Pub Date : 2015-06-17DOI: 10.1179/1753615415Y.0000000007
D. Cashley
Abstract Objectives There has been ample research published to demonstrate the validity and sensitivity of the pressure threshold metre, but none to assess the competence of the analogue metre as compared to the more commonly used digital version. This paper aims to compare the two different types of metre. Method A total of 160 measurements were taken from each metre for comparison. Results A Bland–Altman plot showed the measurements from both metres to be in excellent agreement, while a strong correlation was also evident. Discussion Where changes in excess of 1 kg/cm2 are being sought, both devices perform satisfactorily and there is little or nothing to advance the case for 1 m over the other. Since the minimum clinically significant change is thought to be 1.5 kg/cm either metre should function satisfactorily in the clinical setting.
{"title":"A repeat-measures comparison of the analogue and digital pressure threshold metres: Do they differ in sensitivity?","authors":"D. Cashley","doi":"10.1179/1753615415Y.0000000007","DOIUrl":"https://doi.org/10.1179/1753615415Y.0000000007","url":null,"abstract":"Abstract Objectives There has been ample research published to demonstrate the validity and sensitivity of the pressure threshold metre, but none to assess the competence of the analogue metre as compared to the more commonly used digital version. This paper aims to compare the two different types of metre. Method A total of 160 measurements were taken from each metre for comparison. Results A Bland–Altman plot showed the measurements from both metres to be in excellent agreement, while a strong correlation was also evident. Discussion Where changes in excess of 1 kg/cm2 are being sought, both devices perform satisfactorily and there is little or nothing to advance the case for 1 m over the other. Since the minimum clinically significant change is thought to be 1.5 kg/cm either metre should function satisfactorily in the clinical setting.","PeriodicalId":88907,"journal":{"name":"International musculoskeletal medicine","volume":"47 32 1","pages":"72 - 75"},"PeriodicalIF":0.0,"publicationDate":"2015-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/1753615415Y.0000000007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65723435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-06-16DOI: 10.1179/1753614615Z.000000000105
B. Sweetman
Aim: This is the fourth and last part of a series of literature reviews, which seek to find out whether different types of sleep disturbance can be caused by different sorts of back pain. Here in Part 4 we show how researchers have assumed, speculated, or theorized upon the mechanisms whereby back problems can cause sleep disturbance. Methods: The same search of Medline, Embase, Psycinfo, and the OVID journals databases using the keywords ‘low back pain’ and ‘sleep’ was used as in the previous reviews. Results: It was difficult to synthesize a unified theory of back pain insomnia from the available literature. This was mainly because few researchers have tried to distinguish different sorts of back pain. This has resulted in an inability to compare for their different response to banishing the vertical gravitational forces on adopting the horizontal posture and the other phenomena associated with quiet repose. Though the introduction or discussion section of published articles might have permitted more speculation on relevant mechanisms, most authors have limited their propositions to the data collected. Discussion: Some of the more interesting observations on the matter of back pain insomnia found in the literature are presented.
