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At least 73 records · Page 4Linked to original sources
PubMed1989

Magnetic resonance imaging of the musculoskeletal system. An overview.

Several of the features of magnetic resonance imaging (MRI) are advantageous for diagnostic examination of the musculoskeletal system. For example, the excellent depiction of bone marrow makes it a very sensitive method for identifying trauma, tumor, ischemia and infection of the marrow space. In addition, the high-contrast discrimination of soft tissues and the ability to make thin-section images in any plane allows for the depiction of abnormalities involving the muscles, ligaments, tendons, and neurovascular structures. The major disadvantages are the nonspecificity of many of the findings, the high cost of examinations, and the limited number of available MRI units. MRI is most appropriately utilized when it can be expected to provide diagnostic information not available from less-expensive noninvasive diagnostic methods and when the results of the examination may significantly affect patient management. To get the most out of the examination, it should be performed and interpreted with knowledge of clinical findings and results of other imaging tests, especially plain roentgenograms. To date, MRI has proved to be most useful for the evaluation of the spine, shoulder, hip, and knee.

Bone Diseases↗
PubMed1988

An analysis of the sources of musculoskeletal system impedance.

When antagonistic muscles co-contract, the impedance of musculoskeletal systems to applied loads is known to increase. In this paper a physiologically-based, higher-order, nonlinear antagonistic muscle-joint model is utilized to clarify the sources of impedance modulation during a variety of tasks, ranging from resisting transient loads to holding steady loads to making fast movements in unpredictable surroundings. It is shown that impedance modulation occurs automatically as a function of the specific operating ranges utilized during a given task by each of four different muscle-joint mechanical relations. The relative contribution of each relation depends on the type of task, with impedance during quasi-static conditions sensitive to muscle tension-length and sometimes joint parallel elastic properties and during dynamic tasks dominated by the series element and muscle force-velocity properties. Elimination of any of these causes a decrease in built-in biomechanical capabilities. These findings raise questions concerning past theories on stiffness-impedance modulation which appear to underestimate the role of inherent biomechanical properties.

Biomechanical Phenomena↗
PubMed2004

Outpatient osteopathic single organ system musculoskeletal exam form: training and certification.

The Outpatient Osteopathic Single Organ System Musculoskeletal Exam Form (SOS form) is a standardized examination data form. A standardized form is necessary to ensure that essential quality data are collected during osteopathic studies and that each submitted form is completed adequately and uniformly. Use of the standardized form permits reliable statistical computations from the collected data. The training process for the SOS form incorporated the following elements: (1) training investigators to use the form; (2) having trainees transcribe three clinical case examples onto SOS forms; (3) comparing each transcribed clinical case to a prepared key; (4) evaluating the trainees' work for accuracy; and (5) statistically evaluating the trainees' records for intraexaminer and interexaminer reliability. The success or failure of trainees to receive certification in their training process involved evaluating their ability to accurately and appropriately record data collected from three case examples. These cases were designed to evaluate recording accuracy and intraexaminer and interexaminer reliability. All trainees scored 80% or better for accuracy, and their work had good intraexaminer and interexaminer reliability. As a result, all trainees were awarded a numbered certificate for successful completion of the training process. Having a pool of well-trained, certified investigators available and ready to participate in the gathering of data through the use of the SOS form ensures that necessary data are collected and that the resulting databases are unified. It will also facilitate comparisons and statistical analysis of osteopathic research projects. Standardized forms and certified investigators will improve the quality of osteopathic research throughout the profession.

Ambulatory Care↗
PubMed1994

Ultrasonography of the musculoskeletal system.

This article reviews the numerous applications of ultrasound in the musculoskeletal system. Emphasis is made on the important and often under-utilized role of ultrasound in infections, vascular lesions, arthritis, and trauma.

Arthritis↗
PubMed1989

[Echography of the musculoskeletal system].

The recent, highly efficient and simple systems have enabled ultrasound to find a specific place in the imaging of the musculoskeletal system within a few years. The daily "on-site" examination currently completes plain radiographs with a particularly effective, non-traumatic and cheap exploration of a number of pathological cases, including traumatic musculotendinous lesions and periarticular soft tissue. After describing the normal images and the semiology of the major diseases for which this technique can be used, the author reviews the appearance of the main regional osteoarticular lesions (shoulder, hip, knee, extremities, etc.), with ultrasound.

Bone Diseases↗
PubMed1991

Radiologic manifestations in the musculoskeletal system of miscellaneous endocrine disorders.

