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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Several imaging modalities are available for evaluating the patient with acute scrotal pain. Until recently, scintigraphy was the initial procedure of choice in most patients, as it was the only noninvasive technique for determining integrity of blood flow to the testicle. Ultrasound was valuable when the scintiscan was inconclusive or in the setting of scrotal trauma. With the advent of color Doppler sonography, information about both structure and blood flow can be obtained by means of a single imaging study. If initial promising results with this newer technique are borne out, color Doppler is likely to become the primary diagnostic test in patients with acute scrotal pain. The role of MRI and MRS has yet to be defined.
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PMID:Acute diseases of the scrotum. 186 74

Post-lumbar puncture (LP) headache may be due to "low CSF pressure", leading to stretching of pain sensitive intracranial structures. The low intracranial pressure is secondary to net loss of intracranial CSF. It has, however, not been possible to measure intracranial CSF volume accurately during life until recently. Intracranial CSF volume can now be measured non-invasively by a MRI technique. The changes in intracranial CSF volume were studied in 20 patients who had LP. Total intracranial CSF volume was reduced in 19 of the 20 patients 24 hours after LP (range -1.8 mls to -158.6 mls). Most of the CSF was lost from the cortical sulci. Very large reductions in intracranial CSF volume were frequently related to post-LP headache but some patients developed headache with relatively little alteration in the intracranial CSF volume. There was not a measurable change in position of the intracranial structures following LP.
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PMID:Changes in intracranial CSF volume after lumbar puncture and their relationship to post-LP headache. 186 8

Patellofemoral pain should be approached as thoroughly as any other musculoskeletal disease. A careful patient history and physical examination are mandatory. These are followed by appropriate imaging studies such as radiographs, bone scans, CT scans, CT arthrograms, and MRI, as each individual case demands. Finally, arthroscopy is employed in its proper sequence. This article has been developed as an attempt to define a classification scheme of anterior knee pain and then to narrow this down to pain localized to the patellofemoral joint. The authors have attempted to isolate further the clinical entities to those that can be diagnosed and treated arthroscopically. Arthroscopy and arthroscopic surgery allow recognition and treatment of these disorders with minimal invasiveness and patient morbidity.
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PMID:Patellofemoral pain. An arthroscopic perspective. 186 59

Persistent symptoms such as pain, swelling, or giving way after lateral ligament injuries of the ankle are not uncommon. The treating orthopedist must first decide whether the symptoms are related to the ankle instability. Intra-articular or extra-articular injury may occur concomitantly with either a stable or unstable ankle, and careful diagnostic evaluation must be undertaken. Arthroscopy of the unstable ankle in which there is significant pain without demonstrable intra-articular injury by bone scans, CT scans, and MRI studies is indicated, as intra-articular lesions do occur that may result in chronic pain after the ankle has been rendered stable. An arthroscopic lateral ankle capsulodesis procedure has been described with promising early results. Arthroscopic management of an intra-articular pathologic condition in the stable ankle involves removal or excision of offending bone and/or soft tissue. Patients' symptoms can be improved significantly by these approaches, after which there can be a return to a more normal level of function.
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PMID:Chronic and recurrent ankle sprains. 186 66

We have described the important clinical features and aspects of the Chiari-I malformations, with particular emphasis on Chiari-I malformation. Previously thought to be a rare finding with only minor significance, Chiari-I malformation is an important cause of a variety of symptoms, and will be diagnosed even more frequently as the use of MRI increases. The clinician must consider Chiari-I malformation in any patient with unexplained sensorineural hearing loss, headache, vertigo, ataxia, dysequilibrium, dysphagia or other cranial nerve symptom, especially if accompanied by more classic symptoms of this disorder, such as cervical pain or weakness.
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PMID:The Chiari-I malformation. 187 53

