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At least 235 records · Page 13Linked to original sources
PubMed2002

Spontaneous rupture of the renal pelvis during pregnancy: a case report and review of the literature.

We report a case with spontaneous rupture of the renal pelvis during pregnancy. A 34-year-old Japanese woman was referred at 20 weeks' gestation because of sudden severe right flank pain. She had severe colic pain radiating to the right lower abdomen with percussion tenderness at the right costovertebral angle and was initially suspected to have renal/ureteral calculi. Ultrasonography and intravenous pyelography showed urine extravasating from the renal pelvis, indicating rupture of the right renal pelvis. Immediately following the insertion of a double-J indwelling catheter, her symptoms and perirenal extravasation ceased. She had no further urological problems during pregnancy and a male infant was delivered at 41 weeks' gestation. Cases with spontaneous rupture of the renal pelvis in pregnancy are reviewed.

Adult↗
PubMed2004

[Multislice CT of the pelvis: dose reduction with regard to image quality].

PURPOSE: To optimize the examination protocols of multislice CT (MSCT) of the pelvis for dose reduction with regard to image quality. MATERIALS AND METHODS: MSCT of the pelvis was performed on 5 cadaver specimens with stepwise reduction of the tube current at 140 kV (250, 200, 150, 100, 75, 50, 35, 25 mAs) and 120 kV (50, 27 mAs). The remaining scan parameters like collimation (4 x 1 mm) and table speed of 4 mm per rotation remained unchanged. Axial sections and coronal reconstructions were used to evaluate cortex, trabecular structures, subjective image quality, image noise and detail detectability (pelvis and SI joint), with evaluation performed independently by four blinded experienced radiologists on a 5-point scale. Kappa coefficient, accuracy of the observers to sort the films with regard to dose reduction and mean scores of image evaluation were determined for statistical analysis. RESULTS: The deterioration of the image quality was most pronounced for all criteria between 75 mAs and 50 mAs at 140 kV. Good results with adequate image quality were obtained for detail detectability at 50 mAs and 140 kV (effective dose [E]: 3.3 mSv) and for the remaining four criteria at 75 mAs (E: 4.9 mSv). There was a moderate agreement between the four observers (kappa coefficient: 0.27). All observers were excellent in arranging the images according to the increasing dose reduction. CONCLUSIONS: Image quality of MSCT of the pelvis appears to be acceptable at 75 mAs and 140 kV with the dose reduced to 46% of the average value of the nation-wide survey of the German Roentgen Society in 1999 for this type of examination.

Acetabulum↗
PubMed2000

Posterior locked lateral compression injury of the pelvis: report of three cases.

Lateral compression injuries to the pelvis typically result in a rotationally unstable and vertically stable condition including an impaction and compression fracture of the posterior pelvic ring. The operative and postoperative management, as well as the morbidity and mortality, of these fractures differs significantly from vertical shear injuries to the pelvis, which are characterized by vertical and rotational instability. We report on three unusual lateral compression injuries to the pelvis, resulting in a complete disruption of the pelvic ring with vertical and rotational instability, by definition. Nevertheless, in these patients, locking of the posterior pelvic ring with medial translation of the iliac wing anterior to the sacrum resulted in a pseudostable condition. Their high rate of fracture-related associated injuries and possible complications, as well as the malalignment of the pelvis, required surgical restoration of the pelvic ring. Fracture reduction was successfully performed through an anterior approach in one patient and a posterior approach in two patients; the posterior approach was preferred. Open reduction and internal fixation of these pelvic ring fractures can result in a satisfactory outcome if the associated injuries are successfully dealt with.

Adolescent↗
PubMed1983

Normal kinematics of the lumbar spine and pelvis.

A study was undertaken to provide a data base of pelvic and lumbar spinal movement during walking. The movements of the pelvis and lumbar spine in 48 male volunteers of age range 16 to 74 years were measured using a television/computer motion analysis system. The results were presented both as a range of movement in each plane and as a wave pattern for the movement in each plane. Cadence, the movements of the pelvis and spine in the sagittal plane, and the movement of the pelvis in the transverse plane all showed a negative correlation with age. Analysis of the wave patterns showed that the movements of the pelvis and lumbar spine relate to identifiable events in the gait cycle.