The manifestations of endocrine derangements in the musculoskeletal system in infancy and childhood are disturbances in growth and maturation and in adulthood are disturbances in maintenance and metabolism. Hypercortisolism during skeletal immaturity suppresses growth. In the adult, hypercortisolism leads to osteoporosis, osteonecrosis, and muscle wasting. Deficiency of growth hormone during skeletal development results in short stature. An excess of growth hormone in a skeletally immature individual results in gigantism, an excess in a skeletally mature individual results in acromegaly. Patients with gigantism have extreme height with normal body proportions. Musculoskeletal manifestations of acromegaly include soft-tissue thickening, vertebral body enlargement, characteristic hand and foot changes, and enthesal bony proliferation. Hyperthyroidism causes catabolism of protein and loss of connective tissue, which manifest as muscle wasting. Deficient levels of thyroid hormone cause defects in growth and development. Severe growth retardation from congenital hypothyroidism is rare because neonatal screening recognizes the disorder and leads to early treatment. The skeletal manifestation of hypergonadism in children is precocious growth and early skeletal maturation. Although the initial precocious growth spurt results in a tall child, early closure of the growth plates results in a short adult. Hypogonadism in the prepubertal child results in delayed adolescence and delayed skeletal maturation. Diabetes mellitus in childhood results in decreased growth, a phenomenon presumed to be secondary to nutritional abnormalities. Generalized osteoporosis and short stature are common. In the adult, generalized osteoporosis may accompany insulin-dependent diabetes mellitus if obesity is absent. Calcification of interdigital arteries of the foot is common in diabetics and uncommon in other conditions. Additional skeletal manifestations relate to complications of diabetes such as peripheral neuropathy and diabetic foot disease.

Adult↗
PubMed2004

More 'cries from the joints': assessment of the musculoskeletal system is poorly documented in routine paediatric clerking.

OBJECTIVES: The aim of this study was to describe the assessment of the musculoskeletal (MSK) system in comparison with other systems in routine paediatric medical clerking. Furthermore, to survey trainee paediatricians (SPRs, specialist registrars) about their self-rated confidence in assessing the MSK system. METHODS: Case notes of consecutive general paediatric medical patients admitted to three UK hospitals over a 4-week period were assessed using a standard pro forma. All patients had been assessed by a consultant paediatrician during their admission. A postal questionnaire was sent to all SPRs in training in each of the hospitals, regarding their confidence in assessing the MSK system compared with other systems and their exposure to MSK teaching. RESULTS: Case notes of 257 patients [117 females, median age 3 yr (range 1-18 yr)] were reviewed. The most common reason for admission was acute infection, although the spectrum of other recorded diagnoses varied between hospitals. Thirteen children (5%) had an acute problem (e.g. infection) against a background of chronic disease. The case note documentation showed that cardiovascular (CVS), respiratory (RS) and gastrointestinal (GI) systems were assessed in the vast majority (>90%) of patients, irrespective of the underlying diagnosis. However, other systems were less well recorded; the trend being the same in each hospital and in descending order, the neurological system (38%), skin (32%), eyes (10%) and musculoskeletal system (4%). Only 2.7% (7/257) patients were documented to have been asked about MSK symptoms, and only 1.6% (4/257) had any documentation of joint examination--in all cases this was limited (e.g. range of movement of the knee only), and no patients had documentation of gait being examined, even in those children presenting with 'limp'. The response rate to the postal questionnaire was 60% (67/112). The self-rated confidence in MSK assessment was markedly low in comparison with other systems, even though 61/67 recalled some teaching of the MSK system as an undergraduate (61/67) or postgraduate (50/67). Of note none could recall teaching as an undergraduate in paediatric MSK assessment and where there had been postgraduate rheumatology MSK teaching this had been delivered by paediatric rheumatologists in many cases (34/50), reflecting the centres participating in the study. CONCLUSIONS: In routine general paediatric medical in-patient clerking and throughout the admission, MSK assessment was rarely documented, and even where present was limited. This contrasts markedly with other systems which were examined in most children irrespective of the presenting complaint. Self-rated confidence in MSK assessment is low amongst SPRs compared with other systems, despite most recalling some teaching. This discrepancy between teaching and clinical practice needs to be addressed in undergraduate and postgraduate training.

Adolescent↗
PubMed1987

Liposarcoma of the musculoskeletal system.

Two hundred eleven cases with the diagnosis of liposarcoma of the musculoskeletal system were reviewed. The mean age at diagnosis was 52.9 years. The primary site was the proximal lower extremity in 52%. Myxoid-type liposarcoma was most frequent (60%). Metastasis was observed in 45%. One hundred two patients without prior treatment or distant spread at diagnosis were studied separately. Recurrence was noted in 26%. The median survival time was 7.5 years, with a 5-year survival of 59% and a 10-year survival of 45%. Significant variation in survival time was related to histologic grade, Enneking's stage, tumor size, and histologic type.

Adolescent↗
PubMed1988

Interventional ultrasound in the musculoskeletal system.

This article highlights the multiple applications of ultrasound as a guidance modality for interventional procedures in the musculoskeletal system. The percutaneous aspiration, drainage, and biopsy of musculoskeletal abscesses, masses, and focal muscular pathology in the extremities, trunk, and neck using ultrasound as the guidance system is described. Techniques for biopsy, fluid aspiration, catheter insertion, and needle visualization by ultrasound are discussed.

