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At least 127 records · Page 7Linked to original sources
PubMed2001

On the feasibility of remote palpation using acoustic radiation force.

A method of acoustic remote palpation, capable of imaging local variations in the mechanical properties of tissue, is under investigation. In this method, focused ultrasound is used to apply localized (on the order of 2 mm3) radiation force within tissue. and the resulting tissue displacements are mapped using ultrasonic correlation based methods. The tissue displacements are inversely proportional to the stiffness of the tissue, and thus a stiffer region of tissue exhibits smaller displacements than a more compliant region. In this paper, the feasibility of remote palpation is demonstrated experimentally using breast tissue phantoms with spherical lesion inclusions, and in vitro liver samples. A single diagnostic transducer and modified ultrasonic imaging system are used to perform remote palpation. The displacement images are directly correlated to local variations in tissue stiffness with higher contrast than the corresponding B-mode images. Relationships between acoustic beam parameters, lesion characteristics and radiation force induced tissue displacement patterns are investigated and discussed. The results show promise for the clinical implementation of remote palpation.

Breast↗
PubMed1976

Detection of renal anomalies by abdominal palpation in newborn infants.

In a new technique of palpation for renal anomalies in the newborn one hand supports the infant while the fingers of the other hand support the loin and the thumb explores the abdomen. In a series of 11 000 otherwise normal newborn children superficial palpation detected 11 renal anomalies, and deep palpation led to the discovery of another 42 anomalies. One of two other series in which palpation was performed bimanually gave a similar incidence of renal anomalies (0-5%). Early discovery of an asymptomatic anomaly enables early treatment of the complications that are often found in patients with congenital renal anomalies detected in later life.

Humans↗
PubMed2002

Dorsalis pedis arterial pulse: palpation using a bony landmark.

INTRODUCTION: The unreliability of the pulse examination of the foot has primarily been due to variability of technique between examiners. Whereas the groove between the medial malleolus and the Achilles tendon more readily defines the location of the posterior tibial pulse, the location of the dorsalis pedis pulse remains vague. In this paper a novel method of locating the dorsalis pedis pulse by physical examination is described. METHODS: Forty one consecutive patients admitted to a general surgery service of a tertiary medical centre within a two month period were examined. Using the dorsal most prominence of the navicular bone as a landmark, the distance to the dorsalis pedis pulse in bilateral lower extremities was measured by palpation and compared to Doppler ultrasound. Measurements were confirmed by two separate examiners blinded to each others' results. RESULTS: The dorsalis pedis artery was palpable in 78% of extremities and present by Doppler ultrasound in 95%. The location of the left dorsalis pedis artery was a mean (SD) 9.8 (1.4) mm by palpation and 11.1 (2.1) mm by Doppler ultrasound from the dorsal most prominence of the navicular bone. The right dorsalis pedis artery was 10.4 (3.4) mm by palpation and 11.5 (0.7) mm from the dorsal most prominence of the navicular bone. No significant differences in location of the dorsalis pedis artery were observed bilaterally between Doppler ultrasound and palpation; No significant differences were observed comparing contralateral dorsalis pedis arteries nor any differences between the examiners' results. CONCLUSION: The dorsal most prominence of the navicular bone provides a bony landmark to readily locate the dorsalis pedis artery. Reliability of the examination may be increased as to the patency of the dorsalis pedis artery by using this dependable anatomic landmark.

Adult↗
PubMed1988

Experimental transmission of bovine leukosis virus by simulated rectal palpation.

Eight six-month-old Holstein male calves were experimentally inoculated by rectal palpation with whole blood from a donor seropositive to bovine leukosis virus. The inoculation consisted of the deposition of 2 ml of whole blood on a disposable obstetrical sleeve followed by a 30 second rectal palpation to simulate the process of pregnancy detection or artificial insemination. This procedure was repeated at weekly intervals for three consecutive weeks. All eight calves developed antibodies to bovine leukosis virus within five weeks after the initial palpation. The presence of the virus was demonstrated in the peripheral blood leucocytes of all eight calves at nine weeks. These results indicated that routine rectal palpation may be an effective mode of spread of bovine leukosis virus in susceptible cattle.

Animals↗
PubMed1994

Comparative evaluation of ovarian structures in cattle by palpation per rectum, ultrasonography and plasma progesterone concentration.

