Asymptomatic Joints Research Articles

Aspects of Isometric Contractions and Static Balance in Women with Symptomatic and Asymptomatic Joint Hypermobility

Objective: The aim of the current study was to identify the differences in strength, balance and muscle activity between women with normal mobility and those with generalized joint hypermobility (GJH) with and without symptoms. Methods: A total of 195 women, 67 normomobile (NM) and 128 hypermobile (HM), were included in this explorative cross-sectional study, whereby 56 were classified as symptomatically hypermobile (HM-s) and 47 as asymptomatically hypermobile (HM-as). Peak force (Fmax) and rate of force development (RFD) were measured during single-leg maximal voluntary isometric contractions of the knee extensor and flexor muscles in a sitting position. Balance was investigated on a force plate by calculating the anterior-posterior and medio-lateral sway while maintaining a single-leg stance for 15 seconds. During the sway measurements, muscle activity of six leg muscles was recorded using surface electromyography. The NM and HM groups were compared using independent samples t-tests, whereas the NM, HM-s and HM-as groups were compared using one-way ANOVAs with Tukey post-hoc tests (significance level p ≤ 0.05). Results: While no statistically significant differences were found for Fmax, RFD and postural sway between the three groups, semitendinosus muscle activity showed a difference between the NM and HM (p=0.019) as well as between the NM and HM-as groups (p=0.020). Conclusions: No clinically meaningful differences were found between the three groups. This might be possibly due to the fact that the performance measurements were not sensitive and the motor tasks not challenging enough to detect differences in neuromuscular behavior of the investigated groups.

The Promising Role of Dynamic 18F-NaF PET-CT in Diagnosing Symptomatic Joint Prosthesis

Our purpose was to establish proof of principle case study for the use of dynamic 18F-NaF PET-CT in the assessment of knee and hip prostheses. Approval was granted by the research ethics committee and informed<br />consent was obtained. This is a case study investigating the role of dynamic 18F NaF PET-CT in a patient with ilateral knee prostheses (1 symptomatic/painful and 1 asymptomatic). Both knees were studied with dynamic 18F-NaF PET-CT technique to demonstrate the different pattern of uptake in normal/asymptomatic joint as well as painful joints with aseptic loosening. In addition, a knee aspirate was obtained from the symptomatic knee and serum C-reactive protein and erythrocyte sediment rate levels as well as a peripheral white cell count were<br />obtained in addition to 12 month clinical follow up. Images were obtained with multi-sequential dynamic image acquisition in list mode using GE Healthcare® volume imaging protocol (ViP) after an intravenous injection of 250 MBq 18F-NaF. The images were interpreted as normal, loosening or septic loosening based on the graphical pattern of tracer uptake produced at the bone-prosthesis interface. A final diagnosis was made by a combination of joint aspiration microbiology and clinical follow-up for 1 year; in addition to C-reactive protein and erythrocyte sediment rate levels as well as peripheral white cell count. NaF PET results were compared with 3-phase dynamic bone scan results and plain radiographs. The degree of uptake in the symptomatic joint exceeded background<br />levels and also levels of uptake in the asymptomatic knee. The pattern of uptake and curve slope in both the asymptomatic and symptomatic joints matched the pattern of uptake in our hypothesis. Dynamic 18F-NaF PET-CT is a useful imaging modality for assessing painful joint prosthesis. It can differentiate between asymptomatic joints and aseptic loosening. However, more work is required for the detection of septic loosening.

Detection of asymptomatic enthesitis in psoriasis patients: An onset of psoriatic arthritis?