{"title":"Various types of sleep disturbance due to different sorts of low back pain: A literature review: 4: Mechanisms and theories as to how back pathology might cause sleep disturbance","authors":"B. Sweetman","doi":"10.1179/1753614615Z.000000000105","DOIUrl":"https://doi.org/10.1179/1753614615Z.000000000105","url":null,"abstract":"Aim: This is the fourth and last part of a series of literature reviews, which seek to find out whether different types of sleep disturbance can be caused by different sorts of back pain. Here in Part 4 we show how researchers have assumed, speculated, or theorized upon the mechanisms whereby back problems can cause sleep disturbance. Methods: The same search of Medline, Embase, Psycinfo, and the OVID journals databases using the keywords ‘low back pain’ and ‘sleep’ was used as in the previous reviews. Results: It was difficult to synthesize a unified theory of back pain insomnia from the available literature. This was mainly because few researchers have tried to distinguish different sorts of back pain. This has resulted in an inability to compare for their different response to banishing the vertical gravitational forces on adopting the horizontal posture and the other phenomena associated with quiet repose. Though the introduction or discussion section of published articles might have permitted more speculation on relevant mechanisms, most authors have limited their propositions to the data collected. Discussion: Some of the more interesting observations on the matter of back pain insomnia found in the literature are presented.","PeriodicalId":88907,"journal":{"name":"International musculoskeletal medicine","volume":"37 1","pages":"146 - 152"},"PeriodicalIF":0.0,"publicationDate":"2015-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/1753614615Z.000000000105","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65717805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-06-14DOI: 10.1179/1753614615Z.000000000104
B. Sweetman
Abstract Aim This is the third part of a literature review series of four along with a data analysis study, which seek to find out whether different types of sleep disturbance can be caused by different sorts of back pain. Here in Part 3 we review the insomnia research literature to see if any studies have been able to utilize different sorts of back pain for comparison purposes. Methods The same search of Medline, Embase, Psycinfo, and the OVID journals databases using the keywords ‘low-back pain’ and ‘sleep’ was used as in the previous reviews. But because there was so little relevant information available in cited journals on this topic, some unpublished data from a clinical research study were used to supplement the process. Results It was noted how difficult it is to measure severity of pain and how the explanation may also help explain the well-known discrepancies between subjective and objective evidence of insomnia. We then noted the paucity of attempts to distinguish different sorts of back pain from within the singular concept of non-specific low-back pain. Generally, any differences were mostly due to the variation of back pain case being recruited as a result of unquantified selection bias. Different sorts of back pain probably present to epidemiologists, general practice, casualty, physiotherapy, rheumatology, orthopaedics, pain clinics, psychiatry, and in response to public advertisement. Because of these difficulties, parts of a previously unpublished correlation matrix from our back pain classification study were explored. Aspects of sleep disturbance were related to symptoms, signs, and X-ray findings. The particular sleep disturbance features included difficulty getting off to sleep, being awoken from sleep, early morning stiffness in the back and diurnal variation in back pain. Some of the more interesting aspects of back pain relating to insomnia were identified. Discussion These inspections should help select promising physically based clinical items for the future study of the way in which back pain causes sleep disturbance.
{"title":"Various types of sleep disturbance due to different sorts of low-back pain: A literature review: 3. Back pain severity, symptoms, signs, and sorts of sub-diagnosis","authors":"B. Sweetman","doi":"10.1179/1753614615Z.000000000104","DOIUrl":"https://doi.org/10.1179/1753614615Z.000000000104","url":null,"abstract":"Abstract Aim This is the third part of a literature review series of four along with a data analysis study, which seek to find out whether different types of sleep disturbance can be caused by different sorts of back pain. Here in Part 3 we review the insomnia research literature to see if any studies have been able to utilize different sorts of back pain for comparison purposes. Methods The same search of