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PubMed1979

Laboratory diagnosis of postoperative sepsis of the musculoskeletal system.

The diagnosis of acute sepsis after musculoskeletal surgery is based on the results of the clinical examination. Microbiologic evaluation of clinical specimens permits identification of the causal organism(s) and of the susceptibility studies. In the subacute stage of postoperative sepsis, roentgenographic examination, a peripheral leukocyte count, erythrocyte sedimentation rate, hemoglobin level, and nuclear scans can be helpful to the clinician. Frozen section histologic examination of tissues and Gram staining of fluids obtained at surgery have resolved the choice in differential diagnosis between aseptic and septic loosening of painful prosthetic components. Laboratory evaluation, including tissue biopsy, identifies the chronic complications of amyloidosis and malignant change in patients with long term sepsis of the musculoskeletal system.

Arthritis, Infectious↗
PubMed2000

Diffusion-weighted imaging of the musculoskeletal system in humans.

This article reviews the principles of diffusion-weighted imaging (DWI) and recent results in DWI of the musculoskeletal system. The potential of DWI in the diagnosis of pathology of the musculoskeletal system is discussed. DWI is a relatively new MR imaging technique that has already been established in neuroradiology, especially in the early detection of brain ischemia. The random motion of water protons on a molecular basis can be measured with DWI. To date DWI of the abdomen and of the musculoskeletal system has only been employed in scientific studies, but first results indicate that it may also be beneficial in these fields. Different diffusion characteristics have been found in normal tissues such as muscle, fat and bone marrow. Also, pathologic entities such as neoplasms, post-therapeutic soft tissue changes and inflammatory processes can be differentiated. Normal muscle shows significantly higher diffusion values than subcutaneous fat and bone marrow, due to a higher mobility of water protons within muscle. Soft tissue tumors exhibit a significantly lower diffusion value compared with post-therapeutic soft tissue changes and inflammatory processes. Necrotic tumor tissue can be distinguished from viable tumor due to significantly higher diffusion of water protons within necrotic tissue.

Animals↗
PubMed1995

Helical (spiral) CT of the musculoskeletal system.

Helical (spiral) CT scanning of the musculoskeletal system is a valuable adjunct in patients with complex disease processes where standard radiography may prove to be of limited use. When CT scans are ordered, the use of helical (spiral) acquisition provides specific advantages in terms of ease of performance of the study, potential successful completion of the study, and in quality of the CT data set. Future advances in technology will enhance these advantages.

Adult↗
PubMedDate not supplied

[Tissue bank for the musculoskeletal system. Clinical applications].

From June 1987 to June 1990, the musculoskeletal system tissues bank of the Orthopaedics and Traumatology Department of the University Clinic of Navarra has used 310 allografts. Of this, 219 has been used in our Department, 142 of cancellous bone and 42 of cortical bone. 24 of patellar tendon and 11 of fascia lata. The other 91 grafts have been sent to other hospitals in the country. In the present work we make a retrospective study that included the patients who were operate with allograft. We observe the differences between several types of allografts comparing them with conventional surgery technics. Within the complications we distinguished a 10.52% of infection in cortical bone allografts used in patients with neoplastic treatment. In the other type of allograft we didn't present this complication. We concluded that a bone bank or a musculoskeletal system tissues bank has a great usefulness in different reconstructive surgery technics and arthrodesis. They are used more frequent in orthopaedics and traumatology surgery improving the development of this surgery.

Adolescent↗
PubMed1995

Self-administered examination versus conventional medical examination of the musculoskeletal system in the neck, shoulders, and upper limbs. The Stockholm MUSIC I Study Group.

