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Dysmenorrhea and Adenomyosis
Published in Juan Luis Alcázar, María Ángela Pascual, Stefano Guerriero, Ultrasound of Pelvic Pain in the Non-Pregnant Female, 2019
Intrauterine device displacement constitutes a common complication of both conventional intrauterine devices (IUDs) and intratubal devices.46 Displacement may consist of explusion, simple displacement or migration, and perforation. Three-dimensional ultrasound has been proved a better technique than two-dimensional ultrasound for assessing displaced IUDs or Essure devices,46 especially for the assessment of the coronal plane (Figures 5.23 through 5.25).
Paediatric orthopaedics
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Displacement is often moderate or severe. This situation is essentially equivalent to a displaced intracapsular femoral neck fracture. This means that an acute unstable SUFE is an emergency. The AVN risk is considerable but is reduced by prompt screw fixation that stabilises the ‘fracture' (Figure39.24).
Greater Tuberosity Fracture
Published in Raymond Anakwe, Scott Middleton, Trauma Vivas for the FRCS (Tr & Orth), 2017
Raymond Anakwe , Scott Middleton
If significant displacement is confirmed on CT or if subsequent displacement is noticed at follow-up then I would offer surgery. I would approach the fracture through a deltoid-splitting approach. For a large fracture fragment, as shown here, I would use 4 mm cannulated cancellous screws. Non-absorbable suture fixation would be an alternative should this not be possible.
Long-term safety and efficacy of breast biopsy markers in clinical practice
Published in Expert Review of Medical Devices, 2021
Sharon Smith, Clayton R. Taylor, Estella Kanevsky, Stephen P. Povoski, Jeffrey R. Hawley
In the second case of DD, due to user error, a HydroMARK biopsy marker was misplaced relative to target under ultrasound guidance, requiring replacement. Though breast biopsy markers are intended to mark biopsy sites, research suggests that the position of the markers may sometimes differ from the location of the biopsy site. Some studies have suggested that this might be due to the accordion effect when breast compression is released [2,25]. In such instances, it has been proposed that releasing compression prior to marker deployment may minimize the accordion effect. This was not a likely cause of any DD or AE in this study as all recorded events occurred with ultrasound-guided biopsies which are not performed with the breast in compression. Other hypothesized causes of displacement include errors related to deploying the marker, either from partial deployment of the plug or deploying the plug beyond the biopsy cavity [26,27]. Lastly, marker displacement may result when there is hematoma formation or excess air in the biopsy site. This is particularly true for stereotactic biopsies and MRI-guided biopsies which employ larger gauge needles [6]. Clinicians should be aware of the possibility of marker misplacement as this can affect patient care. In cases of marker misplacement/displacement, the radiologist should either replace the biopsy marker or document in the procedure report and post-biopsy mammogram the relative distance of the marker to the target site to facilitate accurate localizations.
Are athletes ready to return to competitive sports following ACL reconstruction and medical clearance?
Published in Cogent Medicine, 2020
The kinetic assessment portion of the comprehensive examination was focused on measuring the amount of knee flexion, hip flexion and knee valgus during two closed chain activities. When performing the drop landing task 15 participants in this study had less knee flexion and more knee valgus on landing compared to the non-operated side; however, the differences were not statistically significant. Although this was qualitatively and clinically meaningful, the absence of a statistical difference could have been due to adapting a two-dimensional method of data collection of joints’ angular displacement. Two-dimensional video analysis should not be dismissed as there is a growing body of literature demonstrating its clinical utility (Lopes et al., 2018). Three-dimensional methods of kinematic assessment may have higher levels of reliability and validity when compared to 2D but are not easily accessible for data collection in the clinical setting.
Iliac crest avulsion fracture and staged return to play: a case report in youth soccer
Published in Science and Medicine in Football, 2019
Olivier Materne, Al Haddad Hani, Robertson Duncan
X-ray imaging has traditionally been the main radiological investigation used to diagnose pelvis apophyseal avulsion injury (el Khoury et al. 1997). However, sonography has also been used (Pisacano and Miller 2003), but MRI is more useful as it helps to assess any displacement. Also MRI gives a better global view of the extent of the injury and adjacent soft tissue structures that may have suffered concomitant injury, especially to muscle structures (Kjellin et al. 2010). Computerised Tomography (CT) imaging is another recognised imaging tool in this type of injury. But recent publications have again highlighted the concerns over the use of CT scans in sport (Orchard et al. 2014), and exposure of young athletes to ionising radiation. Indeed, children are up to 10 times more sensitive to the effects of medical radiation, and the principle of “As Low As Reasonably Achievable” (ALARA), established in 1974, should always be respected (Slovis 2002). In the authors view, CT imaging is best limited to use only if the player suffers a set-back during recovery or unexpected pain, and can clarify the status of structural bone-healing (Aksoy et al. 1998).