Medline, Embase, Psycinfo, and the OVID journals databases using the keywords ‘low-back pain’ and ‘sleep’ was used as in the previous reviews. But because there was so little relevant information available in cited journals on this topic, some unpublished data from a clinical research study were used to supplement the process. Results It was noted how difficult it is to measure severity of pain and how the explanation may also help explain the well-known discrepancies between subjective and objective evidence of insomnia. We then noted the paucity of attempts to distinguish different sorts of back pain from within the singular concept of non-specific low-back pain. Generally, any differences were mostly due to the variation of back pain case being recruited as a result of unquantified selection bias. Different sorts of back pain probably present to epidemiologists, general practice, casualty, physiotherapy, rheumatology, orthopaedics, pain clinics, psychiatry, and in response to public advertisement. Because of these difficulties, parts of a previously unpublished correlation matrix from our back pain classification study were explored. Aspects of sleep disturbance were related to symptoms, signs, and X-ray findings. The particular sleep disturbance features included difficulty getting off to sleep, being awoken from sleep, early morning stiffness in the back and diurnal variation in back pain. Some of the more interesting aspects of back pain relating to insomnia were identified. Discussion These inspections should help select promising physically based clinical items for the future study of the way in which back pain causes sleep disturbance.","PeriodicalId":88907,"journal":{"name":"International musculoskeletal medicine","volume":"37 1","pages":"115 - 124"},"PeriodicalIF":0.0,"publicationDate":"2015-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/1753614615Z.000000000104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65717659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-06-14DOI: 10.1179/1753614615Z.000000000103
M. Fukushima
I have continued to study how therapy for spinal dysfunction can benefit peripheral joints, and have now studied 55 consecutive cases of knee problems, with 77 knees being treated. My methods for the spine have been reported in this journal in the past. The therapy consisted of placement of pillow and bar under the trunk and pelvis in side-lying, sitting, and supine. Mechanical dysfunction of the knee joint occurs if joint-play is lost through muscle spasm of the quadriceps and hamstrings or internal derangement of the knee joint such as pinching or displacement of the meniscus, which may be caused by excessive stress or injury. The muscle spasm can be eliminated by the therapy for the spinal joint dysfunction defined by dynamic radiographs. The knee problems were classified into (1) meniscus problems (acute locking/derangement 4 cases, subacute with edema or effusion 3 cases, chronic with restricted flexion 14 cases), (2) periarthritis of ligaments of the knee 10 cases, (3) knee pain caused directly (referred pain) from the spine 20 cases, and (4) contracture of the knee 4 cases. The mean improvement in degrees of flexion was, in group (1) 10, 15, and 13° in the respective categories, in group (2) 3°, in group (3) 1°, and (4) 6°. In all cases except those of contracture, the range of flexion ended at over 140°. As well as radiological determination of joint position and side-flexion range in the thoracic and lumbar spines, three clinical tests for the spine were employed, the gliding test with palpating bar to the thoracic, rib, lumbar and sacroiliac joints, cervical atlanto-axial joint with palpating thumb, and pain provoking test at end-range of flexion. The treatment is carried out by utilizing body weight in side-lying, supine, and sitting. All patients were treated with a small pillow with the core made of rolled paper and of three round wooden bars in order to treat all spinal joints in the static state. Small triangular bars (bars) and oval pillows (pillows) in different sizes are placed under the trunk and pelvis to lift the trunk off the treating table to result in releasing locking of the cervical, thoracic, lumbar, and sacroiliac joints. When joint-play was restored to the knee joint a soft end-feel was sensed for knee flexion and no pain was aroused by pressing the tibia, and there was an increase of external and internal rotation in the elastic ligaments of knee. In the cases of medial radial displacement of the meniscus within group 1, the meniscus itself was reduced by knee traction and rotation. In acute cases treatment was completed in a mean of less than 9 days; contractures were treated for a mean of 48 weeks, while all other cases were treated for less than a mean of 14 weeks.