Presence of asymptomatic joint involvement is recognized in patients with psoriasis. However, it remains elusive whether such patients develop psoriatic arthritis (PsA). The aim of the present study was to examine the incidence of asymptomatic joint lesions, in particular, enthesitis in patients with psoriasis vulgaris (PsV) and to further assess the clinical features. Eighteen PsV and 28 PsA patients were enrolled for examination by positron emission tomography/computed tomography (PET/CT) using (18) F-fluorodeoxyglucose (FDG). Any nail, scalp and intergluteal involvements were reported. Levels of serum C-reactive protein (CRP), white blood cell (WBC) counts and erythrocyte sedimentation rate (ESR) were examined. All of the PsA patients showed FDG accumulation in the affected joints. Notably, asymptomatic enthesitis was detected in six out of 18 PsV patients (33%), and they were diagnosed as having subclinical PsA. Incidences of scalp, intergluteal and nail psoriasis in subclinical PsA patients were 100%, 83% and 64%, respectively, which were higher than those in PsV patients (67%, 25% and 40%, respectively). CRP, WBC counts and ESR were invariable between PsV and subclinical PsA groups. PET/CT imaging could discover asymptomatic enthesitis. Our data suggested that the subpopulation of subclinical PsA was much higher than expected. Higher prevalence of nail, scalp and intergluteal psoriasis confirmed the risk of PsA as previously described.

Pulmonary Findings on Computed Tomography in Asymptomatic Total Joint Arthroplasty Patients.

An increase in the diagnosis of pulmonary embolus (PE) in the early postoperative period has been attributed to the use of multidetector 64-slice computed tomographic (CT) scans. It was suspected that this finding was the result of marrow or fat emboli that are commonly associated with arthroplasty rather than a true venous thromboembolic phenomenon. The purpose of this study was to determine the baseline pulmonary findings in asymptomatic patients after total joint arthroplasty (TJA). Over a 1-year period, an institutional review board-approved prospective study of 20 asymptomatic patients using a multidetector 64-slice CT scanner was performed. Overall, 15 TKAs and 5 total hip arthroplasties were included for analysis. All of the CT scans were negative for PE. There were no signs of microemboli or fat emboli on any scan. No patient went on to develop a PE at 2 years postoperatively. Despite the fact that emboli are created during TJA, if emboli are seen on a CT scan postoperatively, they should be assumed to be real events with clinical sequelae. If pulmonary symptoms develop postoperatively, they should not simply be assumed to be the result of fat or marrow embolism.

Evaluation of pisotriquetral motion pattern using four-dimensional CT: initial clinical experience in asymptomatic wrists

To characterise the normal motion pattern of the pisotriquetral (PT) joint during wrist extension and flexion, as well as observer performance of measurements using four-dimensional (4D)-computed tomography (CT) acquisitions and double-oblique multiplanar reconstruction (MPR) technique in asymptomatic contralateral joints of patients with unilateral wrist pain. In this Health Insurance Portability and Accountability Act (HIPAA)-compliant institutional review board-approved study, 4D-CT was performed on the asymptomatic contralateral wrists of 10 patients (mean age: 46 years; M/F: 6/4) for comparison to the symptomatic side. Two independent observers defined the "oblique-sagittal" plane for PT joint measurements. Measurements were obtained for the anteroposterior (AP) interval and craniocaudal (CC) excursion during the extension-flexion arc of wrist motion. The median (interquartile range) of the AP interval was 0.65 mm (0.55-1 mm) in extension, 1.1 mm (0.8-1.82 mm) in the neutral position, and 4.65 mm (2.07-5.87 mm) in flexion. Likewise, the median of the CC excursions in asymptomatic wrists were 0 mm in extension, 0.27 mm (0-0.37 mm) in the neutral position, and 0.28 mm (0.18-0.31 mm) in flexion. The AP interval measurements obtained at wrist flexion were larger than measurements obtained at wrist extension. There was a strong consistency in AP interval difference measurements between the two observers (ICC=0.80; p<0.01); however, CC excursion difference measurements did not reach the significance threshold between the two observers (ICC=0.40; p=0.11). PT joint kinematics in asymptomatic wrists demonstrates an increase in AP interval and CC excursion during wrist flexion. MPR techniques provide good interobserver agreements for AP interval measurements. The reported intervals for asymptomatic joints can be used as a reference for asymptomatic wrists.

Glycosaminoglycan chemical exchange saturation transfer at 3T MRI in asymptomatic knee joints.