The aims of this study were to determine the relationship between the ultrasonographic determination of corpora lutea and the plasma progesterone profile of cyclic cows during an oestrous cycle, and to compare the accuracy of detection of normal and abnormal ovarian structures by ultrasonography and palpation per rectum, based on the plasma progesterone profile. The ovaries of six lactating cyclic dairy cows were scanned and blood samples were obtained three times a week for one month. There was a high correlation (r = 0.85) between the diameter of the corpus luteum and the plasma progesterone concentration, but on days -3 and -2 (oestrus = day 0) the diameter was the same as mid-luteal values but it was functionally inactive (plasma progesterone < 0.5 ng/ml). The accuracy of palpation per rectum and ultrasonography for determining the presence and age of the corpora lutea was investigated in 34 cows by using the plasma progesterone concentration and the dissection of ovaries post mortem as standards. The sensitivity, specificity and positive predictive value of palpation for identifying mid-cyclic corpora lutea were 85 per cent, 95.7 per cent and 89.5 per cent, respectively. Ultrasonography had a sensitivity of 95 per cent, a specificity of 100 per cent and a positive predictive value of 100 per cent. Twenty-nine cows were diagnosed by palpation per rectum as having either follicular or luteal cysts. During ultrasonography, an ovarian cyst was defined as a non-echogenic structure at least 5 mm in diameter.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1996

Comparative assessment of pelvic floor function using vaginal cones, vaginal digital palpation and vaginal pressure measurements.

A group-comparative study to assess pelvic floor muscle function using vaginal cones, vaginal digital palpation, and vaginal pressure measurements in 30 women suffering from genuine stress urinary incontinence and in an age-matched group of continent women was undertaken. Vaginal digital palpation score and vaginal pressure during active contraction were greater (p < 0.001) in continent women (1.9 +/- 0.1 and 8.6 +/- 0.7 cm H2O, respectively) as compared with incontinent women (1.0 +/- 0.1 and 4.1 +/- 0.4 cm H2O, respectively). Continent women were able to retain a vaginal cone of greater weight (6.3 +/- 0.4; n = 9, weight ranging from 10 to 90 g) than women suffering from stress incontinence (4.7 +/- 0.5; p < 0.001). There was a better correlation between all three techniques of assessing pelvic floor function in continent as compared with incontinent women, especially in the comparisons involving vaginal cones. (Vaginal pressure measurement-vaginal digital palpation, r = 0.86/0.75; vaginal pressure measurement-vaginal cones. r = 0.57/0.10; vaginal digital palpation-vaginal cones, r = 0.60/0.18.) In some women, especially those with incontinence, heavy cones were retained in spite of a weak pelvic floor due to the transverse position of the cone in the vagina which was verified radiographically.

Adult↗
PubMed2000

Thyroid ultrasound compared with World Health Organization 1960 and 1994 palpation criteria for determination of goiter prevalence in regions of mild and severe iodine deficiency.

OBJECTIVES: In 1994, WHO/International Council for the Control of Iodine Deficiency Disorders recommended replacing the WHO 1960 four-grade goiter classification with a simplified two-grade system. The effect of this change in criteria on the estimation of goiter prevalence in field studies is unclear. In areas of mild iodine deficiency disorders (IDD) where goiters are small, ultrasound is preferable to palpation to estimate goiter prevalence. However, in areas of moderate to severe IDD, goiter screening by palpation may be an acceptable alternative to thyroid ultrasound. To address these two issues, we compared WHO 1960 and 1994 criteria with thyroid ultrasound for determination of goiter prevalence in areas of mild and severe IDD in Morocco. DESIGN: A cross-sectional study of 400 six- to 13-year-old children from two mountain villages (Ait M'hamed and Brikcha) in rural Morocco was carried out. METHODS: Urinary iodine concentration (UI), whole blood TSH and serum thyroxine were measured. Thyroid size was graded by inspection and palpation by two examiners using both WHO 1960 and 1994 criteria. Thyroid volume was determined by ultrasound. Variation between examiners and examination methods was assessed. Sensitivity and specificity of the two classification systems compared with ultrasound were calculated. RESULTS: Median UIs in Aït M'hamed and Brikcha were 183 and 24 microg/l respectively. In Ait M'hamed, using 1960 and 1994 criteria, goiter prevalence was 21 and 26% respectively, compared with 13% by ultrasound. In Brikcha, with 1960 and 1994 criteria, goiter prevalence was 64 and 67% respectively, compared with 64% by ultrasound. Agreement between observers was better with the 1994 criteria than with the 1960 criteria in Ait M'hamed (kappa=0.53 and 0.47 respectively), while in Brikcha observer agreement was similar with the two systems (kappa=0.67). Using either the 1994 or 1960 criteria, agreement with ultrasound was only moderate in Ait M'hamed (kappa=0.41-0.44), but good in Brikcha (kappa=0.55-0.64). Overall, compared with ultrasound, sensitivity increased 3-4% using 1994 criteria, while specificity decreased 4-5%. CONCLUSIONS: The WHO 1994 criteria are simpler to use than the 1960 criteria and provide increased sensitivity with only a small reduction in specificity. Agreement between observers is better with the 1994 criteria than with the 1960 criteria, particularly in areas of mild IDD. Like the 1960 criteria, the 1994 criteria overestimate goiter prevalence in areas of mild IDD, compared with ultrasound. However, the 1994 palpation criteria provide an accurate estimate of goiter prevalence in areas of severe IDD, and may be an acceptable and affordable alternative to thyroid ultrasound in these areas.

