Cartilage, 2012Co-Authors: Ashley A Williams, Yongxian Qian, S GollaAbstract:Summary Objective Meniscus tear is a known risk factor for osteoarthritis (OA). Quantitative assessment of meniscus degeneration, prior to surface break-down, is important to identification of early disease potentially amenable to therapeutic interventions. This work examines the diagnostic potential of ultrashort echo time-enhanced T2∗ (UTE-T2∗) mapping to detect human meniscus degeneration in vitro and in vivo in subjects at risk of developing OA. Design UTE-T2∗ maps of 16 human cadaver menisci were compared to histological evaluations of meniscal structural integrity and clinical magnetic resonance imaging (MRI) assessment by a Musculoskeletal Radiologist. In vivo UTE-T2∗ maps were compared in 10 asymptomatic subjects and 25 ACL-injured patients with and without concomitant meniscal tear. Results In vitro, UTE-T2∗ values tended to be lower in histologically and clinically normal meniscus tissue and higher in torn or degenerate tissue. UTE-T2∗ map heterogeneity reflected collagen disorganization. In vivo, asymptomatic meniscus UTE-T2∗ values were repeatable within 9% (root-mean-square average coefficient of variation). Posteromedial meniscus UTE-T2∗ values in ACL-injured subjects with clinically diagnosed medial meniscus tear (n = 10) were 87% higher than asymptomatics (n = 10, P Conclusion Significant elevations of UTE-T2∗ values in the menisci of ACL-injured subjects without clinical evidence of subsurface meniscal abnormality suggest that UTE-T2∗ mapping is sensitive to sub-clinical meniscus degeneration. Further study is needed to determine whether elevated subsurface meniscus UTE-T2∗ values predict progression of meniscal degeneration and development of OA.
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ute t2 mapping detects sub clinical meniscus injury after anterior cruciate ligament tear
Osteoarthritis and Cartilage, 2012Co-Authors: Ashley Williams, Yongxian Qian, S Golla, Constance R ChuAbstract:Summary Objective Meniscus tear is a known risk factor for osteoarthritis (OA). Quantitative assessment of meniscus degeneration, prior to surface break-down, is important to identification of early disease potentially amenable to therapeutic interventions. This work examines the diagnostic potential of ultrashort echo time-enhanced T2∗ (UTE-T2∗) mapping to detect human meniscus degeneration in vitro and in vivo in subjects at risk of developing OA. Design UTE-T2∗ maps of 16 human cadaver menisci were compared to histological evaluations of meniscal structural integrity and clinical magnetic resonance imaging (MRI) assessment by a Musculoskeletal Radiologist. In vivo UTE-T2∗ maps were compared in 10 asymptomatic subjects and 25 ACL-injured patients with and without concomitant meniscal tear. Results In vitro , UTE-T2∗ values tended to be lower in histologically and clinically normal meniscus tissue and higher in torn or degenerate tissue. UTE-T2∗ map heterogeneity reflected collagen disorganization. In vivo , asymptomatic meniscus UTE-T2∗ values were repeatable within 9% (root-mean-square average coefficient of variation). Posteromedial meniscus UTE-T2∗ values in ACL-injured subjects with clinically diagnosed medial meniscus tear ( n =10) were 87% higher than asymptomatics ( n =10, P without concomitant medial meniscal tear ( n =15) were 33% higher than asymptomatics ( P =0.001). Posterolateral menisci UTE-T2∗ values also varied significantly with degree of joint pathology ( P =0.001). Conclusion Significant elevations of UTE-T2∗ values in the menisci of ACL-injured subjects without clinical evidence of subsurface meniscal abnormality suggest that UTE-T2∗ mapping is sensitive to sub-clinical meniscus degeneration. Further study is needed to determine whether elevated subsurface meniscus UTE-T2∗ values predict progression of meniscal degeneration and development of OA.
Jane Vine - One of the best experts on this subject based on the ideXlab platform.
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plantar plate imaging correlating ultrasound arthrography and surgical findings
Orthopaedic Proceedings, 2018Co-Authors: Jane Vine, R Jugdey, A Zubairy, Saifullah Kha, J ArrieAbstract:Introduction:Instability and synovitis of the lesser metatarsalphalangeal (MTP) joints is a significant cause of forefoot pain. Plantar plate imaging traditionally has been through MRI and fluoroscopic arthrography. We have described ultrasound arthrography as a less resource-intensive technique without radiation exposure. We report the correlation between ultrasound arthographic and surgical findings.Methods:Patients with lesser MTP joint instability and pain underwent ultrasound arthrography by a consultant Musculoskeletal Radiologist. The main finding was the presence of a full or partial tear of the plantar plate. In some patients the location of the tear along with its size in the long and short axis was also reported.Authors who were not involved in the imaging or surgery reviewed the operation notes of patients who underwent surgery to identifyWhether a partial or full thickness tear was identifiedSize and location of the tearThe accuracy of ultrasound arthrography was calculated using surgical fin...
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plantar plate imaging correlating ultrasound arthrography and surgical findings
Journal of Bone and Joint Surgery-british Volume, 2014Co-Authors: Jane Vine, R Jugdey, A Zubairy, Saifullah Kha, J ArrieAbstract:Introduction: Instability and synovitis of the lesser metatarsalphalangeal (MTP) joints is a significant cause of forefoot pain. Plantar plate imaging traditionally has been through MRI and fluoroscopic arthrography. We have described ultrasound arthrography as a less resource-intensive technique without radiation exposure. We report the correlation between ultrasound arthographic and surgical findings. Methods: Patients with lesser MTP joint instability and pain underwent ultrasound arthrography by a consultant Musculoskeletal Radiologist. The main finding was the presence of a full or partial tear of the plantar plate. In some patients the location of the tear along with its size in the long and short axis was also reported. Authors who were not involved in the imaging or surgery reviewed the operation notes of patients who underwent surgery to identify Whether a partial or full thickness tear was identified Size and location of the tear The accuracy of ultrasound arthrography was calculated using surgical findings as the standard. Results: 53 patients with 55 joints underwent ultrasound arthrography, and of these 34 went on to have surgery. 23 patients had adequate documentation of surgical and ultrasound findings. Surgery confirmed plantar plate tears in 21 patients (91.3%) with 9 full thickness tears and 7 partial thickness tears confirmed both operatively and with ultrasound (in 5 patients the operation note did not specify completeness of tear). In 2 patients, in whom ultrasound demonstrated a partial thickness tear, no tear was found at surgery. The sensitivity of ultrasound arthrography for plantar plate tears is 100%, specificity is 0% (although based on few patients), and positive predictive value of 91.3%. Conclusion: Ultrasound arthrography has a high sensitivity, but low specificity for plantar plate tears, comparable with ultrasound in previous studies. It allows differentiation of partial and full thickness tears which may be important for treatment.