{"title":"Improvement of knee function with treatment of spinal joint dysfunction","authors":"M. Fukushima","doi":"10.1179/1753614615Z.000000000103","DOIUrl":"https://doi.org/10.1179/1753614615Z.000000000103","url":null,"abstract":"I have continued to study how therapy for spinal dysfunction can benefit peripheral joints, and have now studied 55 consecutive cases of knee problems, with 77 knees being treated. My methods for the spine have been reported in this journal in the past. The therapy consisted of placement of pillow and bar under the trunk and pelvis in side-lying, sitting, and supine. Mechanical dysfunction of the knee joint occurs if joint-play is lost through muscle spasm of the quadriceps and hamstrings or internal derangement of the knee joint such as pinching or displacement of the meniscus, which may be caused by excessive stress or injury. The muscle spasm can be eliminated by the therapy for the spinal joint dysfunction defined by dynamic radiographs. The knee problems were classified into (1) meniscus problems (acute locking/derangement 4 cases, subacute with edema or effusion 3 cases, chronic with restricted flexion 14 cases), (2) periarthritis of ligaments of the knee 10 cases, (3) knee pain caused directly (referred pain) from the spine 20 cases, and (4) contracture of the knee 4 cases. The mean improvement in degrees of flexion was, in group (1) 10, 15, and 13° in the respective categories, in group (2) 3°, in group (3) 1°, and (4) 6°. In all cases except those of contracture, the range of flexion ended at over 140°. As well as radiological determination of joint position and side-flexion range in the thoracic and lumbar spines, three clinical tests for the spine were employed, the gliding test with palpating bar to the thoracic, rib, lumbar and sacroiliac joints, cervical atlanto-axial joint with palpating thumb, and pain provoking test at end-range of flexion. The treatment is carried out by utilizing body weight in side-lying, supine, and sitting. All patients were treated with a small pillow with the core made of rolled paper and of three round wooden bars in order to treat all spinal joints in the static state. Small triangular bars (bars) and oval pillows (pillows) in different sizes are placed under the trunk and pelvis to lift the trunk off the treating table to result in releasing locking of the cervical, thoracic, lumbar, and sacroiliac joints. When joint-play was restored to the knee joint a soft end-feel was sensed for knee flexion and no pain was aroused by pressing the tibia, and there was an increase of external and internal rotation in the elastic ligaments of knee. In the cases of medial radial displacement of the meniscus within group 1, the meniscus itself was reduced by knee traction and rotation. In acute cases treatment was completed in a mean of less than 9 days; contractures were treated for a mean of 48 weeks, while all other cases were treated for less than a mean of 14 weeks.","PeriodicalId":88907,"journal":{"name":"International musculoskeletal medicine","volume":"37 1","pages":"132 - 132"},"PeriodicalIF":0.0,"publicationDate":"2015-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/1753614615Z.000000000103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65717186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-06-12DOI: 10.1179/1753614615Z.000000000102
N. Watson
Abstract The case of a 68-year-old woman presenting with back pain and some leg pain is described, together with the difficulties of diagnosis and her progressive development of leg weakness. Tests for borreliosis (Lyme disease) were found to be positive. Features of neuroborreliosis are discussed in relation to this case.
{"title":"Neuroborreliosis: A case report of back pain with leg radiation","authors":"N. Watson","doi":"10.1179/1753614615Z.000000000102","DOIUrl":"https://doi.org/10.1179/1753614615Z.000000000102","url":null,"abstract":"Abstract The case of a 68-year-old woman presenting with back pain and some leg pain is described, together with the difficulties of diagnosis and her progressive development of leg weakness. Tests for borreliosis (Lyme disease) were found to be positive. Features of neuroborreliosis are discussed in relation to this case.","PeriodicalId":88907,"journal":{"name":"International musculoskeletal medicine","volume":"37 1","pages":"111 - 114"},"PeriodicalIF":0.0,"publicationDate":"2015-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/1753614615Z.000000000102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65717038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-06-11DOI: 10.1179/1753615415Y.0000000006
Tamim Khanbhai, B. Hameed, Peter Resteghini
Abstract Objectives Carpal tunnel syndrome (CTS) is currently investigated with nerve conduction studies (NCS) for diagnosis, but these are expensive and invasive. We propose that ultrasound (US) will be comparable to NCS in diagnosing CTS. Method There were two groups in this study – a control (60 wrists) and symptomatic group (56 wrists), who all underwent a clinical examination. US measurements of the median nerve were the cross-sectional area of the carpal tunnel at the level of pisiform (CSAc), pronator quadratus (CSAp), 12 cm proximally in the mid-forearm (CSAmf) and palmar bowing of the flexor retinaculum. The main calculation was the CSA difference (CSAd = CSAc − CSAp). Results In the symptomatic group, NCS diagnosed 32/56 cases (sensitivity 57%). In the control group, the mean CSAc was 8.36 mm2, CSAd of 0.57 mm2, and palmar bowing 1.18 mm. The symptomatic group mean CSAc was 13.73 mm2, CSAd of 5.02 mm2, and palmar bowing 4.02 mm. With a threshold value of 10 mm2 for the CSAc, 48/56 cases were diagnosed with CTS, with a sensitivity of 86% and specificity of 95%. For CSAd with a threshold at 2 mm, 50 cases were identified with CTS with a sensitivity of 89% and specificity of 97%. Palmar bowing had a sensitivity of 96% and specificity of 95%. NCS correlated strongly with CSAd (P = 0.007). Discussion In our study, the US results were statistically significant compared to NCS, with higher sensitivity and specificity. We propose that US should be the first line investigation for the diagnosis of CTS unless there are clinical indications to use NCS.
