Daniel Nissman

Value of MRI of the hand and the wrist in evaluation of bone age: preliminary results.

To evaluate bone age determination using MRI of the hand and wrist.

Investigating magnetic susceptibility of human knee joint at 7 tesla

To evaluate the magnetic susceptibility properties of different anatomical structures within the knee joint using quantitative susceptibility mapping (QSM).

Text-Atlas Of Skeletal Age Determination. Mri Of The Hand And Wrist In Children

Text-Atlas Of Skeletal Age Determination. Mri Of The Hand And Wrist In Children - Libros de Medicina - Ortopedia pediatrica - 120,00

Associations Between Slower Walking Speed and T1ρ Magnetic Resonance Imaging of Femoral Cartilage Following Anterior Cruciate Ligament Reconstruction

To determine whether walking speed, collected at 6 and 12 months following anterior cruciate ligament reconstruction (ACLR), is associated with inter‐extremity differences in proteoglycan density, measured via T1ρ magnetic resonance imaging, in tibiofemoral articular cartilage 12 months following ACLR.

Comprehensively Assessing the Acute Femoral Cartilage Response and Recovery after Walking and Drop-Landing: An Ultrasonographic Study

We compared the acute response and recovery of ultrasonography (US) cartilage outcomes (i.e., thickness, cross-sectional area, and echo intensity) between walking, drop-landing and control conditions in 43 young adults with no history of lower extremity injury. A femoral cartilage US assessment was performed before and after each condition to determine the acute cartilage response and recovery at 15, 30 and 45 min. Percentage change scores from pre- to all post-time points were used for analysis. Acute cartilage response and recovery were analyzed with a 3 × 4 (condition × time) repeated-measures analysis of variance. Greater deformation of the medial and lateral femoral cartilage was observed immediately after both the walking and drop-landing conditions compared with the control condition. Cartilage deformation after the drop-landing condition required longer time to recover compared with the walking condition. The femoral cartilage deformation was not accompanied by concurrent alterations in cartilage echo intensity.

Shear wave elastography of the brachial plexus roots at the interscalene groove

ABSTRACT Objectives: Sonoelastography is an emerging technology that has been used to evaluate the musculoskeletal system including the brachial plexus of peripheral nerves, which has been only recently considered for study by shear wave elastography. The purpose of this study is to establish the normal sonoelastographic features of the C5–C7 nerve roots of the brachial plexus. Methods: Forty healthy individuals (21 males and 19 females) were enrolled in the study. Shear wave elastography was used to evaluate the C5–C7 nerve roots of the brachial plexus at the interscalene interval. Normal sonoelastographic values were obtained. Results: The mean shear elastic modulus of the C5 nerve root was 16.9 kPa (range 5.9–28.8 ± 4.9 standard deviation, SD), 15.7 kPa (range 5.4–26.3 ± 4.3 SD) for the C6 nerve root, and 16 kPa (range 8–29 ± 4.6 SD) for the C7 nerve root. There was a significant statistical difference between both sexes in the elastic modulus at the C6 and C7, but not at the C5 nerve roots. Significant inverse correlation with height was noted at the C6 nerve root. There was no statistical significant difference in tissue stiffness between right- and left-handed subjects, age, and body mass index. Conclusion: The elastic modulus of the C5–C7 nerve roots has been determined in asymptomatic individuals and can serve as a reference when studying pathological conditions of these structures. Abbreviations: BMI: body mass index; SWE: shear wave elastography.

Associations between cartilage proteoglycan density and patient outcomes 12 months following anterior cruciate ligament reconstruction

BACKGROUND Lower proteoglycan density (PGD) of the articular cartilage may be an early marker of osteoarthritis following anterior cruciate ligament (ACL) reconstruction (ACL-R). The purpose this study was to determine associations between the Knee Injury and Osteoarthritis Outcomes Score (KOOS) and PGD of the articular cartilage in the femur and tibia 12-months following ACL-R. METHODS We evaluated KOOS pain, symptoms, function in activities of daily living (ADL), function in sport and recreation (Sport), and quality of life (QOL), as well as PGD using T1rho magnetic resonance imaging in 18 individuals 12.50±0.70months (these are all mean±standard deviation) following unilateral ACL-R (10 females, eight males; 22.39±4.19years; Marx Score=10.93±3.33). Medial and lateral load-bearing portions of the femoral and tibial condyles were sectioned into three (anterior, central and posterior) regions of interest (ROIs). T1rho relaxation times in the ACL-R knee were normalized to the same regions of interest in the non-surgical knees. Alpha levels were set at P≤0.05. RESULTS Worse KOOS outcomes were significantly associated with greater T1rho relaxation time ratios in the posterior-lateral femoral condyle [pain (r=-0.54), ADL (r=-0.56), Sport (r=-0.62) and QOL (r=-0.59)] central-lateral femoral condyle [Sport (r=-0.48) and QOL (r=-0.42)], and the anterior-medial femoral condyle [Sport (r=-0.46) and QOL (r=-0.40)]. There were no significant associations between the KOOS and T1rho outcomes for tibial ROI. CONCLUSIONS Lower PGD of the femoral cartilage in the ACL-R knees was associated with worse patient-reported outcomes.

