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PubMedDate not supplied

The sensitivity and specificity of seven lumbo-pelvic orthopedic tests and the arm-fossa test.

Twenty-nine lumbosacral asymptomatic and 39 symptomatic patients who attended a chiropractic clinic were examined by a practitioner who was blinded to their symptoms. Seven lumbosacral orthopedic tests, along with the arm-fossa test were scrutinized for sensitivity, specificity and diagnostic competency values. Only the arm-fossa test and heel-buttock tests had a significantly higher percentage of positive findings in symptomatic than asymptomatic cases. These same tests were the only ones which could be considered to have an acceptable diagnostic value, when both the sensitivity and specificity were taken into consideration by Youden's index. The number of positive tests was unrelated to the presence of lumbosacral symptoms. Orthopedic tests which appeared to strain several adjacent anatomical structures were most commonly positive. No particular combination of tests could predict if the patient was symptomatic or asymptomatic. Only the heel-buttock test had some predictive value. It appears that these tests were of limited value in differentiating between the symptomatic and asymptomatic subjects who attended the study clinic.

Chiropractic↗
PubMed1990

Malar rash in a patient with Reiter's syndrome--a clue for the diagnosis of human immunodeficiency virus infection.

We describe a man who presented with Reiter's syndrome and a new prominent malar rash. The malar rash was the clue for the early diagnosis of human immunodeficiency virus (HIV) infection in this patient. A high index of suspicion for the diagnosis of HIV infection is required in patients with Reiter's syndrome presenting with unusual clinical manifestations.

Acquired Immunodeficiency Syndrome↗
PubMed1987

The unstable pelvic fracture. Operative treatment.

While the pendulum has swung to the operative side, open reduction and internal fixation will surely not prove to be the panacea for all unstable pelvic fractures. The lasting effects, however, of attempts at aggressive fixation of the pelvic fracture will be the principles of management that are being established. This begins with the recognition of pelvic instability. It is in these unstable injuries that obtaining and maintaining an anatomic reduction is the best way to alter the natural history of the untreated pelvic fracture and to maximize the probability of obtaining a good long-term result. While the actual methods of internal and external fixation will continue to change, this principle is unlikely to alter. Therefore, if effective treatment can be achieved by closed means alone, that is an acceptable method. Similarly, external, internal, and combined operative and traction treatment methods that achieve this goal would also be acceptable. The question remains: Which method achieves the goal of obtaining and maintaining an anatomic reduction yet minimizes the early and late morbidity? This question is best answered by appropriate preoperative evaluation, subsequent planning, and precise, technically skillful surgery done by an experienced surgeon.

Bone Plates↗
PubMed1983

[Articular manifestations of Whipple's disease. A case of sacroiliitis and destructive coxopathy].

Whipple's disease is a systemic illness whose pathogenesis, which is still poorly understood, implies an infectious agent accessible to antibiotic therapy. The authors report a case which is made unusual by the manifold systemic manifestations, important eosinophilia and destructive nature of the joint lesions of the hips. The physiopathological mechanisms of ocular and cutaneous manifestations are considered. A dramatic improvement is obtained with tetracyclin.

Adult↗
PubMed1994

A review of the radiographic manifestations of gout.

Hyperuricemia and gout are found in high percentages of the Pacific Island population. As local clinicians and radiologists are more likely to have patients with either the diagnosis or suspicion of gout, a pictorial review of the common radiographic manifestations is presented especially for their information.

Ankle Joint↗
PubMed1997

Bone and joint involvement in adults with Werner's syndrome.

A 45-year-old man with Werner's syndrome had large asymptomatic calcium deposits about the elbows, hips, and shoulders. During the four-year follow-up, he developed insufficiency fractures of the pelvis, both ulnas, one radius and one metatarsal, all of which failed to heal. Bone mineral densities evaluated by dual-energy X-ray absorptiometry were at the lower end of the normal range, but a histomorphometric study showed a reduction in trabecular bone volume and marked decreases in osteoid parameters with a calcification rate of zero. Serum assays of 25 hydroxy vitamin D3, 1,25 dihydroxy vitamin D3, osteocalcin and alkaline phosphatase were normal. The nonunions in this patient may have been caused by impaired osteoblast function associated with Werner's syndrome and/or by decreased activity of growth factors involved in bone repair.

Bone Density↗