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PubMed2002

Advantages of real-time spatial compound sonography of the musculoskeletal system versus conventional sonography.

OBJECTIVE: Spatial compound sonography is a method that obtains sonographic information from several different angles of insonation and combines them to produce a single image. By reducing speckle and improving definition of tissue planes, this method can potentially improve image quality in musculoskeletal sonography. The purpose of our study was to compare real-time spatial compound sonography with conventional high-resolution musculoskeletal sonography. MATERIALS AND METHODS: Thirty-four patients underwent sonography of the musculoskeletal system for a variety of indications. All patients were evaluated using conventional high-resolution sonography and real-time spatial compound sonography performed with a 12-5-MHz multifrequency linear array transducer. Conventional images and compound images depicting the same musculoskeletal structure were obtained in pairs. A total of 118 images (59 image pairs) were randomly assorted and reviewed on a computer monitor by three experienced sonologists working independently. The reviewers were unaware of the type of images they were evaluating. Image quality was rated using a 5-point scale. The image parameters evaluated were definition of tissue planes, speckle, other noise, and image detail. RESULTS: Analysis of variance revealed that real-time spatial compound sonography significantly improved definition of soft-tissue planes, reduced speckle and other noise, and improved image detail when compared with conventional high-resolution sonography (p < 0.0001 for all evaluated parameters). CONCLUSION: Real-time spatial compound sonography significantly improved sonographic image quality in the musculoskeletal system when compared with conventional high-resolution sonography. Because musculoskeletal sonography is highly dependent on image quality and tissue-plane definition, spatial compound sonography represents an important development.

Adolescent↗
PubMed1983

The role of computed tomography in diseases of the musculoskeletal system.

Computed tomography has added another dimension to the evaluation of musculoskeletal disease. The ability to discern subtle differences in tissue densities and the capability of viewing structures in the axial plane has greatly aided the resolution between normal and pathologic tissue and the appreciation of the anatomic relation between normal and pathologic structures. This paper deals with the application of CT in the evaluation of neoplastic, inflammatory, traumatic, metabolic, and congenital diseases of the musculoskeletal system.

Ankle Injuries↗
PubMed1990

Drug-induced lesions of the musculoskeletal system.

Drugs, whether prescribed by physicians or taken without the knowledge of the physician, may result in profound changes in the musculoskeletal system. Some drugs may produce teratogenic changes in the developing fetus frequently, but not necessarily, in association with anomalies of other systems. Other drugs may have their effects on the child or adult, whereas a number of drugs result in either teratogenic or nonteratogenic abnormalities. In the course of evaluating any diagnostic imaging study, it is essential that the radiologist be aware of any drugs that the patient may be taking and be knowledgeable of the radiologic changes that such drugs may produce in the musculoskeletal system.

Abnormalities, Drug-Induced↗
PubMed1987

Mycobacterial disease in the musculoskeletal system.

Over a six-year period, 12 patients were admitted to a Melbourne teaching hospital with mycobacterial infections of the musculoskeletal system. Four of the infections involved soft tissue and these included three atypical mycobacterial infections. The average age at diagnosis was 60 years. Five patients were born outside Australia. The predisposing factors included a past or family history of tuberculosis, pre-existing arthritis, alcoholism, earlier trauma, and membership of certain occupations. The average delay in diagnosis was four months. Treatment involved a combination of appropriate medication and surgical procedures that ranged from diagnostic aspiration to amputation. Mycobacterial infection of the musculoskeletal system, although uncommon in Australia, remains an important problem that requires continued awareness for early diagnosis.

Adult↗
PubMed1997

Musculoskeletal system. Joint and vertebral column diseases.

Owner complaints that refer to the musculoskeletal system are common in older dogs and cats. When the veterinarian is presented with these types of complaints, the differential lists include chronic intervertebral disk disease, diskospondylitis, degenerative joint disease, spondylosis with nerve root compression, joint/ ligament instability, and/or cancer. The diagnosis and management of some of these conditions is presented in detail with the general goal in mind that the older dog or cat is provided the best quality of life possible through good mobility along with being pain free.