Adolescent↗
PubMed2003

Osteolysis of the pelvis: evaluation and treatment.

Osteolysis of the pelvis is a common and well-recognized complication associated with total hip arthroplasty. The diagnosis and treatment of osteolysis of the pelvis is a challenging and controversial problem. Osteolysis of the pelvis often is asymptomatic and does not present with symptoms until considerable bone loss and loosening of the acetabular socket occur. Radiographs are the most common way to detect and monitor osteolysis around an implant. However, lesions viewed radiographically usually are underestimations of the lesions found intraoperatively. Moreover, some advocate computed tomography scanning to evaluate these lesions. The indications for treatment of osteolysis with cemented acetabular components are defined more clearly than with a cementless component. If the cemented or cementless acetabular component is loose, then revision is necessary. However, it is less clear when to intervene surgically with a well-fixed cup with osteolysis. Many early reports advocated the removal of a well-fixed socket during revision surgery for osteolysis and polyethylene wear. However, the removal of a well-fixed socket has the potential for significant damage and loss of the surrounding bone resulting in loss of integrity of a column or pelvic discontinuity, which may compromise placing another acetabular component. Recently, a new treatment strategy of retaining a well-fixed socket, exchanging the liner, and grafting lesions has proven successful. Without the removal of the acetabular shell, different techniques are needed to graft the osteolytic lesions. Osteolysis is a difficult problem; however, with radiographic surveillance to monitor patients for lesions, proper indications, and good surgical techniques, the treatment of osteolysis of the pelvis can result in a well-functioning total hip arthroplasty.

Algorithms↗
PubMedDate not supplied

Deformity of the pelvis in developmental dysplasia of the hip: three-dimensional evaluation by means of magnetic resonance image.

Magnetic resonance images of the transverse section of the whole pelvis were obtained in eight infants (two boys and six girls) with unilateral developmental dysplasia of the hip (DDH), and then a three-dimensional image of the pelvis was reconstructed from each slice by using a computerized technique. Based on it, the deformity of the pelvis with DDH was analyzed by measuring bony configuration from the superoinferior, anteroposterior and lateral views. The prime deformity of the pelvis with DDH was not only a simple malrotation but also an increased medial twisting of the whole involved pelvic wing. As a result, the entrance of the socket rotates more anteriorly because of this distortion, which leads to poor anterior acetabular coverage over the femoral head.

Female↗
PubMed1984

The pelvis as a passageway. I. Evolution and adaptations.

Man has an unusual pelvis, a large fetal head, and a complicated mechanism of labour. The evolution of the pelvic girdle, like that of the hind limb, is a story with some chapters still missing. In mammals the pelvis has been modified in various interesting ways to effect compromises between its locomotor function and the requirements of parturition. Among the primates, the increasing size of the fetal brain may have necessitated a change in the attitude of the head from extension to flexion as it goes through the pelvis. The distinctive shape of the hominid pelvis is probably an adaptation to bipedal gait. The birth canal has changed from a shallow bony ring to a deep curved tube, through which the mature fetal head can only pass by rotating as it descends.

Adaptation, Physiological↗
PubMed1998

Stress fractures of the vertebral lamina and pelvis in Thoroughbred racehorses.

