Role of conventional MRI and MR arthrography in evaluating shoulder joint capsulolabral-ligamentous injuries in athletic versus non-athletic population

AbstractObjectiveThe aim of this study was to assess diagnostic value of direct MR arthrography compared to conventional MR imaging in the diagnosis of different pathologic entities affecting the capsule-labral complex in athletic and non-athletic population.Subjects and methodsThis study included 60 patients complaining of shoulder pain. Conventional MRI and MR arthrography (MRA) were done for all cases. The musculoskeletal radiologist reviewed the images for evidence of pathologies of the labroligamentous complex. Inter-observer agreement was determined with kappa statistics, and the diagnostic accuracy of each technique was calculated.ResultsComparing the sensitivity of conventional MRI versus MRA was done by correlating the final diagnosis of each modality with the results of arthroscopy. MRI revealed sensitivity (SEN) of 72%, specificity (SPE) of 78%, while MRA revealed a SEN of 78%, SPE of 100%, PPV of 100%, and NPV of 21%.ConclusionMR techniques cannot replace arthroscopy; however, they could be a potent additional tool for diagnosis of the main pathological affection of the shoulder joint guided by the type of the population, which proved to have good impact on the diagnosis. The capsulolabral and ligamentous injuries are more common at the athletic group while the non-athletic population are more prone to rotator cuff tendons injury

High resolution ultrasonography and magnetic resonance imaging in the evaluation of tendino-ligamentous injuries around ankle joint

Purpose: The aim of this study was to rule out the diagnostic accuracy of both ultrasonography (US) and magnetic resonance imaging (MRI) for the assessment of tendino-ligamentous pain around the ankle joint. Patients and methods: This study included 35 patients (25 females and 10 males) complaining of unilateral ankle pain (acute or chronic), and they were subjected to plain X-ray (to exclude osseous pathology), US and MRI examinations. Results: The study included 35 patients where 20 patients showed tendon pathology that was diagnosed into 21 pathological entities by both US and MRI imaging modalities with no difference in interpretation between them. 21 patients had pathological ligaments which were diagnosed by both ultrasound and MRI. However, two ligamentous lesions were diagnosed as partial tear by US, while MRI diagnosed them as complete tear. Associated findings were also diagnosed as retrocalcaneal bursitis in two patients, joint effusion in four patients and joint synovitis in three patients. Conclusion: US is an excellent tool for imaging soft tissue abnormalities, as it allows rapid, in-expensive detailed examination of the structures of the ankle joint. US and MRI are two complementary tools of investigation with the former being used as primary effective tool of investigation and the latter is done to confirm the diagnosis

The role of oblique axial MR imaging in the diagnosis of ACL bundle lesions

Objective: This study was done to evaluate the accuracy of oblique axial MR imaging in studying individual ACL bundle lesions. Subjects and methods: This study included forty-one (41) patients; 20 patients with no symptoms or signs of ACL injury and 21 patients in the suspected ACL lesions group. Each patient had a single MRI examination followed by a single indicated arthroscopy. The standard knee protocol (sagittal FSE proton density, coronal FSE T2-fat suppressed, axial FSE T2, sagittal FSE T1 and sagittal STIR) was designated protocol A, while the standard knee protocol plus oblique axial imaging was designated protocol B. Results: The comparative study was done using MRI protocol A versus protocol B for isolated anteromedial and posterolateral bundle as well as for ACL lesions as a whole with comparing these findings with arthroscopy as the gold standard. The addition of oblique axial imaging, increased sensitivity for ACL lesions (as a whole) from 74% to 95% and the accuracy from 76% to 95% while specificity remained similar. The sensitivity, specificity and accuracy of standard MR imaging for the detection of anteromedial bundle lesions were shown to be 80%, 100% and 86%, while that for posterolateral bundle lesions was 78%, 100% and 81% respectively. However, the addition of oblique axial imaging, increased sensitivity for anteromedial bundle lesions to 88% and accuracy to 90% while specificity remained similar. For posterolateral bundle lesions, the sensitivity increased to 89% and accuracy to 90% while specificity remains similar. Conclusion: Compared with standard MR imaging, the addition of oblique axial imaging improves the diagnostic accuracy for detecting lesions of the ACL, including both bundles’ delineation. This imaging plane seems to provide a useful adjunct to standard MR imaging when ACL lesion is suspected