A self-administered examination protocol of the musculoskeletal system in the neck, shoulders, and upper limbs was mailed to 350 subjects and the results were compared to those of a subsequent medical examination. The prevalences of reported positive findings were higher than in the medical examination. Validity ranged between poor and good. Acceptable validity was noted for items measuring tenderness. No systematic substantial exposure-related misclassification was noted. Self-administered examination of the musculoskeletal system is not suitable to replace a traditional medical examination in epidemiological studies. Self-administered examination of tenderness could, however, be used as a screening method in analytical studies of relations between exposure and disorders in the musculoskeletal system. Subjects reporting such findings at a self-administered examination could be further examined by professional examiners for definite diagnostic appraisal. Substantial savings in medical examination resources could thereby be obtained.

Adult↗
PubMed2003

[Evaluation of individual predisposition to development of musculoskeletal system diseases].

A technique was worked out on the basis of studying of physiological indices of the main and medical aid appealability concerning musculoskeletal system diseases (MSD), physical examination of workers. It will allow for certain determine the character of individual predisposition to the development of the disease and in 84% of the cases rather sooner predict the disease if a worker has high individual predisposition and in 55.2% of other cases. Combination of tension and pain sensitivity indices measuring up 21-80 and 1.1 mm and more; 81-160 and 1.0 mm and more; 161-220 and 0.9 mm and more; 221-300 and 0.8 mm and more; 301 and more, 0.7 mm and more accordingly characterize high individual predisposition; less 50 and 0.5 mm--tolerance to the disease. A risk of the development of musculoskeletal system diseases conditioned by individual predisposition from the mathematical analysis happened in 16.2%. Application of the method before receiving the job can both reveal individual predisposition to musculoskeletal system diseases and prevent from harmful industrial conditions. It will decrease a risk of the development of MSD, keep sound health and prolong professional activity.

Disease Susceptibility↗
PubMedDate not supplied

Toxic effects of quinolone antibacterial agents on the musculoskeletal system in juvenile rats.

Quinolone antibacterial agents have adverse effects on the musculoskeletal system in humans, consisting mainly of myalgia and arthralgia, and additionally of tendon disorders and rhabdomyolysis. The present study was conducted to examine the toxic effects of quinolones on the musculoskeletal system in juvenile rats using light microscopy, 5-bromo-2'-deoxyuridine (BrdU) immunohistochemistry and electron microscopy. Single oral administration of 900 mg/kg pefloxacin (PFLX) or levofloxacin (LVFX) was found to induce lesions in the muscle + fascia, tendon + sheath, and synovial membrane, in addition to articular cartilage in the fore- and hindlimbs. Articular cartilage lesions were not necessarily associated with changes in the muscle, tendon, and synovial membrane, or the reverse. Among all lesions, the ankle and elbow showed the highest incidence and severity. Changes were more severe in the PFLX than in the LVFX group. Lesions in the muscle + fascia, tendon + sheath, and synovial membrane were similar and characterized by edema and increased number of mononuclear cells, many of which were positively stained with BrdU, as well as vascular endothelial cells in the Achilles tendon sheath and synovial membrane in the ankle. Electron microscopic examination revealed an increased number of fibroblasts and macrophages and collagen deposition in the matrix of the synovial membrane and tendon sheath. Capillary endothelial cells were hypertrophied, increased in number, and stratified. These results suggest that quinolones have toxic potentials in the muscle, tendon, and synovial membrane in addition to articular cartilage, and that local vascular hyperpermeability may contribute to the development of these lesions.

4-Quinolones↗
PubMed1998

Biopsies of the musculoskeletal system.

Percutaneous biopsies of musculoskeletal lesions are a safe, economical, and reliable method of obtaining a diagnosis. Most of these biopsies are done under CT guidance, but fluoroscopy is an alternative. Conditions that can be discovered through percutaneous biopsies include metastases, primary benign tumors, infection, and metabolic disease. Experience with invasive procedures and with imaging equipment are the requirements for a physician interested in performing these biopsies.

Aftercare↗
PubMed1986

Perspective: three-dimensional imaging of the musculoskeletal system.