{"title":"A prospective study examining the sensitivity of ultrasound determined median nerve cross-sectional area with nerve conduction investigation in the diagnosis of carpal tunnel syndrome","authors":"Tamim Khanbhai, B. Hameed, Peter Resteghini","doi":"10.1179/1753615415Y.0000000006","DOIUrl":"https://doi.org/10.1179/1753615415Y.0000000006","url":null,"abstract":"Abstract Objectives Carpal tunnel syndrome (CTS) is currently investigated with nerve conduction studies (NCS) for diagnosis, but these are expensive and invasive. We propose that ultrasound (US) will be comparable to NCS in diagnosing CTS. Method There were two groups in this study – a control (60 wrists) and symptomatic group (56 wrists), who all underwent a clinical examination. US measurements of the median nerve were the cross-sectional area of the carpal tunnel at the level of pisiform (CSAc), pronator quadratus (CSAp), 12 cm proximally in the mid-forearm (CSAmf) and palmar bowing of the flexor retinaculum. The main calculation was the CSA difference (CSAd = CSAc − CSAp). Results In the symptomatic group, NCS diagnosed 32/56 cases (sensitivity 57%). In the control group, the mean CSAc was 8.36 mm2, CSAd of 0.57 mm2, and palmar bowing 1.18 mm. The symptomatic group mean CSAc was 13.73 mm2, CSAd of 5.02 mm2, and palmar bowing 4.02 mm. With a threshold value of 10 mm2 for the CSAc, 48/56 cases were diagnosed with CTS, with a sensitivity of 86% and specificity of 95%. For CSAd with a threshold at 2 mm, 50 cases were identified with CTS with a sensitivity of 89% and specificity of 97%. Palmar bowing had a sensitivity of 96% and specificity of 95%. NCS correlated strongly with CSAd (P = 0.007). Discussion In our study, the US results were statistically significant compared to NCS, with higher sensitivity and specificity. We propose that US should be the first line investigation for the diagnosis of CTS unless there are clinical indications to use NCS.","PeriodicalId":88907,"journal":{"name":"International musculoskeletal medicine","volume":"37 1","pages":"100 - 93"},"PeriodicalIF":0.0,"publicationDate":"2015-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/1753615415Y.0000000006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65723411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-05-14DOI: 10.1179/1753614615Z.000000000100
C. Fischhoff, Teejas Goorah, S. Dowlut
Abstract Background Radiological and ultrasound measurements are commonly used in the diagnosis of patellofemoral pain syndrome (PFPS), as no clinical tests have yet demonstrated good reliability or validity. We studied the degree of agreement between two examiners for the qualitative and quantitative criteria used for the diagnosis of PFPS. Methodology Forty-one adults with chronic anterior knee pain for over 2 months were selected consecutively in a hospital's orthopaedic department. They were referred to one junior and to one senior radiologist, who evaluated the positive or negative nature of three ultrasound criteria: the presence of a dysplasia, the distance between patellar tip and trochlear groove (PTTG) during maximal quadriceps contraction, and the cartilaginous trochlear groove (CTG) angle. Each sonographic examination was performed with the radiologist blinded to the clinical details and to the other radiologist's findings. Results The Cohen's Kappa and prevalence and bias adjusted Kappa (PABAK) values were poor for the ultrasound CTG angle criterion (PABAK = 0.55; kappa = 0.52) and moderate for the ultrasound PTTG distance criterion (PABAK = 0.35; kappa = 0.36). It was not possible to calculate Kappa or PABAK values for the dysplasia criterion because of very low prevalence. Conclusion Quantitative ultrasound criteria for PFPS can be reliable if performed in a standardized manner and by trained practitioners. Only the PTTG distance criterion showed a clinically acceptable inter-operator reliability level.