Biochemical alterations such as glycosaminoglycan (GAG) depletion occur early in the course of osteoarthritis, but cannot be detected with standard magnetic resonance techniques. With glycosaminoglycan chemical exchange saturation transfer (gagCEST), a biochemical imaging technique, it is feasible to detect biochemical components in knee joint cartilage. To establish baseline values for gagCEST magnetic resonance imaging (MRI) in knee joint cartilage at 3 Tesla (T). Twenty volunteers (8 women, 12 men; mean age, 24.55 ± 2.35 years;age range, 21-29 years) with no history or clinical findings indicative of knee joint pathologies underwent MRI at 3T. The imaging protocol included three-dimensional (3D) double-echo steady-state sequence for morphological cartilage assessment and a prototype 3D CEST pulse sequence to evaluate the CEST effects in six cartilage regions of the knee joint: (i) lateral femoral condyle; (ii) medial femoral condyle; (iii) lateral tibial plateau; (iv) medial tibial plateau; (v) patella; and (vi) trochlea. We used the asymmetry of the magnetization transfer ratio (MTRasym) parameter to quantify the gagCEST effects in these regions. Regional differences revealed high MTRasym values in the patellar (1.62% ± 1.19%) and the trochlear (1.17% ± 1.29%) cartilages, and low MTRasym values in the medial femoral condyle (0.41% ± 0.58%) and the lateral tibial plateau (0.52% ± 0.53%) cartilages. Regional differences in the gagCEST values must be considered when conducting gagCEST imaging of knee joint cartilage. In the future gagCEST imaging may be an additional feature in the evaluation of the biochemical composition of knee joint cartilage.

Prevalence of Imaging Features on CT Thought to Be Associated With Femoroacetabular Impingement: A Retrospective Analysis of 473 Asymptomatic Adult Hip Joints.

The objective of our study was to investigate the prevalence of imaging features on CT thought to be associated with femoroacetabular impingement (FAI) and the associations among them. Of 430 consecutive adult patients (age range, 18-40 years) who underwent hip CT at our institution for hip symptoms or trauma surveillance, the asymptomatic hips were selected for the study, which resulted in the inclusion of 473 hip joints in the study group. Images were obtained using an MDCT scanner and were reformatted using a bone algorithm. The CT images were retrospectively evaluated by two radiologists for features indicative of FAI such as the alpha angle, femoral head-neck offset, acetabular version angle, and center-edge angle. The intraclass correlation coefficient was used to evaluate intra- and interobserver variabilities. Associations among these parameters were evaluated by calculating the odds ratio between each of the parameters separately. Of the 473 asymptomatic hip joints we studied, 190 (40%) joints showed at least one of the following features on CT: alpha angle greater than 55°, head-neck offset less than 8 mm, acetabular version angle less than 15°, or center-edge angle greater than 40°. At least one feature was found in the hips of male patients (43.2%), which is more frequently than in the hips of female patients (35.4%). There was a high degree of coexistence (odds ratio > 2) among these CT findings. Imaging features on CT that are known to be associated with FAI are common in asymptomatic adult hip joints, especially in men, with a high degree of coexistence among the findings.

Correlation of Muscle Strength and Power with Gait in Elderly Women with Knee Osteoarthritis

Older adults with knee osteoarthritis have decreased quadriceps strength, which is associated with decreased physical function. However, muscle power may be a better predictor of physical function than strength. Another predictor of physical function is gait velocity. Knee osteoarthritis’s patients walk more slowly and have a reduced stride length compared to healthy control subjects. Nevertheless, these gait parameters were not correlated to quadriceps muscle strength and power. PURPOSE: To compare the muscular strength and power of the knee extensors in elderly women between symptomatic and asymptomatic knee joint and to correlate muscular strength and power with cadence, gait speed, stride length and stride time. METHODS: Seventeen elderly women (67,05±5,35 years) with knee osteoarthritis performed an isokinetic test of quadriceps strength (60°/s) and power (180°/s). The kinemactics analyses were conducted to determine the following spatial and temporal gait variables at comfortable speed: cadence, gait velocity, stride length and stride time (Vicon®). To compare strength and power of the symptomatic and asymptomatic knee a paired t-test was applied. Pearson’s correlation was used to verify the correlations between strength and power of the symptomatic knee with spatiotemporal variables of gait (p<0,05). RESULTS: Quadriceps strength and power of symptomatic knee were lower than the asymptomatic knee (p<0,05). There was no correlation between quadriceps strength of symptomatic knee and gait’s spatiotemporal variables. However, correlations between quadriceps power of symptomatic knee and gait’s spatiotemporal variables were observed with cadence (r=0,509; p<0,05) and gait speed (r= 0,494; p<0,05). CONCLUSIONS: The present study showed that both quadriceps strength and power of symptomatic knee were lower than the asymptomatic knee. Additionally, quadriceps power was correlated with gait’s cadence and velocity. Further studies using different velocities are required to analyzed the gait parameters and its correlations with the lower limbs strength and power in elderly women with knee osteoarthritis.