An evaluation of musculoskeletal disorders in 202 patients using three-dimensional CT displays has revealed the usefulness of the technique, especially in patients with fractures of skeletal areas with complex anatomy, articular disorders of the hip, and spinal stenosis. In some cases, plastic models of diseased areas have been created from the CT data and are reasonably accurate, providing a graphic representation of the disease and the ability to perform rehearsal surgery. A preliminary investigation of three-dimensional displays of MR images indicates that the technique is feasible, although its clinical practicality requires further analysis.

Fractures, Bone↗
PubMed1988

Evaluation of the musculoskeletal system with sonography.

Although musculoskeletal sonography historically has received little attention, its use in certain specific situations has clear advantages over use of other imaging techniques. The wide availability of sonography, its modest cost, and its lack of ionizing radiation are other reasons that its use in musculoskeletal conditions is expected to increase. We have reviewed potential applications; some of these applications are new and have been used in a small series of patients, and others, such as infant hip sonography, have already been used in thousands of cases. Additional applications may be possible [64]. Those learning the techniques of musculoskeletal sonography will find that progress is made most quickly when there is close cooperation between the sonographer and the clinician. While experience is being gained, each party must endeavor to understand what the technique is able to determine and what it cannot determine. Only through close cooperation, and with adequate opportunity to learn, will the sonographer and the clinician develop confidence in the technique to the point that it becomes the effective imaging alternative that best suits the needs of the patient.

Achilles Tendon↗
PubMed2000

The influence of walking speed on dynamic loading on the human musculoskeletal system.

PURPOSE: A study was conducted to investigate the effects of walking speed on the magnitude of the heel strike initiated shock waves that propagate throughout the human musculoskeletal system. METHODS: Subjects walking on a treadmill at various speeds were used to acquire the experimental data regarding the heel strike-initiated shock waves. Fifteen young healthy men participated in this study. Each one walked on the treadmill at five various speeds, and their associated cadences, while the heel strike induced shock waves were recorded at the tibial tuberosity for each speed during a 16-s period at a sampling rate of 1 kHz. RESULTS: The obtained data reveal a significant increase in the dynamic loading experienced by the human musculoskeletal system with an increase in the walking speed. CONCLUSION: The analysis of the recorded acceleration suggests that an increase in walking speed contributes to an increase in dynamic loading on the human musculoskeletal system. Further, the evidence indicates that dynamic loading increases with the increase in speed at five times the rate of the ground reaction force increase.

Adolescent↗
PubMed1999

Conclusions regarding the influence of exercise on the development of the equine musculoskeletal system with special reference to osteochondrosis.

This paper summarises and interrelates the findings of a large-scale multidisciplinary investigation to assess the influence of exercise on the development of the equine musculoskeletal system in general and of osteochondrosis in particular, up to age 5 months. Forty-three foals, genetically predisposed to develop OC, were divided into 3 exercise groups: box-rest, box-rest with training and free pasture exercise. At 5 months, all foals were weaned and 8 foals per group were subjected to euthanasia for postmortem examination. The remaining 19 foals were placed together and subjected to euthanasia at age 11 months. Foals were clinically and radiographically monitored during life, muscle and tendon biopsies were taken and gait analysed kinematically. After euthanasia, all major musculoskeletal tissue components (bone, articular cartilage, tendon and muscle) were analysed extensively using a wide variety of techniques. Radiographic monitoring of the stifle and hock joints and postmortem analysis of all diarthrodial joints led to the conclusion that osteochondrosis is a dynamic and very common process in which lesions cannot only develop, but may regress spontaneously during the 'windows of susceptibility' of the various joints, making the clinically diagnosed forms of osteochondrosis into the tip of an iceberg. Closure of the 'window of susceptibility' may be determined by the metabolic status of the chondrocyte which was shown to be inferior in older lesions. Exercise had no influence on the number of lesions, but was related to the distribution of lesions within the joint. There was some evidence that growth rate may be one of the most important intrinsic factors that determine the occurrence of OC. Lack of exercise (box-rest) generally delayed the development of the tissues that make up the equine musculoskeletal system. This was evident in bone mineral density (BMD) at various sites, chemical composition of tendon and of articular cartilage, and in the development of gait. In most cases, this delay was compensated for when box confinement was lifted after 5 months. However, there were indications that this was not true for some collagen characteristics of articular cartilage where the withholding of exercise at early age may therefore have a lifelong effect. The training protocol used (rather high-intensity exercise superimposed on a basic box-rest regimen) appeared to have long lasting negative effects, affecting chondrocyte viability long after the training protocol had ended. A same tendency was seen in bone (decrease in BMD) and tendons (decreases in proteoglycan and hyaluronic acid content). It is concluded that, during the first months postpartum, the equine musculoskeletal system passes through a very dynamic period of growth-related development and intense alteration. In this period, the system is vulnerable to adverse influences that may result in developmental orthopaedic disease. However, regenerative capacity is still high, also in those tissues that are notorious for their lack of repair capacity in the mature individual, such as articular cartilage and tendon. Exercise seems to be an important factor in the determination of the final make-up (and hence biomechanical strength) of these tissues and, therefore, is a potentially powerful tool for the enhancement of injury resistance.

