Sonographic soft tissue arthritic changes associated with post-stroke hemiplegic knee pain : utility of musculoskeletal ultrasound in a resource-limited setting

Purpose: Post-stroke arthritic changes that may compromise rehabilitation have been described in the upper and lower limbs. We aimed at evaluating the soft tissue arthritic changes associated with pain in hemiplegic knees of stroke patients in our environment. Material and methods: Hemiplegic and non-hemiplegic knees of 48 stroke patients as well as both knees of 26 apparently healthy controls were evaluated with a 7.5-12 MHz linear ultrasound probe. History of knee pain, and sociodemographic, laboratory, and clinical data were recorded for all study participants. Muscle tone and power as well as functional ambulatory category (FAC) were graded for the stroke patients. Data was analysed using SPSS version 20. Results: Pain was reported more often in hemiplegic than non-hemiplegic knees (n = 16 vs. n = 6, p = 0.021). The frequencies of soft tissue arthritic changes found, which included reduced lateral and medial femoral cartilage thickness, suprapatellar effusion, and irregular cartilage-bone margin, were similar between hemiplegic and non-hemiplegic knees (p > 0.05). Suprapatellar effusion and reduced lateral femoral cartilage thickness were more prevalent in the hemiplegic knees compared to the healthy control knees (p < 0.05). Stroke patients with pes anserinus tendinosis had greater risk of hemiplegic knee pain (HKP) when compared to stroke patients without this lesion (OR = 10; 95% CI: 1.7-61). FAC, muscle tone, and power showed no association with HKP. Conclusions: Soft tissue arthritic changes associated with knee pain are comparable between hemiplegic and non-hemiplegic knees of stroke patients. The risk of knee pain in stroke is higher in the presence of pes anserinus tendinosis

B-mode sonographic evaluation of optic nerve sheath diameter and lens thickness in Nigerian adults with glaucoma

Objective: This study was done to investigate the effect(s) of glaucoma on the ocular optic nerve sheath diameter and lens thickness using B-mode ultrasonography.Materials and methods: One hundred and twenty study participants were recruited; 60 subjects with glaucoma and 60 age- and sex-matched controls without glaucoma. The optic nerve sheath diameter and lens thickness of both eyes were measured using a linear high frequency transducer with frequency of 6.5-12MHz.Results: The mean optic nerve sheath diameter of the glaucomatous eyes (3.57 ± 0.19mm and 3.59 ± 0.33mm on the right and left, respectively) were significantly thinner than that of controls (4.23 ± 0.34 mm and 4.26 ± 0.30 mm on the right and left, respectively; p &lt; 0.001). There is increased mean lens thickness in the glaucomatous eyes (4.15 ± 0.43mm and 4.18 ± 0.46mm on the right and left, respectively) than in the controls (4.01 ± 0.56mm and 3.99 ± 0.45mm on the right and left, respectively) with a statistically significant difference seen in the left eye (p = 0.024).Conclusion: B-mode ultrasound is a reliable tool of assessing the nerve sheath diameter and lens thickness in glaucoma. Optic nerve sheath diameter is reduced in glaucomaKeywords: Glaucoma, ultrasonography, optic nerve sheath diameter, lens thickness

B-mode sonographic evaluation of optic nerve sheath diameter and lens thickness in Nigerian adults with glaucoma

Objective: This study was done to investigate the effect(s) of glaucoma on the ocular optic nerve sheath diameter and lens thickness using B-mode ultrasonography. Materials and methods: One hundred and twenty study participants were recruited; 60 subjects with glaucoma and 60 age- and sex-matched controls without glaucoma. The optic nerve sheath diameter and lens thickness of both eyes were measured using a linear high frequency transducer with frequency of 6.5-12MHz. Results: The mean optic nerve sheath diameter of the glaucomatous eyes (3.57 \ub1 0.19mm and 3.59 \ub1 0.33mm on the right and left, respectively) were significantly thinner than that of controls (4.23 \ub1 0.34 mm and 4.26 \ub1 0.30 mm on the right and left, respectively; p &lt; 0.001). There is increased mean lens thickness in the glaucomatous eyes (4.15 \ub1 0.43mm and 4.18 \ub1 0.46mm on the right and left, respectively) than in the controls (4.01 \ub1 0.56mm and 3.99 \ub1 0.45mm on the right and left, respectively) with a statistically significant difference seen in the left eye (p = 0.024). Conclusion: B-mode ultrasound is a reliable tool of assessing the nerve sheath diameter and lens thickness in glaucoma. Optic nerve sheath diameter is reduced in glaucom

Uterine artery Doppler velocimetry in hypertensive disorder of pregnancy in Nigeria