Aging↗
PubMed1997

Effects of pediatric cancer therapy on the musculoskeletal system.

This review discusses the effects of treatment of pediatric malignancies on the musculoskeletal system with an emphasis on plain radiographic and MR imaging findings following radiation therapy, chemotherapy, bone marrow transplantation and hematopoietic growth factor administration.

Adolescent↗
PubMedDate not supplied

[Treatment of chronic pain of the musculoskeletal system by epidural stimulation].

In order to reduce refractory chronic pain of the musculoskeletal system, the orthopedic surgeon can stimulate electrically the peripheral nerves or the posterior funiculi of the spinal cord (epidural neurostimulation). The authors specify their current indications for epidural stimulation in the treatment of such painful diseases: radicular pain caused by arachnoepidurites, sequelae of trauma inflicted to the spine and medulla; postoperative lomboradicular pain of mixed source, and distal lesions of the plexus brachialis. The indication for an implant stems from a rigorous strategy which requires more particularly that pain regress by more than 50% under transcutaneous neurostimulation applied for a period of least one month and that the psychological and spinal-cerebral integrity be verified. The surgical procedure comprises two stages: first, positioning of an epidural electrode and, then, insertion of a totally implantable multiprogrammable radiostimulator. Judging from a prospective assessment of 20 cases of postoperative lumbar arachnoepiduritis treated in this way, the results are considered quite encouraging.

Analgesia, Epidural↗
PubMed2006

[Psychological evaluation of patients with benign musculoskeletal system tumors].

OBJECTIVES: This study was designed to determine to what extent psychological status was affected by sociodemographic characteristics and by being informed about the diagnosis in patients with benign musculoskeletal tumors. METHODS: The study included 112 male patients (mean age 23.8 years; range 20 to 35 years) who were hospitalized for benign tumors of the musculoskeletal system. A questionnaire was administered to all the patients concerning their sociodemographic characteristics and the status of their knowledge about the diagnosis. Psychological status was assessed by the Hamilton Depression Evaluation Scale. RESULTS: The depression level was not correlated with the localization (upper or lower extremity) of the musculoskeletal system tumor, the marital status of the patient, and the presence or absence of knowledge of the patient about the diagnosis (p>0.05). Educational status was the only factor that was found to be in correlation with the depression level (p<0.05). CONCLUSION: Lack of correlation between sociodemographic characteristics and the psychological status suggests that informing the patients with special attention to their physical and psychological integrity may contribute positively to the patients' psychiatric status.

Adult↗
PubMed2002

[Problems of the musculoskeletal system in amateur orchestra musicians under special consideration of the hand and wrist].

Studies on professional orchestra musicians have shown a high incidence of physical problems mainly on the level of the musculoskeletal system. At the same time, the individual instrument groups differ in the types and patterns of complaints. So far, no study on amateur orchestra musicians has been conducted. We therefore interviewed the 130 members of the "Bayerisches Arzteorchester", all members being amateur musicians. The complaints were documented and compared with those of professional orchestra musicians. 84 % of the musicians had physical problems, 74 % involving the musculoskeletal system. The high string players suffered mainly from shoulder-neck problems, cellists and bassists complained of neck and lumbar spine problems. Wind players suffered at the spine and woodwind players at individual digits. The hand was affected in 39 % of the musicians. The complaints voiced by amateur musicians are essentially identical with those found in professional musicians.

Adult↗
PubMed1991

Sonography of the musculoskeletal system.

High-resolution ultrasound is an imaging technique with increasing applications in the musculoskeletal system. With the development of high-frequency, realtime transducers, detailed images of small superficial structures can be provided. Tendons, muscles, and subcutaneous tissues can be assessed for disruption, masses, or fluid collections. Foreign bodies can be localized to guide surgical excision. Increased use of this diagnostic tool may lead to new applications as the technology improves.

Bone and Bones↗
PubMed1983

[Computerized tomography and traumatology of the musculoskeletal system].