Animals↗
PubMed2004

Outpatient Osteopathic Single Organ System Musculoskeletal Exam Form series: validation of the Outpatient Osteopathic SOS Musculoskeletal Exam Form, a new standardized medical record.

The authors validate the Outpatient Osteopathic SOS (Single Organ System) Musculoskeletal Exam Form (SOS MSEF), a 1-page form contained within the 4-page Outpatient Osteopathic Single Organ System Musculoskeletal Exam Form Series (SOS-FS). Handwritten physician progress notes (PPNs) in the medical record (considered to be the "gold standard" for clinical records) were compared with information placed on the SOS MSEF for the same patient encounter. Data recorded by 14 trained and certified investigators on the standardized SOS MSEF-which was designed for use with the previously validated Outpatient Osteopathic SOAP (Subjective, Objective, Assessment, Plan) Note Form (SNF)-was compared with data recorded by the same investigators in PPNs. The authors compared the accuracy and efficiency of physicians recording musculoskeletal information in these two formats for 165 patient encounters. Descriptive statistics and t tests were used to compare data recorded after patient encounters. Ninety-seven variables input from the PPNs or SOS MSEFs were significantly different at the P < or = .05 level, whereas 38 variables were not. Insufficient data was recorded for a determination of significance in 3 variables. For 121 variables, more data were recorded using the SOS MSEFs than PPNs; for 84 variables, the amount of data recorded exceeded twice that recorded using PPNs. For 10 variables, more data were recorded in PPNs; however, these differences were not significant. The authors conclude that the SOS MSEF is superior to PPNs for recording patient-encounter data in the osteopathic care setting. Moreover, they argue that the use of the validated SOS MSEF nationwide would ensure that osteopathic physicians would be recording data in a similar manner for uniform insurance claim coding, easy tracking of physicians-in-training and patient outcomes, and data collection for future research.

Forms and Records Control↗
PubMed1988

Alcohol consumption and complaints from the musculoskeletal system among engine drivers--an epidemiological study.

The purpose of this study was to test the hypothesis that a positive correlation exist between level of alcohol consumption and complaints from the musculoskeletal system. 150 randomly selected engine drivers from Sweden were interviewed about complaints from the musculoskeletal system during the last 12 months. In this study the complaints from the neck, shoulders and lower back were investigated. An index counting number of regions with complaints was computed. The subjects were asked to report their level of alcohol consumption during the last month (beer, wine and spirits). The total alcohol consumption was calculated expressed in terms of 40% pure alcohol. The median consumption was 39.5 cl/month. The engine drivers reporting complaints from the neck had a significantly higher consumption of alcohol than those without such complaints. A positive significant correlation existed between the number of complaints (index) and alcohol consumption.

Adult↗
PubMedDate not supplied

[A medical-social description of and approaches to the prevention of musculoskeletal system diseases].

