Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “LEGS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 739 records · Page 41Linked to original sources
PubMed1999

Sclerotherapy for leg telangiectasia--a blinded comparative trial of polidocanol and hypertonic saline.

BACKGROUND: Hypertonic saline (HS) and polidocanol (POL) have been in use around the world for sclerotherapy of telangiectasia for many years. However, despite numerous articles in the literature extolling the virtues of their individual use, few studies scientifically compare their relative efficacies. OBJECTIVE: To compare, in a statistically significant number of female patients, the relative efficacy of hypertonic saline and polidocanol as sclerosants of leg telangiectasia and reticular feeding veins, using each patient as her own control. METHODS: Eighty-one women with roughly matching leg telangiecasia were treated with sclerotherapy. One leg was injected with 20% saline/2% lignocaine, the other with 1% polidocanol, with the patients blinded as to the sclerosant used for each leg. Assessment of percent reduction of vessels, and the complications of matting and hemosiderin staining was conducted at 2 months by 3 methods: the patient's satisfaction, the treating physician's evaluation, and blinded assessment of before and after photographs. RESULTS: There was no statistically significant difference between HS and POL treated legs when assessed clinically or photographically. However, POL caused more staining and matting, and despite patients finding HS more painful at injection, patient satisfaction at follow-up was higher with the HS treated leg. CONCLUSION: 20% HS and 1% POL have equal efficacy in sclerosing leg telangiectasia and reticular feeding veins. POL causes more adverse sequelae, although these may be related to the solution concentration.

Adult↗
PubMed1999

Leg symptoms, the ankle-brachial index, and walking ability in patients with peripheral arterial disease.

OBJECTIVE: To determine how functional status and walking ability are related to both severity of lower extremity peripheral arterial disease (PAD) and PAD-related leg symptoms. DESIGN: Cross-sectional study. SETTING: Academic medical center. PARTICIPANTS: Patients aged 55 years and older diagnosed with PAD in a blood flow laboratory or general medicine practice (n = 147). Randomly selected control patients without PAD were identified in a general medicine practice (n = 67). MEASUREMENTS: Severity of PAD was measured with the ankle-brachial index (ABI). All patients were categorized according to whether they had (1) no exertional leg symptoms; (2) classic intermittent claudication; (3) exertional leg symptoms that also begin at rest (pain at rest), or (4) exertional leg symptoms other than intermittent claudication or pain at rest (atypical exertional leg symptoms). Participants completed the 36-Item Short-Form Health Survey (SF-36) and the Walking Impairment Questionnaire (WIQ). The WIQ quantifies patient-reported walking speed, walking distance, and stair-climbing ability, respectively, on a scale of 0 to 100 (100 = best). MAIN RESULTS: In multivariate analyses patients with atypical exertional leg symptoms, intermittent claudication, and pain at rest, respectively, had progressively poorer scores for walking distance, walking speed, and stair climbing. The ABI was measurably and independently associated with walking distance (regression coefficient = 2.87/0.1 ABI unit, p =.002) and walking speed (regression coefficient = 2.09/0.1 ABI unit, p =.015) scores. Among PAD patients only, pain at rest was associated independently with all WIQ scores and six SF-36 domains, while ABI was an independent predictor of WIQ distance score. CONCLUSIONS: Both PAD-related leg symptoms and ABI predict patient-perceived walking ability in PAD.

Aged↗
PubMed2001

Improved efficiency with a wheelchair propelled by the legs using voluntary activity or electric stimulation.