Strength, balance and muscle activity in women with symptomatic and asymptomatic joint hypermobility

Strength, balance and muscle activity in women with symptomatic and asymptomatic joint hypermobility

Apparent discontinuity of the roof of the glenoid fossa on cone-beam computed tomography images of an asymptomatic temporomandibular joint

The thickness of the roof of the glenoid fossa (RGF) is highly variable, but there are no reported cases of absence of mineralized bone at the RGF in an asymptomatic patient. We present the rare finding of a large apparent discontinuity of the RGF discovered incidentally on cone-beam computed tomography (CBCT) images of an asymptomatic temporomandibular joint in a 22-year-old female, which was proven to be a normal joint on magnetic resonance images. The apparent discontinuity of the RGF in this case, considered in the light of known measurements of the RGF, may actually represent very thin bone that could not be visualized because of the relatively large CBCT voxel size. A review of the published literature revealed no clinical significance of a thin RGF.

Assessment of condyle and glenoid fossa morphology using CBCT in South-East Asians.

IntroductionProper imaging allows practitioners to evaluate an asymptomatic tempormandibular joint (TMJ) for potential degenerative changes prior to surgical and orthodontic treatment. The recently developed cone-beam computed tomography (CBCT) allows measurement of TMJ bony structures with high accuracy. A study was undertaken to determine the morphology, and its variations, of the mandibular condyle and glenoid fossa among Malay and Chinese Malaysians.MethodsCBCT was used to assess 200 joints in 100 subjects (mean age, 30.5 years). i-CAT CBCT software and The Mimics 16.0 software were employed to measure the volume, metrical size, position of each condyle sample and the thickness of the roof of the glenoid fossa (RGF).ResultsNo significant gender differences were noted in thickness of the RGF and condylar length; however condylar volume, width, height and the joint spaces were significantly greater among males. With regards to comparison of both TMJs, the means of condylar volume, width and length of the right TMJ were significantly higher, while the means of the left condylar height and thickness of RGF were higher. When comparing the condylar measurements and the thickness of RGF between the two ethnic groups, we found no significant difference for all measurements with exception of condylar height, which is higher among Chinese.ConclusionThe similarity in measurements for Malays and Chinese may be due to their common origin. This information can be clinically useful in establishing the diagnostic criteria for condylar volume, metrical size, and position in the Malaysian East Asians population.

Associations between Alpha Angle and Herniation Pit on MRI Revisited in 185 Asymptomatic Hip Joints.

ObjectiveTo evaluate the association between alpha angle and herniation pit on MRI in asymptomatic hip joints and their associations with demographic variables.Materials and MethodsHip MRI of 185 asymptomatic hip joints of 105 adults (age 18 to 80 years) from September 2011 through December 2012 were retrospectively studied. Alpha angles were measured on oblique axial MR images by 2 observers. Herniation pit was determined by 1 observer. Size measures, prevalence, and statistical analyses were conducted regarding its association with age, gender, laterality (right or left hip). Intra- and inter-observer agreements were determined by intra-class correlation coefficient.ResultsThe prevalence of herniation pit in asymptomatic hips was 21.6%. The range of alpha angle was 27.6-65.0 degrees. Seventeen and 16 out of 185 (9.1% and 8.6%) hip joints showed alpha angle of ≥ 55 degrees in first and second measurement sessions, respectively. There was no association between alpha angle ≥ 55 and presence of herniation pit. There was no association between alpha angle ≥ 55 and the size of herniation pit. Inter-observer agreement of alpha angle was 0.485 between first measurements of first vs. second observer, respectively. Intra-observer agreement of alpha angle was 0.654, respectively. Forty (21.6%) of 185 hip joints (35 of 105 patients, 33.3%) had herniation pit, with no difference according to age, gender, or laterality of hip joint.ConclusionThere is no association between alpha angle ≥ 55 degrees and presence of herniation pit or demographic variables.