{"title":"Ultrasound measurements for patellofemoral pain syndrome: An inter-operator reliability study","authors":"C. Fischhoff, Teejas Goorah, S. Dowlut","doi":"10.1179/1753614615Z.000000000100","DOIUrl":"https://doi.org/10.1179/1753614615Z.000000000100","url":null,"abstract":"Abstract Background Radiological and ultrasound measurements are commonly used in the diagnosis of patellofemoral pain syndrome (PFPS), as no clinical tests have yet demonstrated good reliability or validity. We studied the degree of agreement between two examiners for the qualitative and quantitative criteria used for the diagnosis of PFPS. Methodology Forty-one adults with chronic anterior knee pain for over 2 months were selected consecutively in a hospital's orthopaedic department. They were referred to one junior and to one senior radiologist, who evaluated the positive or negative nature of three ultrasound criteria: the presence of a dysplasia, the distance between patellar tip and trochlear groove (PTTG) during maximal quadriceps contraction, and the cartilaginous trochlear groove (CTG) angle. Each sonographic examination was performed with the radiologist blinded to the clinical details and to the other radiologist's findings. Results The Cohen's Kappa and prevalence and bias adjusted Kappa (PABAK) values were poor for the ultrasound CTG angle criterion (PABAK = 0.55; kappa = 0.52) and moderate for the ultrasound PTTG distance criterion (PABAK = 0.35; kappa = 0.36). It was not possible to calculate Kappa or PABAK values for the dysplasia criterion because of very low prevalence. Conclusion Quantitative ultrasound criteria for PFPS can be reliable if performed in a standardized manner and by trained practitioners. Only the PTTG distance criterion showed a clinically acceptable inter-operator reliability level.","PeriodicalId":88907,"journal":{"name":"International musculoskeletal medicine","volume":"37 1","pages":"59 - 67"},"PeriodicalIF":0.0,"publicationDate":"2015-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/1753614615Z.000000000100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65717445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-05-14DOI: 10.1179/1753614615Z.00000000099
C. Fischhoff
Abstract Background and aim There is no clinical test with diagnostic consistency for the patellofemoral pain syndrome. Ultrasound allows study of the peripatellar soft tissues and part of the trochlear groove, in particular its hyaline cartilage and its relationship with the patellar tip. Quantitative and qualitative ultrasound criteria have been validated. A literature review to clarify the reliability of diagnostic ultrasound tests for the patellofemoral pain syndrome was therefore proposed. Methods A literature search was carried out relating to ultrasonography and the patellofemoral pain syndrome, and the results analysed for power, bias, and applicability. Results A total of 320 papers were identified (230 in English and 90 in French), and six papers were selected to be of adequate relevance and quality for further review and analysis. Discussion and conclusions Despite the significant prevalence of the patellofemoral pain syndrome, we found only one diagnostic study. This study established three ultrasonographic diagnostic criteria: the cartilaginous trochlear angle, patellar tip to trochlear groove distance, and the presence or absence of dysplasia. Further research on the reliability of ultrasound tests for these criteria is needed.