Thirty-six Thoroughbred racehorses that died at California racetracks between October 1993 and July 1994 were evaluated for stress fractures in the caudal portion of the thoracic and lumbosacral regions of the spine and the pelvis. The lumbosacral spine and pelvis were collected, debrided of soft tissues and examined visually for the presence of an incomplete fracture line and focal periosteal proliferation, characteristic of a stress fracture. Sixty-one per cent of specimens had evidence of stress fracture in the caudal portion of the thoracic and lumbosacral regions of the spine and the pelvis. Vertebral lamina stress fractures were found in 50% of specimens and were positively associated with the severity of dorsal spinous process impingement and overall severity of articular process degenerative changes. Pelvic stress fractures affected 28 % of specimens and occurred more frequently in older horses. Pelvic stress fractures were positively associated with the severity of lumbar transverse process impingement and several ilial articular surface degenerative changes. A high prevalence of vertebral and pelvic stress fractures was noted in this sample of Thoroughbred racehorses that died because of unrelated injuries. Vertebral and pelvic stress fractures need to be considered in the clinical evaluation of horses with back problems or hindlimb lameness. Undiagnosed stress fractures of the vertebrae or pelvis could be a significant cause of poor performance and lameness in Thoroughbred racehorses.

Age Factors↗
PubMed1997

Biomechanics of the Gazi type pelvis external skeletal fixator.

External skeletal fixation is an alternative method of treatment to conventional therapy and open surgical procedures in pelvis fractures. The appropriate type of frame and the configuration of the connecting bars of these fixators are under investigation. In the Gazi type pelvis external fixator (GPEF) which has been developed, a 70 degree angulation is applied to the connecting bars of the anterior quadrangular frame. This configuration, which is expected to improve the stability of the posterior column of the pelvis, was evaluated biomechanically on a phantom with various types of pelvic fractures and separations. The results suggest that the GPEF effectively controls anterior column pelvis fractures such as unilateral pubic ramus fractures, unilateral ischium pubis rami fractures and symphysis pubis separations under vertical loads. The fixator is partially capable of stabilizing the posterior column; however, loads above 700 N cause separation at the fracture site. Further studies and clinical trials are essential to determine the GPEF's effectiveness in reducing blood loss and in providing stability at the posterior column.

Adult↗
PubMed2005

Evaluation of blunt abdominal trauma using PACS-based 2D and 3D MDCT reformations of the lumbar spine and pelvis.

OBJECTIVE: The purpose of this study was to show the value of 2D and 3D reformations of CT data from abdominal and pelvic CT performed immediately at the workstation using a PACS-based software program to evaluate the lumbar spine and pelvis in patients with blunt abdominal trauma. MATERIALS AND METHODS: We reviewed the abdominopelvic CT scans and conventional radiographs of the lumbar spine or pelvis of 156 consecutive patients with blunt abdominal trauma. The CT data were compared with the radiographic findings and also with the findings of dedicated repeat CT of the spine or pelvis, when performed. RESULTS: CT depicted 80 fractures of the lumbar spine and 178 pelvic fractures. Radiography showed 40 fractures of the lumbar spine and 138 pelvic fractures. No additional fractures were identified on dedicated repeat CT. CONCLUSION: Conventional radiographs to clear the lumbar spine are no longer required when abdominopelvic CT data are available. CT and reformatted CT data show more fractures than radiography and miss no fractures compared with dedicated CT of the lumbar spine or pelvis. Having these images immediately available through the PACS workstation saves time for the trauma team in the management of critically ill patients.

Abdominal Injuries↗
PubMed1999

The "crushed open pelvis" in children.

A retrospective analysis was performed in order to review the outcome of open pelvic fractures in children. Medical records, radiographs and CT scans of 15 children with open pelvic fractures admitted to our trauma centre between 1983 and 1995 were reviewed. The minimal follow-up on the survivors was two years. Out of 15 open pelvic fractures ten were vertically unstable. The mechanism of injury was auto-pedestrian collision in 93% (n = 14) of the cases. 86% (n = 13) of the fractures were a result of a "run-over" mechanism, 40% (n = 6) were caused by heavy duty vehicles. All children had injuries in the proximity of the pelvis. Despite the severity of trauma, we found mortality to be 20% (n = 3). Sepsis and deep infection originating from anorectal and genitourinary excretions were found to be the most frequent complications. The improvement in surgical techniques of the pelvis influenced the orthopaedic treatment in these 15 children. External fixation of the pelvis is not always sufficient and to achieve better stabilization of the pelvis, open reduction and internal fixation should be considered. In order to minimize complications, aggressive intervention is needed including irrigation, debridement, intravenous antibiotics, diverging colostomies and cystostomies and fracture fixation. The coordination between trauma teams of different disciplines throughout all stages of the treatment is crucial to achieving better results.