OBJECTIVE: To determine whether a new leg-propelled wheelchair provides enhanced efficiency and mobility to wheelchair users. DESIGN: Observational; subjects were tested while wheeling with the arms and legs and while walking (where possible) for 4-minute periods in random order with approximately 10-minute rest periods between exercise sets. SETTING: Tests were done on an indoor 200-meter track. PATIENTS: Group 1, 13 controls; group 2, 9 persons with complete spinal cord injury (SCI); group 3, 13 persons with other motor disorders (retaining some voluntary control of the legs). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Physiological Cost Index (PCI), (computed as change in heart rate divided by velocity of movement) and oxygen consumption (VO(2)) RESULTS: Arm wheeling took significantly more effort (mean PCI =.52 beats/m) than walking (.33 beats/m) in control subjects. Leg wheeling was most efficient (.23), requiring less than half the effort of arm wheeling and 30% less effort than walking. For SCI subjects, leg wheeling with functional electric stimulation (FES) required less than half the effort (.18) of arm wheeling (.40). The FES group could not walk. Subjects in group 3 could walk, but with substantial effort (1.81) compared with arm (.76) or leg wheeling (.64). Results for VO(2) were similar. CONCLUSIONS: Better wheelchair efficiency can be obtained for many disabled individuals, by moving the leg muscles voluntarily or with FES.

Adult↗
PubMed2004

Evaluation of arm-leg coordination in flat breaststroke.

This study proposes a new method to evaluate arm-leg coordination in flat breaststroke. Five arm and leg stroke phases were defined with a velocity-video system. Five time gaps quantified the time between arm and leg actions during three paces of a race (200 m, 100 m and 50 m) in 16 top level swimmers. Based on these time gaps, effective glide, effective propulsion, effective leg insweep and effective recovery were used to identify the different stroke phases of the body. A faster pace corresponded to increased stroke rate, decreased stroke length, increased propulsive phases, shorter glide phases, and a shorter T1 time gap, which measured the effective body glide. The top level swimmers showed short time gaps (T2, T3, T4, measuring the timing of arm-leg recoveries), which reflected the continuity in arm and leg actions. The measurement of these time gaps thus provides a pertinent evaluation of swimmers' skill in adapting their arm-leg coordination to biomechanical constraints.

Adolescent↗
PubMed2001

Uric acid in cachectic and noncachectic patients with chronic heart failure: relationship to leg vascular resistance.

BACKGROUND: Chronic heart failure (CHF) is a hyperuricemic state, and capillary endothelium is the predominant site of xanthine oxidase in the vasculature. Upregulated xanthine oxidase activity (through production of toxic free radicals) may contribute to impaired regulation of vascular tone in CHF. We aimed to study the relationship between serum uric acid levels and leg vascular resistance in patients with CHF with and without cachexia and in healthy control subjects. METHODS: In 23 cachectic and 44 noncachectic patients with CHF (age, 62 +/- 1 years, mean +/- SEM) and 10 healthy control subjects (age, 68 +/- 1 years), we assessed leg resting and postischemic peak vascular resistance (calculated from mean blood pressure and leg blood flow by venous occlusion plethysmography). RESULTS: Cachectic patients, compared with noncachectic patients and control subjects, had the highest uric acid levels (612 +/- 36 vs 459 +/- 18 and 346 +/- 21 micromol/L, respectively, both P <.0001) and the lowest peak leg blood flow and vascular reactivity (reduction of leg vascular resistance from resting to postischemic conditions: 83% vs 88% and 90%, both P <.005). In all patients, postischemic vascular resistance correlated significantly and independently of age with uric acid (r = 0.61), creatinine (r = 0.47, both P <.0001), peak VO2 (r = 0.34), and New York Heart Association class (r = 0.33, both P <.01). This correlation was not present in healthy control subjects (r = -0.04, P =.9). In multivariate and stepwise regression analyses, serum uric acid emerged as the strongest predictor of peak leg vascular resistance (standardized coefficient = 0.61, P <.0001) independent of age, peak VO2, creatinine, New York Heart Association class, and diuretic dose. CONCLUSIONS: Hyperuricemia and postischemic leg vascular resistance are highest in cachectic patients with CHF, and both are directly related independent of diuretic dose and kidney function. The xanthine oxidase metabolic pathway may contribute to impaired vasodilator capacity in CHF.

