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PubMed1978

Measurement of thyroid size by ultrasound, palpation and scintiscan.

Thyroid gland size was calculated from grey-scale ultrasound images in twenty patients with goitre. Results were compared with measurements by palpation and in some cases with measurements by scintiscan and at operation. There was a good correlation between ultrasound measurements and both the size of surgical specimens and clinicians' estimations, although clinicians under-estimated the size of large (greater than 40 ml) goitres compared with ultrasound and surgical specimens. Gland size calculated from scintiscan did not correspond well with measurements by ultrasound or palpation.

Goiter↗

PubMed1981

Inspection-palpation-percussion-auscultation and an outcome-oriented alternative approach to the musculoskeletal examination.

Thirty-two university-based doctors and sixty-seven medical students used a visual analogue scale (VAS) to estimate the usefulness of the inspection-palpation-percussion-auscultation (IPPA) approach. Doctors considered IPPA less useful in the examination of the musculoskeletal system than in other systems, both in clinical practice (P less than 0.01) and as an aid in teaching (P less than 0.01). Students rated IPPA less useful in the musculoskeletal examination than in other systems as a learning aid (P less than 0.001). Based on these findings, an alternative model for physical examination of the musculoskeletal system was devised, using inspection, palpation and other clinical methods only when required to reach a diagnosis. The model focused on the outcome of the diagnostic process (aetiological, anatomical/pathophysiological and functional diagnoses) rather than on the process itself. Thirteen students taught this method found it a useful learning aid. Those familiar with both methods preferred the outcome-oriented to the IPPA method (P less than 0.001).

Auscultation↗

PubMed1991

Confirmation of estrus rates by palpation per rectum of genital organs in normal repeat dairy cows.

Data were from 6084 normal repeat to second service cows, visually detected in estrus, in a commercial artificial insemination program on a.m./p.m. schedule. The percentage of cows confirmed in estrus by rectal examination and inseminated after palpation was 96.2. The remainder of the cows were not inseminated and non-return rate for these cows was 86.9% (150-day non-return). In cows confirmed in estrus, the percentage of cows ready for service at palpation was 96.1 and the 150-day non-return percentage for these cows (43.9) was different from those cows in which estrus and insemination were considered incorrectly timed (26.7%). These results suggest that the efficiency of reproduction in dairy herds may be improved by examination per rectum of the genital organs at insemination as an effective complement to visual detection of estrus.

Animals↗

PubMed1997

Lingual cyst in infancy: importance of palpation for diagnosis.

Two infants, 5 and 12 weeks of age, with lingual cysts were presented. Histological findings were compatible with a salivary retention cyst in one and a thyroglossal duct cyst in the other. Both infants were admitted to our hospital because of severe stridor that had developed from one to two weeks of age. Their lingual cysts were easily recognizable by simple palpation and were confirmed by non-invasive imaging techniques, such as ultrasound sonography, computed tomography and magnetic resonance imaging. Lingual cyst in infancy may be large enough to cause stridor and dyspnea, and occasionally result in sudden infant death, although once diagnosis is made a radical operation can be easily performed. Therefore, it is important that palpation in the oral cavity should be performed with all infants with persistent stridor as a part of a physical examination.

Cysts↗

PubMed1975

The diagnosis of pregnancy in sheep by abdominal palpation.

Pregnancy diagnosis in Merino ewes by abdominal palpation was 80 to 95 percent accurate in ewes 90 to 130 days pregnant. The ease with which the foetus could be palpated increased with increasing gestational age. Animals in store body condition were more easily diagnosed than those in forward store condition. Withholding feed and water for 12 to 24 hours increased the ease of diagnosis. One operator and two assistants could perform the technique at a rate of 150 to 200 sheep per hour. The animals were held in the sitting position and no special restraining apparatus was necessary. The potential for using this technique may be associated with investigations of reproductive wastage or the selection of pregnant animals for preferential management during drought conditions.

Abdomen↗

PubMed1979

Progesterone assays and rectal palpation in pre-service management of a dairy herd.

Fifty-one dairy cows were examined three times at weekly intervals during weeks 5 to 7 after calving. Rectal palpation of the ovaries and plasma progesterone assay were used to determine cyclic ovarian function. Eight of 51 cows exhibited true anoestrus by day 49 after calving. Only 23 of 43 cycling cows were served by day 77, the end of the target period for first service. In 77 per cent of 142 examinations, rectal palpation and progesterone assay gave compatible results. Most incompatibility occurred early or late inthe cycle, or in association with cystic structures in the ovaries. Eleven of the 51 cows had cysts in the ovaries but cyclicity and fertility were not adversely affected.