Accidents, Traffic↗
PubMed2000

[Fractures of the pelvis--a survey of "nonunion" and "malunion" surgical results].

UNLABELLED: Nonunion (NU) and malunion (MU) of the pelvis are conditions of absent and malaligned healing of a previous pelvis fracture causing severe disabling symptoms. Reconstructive surgery of the pelvis is more demanding than treatment of the acute fracture. Ten cases of NU and/or MU of the pelvis were treated. Average time from injury to referral was 33 months. Initial treatment was conservative (seven patients), internal fixation (two patients) or combined internal and external fixation (one patient). Complaints were pain (ten patients), limp (eight patients), leg length difference (five patients) and sitting problems (seven patients). RESULTS: All patients showed radiological union. Nine patients had less or no pain at all. All eight with a preoperative limp showed improvement or no limp after surgery. Two of five still had minor leg length difference. All seven patients with sitting problems claimed relief or complete removal of sitting problems. It is concluded that patients with severe disabling symptoms from NU and/or MU can expect relief of symptoms by late correction of the pelvic deformity.

Adolescent↗
PubMed2000

[Arcus tendineus fascia pelvis: anatomical study].

OBJECTIVE: To reveal the anatomy of arcus tendineus fascia pelvis. MATERIAL: and methods. 2 fixed female cadaver pelvises (88 and 66 years old) were dissected. RESULTS: The arcus tendineus fascia pelvis is a fibrous recess of the pelvic fascia which is 10 cm long, laterally to the obturator internus muscle and medially to the peritoneum. It reaches the ischial spine lower and anteriorly to the pubo-vesical ligament. The third posterior part of the arcus tendineus of the pelvic fascia is commun with the posterior part of the arcus tendineus of the levator ani. This third posterior part is like a curve concave anteriorly. This curve is thick and easy to recognize by the palpation. This third posterior curve is 1cm in front of the ischial spine and 2cm in front of the pudendal vessel which took place behind the ischial spine. The vessels of the obturator internus muscle originated from the internal iliac vessel and crossed laterally the median part of the arcus tendineus of the pelvic fascia. CONCLUSION: Sutures must be placed through the anterior and median part of the arcus tendineus fascia pelvis, in front of the posterior part of the arcus tendineus fascia pelvis to avoid any injury to the pudendal vessels.

Aged↗
PubMed1992

[Laparoscopy in the diagnosis of chronic painful disorders of the pelvis].

The objective of the paper was the evaluation of the results in laparoscopic examinations performed in women reporting chronic painful ailments in the pelvis. The investigation has covered 194 women in whom the laparoscopic procedure was performed by multidirectional diagnostic examinations, and the inflammatory changes had been excluded. The most frequent change recorded during laparoscopy was adhesions of the pelvic organs 103 (53.09%). In 58.63% of cases the cause of adhesions were post inflammatory states of uterine adnexa, in 24.8% the post operative procedures, in 9.2% the adhesions accompanied endometriosis, while in 7.22% the adhesions were the cause responsible for the retroflexion of uterus. In 29.38% the studied group of women was found to have a normal image of the pelvis, and in 8.76% there was a picture of congested pelvis. Laparoscopy is a valuable diagnostic examination, frequently allowing to establish the cause of chronic painful ailments in the area of pelvis, therein also some forms of functional disturbances.

Adult↗
PubMed1992

Laterally transposed pelvis: a new and proper name for an old problem.