Adult↗
PubMed2002

Effects of leg and body position on transcutaneous oxygen measurements in healthy subjects and subjects with peripheral artery disease after lower-extremity arterial revascularization: a pilot study.

Transcutaneous oxygen (TcPO(2)) measurements provide a noninvasive, objective determination of the oxygen level at the skin surface. This offers a means of estimating the underlying circulation and tissue oxygenation. The purpose of the pilot study was to measure the TcPO(2) value of the lower extremity of healthy men and women and of patients with peripheral arterial disease (PAD) in 4 different body and leg positions 24 hours after peripheral vascular surgery reconstruction. The specific aim was to determine if lower-extremity TcPO(2) measurements were affected by changes in extremity position in these subject populations. A convenience sample of 4 healthy health care professionals and 4 patients who had peripheral vascular reconstruction surgery 24 hours before the measurements were studied. Subjects were studied in 4 different leg and body positions: supine with legs extended, sitting with legs dependent, a 5 degrees head-up reverse Trendelenburg, and supine with legs elevated 10 in. The Radiometer TCM30 TcPO(2) monitor was used to carry out these measures. Findings revealed a statistically significant difference in TcPO(2) measurements between the 2 groups, with the healthy subjects having a significantly higher TcPO(2) measurement in all extremity positions compared with the revascularized subjects with PAD (P =.02-.05). Significant changes were noted in both the foot temperature (P =.03) and TcPO(2) measurements with extremity positions within the healthy subject group (P =.001). The foot and leg TcPO(2) measurements affect from leg and body position did not reach significance (P =.09) in the subjects with PAD. No change in foot temperature with extremity positioning (P =.42) was noted in the subjects with PAD. This pilot study provides a base in which additional research will be performed with TcPO(2) measurements in both the healthy and revascularized person.

Aged↗
PubMed1999

Treatment of leg ulcers with split skin grafts: early and late results.

Sixty patients (mean age 73.5 years) with 88 leg ulcers that had not responded to conservative treatment had split skin grafts applied at the Department of Plastic Surgery, Linköping, Sweden. Of 51 venous leg ulcers 45 (88%) healed after a mean of 15 days (range 5-30); and 13 (62%) of the 21 arterial ulcers healed after a mean of 18 days (range 8-30). Additional skin grafting was done on nine of the venous and on three of the arterial ulcers. Twenty-two (49%) of the healed venous ulcers recurred after a mean of four months while only two (15%) of the healed arterial ulcers recurred after a mean of 10 months. At late follow up after a mean of four years 18 of the patients were dead and 10 had had the leg in question amputated. Of the 34 patients still alive who had not had amputations, 31 were investigated at open ward or interviewed by telephone and 23 patients were examined with colour duplex scan. Seven of these patients had open leg ulcers. At duplex scan six patients had no venous or arterial insufficiency that could cause a leg ulcer. Of 16 patients with venous insufficiency 10 patients had only an inadequate superficial system. The mean cost for treating one leg ulcer by skin grafting is estimated at SEK 89000 (US$11125). We conclude that leg ulcers often heal with skin grafting but that venous ulcers often recur. To reduce the recurrence rate we suggest a better preoperative aetiological evaluation and improved postoperative treatment with a compression bandage.

Adult↗
PubMed2005

Foot and leg problems are important determinants of functional status in community dwelling older people.