Animals↗

PubMed2004

Palpation imaging using a haptic system for virtual reality applications in medicine.

In the field of medical diagnosis, there is a strong need to determine mechanical properties of biological tissue, which are of histological and pathological relevance. Malignant tumors are significantly stiffer than surrounding healthy tissue. One of the established diagnosis procedures is the palpation of body organs and tissue. Palpation is used to measure swelling, detect bone fracture, find and measure pulse, or to locate changes in the pathological state of tissue and organs. Current medical practice routinely uses sophisticated diagnostic tests through magnetic resonance imaging (MRI), computed tomography (CT) and ultrasound (US) imaging. However, they cannot provide direct measure of tissue elasticity. Last year we presented the concept of the first haptic sensor actuator system to visualize and reconstruct mechanical properties of tissue using ultrasonic elastography and a haptic display with electrorheological fluids. We developed a real time strain imaging system for tumor diagnosis. It allows biopsies simultaneously to conventional ultrasound B-Mode and strain imaging investigations. We deduce the relative mechanical properties by using finite element simulations and numerical solution models solving the inverse problem. Various modifications on the haptic sensor actuator system have been investigated. This haptic system has the potential of inducing real time substantial forces, using a compact lightweight mechanism which can be applied to numerous areas including intraoperative navigation, telemedicine, teaching and telecommunication.

Biomechanical Phenomena↗

PubMed1980

Enhancement of tactile perception in palpation.

We studied tactile perception in palpation of the precordium to determine the frequency response of the hand and to improve, if possible, the sensitivity of the hand as a transducer for precordial movement. The threshold of tactile sensation was determined for 10 subjects by manipulating the amplitude of movement of an impulse generator at each of a series of frequency settings in the subaudible range (1-40 Hz.) Relatively gross movements were necessary to achieve threshold in the lowest frequencies. A more than four-fold increase in sensitivity was obtained by restraining the fingers with the application of a light but unyielding disc to their dorsal surface. Clinical application of this device permitted the easy perception of a systolic thrust as well as a rapid filling wave in normal adult subjects over the right ventricle at the left sternal edge, an area generally considered to be motionless by conventional palpation.

Hand↗

PubMed1998

Splenic palpation for the evaluation of morbidity due to schistosomiasis mansoni.

This study was undertaken to determine the accuracy of splenic palpation for the diagnosis of splenomegaly, and to determine whether the frequency of individuals with a palpable spleen in an endemic area can be considered as an index of morbidity of schistosomiasis. For the clinical diagnosis of splenomegaly, two criteria have been tested: (A) presence of a palpable spleen and (B) presence of a palpable spleen whose border could be felt more than 4 cm below the costal margin. In an area of high prevalence of the disease (66.3%) 285 individuals aged 18 years or more have been submitted to abdominal ultrasonography and physical examination. Splenomegaly was defined as a splenic length greater than 120 mm by ultrasound and the sensitivity, specificity, positive and negative predictive values of criterion A were 72.2%, 90.5%, 35.1% and 97.8%. The values for criterion B were 27.8%, 98%, 50% and 95%, respectively. In an non endemic area, 517 individuals were submitted to the same protocol and 22 individuals had a palpable spleen, but no patient fulfilled criterion B for splenomegaly, and only one met the ultrasonographic criterion for splenomegaly. The authors concluded that abdominal palpation is a poor method for the diagnosis of splenomegaly.

Adolescent↗

PubMed1989

The arterial pulse analyzer as a potential replacement for manual pulse palpation in Oriental medicine.

Application of the arterial pulse analyzer now makes it possible to automatically diagnose such geriatric disorders as arteriosclerosis by using simple electrocardiograms and radial, carotid and posterior tibial artery pressure pulse wave charts. If the arterial pulse analyzer is adopted for use in Oriental medical clinics, there will no longer be a need for manual pulse palpation. In brief, applying the arterial pulse analyzer to the 8 key pulses of Oriental medicine yields the following results: 1) 'Slow' or 'rapid' pulses can be defined by the S-S interval (almost identical to the R-R interval of the ECG). 2) 'Slippery' or 'hesitant' pulses can be defined by the S-P time and the Dh/Ch% (P time & Incisura) ratio. 3) 'Floating' or 'submerged' pulses can be defined by the Ph/Ch% (pressure pulse wave to height) ratio. 4) 'Scattered' or 'moderate' pulses can be defined by the S-C- time (E time). Thus, by employing the arterial pulse analyzer, subjectivity problems inherent in the manual pulse palpation used by Oriental medicine for over 1500 years can be analyzed objectively.