There is need for specific terminology for osteopathic findings, including the findings in postural examination. A static test for laterally transposed pelvis is sometimes critical to the establishment of a diagnosis of postural imbalance, particularly in the minor forms of this important clinical entity. There is need for a word or phrase that identifies this clinical finding and nothing else. The phrase laterally transposed pelvis is nominated to indicate a specific finding in the static evaluation of pelvic position in the frontal (coronal) plane in relation to the vertical extension of the midheel line (sagittal plane). The definition of laterally transposed pelvis is: With the patient standing, knees fully extended bilaterally and the feet together on a flat horizontal surface, the median (midsagittal) plane of the pelvis is observed to lie laterally to the vertically extended midheel line (median/midsagittal plane).

Humans↗
PubMed1989

Analgesics, cigarette smoking, and other risk factors for cancer of the renal pelvis and ureter.

Results from a population-based case-control study of cancer of the renal pelvis and ureter are reported. Telephone interviews were conducted with 187 residents of Los Angeles County diagnosed with cancer of the renal pelvis and ureter over a 4-year period ending December 31, 1982, and with individually sex-, age- and race-matched neighborhood controls. The major risk factor identified for cancer of the renal pelvis and ureter was cigarette smoking. Subjects who smoked more than 25 years had a relative risk of 4.5 of developing these tumors, compared to nonsmokers (P less than 0.0001). Heavy use of over-the-counter analgesics was also associated with a significant increase in risk; it appears that an elevated risk was conveyed by all the major active constituents of those compounds currently marketed in the United States, aspirin, caffeine, and acetaminophen. Persons who had used these drugs for 30 consecutive days at any time in their life preceding diagnosis had twice the risk of developing cancer of the renal pelvis or ureter compared to persons not reporting such use (P less than 0.01). Heavy coffee drinkers (greater than or equal to 7 cups/day) had a 1.8-fold increase in risk compared to nondrinkers. Although risk tended to increase with increasing consumption, this result was not statistically significant. The risk associated with heavy coffee consumption was reduced to 1.3 after adjusting for smoking. Nine cases compared to no controls reported a first degree relative with kidney cancer. A history of kidney stones was associated with an increased risk of cancer of the ureter (relative risk = 2.5) that was not, however, statistically significant.

Analgesics↗
PubMedDate not supplied

The pelvis of fetuses in the exstrophy complex.

By using a three-dimensional computed tomography (CT) scanner, we compared the anatomic features of the pelvis of three fetuses of same gestational age, one with a normal pelvis representing the reference model, one with classic bladder exstrophy, and one with cloacal exstrophy. The tomography slices were selected at the same levels for each case. Three angles expressing external opening of the pelvis were defined. Comparing normal and abnormal pelvises allowed definition of three criteria for the correction of the malformation: (a) the sum of the differential angles gives the amplitude of the correction needed; (b) a supraacetabular osteotomy appears to allow best closure of the pelvic ring; (c) only three slices of a CT scan are needed, which cannot be harmful, especially for neonates. Therefore, we believe that a CT scan of the pelvis should be performed whenever an osteotomy is planned in the surgical reconstruction of bladder and cloacal exstrophy.

Anthropometry↗
PubMed1997

Possible relation between hypertension and cancers of the renal pelvis and ureter.

To evaluate the relationship of selected medical conditions and medications with cancers of the renal pelvis and ureter, we interviewed 308 subjects with renal pelvis cancer, 194 subjects with ureter cancer and 496 control subjects in 3 areas of the United States. After controlling for the effects of smoking, age, gender and geographic residence, a history of hypertension (reported to have been diagnosed more than 5 years before interview) was associated with a small but significantly increased risk (odds ratio [OR] = 1.3; 95% confidence interval [CI], 1.0-1.8), whereas no relationship was observed with a variety of other medical conditions or medications. Stratified analysis showed that the risk associated with hypertension was twice as high among users of diuretics or other antihypertensive drugs (OR = 2.4; 95% CI, 1.1-4.9) as it was among those who never used these medications (OR = 1.2; 95% CI, 0.8-1.7). Our findings suggest that the association previously reported between hypertension and renal cell cancer may extend to cancers of the renal pelvis and ureter.

Adult↗