Lateral trochlear inclination (LTI) of the knee was compared on magnetic resonance (MR) images obtained in 30 patients with patellar instability (PI) and 30 patients with nonspecific internal knee derangement. Differences in LTI values between the two populations were significant (P <.001). Reproducibility of the measurement was judged excellent with an intraclass correlation superior to 0.98. Below a threshold value fixed at 11 degrees, LTI appears to be an excellent diagnostic test of PI with a sensitivity of 0.93 (28/30), a specificity of 0.87 (26/30), and an accuracy of 0.90 (54/60).
Posteromedial tarsal tunnel syndrome is a disorder affecting the tibial nerve or its branches. Diagnosis is established on the basis of physical examination and can be confirmed by electrophysiological evidence. However, diagnostic imaging is always required to identify the possible site of compression. High-resolution ultrasound (US) is playing an increasingly important role in the study of the nerves thanks to a series of advantages over magnetic resonance imaging, such as lower costs and widespread availability, high spatial resolution, fast examination using axial scans, dynamic and comparative studies, possibility of carrying out a study with the patient in the standing position, US Tinel sign finding, and the contribution of color/power Doppler US. We present the results obtained in a series of 81 patients who underwent US imaging between 2008 and 2013 due to posteromedial tarsal tunnel syndrome.
Keywords Tarsal tunnel Á Tibial nerve Á UltrasoundRiassunto La sindrome del tunnel tarsale posterioremediale è una sofferenza del nervo tibiale o di un suo ramo. La diagnosi è clinica e può essere confermata dall'elettrofisiologia, ma un'indagine con imaging è sempre necessaria per trovare l'elemento di compressione. L'ecografia ad alta risoluzione sta giocando un ruolo sempre più importante per lo studio dei nervi, per i diversi vantaggi rispetto alla risonanza magnetica: costo e disponibilità, risoluzione spaziale, esplorazione rapida mediante tecnica di scansione assiale, dinamica e comparativa, possibilità di uno studio con paziente in piedi, segno di Tinel ecografico, contributo del Doppler.
Pathological lesions of osteoarthritis, demonstrated by conventional radiography, can be assessed by scoring systems and/or measurement with a quite acceptable reproducibility. Scores are recommended for a rough staging of osteoarthritis and of bone changes. Measurement is recommended for assessment of joint space narrowing progression. A good assessment of progression implicates a perfect reproducibility of the radiographic image of the joint. Accuracy of standard radiograph is improved by some views such as the hip profile and the schuss view.
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