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[The inguinal paravascular technique of lumbar plexus block--anatomical pretests were unsuccessful].

Using 28 anatomic preparations, the boundaries of dye expansion in tissues adjacent to nervous stems have been experimentally studied during the application of lumbar plexus local anesthesia technique via inguinal paravascular approach according to A. Winnie. It has been established that the above technique is not associated with anatomic conditions for simultaneous contact of a model dye solution with 3 basic derivates of the lumbar plexus both at the level of formation and further on. There is massive dye diffusion from femoral nerve perineural space into the intermuscular connective tissues. Compact structure of perineural spaces in musculus psoas major prevents lumbar plexus infiltration. The junction of lumbar and obturator fascia, forming the fascial node between large and small pelvis, excludes any possible contacts between the dye solution and the obturator nerve.

Female↗
PubMed1989

HLA-B27 testing in ankylosing spondylitis: an analysis of the pretesting assumptions.

Typing for histocompatibility antigen HLA-B27 has been suggested as a useful diagnostic test for ankylosing spondylitis (AS) in certain clinical situations. The appropriate use of any diagnostic test requires the clinician to estimate the likelihood of disease before the test is performed. One clinical situation in which B27 testing has been suggested to be useful is in the investigation of a patient with low back pain suggestive of AS but with normal sacroiliac radiographs. We analyze here the sequence of steps taken by the clinican in estimating the likelihood of AS. The assumptions that must be made to render B27 typing useful are calculated.

Back Pain↗