Arteriosclerosis↗

PubMedDate not supplied

Comparison of palpation-guided versus ultrasound-guided fine-needle aspiration biopsies of thyroid nodules in an outpatient endocrinology practice.

OBJECTIVE: To investigate the role of thyroid ultrasonography in our outpatient endocrine practice. METHODS: We compared the efficacy of ultrasound-guided fine-needle aspiration biopsy (US-FNAB) of thyroid nodules with that of palpation-guided aspiration (P-FNAB) and determined the malignancy rates of palpable and nonpalpable nodules. All patients referred for assessment of thyroid nodular disease from October 1997 through August 2001 were included in the study. Fine-needle aspirations were performed by palpation guidance until October 1999, after which US-FNAB was exclusively performed. All thyroid examinations, ultrasound imaging, and aspiration biopsies were performed by the same endocrinologist in an office-based setting. Histopathologic and cytologic diagnoses were compared for patients who underwent thyroidectomy. RESULTS: A total of 376 nodules in 276 patients were aspirated during a 47-month period. P-FNAB was used on 157 nodules, and US-FNAB was performed on 219 nodules (both procedures were done on 21 nodules). For palpable thyroid nodules that were resected, the cytologic diagnostic accuracy rate was 60.9% and 80% for P-FNAB and US-FNAB, respectively. With use of ultrasound guidance, the sensitivity, positive predictive value, and negative predictive value increased significantly. In addition, the inadequate specimen rate decreased from 11.2% in the P-FNAB group to 7.1% in the US-FNAB group. Among the nodules that were not palpable, the malignancy rate was similar to that for the palpable thyroid nodules (5.1% versus 6.8%). CONCLUSION: US-FNAB improved the cytologic diagnostic accuracy, sensitivity, and positive predictive value and reduced the false-negative rate in comparison with P-FNAB. The malignancy rate for nonpalpable thyroid nodules was similar to that for palpable nodules.

Adolescent↗

PubMed1975

Comparison of the methods of rectal palpation and haemagglutination-inhibition assay for diagnosis of pregnancy in mares.

The diagnostic value of rectal palpation and immunological assay of PMSG was tested at different stages of pregnancy in mares inseminated with frozen semen in three separate studies. The results were based on foaling success and particular attention was paid to the numbers of inconsistent results obtained by the two tests. Generally, the number of false positive diagnoses was lower for the immunological assay than for palpation in early pregnancy (Days 40 to 60) and the relationship became reversed later in gestation.

Animals↗

PubMed2000

[Physical diagnosis--percussion and palpation of the spleen].

The accuracy of physical examination of the spleen was investigated in the literature. Ultrasonography or scintigraphy was used to test the findings at physical examination. Physical examination has a low sensitivity, but a reasonably good specificity. The interobserver variability is rather high. In general, palpation is more sensitive and specific than percussion. The findings of percussion improve the accuracy of palpation and the combination has a high specificity, of approximately 90%. The two should therefore be used in conjunction. The sensitivity is much lower although it is greatly influenced by the degree of splenic enlargement and the leanness of the patient.

Humans↗

PubMed2001

[Adenocarcinoma of prostate in men younger than 50--rectal palpation mandatory with micturition problems].

In three men, aged 44, 47, and 48 years, prostatic carcinoma was diagnosed after a long delay, more than eight months after the onset of symptoms (obstructive and irritative micturition problems, erectile dysfunction, and haemospermia). The cancer was suspected on eventually performed rectal palpation and confirmed in biopsies. The serum prostate-specific antigen (PSA) levels were moderately increased. All were treated with goserelin and flutamide and radiotherapy on the emerging metastases (two patients). Two patients died, the third one, who had received antibiotic treatment for three months because at first prostatitis was suspected, was still in remission at the last follow up. Prostate cancer in young men is rare and may demonstrate aggressive biological behaviour. The age group less than 50 years of age accounts for 0.8% to 1.1% of all patients with prostate cancer. This form of the disease responds poorly to radiation or hormonal therapy and is often already too advanced for surgery. The symptoms at presentation of prostate cancer in young men are quite similar to those in prostate cancer patients beyond the fifth decade. When carcinoma grows beyond the margins of the prostate the prognosis is poor. In all men with micturition problems, rectal palpation of the prostate should be carried out as a routine.

Adenocarcinoma↗

PubMed2001

Haptic palpation of head and neck cancer patients--implication for education and telemedicine.

