Biomedical subjects

Kjell Jonsson

Publications and source records attributed to Kjell Jonsson.

5 recordsLinked to original sources

PubMed2005

Core-needle biopsy performed by the cytopathologist: a technique to complement fine-needle aspiration of soft tissue and bone lesions.

BACKGROUND: Fine-needle aspiration cytology (FNAC) is gaining increased popularity in the diagnosis of musculoskeletal lesions; and, in many patients, a definitive diagnosis can be rendered from aspiration smears alone. The main limitation of FNAC of soft tissue and bone neoplasms is in the evaluation of tissue architecture. In addition cytologic specimens are not always adequate for ancillary studies. METHODS: A consecutive series of 130 patients with soft tissue and bone lesions was examined by core-needle biopsy (CNB) performed by a cytopathologist in conjunction with FNAC. The findings of this combined diagnostic approach were compared with histologic diagnoses made on surgical biopsies and resected specimens from 86 patients. Adequate follow-up was available in all patients. RESULTS: FNAC combined with CNB correctly could identify 77 of 78 malignant lesions and 50 of 52 benign lesions. Only seven patients underwent incisional biopsy. The tumor subtype was determined correctly in 30 of 39 patients (77%) and the malignancy grade was determined in 35 of 39 patients (90%) with primary soft tissue and bone sarcomas compared with the biopsy or operative specimens. CONCLUSIONS: FNAC of musculoskeletal tumors/lesions complemented with CNB combined cytomorphology with tissue architecture and ancillary procedures. In the current study, obtaining FNAC as well as CNB at the same clinic visit and by the cytopathologist made preliminary diagnosis on the day of referral possible. This speeded diagnosis increased the number of correct diagnoses and usually enabled correct subtyping and malignancy grading of sarcomas.

Adult↗

PubMed2005

Ultrasound assessment of early clubfoot treatment: a comparison of the Ponseti method and a modified Copenhagen method.

The purpose of this study was to sonographically compare the early anatomical outcome of a group of clubfeet treated with the Ponseti method (group A, nine clubfeet) with a group treated with an adjustable plexidur splint, the Copenhagen method (group B, 19 feet). The clinical severity was assessed using the Diméglio-Bensahel classification. The need for complementary surgery was clinically assessed at the age of about 2 months. Ultrasound investigation was made in the neonatal period, after 2-3 months of non-surgical treatment and 1-2 months post-surgically. After 2 months of non-surgical treatment the correction obtained at the talo-navicular joint, expressed as the distance between the medial malleolus and the navicular (MM-N distance), was significantly greater in group A. After surgery, tenotomy of the Achilles tendon for all group A feet, and posterior or posteriomedial release for 13 feet in group B, the correction at the talo-navicular and calcaneo-cuboid joints was similar for the two groups. Anatomical correction of the displacement in these joints can be achieved without extensive interventional procedures. Ultrasound may be a valuable tool to assess the effects of different treatment protocols quantitatively.

Achilles Tendon↗

PubMed2004

[Low frequency of missed or invisible hip fracture in X-ray examination. The rule-of-2--a simple method for quality assessment].

A new method for quality check of roentgen diagnosis of femoral neck fracture is presented. Use of the rule-of-2 means that only cases with two X-ray examinations of the hip before surgery need to be reviewed. This rule identifies a small subset which contains the false negative cases. Quality analysis of this group, approximately 10% of the material, yields all the false negatives. During the 1990's quality studies of radiography of hip fractures were performed at the University Hospital in Lund and the method later tested at the Kristianstad Central Hospital. The false negative rate was 1.6 to 2.2% in Lund and 3.5% in Kristianstad. However, the majority of the false negative cases represented fractures that were invisible even at review of the films (i.e. undisplaced fractures, impacted fractures or stress fractures). Missed diagnoses (i.e. fracture visible at review of films) were only present in 0.4 to 1%. The method presented is simple. It can be used in all hospitals that have databases for X-ray examinations and for orthopedic surgical procedures. If, in addition to conventional X-ray, MR of the hip is performed as an emergency procedure in questionable cases, the false negative rate of hip fracture diagnosis will be zero.

Diagnostic Errors↗

PubMed2004

Radiological theses.

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Academic Dissertations as Topic↗

PubMed2002

[Hip and knee osteoarthritis. Conventional X-ray best and cheapest diagnostic method].

Osteoarthritis is a multifactorial disease affecting cartilage and subchondral bone. Conventional radiographs are inexpensive and readily available. The hip joint should be examined in weight-bearing with an anteroposterior and a right and left anterior oblique view, rotating the patient 55 degrees in each oblique view. Radiographically established osteoarthritis of the hip is present when the joint space width is less than 3 mm or less than the width in the contralateral hip joint. The femorotibial joint should be examined in a posteroanterior view in weight-bearing and in semiflexion with the central X-ray beam tangential to the medial tibial plateau and with the medial aspect of the foot parallel to the beam. A diagnosis of osteoarthritis of the femorotibial joint is established with the presence of osteophytes at the medial or lateral aspect of the joint. Joint space narrowing with a joint width less than 3 mm is a sign of severe disease. The femoropatellar joint should be examined in skyline view in standing with the X-ray beam parallel to the articular aspect of the patella. A diagnosis of osteoarthritis of the femoropatellar joint is established with a joint space width less than 5 mm. Conventional radiographs of the hip and knee joints are believed to remain the primary examination for detecting signs of degenerative disease in these joints, although MRI is a superior technique for revealing even small areas of degenerative changes.

Cost-Benefit Analysis↗