Recent advances in MRI in the preoperative assessment of anorectal malformations

Objective: To prospectively evaluate the diagnostic accuracy of triplanar 2D magnetic resonance (MR) images versus the post processing reconstructed MR images generated from a single 3D VISTA sequence in children with anorectal malformations compared with the operative findings as the Golden standard. Materials and methods: This study had institutional review board approval, and informed consent was obtained from all participants. There were 20 patients with anorectal anomalies age range (2 months–3.5 years), referred from the pediatric surgery unit for preoperative MRI. The 2D sequences included Coronal TSE T2 WI parallel to the plane of the anal canal as seen on the sagittal images, and Axial TSE T2 WI oblique, perpendicular to the coronal plane. Sagittal T2 weighted 3D-sequence; volumetric isotropic turbo spin echo acquisition (VISTA) was taken parallel to the mid-sagittal plane. Results: Comparing the two MR imagining protocols the acquisition time of the sagittal 3D sequence (6 min 42 s) was shorter than the total acquisition time of the 2D sequences (10 min 12 s) without jeopardizing the image quality or accuracy of the diagnostic information. MRI depicted the fistula in 94% (16 out of 17) of patients who were clinically proven fistulous, which is a privilege to detect associated anomalies on the same examination. The frequency of associated anomalies was 100% in high anorectal malformations (ARMs), 64% in intermediate and only 20% in low ARMs. From these associated anomalies vertebral anomalies were seen in 50% of patients. Concomitant cord anomalies were encountered in 60% of those with vertebral anomalies the most common of which was tethered cord observed in 35% of the patients. Conclusion: MRI is a valuable diagnostic tool to diagnose type and level of ARM in addition to the privilege of associated anomalies detection on the same examination. The 3D sequence acquisition with multiplanar reconstruction has the advantage of time saving without compromise on image quality or the diagnostic accuracy compared to 2D images

Value of dynamic sonography in the management of shoulder pain in patients with rheumatoid arthritis

Purpose: The purpose of this study is to evaluate the role of dynamic high resolution ultrasonography in the detection of abnormalities of rheumatoid arthritis and to find out the value added to the management plan of the disease. Patients and methods: 21 shoulders of rheumatoid arthritis patients complaining of shoulder pain were scanned with ultrasound (static and dynamic) and compared to clinical examination. Result: The most predictive sign of rheumatoid arthritis was sub-acromial impingement which was screened and graded by ultrasound in (100%). Other US signs included sub-acromial bursitis in 14.2%, biceps teno-synovitis in 52.4%, supraspinatous tendinopathy in 57.1%, supraspinatous partial thickness bursal surface tear in 14.2% and joint effusion in 9.5% of our patients. The combination of more than one finding was of higher sensitivity than isolated sign alone. Conclusion: Dynamic ultrasound examination for the diagnosis of shoulder impingement in Rheumatoid arthritis should be done in addition to the clinical and static ultrasound examination to improve the management plan

Evaluation of lesions of the internal ligaments of the wrist; conventional magnetic resonance imaging versus MR arthrography (MRA)

Objective: The aim of this study is to assess the diagnostic value of direct MR arthrography compared to conventional MR imaging in the diagnosis of different pathologic entities affecting the internal ligaments of the wrist mainly the scapholunate and lunotriquetral ligaments. Subjects and methods: This study included 51 patients complaining of chronic wrist pain. Conventional MRI and MR arthrography (MRA) were done in all cases. Results: A comparison of the sensitivity of conventional MRI versus MRA was done by correlating the final diagnosis of each modality with the results of arthroscopy. Regarding complete SLL tears, MRI revealed a SEN, SPE and ACC of 61.54%, 96.77%, and 86.36%, while MRA showed a SEN, SPE and ACC of 92.31%, 100%, and 97.73% respectively, partial SLL tears, un-enhanced MRI revealed SEN, SPE and ACC of 10%, 94.12%, and 75%, while MRA showed 66.67%, 85.71%, and 81.82% respectively, complete LTL tears un-enhanced MRI revealed a SEN, SPE, and ACC of 25%, 100%, and 79.5% respectively, while MRA showed 91.67%, 100%, and 97.73% respectively. Conclusion: MR arthrography is a potent additional tool facilitating the diagnosis of different pathologic entities affecting the major internal ligaments of the wrist joint and helps to reduce arthroscopic interventions

Response of Camelina sativa Oil to Different Levels of N-P-K and Compost Fertilizers