Adolescent↗
PubMedDate not supplied

The palpator: an instrument for measuring the positions of bones in three dimensions.

In order to measure the three-dimensional (3D) position of the shoulder girdle bones, as well as the 3D positions of muscle attachments and joint surfaces in cadaver experiments, a measurement instrument, called the palpator, was developed. The palpator is composed of an open chain of four links connected by four hinges. By recording the rotation of the hinges using potentiometers, the position of the end-point of the palpator can be calculated. After the identification of 23 parameters of the palpator, a measurement accuracy of 1.43 mm is obtained.

Biomechanical Phenomena↗
PubMed2005

Integrating a bovine rectal palpation simulator into an undergraduate veterinary curriculum.

There are problems associated with teaching bovine rectal palpation to undergraduate veterinary students. The students need opportunities to examine enough cows to develop the required skills, but increasing student numbers and limitations on access to cows have made this more and more difficult to achieve. A virtual reality-based teaching tool, the Bovine Rectal Palpation Simulator, has been developed as a supplement to existing training methods. The student palpates computer generated virtual models of the bovine reproductive tract while interacting with a haptic (touch feedback) device. During training sessions, the instructor follows the student's actions inside the virtual cow on the computer screen and gives instruction. A trial integration of the simulator into the fourth-year bovine reproduction course was undertaken at the University of Glasgow Veterinary School during the 2003/2004 academic year. Students were offered two training sessions, and feedback was gathered using questionnaires. In the first session, all students were taught a range of basic skills using a standardized teaching protocol. The second training session was customized to each student's learning needs and included practice in dealing with a range of on-farm scenarios. Student feedback indicated that the training had been useful for learning various aspects of bovine rectal palpation and provided information that helped in the further development of the simulator as a teaching tool.

Animals↗
PubMed2002

Endemic goiter in pregnant women: utility of the simplified classification of thyroid size by palpation and urinary iodine as screening tests.

OBJECTIVE: To validate urinary iodine (I) excretion and the simplified classification of goiter by palpation, comparing them with ultrasound of the thyroid gland as the gold standard, to identify endemic goiter in pregnant women. POPULATION AND SETTING: 300 pregnant women identified in referral hospitals, in three geographic regions. METHODS: Two endocrinologists, previously trained, evaluated thyroid size by palpation and by ultrasound. Urinary iodine excretion in a sample of urine was determined. Thyroid size below the 90th centile by ultrasound was considered normal. RESULTS: Mean age of study women was 23 years old. The prevalence of low weight for gestational age was 39% and of anaemia 47%. Our sample distribution showed that 120 microg I/L was the best cut off for low urinary iodine excretion to identify endemic goiter in pregnant women (sensitivity 57% and specificity 70%, likelihood ratio of 1.4). The prevalence of goiter was 10% using ultrasound. Palpation had a sensitivity of identification goiter of 94% (95% CI 89-99%), a specificity of 80% (95% CI 75-85%), a likelihood ratio of 4.7, positive post-test probability of 36.5% and negative post-test probability of 99%. CONCLUSIONS: Low urinary iodine excretion identified up to 46% of women with goiter. This test by itself is not useful as a screening tool to identify pregnant women at risk of goiter. Identification of thyroid size by palpation was a better screening test. However, when both tests were combined in parallel, up to 100% of women with goiter were correctly identified. Our results suggest that the commonly used cut off point of 100 microg I/L to identify low urinary iodine excretion may under-estimate the prevalence of iodine deficiency disorders when used during pregnancy.