A 26-year-old man had a right infraspinatus muscle weakness and aching of the shoulder due to suprascapular nerve entrapment confirmed by electromyography. MRI revealed a well-defined area of increased signal intensity over the suprascapular notch. An ultrasonogram showed a homogeneous hypoechogenic area at the base of the scapular spine. A diagnosis was made of a ganglion compressing the inferior branch of the suprascapular nerve. After removal of several ganglia, the patient had immediate pain relief, and normal electromyographic findings were obtained 5 months postoperatively.
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PMID:Ganglion causing paralysis of the suprascapular nerve. Diagnosis by MRI and ultrasonography. 188 86

MRI is an accurate technique for diagnostic evaluation of a broad spectrum of shoulder pathology. In particular, rotator cuff injuries are a frequent cause of pain and disability. The mechanism of injury to the supraspinatus tendon usually begins with microscopic tears of fibers of the triple helix collagen molecule. This leads to increased motion of the bound water within the collagen molecule that lengthens the effective T2 of the tendon, allowing short TE imaging sequences to detect signal in abnormal tendons. Clinically significant disease probably does not occur without frank collagen rupture, and the associated collection of free water within the severely diseased tendon presents as high signal on long TE images. Thus, the clinical significance of tendon disease is best evaluated on long TR, long TE image acquisitions. Any process that accelerates microscopic tear formation or delays repair can increase a patient's risk of supraspinatus tendon tears. Impingement is the most important process accelerating microscopic tear formation. MRI's multiplanar, tomographic imaging ability markedly improves the ability to sensitively and specifically detect bony impingement. Hopefully, this will allow earlier arthroscopic decompression and improved patient prognosis with impingement.
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PMID:Magnetic resonance imaging of shoulder impingement. 191 Aug 27

The patellofemoral joint is one of the most common sources of painful symptoms encountered by athletes and is one of the most frequently injured joints. Patellar incongruency is the primary pathologic condition that affects the patellofemoral joint and has been reported to be associated with patellar subluxation, patellar dislocation, chondromalacia, and arthrosis. The diagnosis of patellofemoral incongruency by physical examination alone is extremely difficult because the clinical signs may stimulate other types of internal derangements of the knee, and there is a high incidence of combined abnormalities. In consideration of these issues, a kinematic MRI technique was developed to identify and characterize abnormal anatomic and functional aspects of the patellofemoral joint. Because the patellofemoral joint is often injured in athletes and patellofemoral incongruency is a common site of their pain, this article will discuss the use of kinematic MRI to assess the anatomy and function of the patellofemoral joint, with an emphasis toward special problems that may be found in relation to sports-related activities.
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PMID:Patellofemoral joint abnormalities in athletes: evaluation by kinematic magnetic resonance imaging. 191 Aug 29

Four patients with symptomatic Paget's disease of the appendicular skeleton were evaluated by magnetic resonance (MR) imaging. The plain film findings in each case were advanced but dissimilar. All patients had progressive symptoms of pain, and one presented with excruciating pain of short duration. The radiographic features included diffuse progressive osteolysis, cortical resorption, insufficiency fractures, bowing, and cortical and trabecular thickening. In three of the patients, MRI was performed to exclude sarcoma, revealing preservation of fatty marrow signal in all phases of Paget's disease except in patients with an acute fracture (demonstrated by MRI) and sarcoma. Small, focal, linear or oval areas of low signal seen against a background of normal marrow signal on short or long TR/TE do not mimic tumor. These findings suggest that fatty marrow signal is preserved in advanced Paget's disease unless an acute fracture or tumor is present.
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PMID:Magnetic resonance imaging in symptomatic Paget's disease. 192 72

A 13-year-old female presented after repeated trauma with pain of the distal end of the thigh. The findings on plain films, bone scan, and CT were indeterminate. MRI accurately demonstrated a fracture line with bone marrow edema, suggesting the diagnosis of stress fracture. MRI patterns of stress fracture were considered and the importance of establishing the correct diagnosis was emphasized.
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PMID:Case report 686. Stress fracture at distal end of femur simulating "periosteal desmoid". 192 80


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