Value and indication of computerized tomography in diagnostic procedures after trauma of the musculoskeletal system is shown analyzing the case material with CT in traumatized patients. In general CT is not to take place of conventional X-ray methods. We feel CT is indicated in evaluation of: intraarticular fragments, congruity of joints, lesions of the cruciate ligaments and osteocartilagineous fractures, if conventional X-ray procedures prove insufficient.

Female↗
PubMed1996

The effect of heavy work on the musculoskeletal system of dockers.

In compass of 1989-1995 all in all 388 dockers were examined, including 136 stevedores, 128 operators of mechanic equipment, 74 hoistmen and 73 retired stevedores. Out of the group of 508 stevedores that in 1989 was selected for the purpose of the study, at the end of 1995 there were 136 still working, and out of 141 operators 128 remained in employment. The number of the hoistmen working did not change. The stevedores perform heavy and a very heavy loading labour, the rest moderate and light. The highest number of changes was found in the lumbar segment of the spine-totally 56.2%, then in the sacroiliac articulations-totally 50.6%, in the cervical spine-totally 34.4%, within the shoulder girdle-33.1% and in the thoracic segment of the spine-26.3%. In stevedores these proportions were higher. A transfer to a lighter work or retirement could not inhibit the degenerative process within the musculoskeletal system. Evaluating the development of the disease in the period of observation, a progress of the pathological process was observed. No relation between the loss of fitness in stevedores and their body mass could be found. The mean time of the disease tended to increase with age of the examined. In a considerable number of the subjects a casual connection between the changes in the musculoskeletal system and the work performed was revealed.

Absenteeism↗
PubMed1993

Effects of spaceflight on the musculoskeletal system: NIH and NASA future directions.

Prolonged bed rest, undertaken by volunteers or resulting from injury and disease, can impair bone and muscle function and structure; extended travel in space also induces these effects. Fluid shifts and disrupted fluid balance may also contribute to observed musculoskeletal aberrations in the weightless environment. Some molecular and cellular events involved in the loading and unloading of the musculoskeletal system are under neural and endocrine influence or control, whereas other events are influenced by local growth factors. Studies are in progress to develop interventions that preserve or improve musculoskeletal integrity in 1g. The NIAMS and NASA are interested in basic and clinical studies of the influence of microgravity on the musculoskeletal system. The interagency workshop results form the basis for new collaborative and cooperative research emphases for the biomedical community under a broad agreement between the National Institutes of Health and NASA.

Bone and Bones↗
PubMed1990

Sonography of the musculoskeletal system.

Improved technology and the development of high-resolution transducers have made sonography of the structures of the musculoskeletal system possible. The vast majority of scientific reports on the value of sonography for imaging musculoskeletal abnormalities have been written only in the last decade. Sonography has several inherent advantages: it is relatively inexpensive, allows comparison with the opposite normal side, uses no radiation, and can be performed at bedside or in the operating room if necessary. The advent of MR imaging has revolutionized musculoskeletal imaging and may be used in many instances rather than sonography for evaluating the same abnormalities or anatomic structures. It is important, however, to keep in perspective what the different imaging techniques have to offer, and, if one is just as efficacious as the other, the least invasive and least expensive should be chosen whenever possible. The goal of this article is to review the applications of sonography to the evaluation of musculoskeletal disorders including tendon disease, soft-tissue masses, identification of foreign bodies, osteomyelitis, cellulitis, and certain joint abnormalities.

Aneurysm↗
PubMed2005

Calcium phosphate cements: competitive drug carriers for the musculoskeletal system?

This paper attempts to provide an insight in the application of calcium phosphate cements (CPC) in the field of drug delivery devices for the musculoskeletal system. Their ability to set once implanted within the body, giving a highly microporous material, allows incorporation of many types of drugs and biologically active molecules, without losing activity and denaturalization. Additionally, by being injectable these materials can be used in the growing market for new technologies of minimally invasive surgery, and in the treatment of difficult accessible sites. All these characteristics, together with the excellent biological behaviour of CPC, make them good candidates for drug delivery devices to be used in the pharmacological treatment of a great number of diseases of the bone tissue.