Adult↗
PubMed2004

FEM-based interaction model between elastic objects for indirect palpation simulator.

Indirect palpation is required to examine lots of cases like breast cancer and prostate malignance. This paper proposes interaction model between elastic objects to simulate indirect palpation. The interaction is simulated by displacement of colliding elements based on normal stress derived from temporary displacement. The physics-based approach represents the difference of physical properties such as stiffness of colliding objects. Deformation and haptic reproduction is possible to be carried out in real time with two organ models consisting of roughly 200 nodal points. As an example, we developed a rectal palpation simulator based on the proposed method. The experiment using rectal palpation simulator confirmed that the method enables a user to perceive difference of stiffness of prostate model located behind rectum model indirectly.

Computer Simulation↗
PubMedDate not supplied

Verification of palpation-guided intra-articular injections using glucocorticoid-air-saline mixture and ultrasound imaging (GAS-graphy).

OBJECTIVE: To examine a contrast medium method using a glucocorticoid-air-saline mixture and ultrasound imaging (GAS-graphy) for the verification of palpation-guided injections in different joints and to assess the inter-reader reliability of the method. METHODS: A palpation-guided injection of an air-steroid-saline mixture was given into a joint or tendon sheath of 133 consecutive patients. The dynamic ultrasound monitor images of the joints and tendons involved were videotaped before and after the injection. A rheumatologist and two radiologists analyzed separately the video clips of each patient, under blinded conditions. The readers evaluated the accuracy of the injections and the difficulty of the reading process. The inter-reader agreement was assessed by calculating the percentual values and overall kappa coefficient between the readers. RESULTS: The overall accuracy of the successful injections was 76%, 80% and 82 % evaluated by the three readers. In six out of the ten injection sites the accuracy was higher than 80%. The clarity of the method evaluated by the readers was 8, 8 and 8.5 on a scale from 0 to 10. The inter-reader agreement assessed by percentual values was 84.2%, 85.0% and 88.7%. The kappa coefficient between all readers was 0.595 showing moderate agreement. CONCLUSION: The GAS-graphy method for the verification of palpation-guided injections is a simple procedure performable to any joint site and the result can be seen immediately on the monitor after the injection. The reliability of the method is good and it can be used in developing injection techniques as well as in medical or nurse education. The method can be used as an alternative for the radiographic contrast medium method in verifying successful palpation-guided intra-articular injections.

Adult↗
PubMed1991

[A histologically controlled study of the value of sonography and palpation for the detection and exclusion of neck lymph node enlargements and metastases].

Preoperative evaluation of cervical lymph nodes by ultrasound and palpation was compared retrospectively in 123 patients with tumours on the head and neck. The diagnostic accuracy was higher by ultrasound (96.5%) than by palpation (85.5%). Hence, the sensitivity for detecting cervical metastases was also higher for ultrasound than for palpation (96% versus 83%), because of the reduced false negative findings. Specificity, however, was higher for palpation (82%) than for ultrasound (74%). Ultrasound was superior in delineating the relationship of metastases to adjacent tissues (vessels). Major disadvantages of ultrasound were the higher percentage of false positive findings (26%) and absence if delineation of the relationship to bony structures.

Adult↗
PubMed1990

[The clinical relevance and reproducibility of pedal pulse palpation].