Prevalence of radiological femoroacetabular impingement in Japanese hip joints: detailed investigation with computed tomography

BackgroundFemoroacetabular impingement (FAI) has been highlighted as a new etiology for osteoarthritis of the hip, and its prevalence has been reported in the past decade. In the present study, we performed a detailed investigation of the anatomical parameters related to FAI and calculated the prevalence of FAI-related findings in asymptomatic Japanese hip joints using computed tomography. MethodsWe evaluated high-resolution reconstructed multislice computed tomography images in patients who had undergone computed tomography imaging in our institution for conditions unrelated to hip disorders. The examined parameters were as follows: center-edge (CE) angle; acetabular index; acetabular anteversion (five slices in the axial plane); and asphericity angle of the femoral head (AAFH) (six slices in multiple radial planes). The AAFH in the oblique axial slice through the center of the femoral neck is the so-called α-angle. We then examined the accurate prevalence of FAI-related findings in Japan. ResultsWe investigated a total of 103 hips. The mean age of the subjects was 59.4years. The mean CE angle was 31.1° and the mean acetabular index was 7.0°. The mean acetabular anteversion was 20.3° at the level of the hip center, and decreased as the slice level neared the superior margin of the femoral head. The mean AAFH ranged from 40.6° to 49.2° in the radial planes. The AAFH was largest at 60° rotated slice from the oblique axial slice through the center of the femoral neck. The prevalence of FAI-related findings in these Japanese hip joints was assessed as follows. An AAFH of >50° in any slice was detected in 51.5% of the hips, and acetabular anteversion was negative for all images in 16.5 % of the hips, meaning that a total of 56.3% of the images met the criteria for radiological FAI. ConclusionsWith consideration of our results, we emphasize that “anatomical or radiological FAI” is not uncommon in Japanese hips. Therefore, the diagnosis of FAI should be performed with the clinical findings taken into account.

First metatarsophalangeal joint- MRI findings in asymptomatic volunteers.

To evaluate the spectrum and frequency of MR findings of the first metatarsophalangeal joint (MTPJ) in asymptomatic volunteers. MR imaging of 30 asymptomatic forefeet was performed with a dedicated extremity 1.5-Tesla system. Participants were between 20 and 49 years of age (mean ± SD: 35.5 ± 8.4 years). Two radiologists assessed cartilage, bone, capsuloligamentous structures, and tendons of first MTPJs on MR images. Cartilage defects were observed in 27 % (n = 8) of first MTPJs, most frequently located at the base of the proximal phalanx (23 %, n = 7), whereas cartilage defects of the metatarsal head (13 %, n = 4) and the metatarsosesamoid compartment were rare (0 %-3 %, n = 0-1). Bone marrow oedema-like signal changes were present in 37 % (n = 11) and subchondral cysts in 20 % (n = 6) of first MTPJs. Hyperintense areas on intermediate-weighted sequences (range: 30-43 %, n = 9-13) and on fluid-sensitive sequences with fat suppression (range: 33-60 %, n = 10-18) within the medial and lateral collateral ligament complex were common. Plantar recesses (77 %, n = 23) and distal dorsal recesses (87 %, n = 26) were frequently observed. Cartilage defects, bone marrow oedema-like signal changes, subchondral cysts, plantar recesses, and distal dorsal recesses were common findings on MRI of first MTPJs in asymptomatic volunteers. The collateral ligaments were often heterogeneous in structure and showed increased signal intensity. • Cartilage defects of asymptomatic first metatarsophalangeal joints were common on MRI. • The collateral ligaments were often heterogeneous in structure and showed increased signal intensity. • Areas of increased signal intensity within the flexor and extensor tendons were rare. • These observations need to be considered in MR examinations of symptomatic cases.