Abscess↗
PubMed1984

Digital film processing: applications to the musculoskeletal system.

A prototype digital film processing system was systematically evaluated for specific applications to the musculoskeletal system. Test objects included a line pair resolution phantom and specimens designed to simulate lytic cortical and both lytic and sclerotic cancellous bone lesions. Clinical radiographs from a wide variety of osseous and soft tissue disorders were studied. Although digitization cannot improve the inherent resolution and information content of film, it is capable of enhancing contrast and visualization of detail. As a result, digital processing carries significant potential for improved diagnosis in musculoskeletal radiology.

Bone Diseases↗
PubMed2005

A 'cheap' optimal control approach to estimate muscle forces in musculoskeletal systems.

This paper shows a new method to estimate the muscle forces in musculoskeletal systems based on the inverse dynamics of a multi-body system associated optimal control. The redundant actuator problem is solved by minimizing a time-integral cost function, augmented with a torque-tracking error function, and muscle dynamics is considered through differential constraints. The method is compared to a previously implemented human posture control problem, solved using a Forward Dynamics Optimal Control approach and to classical static optimization, with two different objective functions. The new method provides very similar muscle force patterns when compared to the forward dynamics solution, but the computational cost is much smaller and the numerical robustness is increased. The results achieved suggest that this method is more accurate for the muscle force predictions when compared to static optimization, and can be used as a numerically 'cheap' alternative to the forward dynamics and optimal control in some applications.

Humans↗
PubMedDate not supplied

Magnetic resonance imaging of the musculoskeletal system.

During the last few years, the interest and experience in magnetic resonance imaging (MRI) of the musculoskeletal system has increased rapidly. Modern equipment with good spatial resolution and multislice, multiecho technique provides detailed information on the joints, soft tissue and spine within a reasonable examination time, both with superconductive and resistive systems. Today, MRI is an established technique for examination of musculoskeletal tumors and aseptic bone necrosis and it has proven to be of great value for evaluation of diseases of the spine and spinal canal. The definite place of MRI within musculoskeletal diagnostic imaging is not yet settled, but its potential is great, and it will have an important role in the future.

Bone Neoplasms↗
PubMed1993

[Pustular arthro-osteitis. An affection of the musculoskeletal system in pustulosis palmoplantaris].

Musculoskeletal involvement is seen in approximately 15% of patients with pustulosis palmoplantaris. Usually the upper anterior parts of the trunk are affected, but, not infrequently, the peripheral joints are involved. The author reports the case of a female patient with pustulosis palmoplantaris and arthritis of a wrist and a knee. The patient was followed for more than seven years, and the course of pustulotic arthroosteitis was characterized by frequent exacerbations of unilateral gonarthritis. The arthritis of the wrist did not respond to treatment with non steroidal anti-inflammatory drugs or to intraarticular injections of corticosteroids. She responded well, however, to surgical synovectomy.

Aged↗
PubMed1986

Magnetic resonance spectroscopy of the musculoskeletal system.

Magnetic resonance spectroscopy can be used to characterize the bioenergetic state of the musculoskeletal system, and several marker compounds related to the tissue's biochemistry have been found to exist. Potential new techniques involving better spatial localization, spectral editing, and examination of nuclei other than phosphorus are in the developmental stage. Their development over the next few years will determine the extent to which MRS will become a universally used medical tool. However, the results with 31P alone guarantee a continued role in the study of muscular disease, peripheral vascular disease, and hypoxia and ischemia of the neonatal brain.

Adolescent↗
PubMed1978

Computed tomography. Its use in space-occupying lesions of the musculoskeletal system.

The value of computed tomography in the diagnosis and management of lesions of the musculoskeletal system is being determined. Illustrative cases including a lipoma of the thigh, osteochondroma of the hip, simple cyst of the ilium, recurrent liposarcoma of the lumbar spine, desmoid tumor in the gluteal region, and postoperative interspace infection of the lumbar spine are presented to indicate the potential value of this procedure in the diagnosis and planning of treatment of musculoskeletal lesions.

Adolescent↗
PubMed2003

Percutaneous ultrasound-guided injections in the musculoskeletal system.

Ultrasound guidance is an accurate method for the delivery of therapeutic injections in the musculoskeletal system. The visualization of the needle in real time allows for reliable placement of the needle tip in the tendon sheath, bursa, or joint of interest. Both superficial and deep articulations and tendon sheaths can be targeted for diagnostic or therapeutic interventions. In addition, intratendinous calcifications, the plantar fascia, and interdigital (Morton's) neuromas can also be visualized and injected directly under real-time guidance. Performing percutaneous interventions with ultrasound ensures accurate needle tip placement and helps direct the needle away from other regional soft-tissue structures such as nearby neurovascular bundles.

Humans↗