The object of the present investigation was to investigate the diagnostic information which can be obtained by pedal pulse palpation. This is done by relating the findings on pulse palpation to the measured distal systolic blood pressure and comparison of these results with those of previous examinations where the connection between the distal systolic blood pressure and the prognosis is illustrated. In addition, the reliability of pulse palpation was assessed by an inter-observer investigation. Fifty four patients (average age 66 years) suspected of occlusive arterial disease participated in the investigation. Three observers undertook pulse palpation on the foot in a randomized sequence. The pulse in a foot was defined as the pulse in the dorsalis pedis artery and/or the pulse in the posterior tibialis artery. After this, the distal systolic blood pressure was measured in the patients with the strain gauge technique. Considerable inter-observer agreement was found (kappa-values between 0.66 and 0.76). Provided an observer found the pulse present, severe occlusive arterial disease could be excluded (ankle index less than 50%, toe pressure less than or equal to 30 mmHg). Absence of pulse in a foot provides a high probability for an ankle index less than or equal to 90% and thus a high probability for presence of occlusive arterial disease, but the extent of this cannot, however, be described.

Adult↗
PubMed1989

[Palpation and sonography of lymph node metastasis of the neck].

In a retrospective study, the diagnostic value and ranking of preoperative palpation and sonography for the identification of cervical lymph nodes was assessed in 130 patients with tumours of the head and neck. The diagnostic accuracy (85%) of palpation is below that of sonography (90%). The importance of sonography lies in reducing false negative findings. The increase in sensitivity (palpation 74%, sonography 90%) is, however, offset by an increase in false positive findings, i.e. by a reduction in specificity (palpation 94%, sonography 90%).

False Negative Reactions↗
PubMedDate not supplied

[Vaginal sonography versus vaginal palpation: initial experiences in 120 pregnant patients with suspected cervix insufficiency].

In a clinical study a group of pregnant women with suspected cervical incompetence was examined by vaginal sonography. Aim of the investigation was to compare results of performed vaginal palpation with results of sonography. 120 pregnant women with cervical insufficiency between 16th and 33rd week of gestation were examined by a 5-MHz vaginal sectorscanner probe. After focussing sagittal projection of uterine cervix and lower uterine segment the cervical length and opening of the internal os were assessed prior to cerclage. Postoperative vaginal sonography was performed to ascertain lengthening and stabilization of the incompetent cervix. Another group of 50 pregnant women with unsuspicious obstetrical findings were also examined to gain information about normal sonographical morphology and length of the competent uterine cervix. Comparing results of vaginal palpation and vaginal sonography showed, that the cervical length obtained by sonography was constantly higher in all patients than the results obtained by palpation. This difference became more distinct in the group of patients with extreme cervical incompetence. We are of the opinion that vaginal sonography is an objective method revealing the extent of cervical incompetence. Exact measurement of the cervical length and assessment of the internal os are efficient diagnostic criteria. They complete results of cervical palpation and offer precise information concerning an intended cerclage. In case of suspected cervical incompetence continuous sonographical examination can supervise the development of the uterine cervix during pregnancy. In future the number of prophylactic cerclage-operations perhaps decreases by using the technique of transvaginal sonography.

Adolescent↗
PubMed1987

Inter- and intra-examiner reliability of motion palpation for the thoracolumbar spine.

An inter- and intra-examiner reliability study was conducted to determine the reliability of a standardized method of motion palpation. Eight senior students in the Palmer College Public Clinic palpated the thoracolumbar spine of 32 student volunteers. Each volunteer was palpated twice by each examiner to allow inter- and intra-examiner analysis. Each examiner had at least 1 yr of experience using the procedure. Only the most hypomobile motor unit of the spine was recorded. Analysis of the data revealed statistically significant agreement for intra-examiner reliability. Inter-examiner reliability was not statistically significant. T9-T10 was chosen significantly more often by the palpators as the most hypomobile motor unit.

Adult↗
PubMed1987

[Value of breast palpation in gynecologic practice].

A representative inquiry was carried out among 100 Austrian gynecologists and obstetricians. Aim of the study was to determine the percentage of gynecologists, who carry out routinely the palpation of the breast in their office: 73% of all gynecologists are performing breast-palpation routinely in every patient, 27% only in case of complaints. The highest percentage of routine-breast-palpation performing gynecologists was found among doctors, who are in private-practice only (97%). Particularly low percentages, however, were found e. g. among doctors, who have contracts with all social insurances (58%), who have a high frequency of social-insured patients (55%) or have many patients per day (61%). Since the routine-breast-palpation is of particular importance for the reduction of breast cancer mortality, this examination should be also performed routinely by all general practitioners, internists and surgeons. Therefore, from the point of view of preventive medicine and public health the routine examination of the female breast should be refunded by social insurance in Austria.

Austria↗