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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_VII | Pages 2 - 2
1 Mar 2012
Clarke A Barnes J Atherton W Grier D Buckingham R
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Purpose of study

To determine whether hemiplegia causes abnormal torsion of the radius of the affected compared with the unaffected limb as demonstrated by MRI measurements, and to assess whether this correlates with the passive range of movement as measured clinically.

Methods

27 patients who fit the inclusion criteria were recruited from an existing database of hemiplegic patients into our prospective cohort study.

A clinical assessment was made of each subject to determine the range of active and passive upper limb movements. A functional assessment of the children's upper limbs was made using the validated House score. Subsequent MRI scans of both upper limbs were then performed. A single radiologist (blinded as to the affected limb) then measured the torsional profiles of both radii using a method validated by Bindra et al.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_6 | Pages 9 - 9
1 Feb 2013
Singhal R Perry D Prasad S Davidson N Bruce C
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Background

The association between idiopathic scoliosis and intrinsic abnormalities of the spinal cord are well known. MRI is the most sensitive imaging modality available to diagnose an intraspinal anomaly. The use of a routine ‘screening MRI’ prior to scoliosis correction is controversial.

Purpose

This study sought to quantify the frequency of previously unidentified cord anomalies identified by a routine pre-operative MRI, in patients planned for surgical scoliosis correction.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_24 | Pages 14 - 14
1 May 2013
Tennant S Chakravorty S Alavi A
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Aim. Differentiation between bone infarction and bone infection in sickle cell disease has traditionally been difficult, even with modern imaging techniques, and widespread antibiotic use is common. Early differentiation between the two conditions would enable more appropriate targeting of radiological investigations, antibiotics and surgery, and avoid un-necessary antibiotic usage. Method. At our tertiary paediatric sickle cell centre, we have developed a sequencing protocol to be able to accurately differentiate between infection and infarction in sickle cell children using Magnetic Resonance (MR) Imaging. We have undertaken a preliminary retrospective study to analyse clinical and laboratory parameters in these children to see whether earlier differentiation prior to MR imaging is possible. Results. We identified 52 episodes in 27 patients of bony pain in sickle cell children between 2006 and 2012. In 30 episodes in 27 patients, the MR sequences used allowed accurate determination of pathology, diagnosing infarction in 19 episodes in 17 patients, and infection in 8 episodes in 7 patients. The remainder showed no evidence of acute infarction or infection despite pain. As a general trend, admission white cell counts were higher in the infection group, with a temperature on admission also being more likely. There was no significant difference in CRP or platelet count between the infarction and infection groups. Conclusion. From a small retrospective study it may be possible to identify factors making infection as a cause of bone pain in sickle cell disease more likely, enabling better targeting of urgent MR imaging and surgery and preventing un-necessary antibiotic usage. A larger, prospective study is required and is currently underway