Malignancy in the head and neck area is a disease that often gives high morbidity in functions like speech, eating, breathing and cosmetics. To ensure a treatment of high clinical standard these patients are presented for a multidisciplinary tumor-team at Sahlgren University hospital. The team usually involves ENT-surgeons (Ear, Nose and Throat), oncologists, radiologists, pathologists, plastic surgeon, general surgeon and oral surgeons. The aim of the presentation is to classificate the tumor and suggests a treatment. The patients presented are from the whole western region of Sweden, and therefore some patients have to travel long distances. To minimize travel telemedicine was introduced 1998 with success [1]. One concern, when presenting a patient with telemedicine, has been the lack of possibility to palpate the tumor and the tissue surrounding it. To address this problem a 3D model of the tumor visualizes the region and possibly allows haptic palpation. Based on a series of high resolution CT/MR scans, a model of the region around the patients tumor is created. Haptic properties are added to the skin and subcutaneous structures (including the tumor) of the model. Initially, the haptic tuning is done by an examining physician, but in the final telemedical application, the aim is to develop a sensory device for this purpose (e.g. a position sensitive glove, such as Virtual Technologies, Inc. CyberGlove [2] and a graded system for setting firmness of the tissue). The model with its haptic properties can then be examined visually and haptically, the latter using a haptic device such as the SensAble PHANToM [3]. The present system uses a 3D model in VRML format based on reconstructed structures in the ROI (which includes the jawbones, the vertebra, the throat, major muscles and the skin) from high resolution CT. Haptic properties are added using MAGMA 2.5 (ReachIn Technologies AB, Sweden) [4]. Haptic force feedback is provided using a PHANToM Desktop (SensAble Technologies Inc) [3]. Visual feedback can be either monoscopic or stereoscopic (StereoGraphic CrystalEyes) [5]. The system will be used for concept testing and for evaluating possible limitations and/or the need for a modified examination protocol. Once a reliable set of parameters has been generated (using both professionals and medical students at various levels), the remote components will be added.

Computer-Assisted Instruction↗

PubMedDate not supplied

Quantification of masseter muscle deformation during palpation using MRI and image-analysis procedure.

PURPOSE: The aim of this study was to quantify masseter muscle deformation during palpation and to discuss the clinical significance of muscle palpation using magnetic resonance imaging (MRI) and the image-analysis procedure. MATERIALS AND METHODS: Subjects were 10 male volunteers with a mean age of 26.8 years. MRIs were taken under two muscle conditions: compressed and noncompressed (control). By superimposing a compressed image on a noncompressed image, muscle deformation (the cross-sectional area, length of the surrounding area, thickness, circular convolution, compressed point, and anterior and posterior extension) was measured. RESULTS: The cross-sectional area of the masseter muscle was diminished by 14%, circular convolution of the muscle was reduced by 31%, the length of the surrounding area was enlarged by 11%, and the thickness of the muscle was reduced by 6.7 mm because of compressing. Thus, the masseter muscle was compressed. An uneven stretch of the muscle caused by compression was observed at the same time. The anterior portion of the masseter muscles extended on average 10%, with great individual differences. On the other hand, posterior extension (3%) and its individual differences were small. CONCLUSION: The method used made it possible to quantify masseter muscle deformation. By compressing, the masseter muscles were deformed especially in the anterior direction but with great individual differences.

Adult↗

PubMed1997

[Unearathed ancient pulsological books and theoroy of "three parts with nine palpation sites"].

Textual research is made on the evolution of the theory of "three parts with nine palpation sites" in TCM. It is concluded that the theory, having received the influence of ancient astrology and arithmatics, was sprouted in the Eastern Han Dynasty and still is valid today. It further points out that the arrangement of channel order, and selection of channel title were all influenced by the theory of "Three Parts with Nine Palpation Sites".

China↗

PubMed2005

A comparison of palpation guided and ultrasound guided percutaneous biceps brachii tenotomy in dogs.

The purpose of this study was to compare palpation guided and ultrasound guided techniques for biceps brachii tenotomy in dogs. The differences between the two tenotomy procedures in muscle incision length, confidence level of tenotomy, percentage tendon transection, difficulty of tendon location or transection, or amount of haemorrhage, were not significant. The ultrasound guided tenotomy procedure took significantly longer to perform and required a longer skin incision, but these differences were not considered to be clinically important. With palpation guided tenotomy, several surrounding muscular and tendinous structures were damaged. We concluded that ultrasound guided tenotomy is an accurate method of tendon identification because it allowed for complete transection in 10 out of 11 tendons, and provides a method for checking completeness of tendon transection after the procedure.

Animals↗