PURPOSE: To determine whether foot and leg problems are independently associated with functional status in a community sample of older people after adjusting for the influence of socio-demographic, physical and medical factors. METHOD: Data were analysed from the Health Status of Older People project, a population-based study involving a random sample of 1000 community-dwelling people aged 65 - 94 years (533 females, 467 males, mean age 73.4 years +/- 5.87). A structured interview and brief physical examination were used to investigate the associations between self-reported foot and leg problems and functional status. Functional status was assessed using: (i) timed 'Up & Go' test, (ii) self-reported difficulty climbing stairs, (iii) self-reported difficulty walking one kilometer, (iv) self-reported difficulty performing instrumental activities of daily living (IADLs), and (v) self-reported history of one or more falls in the previous 12 months. These associations were then explored after adjusting for socio-demographic, physical and medical factors. RESULTS: Thirty-six percent of the sample reported having foot or leg problems. Univariate analyses revealed that people with foot and leg problems were significantly more likely to exhibit poorer functional status in all parameters measured. After adjusting for socio-demographic, physical and medical factors, foot and leg problems remained significantly associated with impaired timed 'Up & Go' performance (OR = 2.15, 95%CI 1.55 - 2.97), difficulty climbing stairs (OR = 3.33, 95%CI 1.98 - 5.61), difficulty walking one kilometer (OR = 3.13, 95%CI 2.09 - 4.69), and history of falling (OR = 1.73, 95%CI 1.26 - 2.37). CONCLUSIONS: Foot and leg problems are reported by one in three community-dwelling people aged 65 years and older. Independent of the influence of age, gender, common medical conditions and other socio-demographic factors, foot and leg problems have a significant impact on the ability to perform functional tasks integral to independent living.

Accidental Falls↗
PubMed2004

Differences in stroke phases, arm-leg coordination and velocity fluctuation due to event, gender and performance level in breaststroke.

The purpose of this study was to analyse stroke phases, arm-leg coordination and trunk motion fluctuation during breaststroke in elite male and female 50, 100 and 200 m events at the 9th FINA World Swimming Championships, Fukuoka 2001. Four phases of the arm stroke and three phases of the leg kick as well as phases of simultaneous arm and leg propulsion and recovery were identified from video of swimmers' motions below the surface. The duration of each phase was expressed as a proportion of the whole stroke cycle. Three measures of the arm-leg coordination, percent simultaneous arm-leg recovery time (%SRT), percent arm lag time (%ALT) and percent simultaneous arm-leg propulsion time (%SPT) were calculated. Mean mid-pool swimming hip velocity (V), stroke rate (SR) and stroke length (SL) were also calculated. In addition, the intra-cycle hip velocity of the swimmers was obtained by cinematographic analysis. The SR decreased and SL increased significantly as the event distance increased. For the arm-leg coordination the %ALT, %SPT and %SRT indicated significant differences between event, gender and performance level. In particular, for increasing event distance and for the higher performing swimmer the lower the %SPT and the higher the %SRT. In addition, the range of the intra-cycle hip velocity fluctuation in the lower performing group was greater than the higher performing group. The non-propulsive phase seems to be a key factor for better performance. The breaststroke swimmers must avoid rapid deceleration during the non-propulsive phase by adopting a low resistance posture and stroking technique.

Arm↗
PubMed1994

Leg weakness due to stroke. Site of lesions, weakness patterns and causes.

Among 1575 patients with an acute stroke, 63 (4%) were found to have a leg-predominant weakness. The cerebral lesions were situated in (i) the anterior cerebral artery (ACA) territory in 12 cases, including one patient with a thrombosis of the sagittal sinus; (ii) the middle cerebral artery (MCA) territory in nine cases; (iii) both territories (not watershed) in two cases; (iv) the internal capsule in 18 cases, of which six cases had lesions in the ponto-peduncular or pontine; (v) other brainstem regions in 10 cases; (iv) the thalamus in two cases. Four were not precisely classified. In short, 41 were hemispheric and 18 were in the brainstem or thalamus. Lesions restricted to the rear portion of the medial part of the precentral gyrus caused a contralateral predominantly distal leg weakness. The weakness was severe with little improvement. Lesions involving the medial part of the premotor cortex, the supplementary motor area (SMA) and the rear portion of the medial part of the precentral gyrus caused a contralateral, severe leg-predominant hemiplegia, distally predominant and a less severe proximal weakness of the arm. Recovery was much better for the arm than for the leg. Lesions affecting the medial part of the premotor cortex, the SMA and sparing the precentral gyrus caused a contralateral hemiparesis predominating on the leg but predominating proximally on both leg and arm. Recovery was good for leg and arm. There were 22 infarcts due to ACA or MCA occlusion, one due to superior sagittal sinus occlusion, 18 lacunes and five haemorrhages.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1996

The epidemiology of chest and leg wound infections following cardiothoracic surgery.