Biocompatible Materials↗
PubMed2000

The effects of pregnancy on the musculoskeletal system.

During pregnancy the female body undergoes many hormonal and anatomic changes that affect the musculoskeletal system. These changes may cause various musculoskeletal complaints, predispose to injury, or alter the course of preexisting conditions. The changes of pregnancy should be taken into account when counseling women who wish to exercise through their pregnancy. Treatment of musculoskeletal complaints during pregnancy must include the potential effects on mother and fetus.

Female↗
PubMed2006

[Linezolid in the treatment of antibiotic-resistant gram-positive infections of the musculoskeletal system].

PURPOSE OF THE STUDY: The growing incidence of resistant microorganisms has been responsible for complications associated with treatment of osteomyelitis, infections following joint arthroplasty, as well as septic arthritis. Their therapy often requires a long-term administration of antibiotics to which the bacterial strain is sensitive. Oxazolidinons present a novel group of antibiotics recently adopted in clinical medicine. However, the only member of this group so far approved for clinical use is linezolid. It is effective for Gram-positive bacteria including antibiotic-resistant strains, such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), resistant coagulase-negative staphylococci and penicillin-resistant pneumococci. Linezolid is well absorbed in the intestinal system. Oral administration results in serum levels comparable with those following intravenous injection of the same dose. MATERIAL, METHODS AND RESULTS: In the 1st Orthopedic Department of the 1st Faculty of Medicine at Charles University, linezolid was used for treating infections of the musculoskeletal system caused by MRSA and methicillin-resistant Staphylococcus epidermidis (MRSE). Fourteen patients, eight women and six men, were treated in the period from 1999 to 2005. The average age at the time of therapy was 65 years (range, 24-80). The treatment involved infection of 10 joints following arthroplasty (six total hip and four total knee replacements), one osteomyelitis, one septic arthritis, one abscess in the gluteal region and one infected amputation stump. With the exception of one patient, antibiotic therapy was always combined with an appropriate surgical intervention. The average antibiotic course was 27 days, with intravenous administration of linezolid at the beginning (average, 11.4 days; range, 9-14) and oral administration later (average, 15.9 days; range, 14-18). Antibiotic therapy was well tolerated by the patients, and no adverse side-effects were recorded. The success rate of therapy was 93 %. The only failure was in the patient in whom the infection of total knee replacement was treated with mere antibiotics, without any surgical intervention. DISCUSSION: Linezolid is a treatment option for joint infections following arthroplasty that are caused by resistant bacterial strains, such as MRSA, MRSE or VRE. The therapeutic efficiency varies in relation to whether the patients have undergone conservative or surgical treatment and, in the latter case, on the surgical technique used. On the basis of our results we suggest that a radical surgery is necessary, but in agreement with other recent reports we prefer a surgical approach combined with antibiotic therapy. The costs of linezolid treatment are high, but the possibility of its oral administration, with maintenance of the required tissue levels, markedly reduces hospital stay costs and increases patients' comfort during treatment. In our group, the patients received linezolid doses orally for up to 16 days, which means a hospital stay shorter by more than two weeks. The antibiotic course varies and, in relation to the kind of infection, may range from 5 days to 2 months; however, linezolid administration for 4 to 8 weeks is most frequent. The period of 28 days recommended by the manufacturer is thus usually extended. CONCLUSIONS: Infections caused by Gram-positive bacteria resistant to common antibiotics present serous epidemiological, therapeutic and economic problems, which will soon be in the focus of attention in the majority of Czech hospitals. In the patients who, due to allergic reactions, intolerance or bacterial resistance, cannot be treated with vancomycin or other antibiotics, linezolid may be a useful option for treatment of musculoskeletal system infections. The possibility of linezolid administration in oral doses markedly reduces hospital stay costs and increases patients' comfort during treatment.

Acetamides↗