Quadriceps Rate of Torque Development and Disability in Persons With Tibiofemoral Osteoarthritis

• BACKGROUND: Declines in the ability to rapidly generate quadriceps muscle torque may underlie disability in individuals with tibiofemoral osteoarthritis. • OBJECTIVE: To determine whether quadriceps rate of torque development (RTD) predicts self‐reported disability and physical performance outcomes in individuals with tibiofemoral osteoarthritis. • METHODS: This controlled laboratory, cross‐sectional study assessed quadriceps strength and RTD in 76 individuals (55% female; mean ± SD age, 61.83 ± 7.11 years) with symptomatic and radiographic tibiofemoral osteoarthritis. Early (0‐50 milliseconds), late (100‐200 milliseconds), and overall peak RTDs were quantified in the symptomatic (involved) and contralateral limbs and used to calculate bilateral average values. Disability was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function subscale and 3 physical performance tests, including the (1) 20‐m fast‐paced walk, (2) 30‐second chair stand, and (3) timed stair climb. Separate univariate regression models were used to determine the unique associations among measures of quadriceps RTD, WOMAC function score, and physical performance outcomes after accounting for quadriceps strength (change in R2). • RESULTS: Greater involved‐side late RTD and greater bilateral average early RTD were associated with faster walking (change in R2 = 0.05, P = .013 and change in R2 = 0.05, P = .043, respectively). Greater bilateral average late RTD was associated with faster walking (change in R2 = 0.20, P<.001) and faster stair climb (change in R2 = 0.11, P = .001). No quadriceps RTD variable was significantly associated with WOMAC function score (change in R2 range, <0.01‐0.017). • CONCLUSION: Involved‐limb quadriceps RTD was weakly associated with physical performance outcomes, but not self‐reported disability, in individuals with tibiofemoral osteoarthritis. Bilateral average quadriceps RTD was moderately associated with walking speed. • LEVEL OF EVIDENCE: Prognosis, level 2b. • KEY WORDS: chair stand, self‐reported function, stair climb, strength, walking speed

The association between habitual walking speed and medial femoral cartilage deformation following 30 minutes of walking

Habitual walking speed is a key functional outcome that has implications for knee biomechanics that occur during gait. Lower extremity biomechanics during walking affects the loading of the femoral cartilage. Ultrasonography (US) can be used to assess resting femoral cartilage thickness and acute cartilage deformation in response to walking. The purpose of this study was to determine the association between habitual walking speed and both resting femoral cartilage thickness and deformation. Twenty-four healthy participants with no history of knee injury volunteered for this study. Habitual walking speed was assessed with a 20-m walk test. Femoral cartilage thickness was assessed with US in the medial condyle, lateral condyle, and intercondylar regions prior to and immediately following 30min of walking. Femoral cartilage deformation was calculated as the percent change in cartilage thickness acutely following the walking protocol. Separate Pearson product moment correlations were used to assess the association between habitual walking speed and each US cartilage variable. Slower habitual walking speed was significantly associated with greater medial femoral cartilage deformation (r=0.48, P=0.018), but not with lateral and intercondylar deformation. Habitual walking speed was not significantly associated with the resting cartilage thickness in any cartilage region. These findings highlight the in vivo association between walking speed and medial femoral cartilage deformation. When controlling for body mass index, the association between walking speed and medial cartilage deformation was weakened (Δr=-0.12). Future studies are needed to determine the extent to which BMI influences the association between walking speed and cartilage deformation.

Current Concepts and Future Directions of Minimally Invasive Treatment for Knee Pain

Purpose of ReviewThe purpose of this paper is to review the percutaneous interventions available for the treatment of osteoarthrosis of the knee that address pain and prolong the time to arthroplasty.Recent FindingsCorticosteroid injection and viscosupplementation have been the most studied, but there is still no consensus about their value. Thermal nerve ablation, including both radiofrequency ablation and cryoneurolysis, is a promising new modality of therapy that may increase in clinical use given current data showing favorable outcomes. Of the future therapies that are currently under investigation, synovial embolization via the geniculate arteries represents an exciting new approach that may soon be available clinically.SummaryThere are various percutaneous interventions available for the treatment of osteoarthrosis of the knee that address pain and prolong the time to arthroplasty.