The epidemiological as well as medical-and-social aspects related with diseases of the musculoskeletal system as observed in the Saratov Region over the recent 7 years are presented in the paper. A set of measures was worked out to optimize the medical-and-social aid rendered to patients with defects in the musculoskeletal system; the mentioned measures can be also used to advance the prevention system.

Adolescent↗
PubMed2004

Scintigraphic techniques for the diagnosis of infectious disease of the musculoskeletal system.

In imaging infectious diseases of the musculoskeletal system, the metabolic information provided by nuclear medicine studies complements the structural information of radiologic modalities. Often the diagnosis can be confirmed by combining the methods in a diagnostic algorithm. The decision about whether a single study is best depends on the clinical setting and the questions that require an answer. Whereas radiography, magnetic resonance imaging (MRI), and computed tomography (CT) usually focus on a single area, nuclear medicine imaging offers the advantage of whole body imaging. However, despite significant improvements it cannot approach the detailed anatomical visualization provided by MRI or CT. In most cases scintigraphy is a very sensitive (e.g., bone scan, positron emission tomography) and often quite specific tool (e.g., white blood cell scintigraphy). The metabolic information of the single scintigraphic procedure depends on the accumulation mechanism. For the work-up of infectious disorders different radiopharmaceuticals can be used, and the decision for the best modality should be tailored to the clinical question and the special pathophysiologic condition of the infection. This article describes the most common nuclear medicine studies and their clinical relevance in some infectious diseases.

Humans↗
PubMed1986

Screening for congenital dislocation of the hip, scoliosis, and other abnormalities affecting the musculoskeletal system.

The three main conditions affecting the musculoskeletal system currently being screened for are spina bifida cystica, congenital dislocation of the hip, and scoliosis. The techniques of screening are different for each: amniotic fluid analysis for spina bifida cystica, a manual physical examination for congenital dislocation of the hip, and a visual examination for scoliosis. Properly time amniotic fluid analysis for alpha-fetoprotein is both a sensitive and specific test for neural tube defects. However, because of the low incidence of spina bifida cystica, this examination is justified only in high-risk pregnancies. Maternal serum screening has not achieved widespread acceptance because of its lack of sensitivity and the low and apparently falling incidence of the deformity. The neonatal manual examination for congenital dislocation of the hip is now well established and widely practiced. Almost all agree that the incidence of persistent congenital dislocation of the hip has been lowered as a result. However, the examination lacks both sensitivity and specificity because of intrinsic difficulties with the examination and the occurrence of late onset subluxation and dislocation. It is becoming apparent that congenital dislocation of the hip is a dynamic problem in the peri- and early neonatal period. Repeated careful evaluation of the hips during infancy is necessary to make the diagnosis as early as possible. To further enhance early detection, it may be necessary to consider obtaining an anteroposterior pelvis radiograph at age 4 to 6 months in babies at high risk. The visual evaluation for scoliosis is a very sensitive test but lacks specificity. Efforts are now being made to quantify visual screening techniques and thus decrease the numbers of false-positive examinations.

Adolescent↗
PubMed2005

Assessment of functional capacity of the musculoskeletal system in the context of work, daily living, and sport: a systematic review.

The aim of this systematic review was to survey methods to assess the functional capacity of the musculoskeletal system within the context of work, daily activities, and sport. The following key words and synonyms were used: functional physical assessment, healthy/disabled subjects, and instruments. After applying the inclusion criteria on 697 potential studies and a methodological quality appraisal, 34 studies were included. A level of reliability > 0.80 and of > 0.60 resp 0.75 and 0.90, dependent of type of validity, was considered high. Four questionnaires (the Oswestry Disability Index, the Pain Disability Index, the Roland-Morris Disability Questionnaire, and the Upper Extremity Functional Scale) have high levels on both validity and reliability. None of the functional tests had a high level of both reliability and validity. A combination of a questionnaire and a functional test would seem to be the best instrument to assess functional capacity of the musculoskeletal system, but need further examined.

Activities of Daily Living↗