Aim of the study: To evaluate the value of uterine artery Doppler indices and waveform pattern in predicting fetuses at risk for intrauterine growth restriction in hypertensive disorders of pregnancy. Materials and methods: This was a prospective cross-sectional study including 80 pregnant subjects with hypertensive disorders of pregnancy and two control groups. Uterine artery Doppler sonography was performed in all study participants. Uterine artery Doppler indices across the groups were compared using the analysis of variance (ANOVA) while the presence of prediastolic notch was analyzed with the Chi Square test. Results: For the hypertensive disorders of pregnancy group, resistivity index > 0.66 had a sensitivity of 50.0%, specificity of 69.1% and a positive predictive value of 22.2% for predicting intrauterine growth restriction. The odds ratio was 2.2 with a 95% confidence interval of 0.6–7.8. The presence of prediastolic notching had a sensitivity of 100.0%, specificity of 96.0% and a positive predictive value of 80.0% for predicting intrauterine growth restriction. The odds ratio was 22.7 with a 95% confidence interval of 7.5–68.5. Conclusion: Uterine artery Doppler sonography is useful for predicting fetuses at risk for intrauterine growth restriction in hypertensive disorder of pregnancy. Prediastolic notching is more sensitive and more specific than uterine artery resistivity index in predicting fetuses at risk of intrauterine growth restriction in established hypertensive disorder of pregnancy

Badanie dopplerowskie przepływu przez tętnice maciczne w nadciśnieniu tętniczym u ciężarnych w Nigerii

Aim of the study: To evaluate the value of uterine artery Doppler indices and waveform pattern in predicting fetuses at risk for intrauterine growth restriction in hypertensive disorders of pregnancy. Materials and methods: This was a prospective cross-sectional study including 80 pregnant subjects with hypertensive disorders of pregnancy and two control groups. Uterine artery Doppler sonography was performed in all study participants. Uterine artery Doppler indices across the groups were compared using the analysis of variance (ANOVA) while the presence of prediastolic notch was analyzed with the Chi Square test. Results: For the hypertensive disorders of pregnancy group, resistivity index > 0.66 had a sensitivity of 50.0%, specificity of 69.1% and a positive predictive value of 22.2% for predicting intrauterine growth restriction. The odds ratio was 2.2 with a 95% confidence interval of 0.6–7.8. The presence of prediastolic notching had a sensitivity of 100.0%, specificity of 96.0% and a positive predictive value of 80.0% for predicting intrauterine growth restriction. The odds ratio was 22.7 with a 95% confidence interval of 7.5–68.5. Conclusion: Uterine artery Doppler sonography is useful for predicting fetuses at risk for intrauterine growth restriction in hypertensive disorder of pregnancy. Prediastolic notching is more sensitive and more specific than uterine artery resistivity index in predicting fetuses at risk of intrauterine growth restriction in established hypertensive disorder of pregnancy.Cel badania: Ocena wartości wskaźników dopplerowskich w tętnicach macicznych oraz kształtu fali przepływu w przewidywaniu wystąpienia wewnątrzmacicznego zahamowania wzrostu płodu w przebiegu nadciśnienia tętniczego u kobiet w ciąży. Materiał i metody: Było to prospektywne badanie przekrojowe obejmujące 80 ciężarnych pacjentek z nadciśnieniem tętniczym oraz 2 grupy kontrolne. U wszystkich uczestniczek wykonano badanie przepływu przez tętnice maciczne z użyciem opcji dopplerowskich. W celu porównania wskaźników dopplerowskich tętnic macicznych we wszystkich grupach zastosowano analizę wariancji (ANOVA), natomiast obecność wcięcia wczesnorozkurczowego analizowano z wykorzystaniem testu chi-kwadrat. Wyniki: W grupie ciężarnych z nadciśnieniem tętniczym wrażliwość wskaźnika oporu naczyniowego >0,66 wynosiła 50%, specyficzność – 69,1%, natomiast dodatnia wartość predykcyjna dla wewnątrzmacicznego zahamowania wzrostu płodu – 22,2%. Iloraz szans wynosił 2,2 przy 95-procentowym przedziale ufności wynoszącym 0,6–7,8. Obecność wcięcia wczesnorozkurczowego wykazywała wrażliwość na poziomie 100%, specyficzność – 96% i dodatnią wartość predykcyjną dla wewnątrzmacicznego zahamowania wzrostu płodu wynoszącą 80%. Iloraz szans wynosił 22,7 przy 95-procentowym przedziale ufności wynoszącym 7,5–68,5. Wnioski: Badanie przepływów w tętnicach macicznych z zastosowaniem opcji dopplerowskich jest użytecznym narzędziem do przewidywania ryzyka wystąpienia wewnątrzmacicznego zahamowania wzrostu płodu w przebiegu nadciśnienia tętniczego w ciąży. Obecność wcięcia wczesnorozkurczowego charakteryzuje się większą wrażliwością i specyficznością w przewidywaniu ryzyka wystąpienia wewnątrzmacicznego zahamowania wzrostu płodu w przebiegu rozpoznanego nadciśnienia tętniczego w ciąży niż wskaźnik oporu naczyniowego w tętnicach macicznych. Artykuł w wersji polskojęzycznej jest dostępny na stronie http://jultrason.pl/index.php/wydawnictwa/volume-17-no-7