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Is CT scan a predictor of instability in recurrent dislocation shoulder?

Chinese Journal of Traumatology 2019年第3期22卷 177-181页

作者： K.P.Shijith Munish Sood ajay deep sud Amresh Ghai Department of Radiology Army Hospital (R & R)Delhi Cantt110010India Department of Orthopaedics Command Hospital ChandimandirHaryana134107India Department of Orthopaedics AFMCPune410040India Department of Orthopaedics Base Hospital Delhi CanttNew Delhi110010India

Purpose: Glenoid bone defect and the defect on the posterior-superior surface of the humerus “Hill- Sachs lesion” are the commonly seen bony lesions in patients with recurrent dislocation shoulder. Computed tomography (CT) scan is considered as the best option in assessing the bony defects in the recurrent dislocation shoulder. The aim of this study was to assess the clinical and radiological corelation in the patients with recurrent dislocation shoulder. Methods: Forty-four patients of recurrent dislocation shoulder who were evaluated between January 2015 and December 2017 at a tertiary care center, clinically and radiologically using CT scan and meeting the inclusion criteria, were included. The correlation between the clinical history of the number of dislocations and the bone loss using CT scan was evaluated. Two sided statistical tests were performed at a significance level of α=0.05. The analysis was conducted using IBM SPSS STATISTICS (version 22.0). Results: All the patients were male with mean age of 25.95 (SD ± 4.2) years were evaluated. Twenty-four patients sustained injury in sporting activities while 20 patients sustained injury in training. There were an average of 4.68 (SD ± 3.1, range 2e15, median 3) episodes of dislocation. Forty-one patients had the glenoid bone loss while 40 had the Hill-Sachs lesions. The mean glenoid width defect was 10.80%(range 0e27%) while the mean Hill-Sachs defect was 14.27 mm (range 0e26.6 mm). The mean area of bone loss of the glenoid surface was 10.81%(range 0e22.4%). The lesions were on track in 34 patients and off track in 10 patients. Conclusions: CT scan of the shoulder joint is an effective method for assessing the amount of bone loss. The number of dislocations are correlated significantly with off-track lesions and the amount of bone loss on the glenoid and Hill-Sachs lesion. The glenoid width bone loss of more than 9.80% or Hill-Sachs defect of more than 14.80 mm are the critical defects after which the frequency

关键词： Shoulder joint Recurrent dislocation Hill-Sachs lesion

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Per oral cholangiopancreatoscopy in pancreatico biliary diseases- Expert consensus statements

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World Journal of Gastroenterology 2015年第15期21卷 4722-4734页

作者： Mohan Ramchandani Duvvur Nageshwar Reddy Sundeep Lakhtakia Manu Tandan Amit Maydeo Thoguluva Seshadri Chandrashekhar ajay Kumar Randhir sud Rungsun Rerknimitr Dadang Makmun Christopher Khor Asian Institute of Gastroenterology Baldota Institute of Digestive Sciences Gastro-enterology and Endocrinology MedIndia Hospitals Department of Gastroenterology Apollo Hospital Delhi Department of Gastro-enterology Medanta Gastroenterology and Hepatology King Chulalongkorn Memorial Hospital Department of Medicine Cipto Mangunkusumo Hospital Department of Internal Medicine Faculty of Medicine National University Hospital Department of Gastroenterology and Hepatology

AIM: To provide consensus statements on the use of per-oral cholangiopancreatoscopy(POCPS).METHODS: A workgroup of experts in endoscopic retrograde cholangiopancreatography(ERCP), endosonography, and POCPS generated consensus statements summarizing the utility of POCPS in pancreaticobiliary disease. Recommendation grades used validated evidence ratings of publications from an extensive literature ***: Six consensus statements were generated:(1) POCPS is now an important additional tool during ERCP;(2) in patients with indeterminate biliary strictures, POCS and POCS-guided targeted biopsy are useful for establishing a definitive diagnosis;(3) POCS and POCS-guided lithotripsy are recommended for treatment of difficult common bile duct stones when standard techniques fail;(4) in patients with main duct intraductal papillary mucinous neoplasms(IPMN) POPS may be used to assess extent of tumor to assist surgicalresection;(5) in difficult pancreatic ductal stones,POPS-guided lithotripsy may be useful in fragmentation and extraction of stones; and(6) additional indications for POCPS include selective guidewire placement,unexplained hemobilia, assessing intraductal biliary ablation therapy, and extracting migrated stents. CONCLUSION: POCPS is important in association with ERCP, particularly for diagnosis of indeterminate biliary strictures and for intra-ductal lithotripsy when other techniques failed, and may be useful for preoperative assessment of extent of main duct IPMN, for extraction of difficult pancreatic stones, and for unusua indications involving selective guidewire placement,assessing unexplained hemobilia or intraductal biliary ablation therapy, and extracting migrated stents.

关键词： Per oral cholangiopancreatoscopy Intraductallithotripsy Indeterninate biliary strictures Cholangioscopy Pancreatoscopy

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