Magnetska rezonancija u dijagnostici ozljeda koljenskoga zgloba

The possibilities of MR diagnosing knee pathology on high field scanners of 1T and 1.5T are well known. A sensitivity of 87%-100% and specificity of 64%-100% in diagnosing meniscal pathology are quoted in the literature. The aim of this work was to define the sensitivity and specificity of evaluation of meniscal lesions and cruciate ligament tears with a 0.2T permanent magnet of low field strength, as well as of other associated lesions of the bone, cartilage and collateral ligaments. We wished to estimate the value of particular sequences and projections of scanning chosen for certain pathology, and to recommend the type of scanning. MR findings were correlated with arthroscopy as the "gold standard method" in evaluating knee pathology. Two radiologists of different clinical experience interpreted MR findings by the principle of "interobserver difference". A total of 40 patients were examined, 32 men and 8 women, aged 17-46, mean age 27±5 years. The following sequences were used always in three projections: SE 1500/38; SE 1500/25; SE 1700/40; SE 200/38; SR 550/25; SR 550/38; GE 100/23/45; GE 100/23/60; and GE 500/23/40. We conclude that low field MRI is as sensitive and specific as diagnostic arthroscopy for traumatic meniscal lesions, yet better due to its noninvasiveness. MRI 0.2 T is of a lower specificity and sensitivity in detecting anterior cruciate ligament and chondral lesions in comparison with arthroscopy.Mogućnosti MR dijagnostike patologije koljenskoga zgloba na uređajima 1 i 1.5 T su poznate. U literaturi se navodi osjetljivost od 87%-100% i specifičnost od 64%-100% u dijagnostici patologije meniska na tim uređajima. Cilj rada bio je ustanoviti osjetljivost i specifičnost, odnosno vrijednost MR-e u pregledu meniska i ukriženih ligamenata koljenskoga zgloba MR-om 0.2T, niske jačine magnetskog polja, kao i procijeniti pridružene ozljede MR-om (ozljede hrskavice, kosti, kolateralnih ligamenata). Dobiveni MR nalazi korelirani su s artroskopijom kao zlatnim standardom. MR nalaze provjerilo je dvoje radiologa po načelu među promatračima ("interobserver difference"). Pregledano je ukupno 40 bolesnika, od toga 32 muškarca i 8 žena, u dobi od 17-46 godina, prosječne životne dobi 27±5 godina. Sljedeće sekvence su bile napravljene uvijek u tri projekcije: SE 1500/38; SE 1500/25; SE 1700/40; SE 200/38; SR 550/25; SR 550/38; GE 100/23/45; GE 100/23/60; GE 500/23/40. U zaključku: MR 0.2T je jednako osjetljiva metoda kao dijagnostička artroskopija u procjeni traumatskih ozljeda meniska, no dajemo joj prednost zbog neinvazivnosti. MR niske jačine polja slabije je osjetljiva metoda od artroskopije u procjeni lezije prednjega ukriženog ligamenta te ozljeda hrskavice

Scoliosis and dental occlusion: a review of the literature

<p>Abstract</p> <p>Background</p> <p>Idiopathic scoliosis is a deformity without clear etiology. It is unclear wether there is an association between malocclusion and scoliosis. Several types of occlusion were described in subjects with scoliosis, mostly case-reports.</p> <p>Objectives</p> <p>The aim of this review was to evaluate the type of occluslins more prevalent in subjects with scoliosis</p> <p>Search strategy</p> <p>All randomised and controlled clinical trials identified from the Cochrane Oral Health Group Trials Register, a MEDLINE search using the Mesh term scoliosis, malocclusion, and relevant free text words, and the bibliographies of papers and review articles which reported the outcome of orthodontic treatment in subjects with scoliosis that were published as abstracts or papers between 1970 and 2010.</p> <p>Selection criteria</p> <p>All randomised and controlled clinical trials published as full papers or abstracts which reported quantitative data on the outcomes malocclusion in subjects with scoliosis.</p> <p>Data collection and analysis</p> <p>Data were extracted without blinding to the authors, age of patients or type of occlusion.</p> <p>Main results</p> <p>Using the search strategy eleven observational longitudinal studies were identified. No randomized clinical trials were recorded. Twenty-three cross-sectional studies were recorderd, and the others studies were reviews, editorials, case-reports, or opinions. The clinical trials were often not controlled and were about the cephalometric evaluation after treatment with the modified Milwuakee brace, followed by the orthodontic treatment of the class II relationship with a functional appliance. Clinical trials also included the study of the associations between scoliosis and unilateral crossbite, in children with asymmetry of the upper cervical spine. This association was also investigated in rats, pigs and rabbits in clinical trials. The other associations between scoliosis and occlusion seems to be based only on cross-sectional studies, case-reports, opinions.</p> <p>Authors' conclusions</p> <p>Based on selected studies, this review concludes that there is plausible evidence for an increased prevalence of unilateral Angle Class II malocclusions associated with scoliosis, and an increased risk of lateral crossbite, midline deviation in children affected by scoliosis. Also, documentation of associations between reduced range of lateral movements and scoliosis seem convincing. Data are also mentioned about the association between plagiocephaly and scoliosis.</p