Hidden gout- Ultrasound findings in patients with musculo-skeletal problems and hyperuricemia.

The goal of this study was to investigate the frequency of gout-specific ultrasonography findings in a cohort of hyperuricemic patients with various musculo-skeletal complaints.A blinded examiner regarding the patients’ clinical and laboratory assessment performed standardized ultrasound examinations of 12 joints in 74 individuals with diverse musculo-skeletal complaints. Gout-specific changes were assessed and combined with the patients’ medical history (diagnosis gout vs. non-gout) and laboratory values of hyperuricemia.Of 74 patients, 58 (mean age 55 yrs) had hyperuricemia (serum uric acid levels > 7 mg/dl/420 μmol/L). Of those, 27 (47%) had a history of gout attacks.In total, 888 joints were examined by ultrasound. With 44/324 joints (14%) the pathological finding most often found in joints of gout patients was the double contour sign compared to 29/372 joints (8%) in patients with asymptomatic hyperuricemia and 2/192 joints (1%) in normouricemic controls.In patients with gout, the ultrasound showed pathological findings in 67/324 joints (21%). In 26/39 (67%) previously affected joints, gout-specific sonographic indications were found. With regard to the first metatarsophalangeal joint, sonographic pathologies were detectable in 16/22 (73%) so far asymptomatic joints on the contralateral.Ultrasonographic gout-specific signs are not only found in joints affected by gout attacks, but often also in the corresponding contralateral, asymptomatic joint. Patients with asymptomatic hyperuricemia already showed sonographic features implicating an as yet “silent” precipitation of urate crystals. As the examined cohort represents patients at high risk, further research for gout-specific findings is indicated, especially for hyperuricemic patients.Electronic supplementary materialThe online version of this article (doi:10.1186/2193-1801-3-592) contains supplementary material, which is available to authorized users.

THE CLINICAL MANIFESTATIONS OF CALCIUM PYROPHOSPHATE CRYSTAL DEPOSITION DISEASE

Система комплексной поддержки и сопровождения научного журнала Elpub позволяет запустить двуязычный сайт журнала со встроенной системой электронной редакции в соответствии с лучшими издательскими практиками, а так же предусматривает техническую и методическую поддержку со стороны специалистов НЭИКОН.

Imaging characteristics of contralateral asymptomatic patellofemoral joints in patients with unilateral instability.

To test the hypothesis that in patients with unilateral patellofemoral instability ( PI patellofemoral instability ), the contralateral asymptomatic joints have abnormal morphology and imaging features of osteoarthritis ( OA osteoarthritis ) at four-dimensional ( 4D four-dimensional ) computed tomography (CT). The institutional review board approved this HIPAA-compliant retrospective study. Informed consent was waived. Radiology records were reviewed to identify 25 patients (male-female ratio, 0.56; median age, 20 years; range, 13-43 years) with unilateral PI patellofemoral instability undergoing 4D four-dimensional CT and 25 age- and sex-matched control patients undergoing multidetector CT. Trochlear groove depth ( TGD trochlear groove depth ), tibial tuberosity-trochlear groove ( TT-TG tibial tuberosity-trochlear groove ) distance, and patellar height ratio ( PHR patellar height ratio ) were determined to compare morphology, and bisect offset ( BO bisect offset ) measurements were obtained to compare lateral displacement of the patella between the two groups by using the Wilcoxon rank-sum test. All images were interpreted by trained observers. Tracking patterns of the patellae were determined by obtaining BO bisect offset measurements at various flexion angles with 4D four-dimensional CT. In the contralateral asymptomatic joints, TGD trochlear groove depth (median, 3.0 mm; 95% confidence interval [ CI confidence interval ]: 2.5, 4.6; P < .0001), TT-TG tibial tuberosity-trochlear groove (median, 15 mm; 95% CI confidence interval : 12.7, 18; P = .008), PHR patellar height ratio (median, 1.17; 95% CI confidence interval : 1.09, 1.2; P = .002), and patellar lateral displacement ( BO bisect offset , 85%; 95% CI confidence interval : 76.2%, 98.2%; P < .0001) were different from measurements obtained in the control group: TGD trochlear groove depth median, 5.0 mm (95% CI confidence interval : 2.2, 7.6); TT-TG tibial tuberosity-trochlear groove median, 10.9 mm (95% CI confidence interval : 3.4, 20.7); PHR patellar height ratio median, 0.92 (95% CI confidence interval : 0.67, 1.36); and BO bisect offset median, 63% (95% CI confidence interval : 59%, 68.4%). OA osteoarthritis was detected in 40% of asymmetrical contralateral joints (10 of 25). By using 4D four-dimensional CT data, multiple regression analysis demonstrated that TGD trochlear groove depth (P = .026) and BO bisect offset measurements obtained at 30° of knee flexion (P = .047) had an association with the presence of OA osteoarthritis . Abnormal morphology and imaging features of OA osteoarthritis are relatively common in contralateral asymptomatic joints of young patients with unilateral PI patellofemoral instability .