The occurrence of wound infections following cardiothoracic surgery has significant implications. However, the epidemiology of all chest and leg wound infections is infrequently described, and the effects on morbidity, mortality, and cost of care remain undefined. We identified 182 superficial and deep chest and leg infections in 163 patients following 1,554 coronary artery bypass graft (CABG), valve, and CABG/valve procedures over 30 months. The overall infection rate was 11.7%; infections of specific sites involved in the 1,554 procedures occurred at the following rates: 3.1%, superficial chest wounds; 2.3%, deep chest wounds; 4.6%, superficial leg wounds; and 2.2%, deep leg wounds. Chest infection rates were similar for all procedures. Multiple infections occurred in 9.8% of patients and were associated with female sex, diabetes, and prolonged surgery (P < .05). Purulent drainage and fever were more common in chest infections; erythema and pain were more common in leg infections (P < .05). Staphylococcus aureus (32.9%), coagulase-negative staphylococci (27.4%), and Enterobacteriaceae (26.0%) were identified most commonly. Enterobacteriaceae were more commonly isolated from leg wounds (P < .05). Adverse outcomes included reexploration (20.9%), flap surgery (12.3%), and death (4.3%). All adverse outcomes were more commonly associated with deep chest infections (P < .05), but superficial chest and leg infections also had a substantial impact on cardiothoracic surgery-related morbidity. Studies are needed to define site-specific risk factors so that the full potential of prevention and control measures can be realized.

Coronary Artery Bypass↗
PubMed1997

Leg extension power and walking speed in very old people living independently.

BACKGROUND: Leg extension power can be determined as the product of the force and velocity of movement. Its association with maximal walking speed was studied in 131 80- and 85-year-old men and women. METHODS: Leg extension power was measured with the help of a sledge ergometer in a sitting position using a facilitated "jump test." The participant was attached by belts to a sliding chair on rails inclined at 12.6 degrees to the floor. The feet were placed on the force plate attached perpendicularly to the rails, and the knee angle was 90 degrees at the starting position. The participant was advised to extend his or her legs powerfully. The highest value of five to eight attempts was accepted as the result. The results were adjusted for body mass and expressed as watts.kilogram-1. Maximal walking speed was measured in the laboratory corridor over a distance of 10 m. RESULTS: Men and 80-year-old subjects exhibited greater leg extension power and were faster walkers than women and 85-year-old persons. Leg extension power correlated positively with maximal walking speed in all groups: the correlation coefficients were .412 in the 80-year-old men (n = 41, p = .007), .619 in the 80-year-old women (n = 56, p < .001), .939 in the 85-year-old men (n = 8, p = .001), and.685 in the 85-year-old women (n = 23, p < .001). The regression lines for leg extension power and walking speed were coincident, indicating that the power requirements to attain a given walking speed were similar for both sexes. The minimum power threshold for those with a maximal walking speed of 1.30-1.49 m.s-1 was on the order of 4 W.kg-1; a maximal walking speed of 1.50-1.99 m.s-1 required 7 W.kg-1; and for a speed over 2.00 m.s-1 the power threshold was 9.5 W.kg-1. CONCLUSIONS: Their lower average leg extension power may be one of the factors explaining the greater prevalence of mobility problems among women than men.

Activities of Daily Living↗
PubMed2003

Quantification of leg oedema in postmenopausal hypertensive patients treated with lercanidipine or amlodipine.