This study was conducted during the two winter seasons (2018/2019&2019/2020) to investigate the effect of NPK and compost fertilizers on the Camelina sativa plant under Egyptian ecology. The fertilizer levels of NPK were 0, 25, 50, 75 and 100%, recommended doses, whereas compost was applied at 6, 8 and 10 m3/fed to investigate the effect of these fertilizers and the interaction of both chemical and organic fertilizers on the vegetative growth, oil yield and oil components percentage, especially Linolenic acid (ω-3). The obtained results indicated that the application of 100% NPK as well as 10 m3 of compost produced the highest mean values of all vegetative characteristics compared to unfertilized plants at both samples in the two growing seasons and the other treatments. On the other hand, the results showed that all NPK treatments, i.e. 25, 50, 75, and 100% NPK significantly increased seed yield (g/plant) as compared to control, the mean values were 3.06, 4.70, 9.09 and 10.20 g/plant compared to 1.84 g/plant, respectively, for the 1st season and 3.11, 4.48, 9.27 & 10.27 g/plant comparing to 1.80 of control for the 2nd season. Compost treatments significantly increased the seed yield; the mean values were 5.10, 5.72, 5.88 and 6.42 g/plant in the 1st season and 5.09, 5.73, 5.99 and 6.32 g/plant in the 2nd season for fertilization with 0, 6, 8 and 10 m3/Fed., respectively. The maximum mean values were obtained by compost at 10 m3/fed. The interaction treatment between 100% NPK and 10 m3/fed showed the maximum mean value of seed yield which recorded 10.51 and 10.78 g/plant for the 1st and 2nd seasons, respectively. In contrast, the lowest values of seed yield were obtained from unfertilized plant which recorded 1.09 and 1.04 g/plant for the 1st and 2nd seasons, respectively. The promising effect of NPK fertilizer on fixed oil % and yield was evident with NPK 100%, 52.53% and 52.83% fixed oil, whereas yield was 408.63 and 413.68 l/fed.), followed by 75% NPK which produced fixed oil percentage and yield 46.82, 46.77% as well as 207.29 and 208.06 l/fed for the first and second season, respectively, compared with other treatments and control. The highest fixed oil percentages and yield (l/fed) were recorded with NPK at 100% and compost at 10 m3/fed during both seasons

Value of ultrasound in grading the severity of sarcopenia in patients with hepatic cirrhosis

Abstract Background Ultrasound is emerging as an efficient significant method for measuring muscle mass in patients with liver cirrhosis. It has been applied in numerous studies as an accurate measuring tool for the muscles of the limbs. This study was conducted to assess the severity of sarcopenia in liver cirrhosis patients, through utilizing ultrasound in measuring the cross-sectional area and consequently estimating the muscle mass of both the upper and lower limb muscles, than correlating the results with hand grip strength as representative of functional status. Also, the severity of sarcopenia was correlated with conventional prognostic scores for liver cirrhosis, like Child or MELD scores and detecting its effect on the duration of hospital stay and mortality. Results This study was conducted on 101 liver cirrhosis patients who were admitted to the internal medicine hospital, 30 healthy participants were added as a control group. Using the FNIH (Foundation for the national Institutes of health) cuff off of hand grip (< 26 kg in male and < 16 kg in female, Quadriceps muscle index cutoff was estimated to be(1.67 cm/m2 for male and 1.58 cm/m2 for female). Ultrasound (mid upper arm, mid-thigh and Quadriceps muscle index) showed significant indirect correlation with (Child even in Child A and MELD) scores, as well as with the duration of hospital stay. Also, they showed a direct correlation with HGS. Conclusion Sarcopenia in cirrhotic patients assessed by ultrasonography of (mid upper arm, mid-thigh muscle thickness) and HGS are independent predictors of disease severity and poor outcome, which is assessed by high Child and MELD scores. Also, ultrasound and HGS are straightforward bedside techniques used for assessment of sarcopenia

Antibiotics Susceptibility Phenotyping and Extracellular Polymeric Substances Production of Listeria monocytogenes Biofilm and Planktonic Cells

ABSTRACT The present research aimed to compare the susceptibility of L. monocytogenes planktonic cells and three different ages (10, 40 and 90 days-old) of biofilm to antibiotics. A second objective was to determine the relationship between the amount of produced EPS by L. monocytogenes biofilm and antibiotic susceptibility of L. monocytogenes biofilm. The extraction of EPS was carried out by using a cation exchange resin method and exopolysaccharides content in crude EPS was determined using phenol-sulfuric acid method. Antibiotic susceptibility of L. monocytogenes biofilm and planktonic cells were performed by the standard disk diffusion method. The maximum amount of exopolysaccharides was determined (411.5µg/cm 2 ) in 90 days-old L. monocytogenes biofilm collected from iron pipe. While, the minimum amount (203.4µg/cm 2 ) was in Cu pipe. Regarding to the antibiotic susceptibility results, it was found that, L. monocytogenes plankton cells were more sensitive to the tested antibiotic than L. monocytogenes biofilm. Also, it was found that, 90 days-old L. monocytogenes biofilm collected from iron pipe was more resistant to all tested antibiotics than which collected from Cu pipe. The findings in this research provide useful information and background data on the role of EPS in antibiotic resistance of L. monocytogenes biofilm