Comparison of TMJ vibration frequencies under different joint conditions

Objective:To compare 10 Hz wide segments of the 0 to 1000 Hz frequency distributions of vibrations recorded from five stages of internally deranged and asymptomatic temporomandibular joints (TMJs).Methods:TMJ vibrations were recorded from 236 patients with five stages of TMJ dysfunction: (1) reducing partial disc displacement (PDDR, n = 39); (2) acute reducing complete disc displacement (A-DDR, n = 39); (3) chronic reducing complete disc displacement (C-DDR, n = 55); (4) un-adapted, non-reducing, complete disc displacement (DDUA, n = 57); and (5) well adapted, non-reducing, complete disc displacement (DDWA, n = 46). A totally asymptomatic control group with quiet TMJs (AQ, n = 43) and a group with vibrating TMJs (AWV, n = 93), but otherwise asymptomatic were also recorded. Frequency distributions were calculated for each group using discrete Fourier transform methods in 10 Hz increments (0–10 Hz, 10–20 Hz,…, 990–1000 Hz). The 10 Hz segments were compared between the seven groups using Student’s t test with Bonferroni adjustment.Results:There were significant differences (P<0·05) in all 21 comparisons for the three segments between 80 Hz and 110 Hz, in 20 of 21 comparisons between 180 and 200 Hz, in 19 of 21 comparisons between 110 and 180 Hz and between 50 and 80 Hz.Discussion:The segments of the frequency distributions from 80 to 110 Hz provided the best differentiation between all seven groups.

Reliability of hip internal rotation range of motion measurement using a digital inclinometer

Assessment of hip internal rotation (IR) is a critical element in the evaluation of a painful hip, yet there currently exists no consistent method of determining this measurement. The purpose of this study is to report the intra-rater and inter-rater reliability of active and passive hip IR measurement using a digital inclinometer. Twenty-five subjects (8 men, 17 women) with asymptomatic hip joints, and no known pathology between the ages of 22 and 42 participated. Two examiners measured hip IR for each subject using a digital inclinometer while visually monitoring pelvic motion. Measurements included passive IR, active IR, and active IR while internally rotating both legs simultaneously. Statistical analysis was performed including intra-rater and inter-rater reliability. There was no significant difference in measured IR values. Mean range of motion values for all techniques and both examiners ranged from 30.7° to 32.8°. Intra-rater reliability for examiner 1 ranged from 0.84 to 0.92. Inter-rater reliability ranged from 0.89 to 0.93. Of the methods utilized, active IR of a single leg was the most responsive technique with a minimal detectable change value of 5.4°. Clinical assessment of hip IR range of motion can be performed efficiently and reliably with a digital inclinometer along with visual monitoring of the pelvis for unwanted motion. Findings from this study support unilateral active hip IR in a seated position as a reliable and responsive technique for obtaining hip IR measurements.

AB0995 Clinical and Ultrasound Findings in Manual Workers at High Risk of Occupational Disability and Hyperuricemia

BackgroundIn the last decade, the role of musculoskeletal ultrasound in investigating monosodium urate deposition is rapidly evolving since various findings have been described as specific for gout.ObjectivesThe goal of this...