27 research outputs found
Intra-articular osteoid osteoma as a differential diagnosis of diffuse mono-articular joint pain
Responsiveness and minimal clinically important difference for pain and disability instruments in low back pain patients
BACKGROUND: The choice of an evaluative instrument has been hampered by the lack of head-to-head comparisons of responsiveness and the minimal clinically important difference (MCID) in subpopulations of low back pain (LBP). The objective of this study was to concurrently compare responsiveness and MCID for commonly used pain scales and functional instruments in four subpopulations of LBP patients. METHODS: The Danish versions of the Oswestry Disability Index (ODI), the 23-item Roland Morris Disability Questionnaire (RMQ), the physical function and bodily pain subscales of the SF36, the Low Back Pain Rating Scale (LBPRS) and a numerical rating scale for pain (0–10) were completed by 191 patients from the primary and secondary sectors of the Danish health care system. Clinical change was estimated using a 7-point transition question and a numeric rating scale for importance. Responsiveness was operationalised using standardardised response mean (SRM), area under the receiver operating characteristic curve (ROC), and cut-point analysis. Subpopulation analyses were carried out on primary and secondary sector patients with LBP only or leg pain +/- LBP. RESULTS: RMQ was the most responsive instrument in primary and secondary sector patients with LBP only (SRM = 0.5–1.4; ROC = 0.75–0.94) whereas ODI and RMQ showed almost similar responsiveness in primary and secondary sector patients with leg pain (ODI: SRM = 0.4–0.9; ROC = 0.76–0.89; RMQ: SRM = 0.3–0.9; ROC = 0.72–0.88). In improved patients, the RMQ was more responsive in primary and secondary sector patients and LBP only patients (SRM = 1.3–1.7) while the RMQ and ODI were equally responsive in leg pain patients (SRM = 1.3 and 1.2 respectively). All pain measures demonstrated almost equal responsiveness. The MCID increased with increasing baseline score in primary sector and LBP only patients but was only marginally affected by patient entry point and pain location. The MCID of the percentage change score remained constant for the ODI (51%) and RMQ (38%) specifically and differed in the subpopulations. CONCLUSION: RMQ is suitable for measuring change in LBP only patients and both ODI and RMQ are suitable for leg pain patients irrespectively of patient entry point. The MCID is baseline score dependent but only in certain subpopulations. Relative change measured using the ODI and RMQ was not affected by baseline score when patients quantified an important improvement
Hip arthroscopy for the management of osteoid osteoma of the acetabulum: a systematic review of the literature and case report
Porous metal revision shells for management of contained acetabular bone defects at a mean follow-up of six years
Multiple level noncontiguous fractures of the spine
From 1970 to 2000, 81 patients with noncontiguous fractures of the spine
were evaluated. Of these 81 patients, 36 had a neurologic deficit.
Sixty-six patients with stable injuries were treated conservatively,
whereas 15 patients with unstable injuries required surgical
stabilization. There was no neurologic deterioration either in the
patients who had surgical stabilization or in the patients who were
treated conservatively. Thirteen patients with an A score on the
American Spinal Injury Association neurologic impairment scale did not
improve and had a high mortality rate (61.5%). Although multiple level
noncontiguous fractures of the spine are uncommon, they constitute a
threat to neurologic function, and therefore warrant radiographic
evaluation of the entire spine with multiple injuries
Offset acetabular cups: A solution to wear?
Change of tribological properties has been the main goal in the effort
to augment the longevity of total hip arthroplasty, while the reduction
of forces acting across the artificial joint space has received little
attention. Spurred by recent reports of wear behaviour and good clinical
results of the offset low friction arthroplasty cups, the authors, using
the simplified free body technique, estimated the resultant hip joint
reaction force and the angle of its application on 100 individual
anteroposterior pelvic radiographs, by templating on the same hip a
conventional concentric cup and an offset eccentric one. The results
showed a highly significant reduction (p < 0.0001) of the resultant hip
joint reaction force in the offset group by 28.8% or 1.02 body weight
and of the angle of the hip joint reaction force by 2.8 degrees. The
authors believe that the reduction of the resultant hip joint reaction
force in the offset cup group is the result of lowering and medialising
the centre of rotation of the hip, a previously reported fact on
non-clinically applicable conditions. They are also tempted to propose
the generalized use of the offset type acetabular cup, since adverse
events are not anticipated
Greek versions of the Oswestry and Roland-Morris disability questionnaires
Disability questionnaires are increasingly used for clinical assessment,
outcome measurement of treatment and research methodology of low back
pain. Their use in different countries and cultural groups must follow
certain guidelines for translation and cross-cultural adaptation. The
translation of such an instrument must be tested for its reliability and
validity to be applied and to allow comparability of data. The Oswestry
Disability Index and the Roland-Morris Disability Questionnaire are two
disability questionnaires most commonly used as outcome measures in
patients with low back pain. The two questionnaires were translated for
use with the Greek population, were back translated and tested, and
became available in a final version. The Greek versions of the Oswestry
Disability Index and the Roland-Morris Disability Questionnaire were
tested in 697 patients with low back pain. Internal consistency
reliability for the Greek translation of the Oswestry Disability Index
and the Roland-Morris Disability Questionnaire reached a Cronbach’s
alpha coefficient of 0.833 and 0.885 respectively. Face validity and
content validity were ensured. Concurrent validity was assessed using a
six-point pain scale as a criterion. The correlation of both scales was
significant. The Greek translation of these disability questionnaires
provided reliable and valid instruments for the evaluation of
Greek-speaking patients with low back pain
Removal of the well-bonded distal part of a non-cylindrical broken femoral stem (Autophor 900S) with hollow trephine reamers-report of two cases
Prediction of Cobb angle in idiopathic adolescent scoliosis
We did a prospective study of 291 children and adolescents with
idiopathic scoliosis to identify possible correlations between clinical
(scoliometer value, age, height) and radiographic (Cobb angle, Nash-Moe
rotation, Risser iliac apophysis classification) parameters to predict
the curve angle. There was a statistically significant correlation
between thoracic, thoracolumbar, and lumbar scoliometer values and the
thoracic, thoracolumbar, and lumbar Cobb angles, respectively (Pearson’s
r-0.685, 0.572, and 0.677, respectively). There was a statistically
significant correlation between Cobb angle in the thoracic,
thoracolumbar, and lumbar spine and the patients’ age and height.
Mathematical formulas that predict the Cobb angle of thoracic,
thoracolumbar, and lumbar scoliosis using the scoliometer measurements
are reported