{"title":"Patellofemoral pain syndrome: Ultrasound measurements for diagnosis","authors":"C. Fischhoff","doi":"10.1179/1753614615Z.00000000099","DOIUrl":"https://doi.org/10.1179/1753614615Z.00000000099","url":null,"abstract":"Abstract Background and aim There is no clinical test with diagnostic consistency for the patellofemoral pain syndrome. Ultrasound allows study of the peripatellar soft tissues and part of the trochlear groove, in particular its hyaline cartilage and its relationship with the patellar tip. Quantitative and qualitative ultrasound criteria have been validated. A literature review to clarify the reliability of diagnostic ultrasound tests for the patellofemoral pain syndrome was therefore proposed. Methods A literature search was carried out relating to ultrasonography and the patellofemoral pain syndrome, and the results analysed for power, bias, and applicability. Results A total of 320 papers were identified (230 in English and 90 in French), and six papers were selected to be of adequate relevance and quality for further review and analysis. Discussion and conclusions Despite the significant prevalence of the patellofemoral pain syndrome, we found only one diagnostic study. This study established three ultrasonographic diagnostic criteria: the cartilaginous trochlear angle, patellar tip to trochlear groove distance, and the presence or absence of dysplasia. Further research on the reliability of ultrasound tests for these criteria is needed.","PeriodicalId":88907,"journal":{"name":"International musculoskeletal medicine","volume":"37 1","pages":"54 - 58"},"PeriodicalIF":0.0,"publicationDate":"2015-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/1753614615Z.00000000099","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65718773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-04-15DOI: 10.1179/1753614615Z.00000000098
B. Sweetman
Abstract Aim This is the second part of a literature review series and a data analysis study, which seek to find out whether different types of sleep disturbance can be caused by different sorts of back pain. Here in Part 2, we examine how the single item sleep question acts as a severity measure of back pain for statistical purposes. Conversely, there are multiple subdivisions, items, or factors that are distinctive each in their own right, and may each have clinical meaning. Methods The same search of Medline, Embase, PsycINFO, and the OVID journals databases using the keywords ‘low back pain’ and ‘sleep’ used for the initial part of the review process was again the basis for this part of the literature review. Results The manner in which ancient languages and modern English describe aspects of sleep, insomnia, fatigue, and tiredness has evolved over time was felt to be worth examination. Then the single and multiple item views of insomnia studied in questionnaire-based research were inspected. This was in part done with the help of the few regression, principal component, and factor analyses available in the literature. Back pain seems to have a profound effect on causing insomnia and depressed mood generally. Furthermore, the worse the peak and average pain are, the greater the difficulty getting off to sleep and the more often the awakenings during the night. However, different factors seem to influence the delayed sleep onset and the difficulty maintaining sleep in unexpected ways. Also the experimental sleep disturbance studies and the objective assessments of sleep quantity and quality sometime add an extra twist to the story. Some of the more appropriate aspects of sleep disturbance relating to back pain were identified. Discussion These inspections helped steer the insomnia questionnaire focus away from the psychometric complexion of most material in the current literature towards a more physically based focus suited to inspection of the mechanisms of back pain which cause sleep disturbance.
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Pub Date : 2015-04-13DOI: 10.1179/1753615415Y.0000000005
Tomonori Sato, N. Sato
The hip joint is a complex anatomic structure composed of osseous, ligaments, and muscular structure. It is a unique joint because it provides both stability and multiaxial mobility, and is involved in transferring the weight of the body. It is a common site of osteoarthritis (OA). OA is believed to be the most prevalent chronic joint disease of the hip joint and its incidence is rising as the population ages. A thorough anatomical understanding of the hip joint may us help to improve the management of hip conditions, including OA. This article presents a review of anatomy of the hip joint, designed to help a better understanding of the principles of management. We also discuss the clinical importance of anatomy of this joint from the perspective of conservative treatment.
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