OBJECTIVE: Of the study was to compare the leg oedema-forming potential of two different dihydropyridine calcium channel blockers in postmenopausal women. DESIGN: A total of 92 postmenopausal hypertensive patients [systolic blood pressure (SBP) 150-179 mmHg or diastolic blood pressure (DBP) 95-109 mmHg were randomized to receive a 4-week treatment with either 10 mg/day lercanidipine (n = 48) or 5 mg/day amlodipine (n = 44), with force-titration to 20 and 10 mg/day, respectively for an additional 4 weeks. METHODS: Leg volume was measured by water displacement volumetry, patients were questioned for symptoms and a physical examination was performed to detect the presence of oedema. RESULTS: A total of 77 patients completed the study, without a major protocol violation and were included in the primary analysis. Leg volume increase from baseline was significantly higher in the amlodipine than in the lercanidipine group (60.4 +/- 8.6 versus 5.3 +/- 8.1 ml; P < 0.001). The percentage of patients with evidence of oedema on physical examination (33.3 versus 9.8%, P = 0.011) and with symptoms of leg swelling (63.9 versus 22%, P < 0.001) and leg heaviness (47.2 versus 12.2%, P < 0.001) was also greater with amlodipine compared with lercanidipine. A positive correlation was found between leg volume and sign or symptoms of oedema (P < 0.001). Both drugs reduced SBP and DBP, with no significant differences between treatments. No correlation was found between leg volume changes from baseline and the antihypertensive effect of either drug. CONCLUSIONS: In postmenopausal females with mild to moderate hypertension the oedema formation of Lercanidipine was significantly less than that of Amlodipine, despite no significant differences in the antihypertensive effect.

Aged↗
PubMed1997

Leg tissue perfusion in simple tibial shaft fractures treated with unreamed and reamed nailing.

BACKGROUND: To compare the effects of unreamed and reamed intramedullary nailing on tibialis posterior, dorsalis pedis, and sum (tibialis posterior plus dorsalis pedis) distal arterial peak pulses. Additionally, leg skin temperature and transcutaneous oxygen tension were measured in patients with low energy, closed tibial shaft fractures. METHODS: The patients were randomized to unreamed and reamed groups, and intramedullary nailing without or with reaming was performed under spinal anesthesia. The measurements were carried out before the operation and on 5 postoperative days. RESULTS: In the unreamed group, the only significant difference between contralateral and nailed legs was in raised leg skin temperature (p = 0.0001). In the reamed group, tibialis posterior distal arterial peak pulses and transcutaneous oxygen tension remained at a significantly lower level and leg skin temperature at a significantly higher level, respectively, in the nailed legs after the operation when compared with contralateral legs (p = 0.0026, p = 0.0001, and p = 0.0001, respectively). There were no statistical differences between preoperative and postoperative values in the measured parameters in both groups. Additionally, there were no intergroup changes in the measured parameters in the injured legs. CONCLUSION: The present study suggests that altered distal arterial pulsations, decreased transcutaneous oxymetry values, and thermal reaction are not due to differences in nailing method but caused by a manifestation of the trauma mechanism of the tibial shaft fracture. The potentially negative effects of reaming to soft tissue perfusion parameters could not be established.

Adult↗
PubMed1998

Abnormally increased intramuscular pressure in human legs: comparison of two experimental models.

BACKGROUND: Abnormally increased pressure in the anterior compartment of 20 legs in 10 subjects was induced by applying venous stasis of a casted leg and external compression by a cylindrical air splint of the contralateral leg. The effects of increased intramuscular pressure (IMP) on blood perfusion pressure and clinical symptoms in the foot were compared during 30 minutes by the two methods. RESULTS: Intramuscular pressure increased to 38.9 (SD = 2.9) mm Hg when venous stasis was applied and to 39.8 (SD = 1.6) by external compression (not significant). Blood perfusion pressure in the anterior compartment decreased significantly to 25 mm Hg in both legs when they were elevated. Subjects experienced loss of sensation and muscular weakness only in the foot of the casted obstructed leg. CONCLUSIONS: Venous stasis of a casted elevated leg is an alternative experimental model to induce abnormally increased intramuscular pressure and neuromuscular dysfunction in the human leg. The venous stasis model may be better than external compression in the study of pathogenesis and pathophysiology of simulated imminent acute compartment syndrome in man.

Adult↗
PubMed1992

Straight leg raising test versus radiologic size, shape, and position of lumbar disc hernias.

In 30 patients with a computed tomography-verified lumbar disc herniation, the relation between the straight leg raising test and the size, shape, and position of the hernia was evaluated before, 3, and 24 months after inception of nonoperative treatment. Hernia size was expressed as an index relating it to the size of the spinal canal. The limitation of the straight leg raising test was not related to size or position of the hernia. Before treatment, straight leg raising was equally restricted in patients with sharply pointed or blunt hernias, but after 3 months straight leg raising was less limited in patients with sharply pointed hernias, whereas after 24 months straight leg raising was regularly normalized. Size index was lower for sharply pointed hernias at all three computed tomography scans. A decrease in hernia size over time, irrespective of shape, was not correlated to a concomitant improvement in straight leg raising. It must be presumed that additional factors, such as inflammatory reactions affecting the nerve roots, are of importance for the magnitude of straight leg raising.

Adult↗
PubMed2005

Low back pain on passive straight leg raising: the anterior theca as a source of pain.

STUDY DESIGN: A prospective clinical and radiologic investigation of two groups of patients presenting with either acute back pain only or acute leg pain only, yet similar restriction in straight leg raising (SLR). OBJECTIVES: To highlight a group of patients presenting with acute low back pain only, yet a restricted SLR normally associated with leg pain (sciatica) caused by a posterolateral disc prolapse. To determine the anatomic source of the pain in the low back pain only group. SUMMARY OF BACKGROUND DATA: A restricted SLR is commonly associated with leg pain (sciatica) due to compression of a nerve root by an intervertebral disc prolapse. Previous studies investigating pain patterns on SLR have suggested that central disc prolapses tend to induce back pain whereas the more lateral prolapses induce leg pain. Such research work has involved patients presenting with typical sciatic pain investigated by myelography and undergoing decompressive surgery. There are no studies specifically investigating patients presenting with low back pain only and reduced SLR. METHODS: Two groups of patients, one with acute low back pain only and one with acute leg pain only, yet showing similar restriction in SLR underwent MR imaging. The scans were reviewed "blind" by an experienced spinal radiologist and imaging features recorded according to a detailed protocol. The MR findings were then compared. RESULTS: Significant disc prolapses were seen equally in both groups. The disc prolapses in the back pain only group were more likely to be central, smaller, to compress the theca only, and to be at a higher lumbar level as compared with the leg pain only group. CONCLUSIONS: Acute low back pain associated with significant restriction in SLR is likely to be caused by a disc prolapse compressing the anterior theca.

Acute Disease↗
PubMed2005

Restless legs syndrome.

PURPOSE OF REVIEW: In the review period since February 2004 a number of papers have been published that make significant contributions to the current understanding of the epidemiology, clinical assessment, pathophysiology and treatment of restless legs syndrome. Those with the most significant findings were selected and will be reviewed. RECENT FINDINGS: Several epidemiological studies about restless legs syndrome have become available in the review period. A new susceptibility locus for restless legs syndrome has been reported. Neuropathological studies have provided profound insights into the key role of iron regulation in the pathophysiology of restless legs syndrome. Several randomized, double-blind, placebo-controlled studies have demonstrated that dopamine agonists are efficacious in the treatment of restless legs syndrome. A few pilot treatment studies with intravenous iron have been performed. SUMMARY: In this paper, recent advances in the field of restless legs syndrome are reviewed. Special emphasis is placed on pathophysiology and treatment. Restless legs syndrome is still an underdiagnosed disorder. The evidence basis for its treatment has been considerably increased in the review period.

Anticonvulsants↗