Publications by authors named "Anders Isacsson"

2 Publications

  • Page 1 of 1

Agreement Between Clinical Examination and Magnetic Resonance Imaging in Acute Knee Trauma With Hemarthrosis.

Clin J Sport Med 2021 Jun 9. Epub 2021 Jun 9.

Department of Orthopaedics, NU-Hospital Group, Uddevalla/Trollhättan, Sweden; Department of Clinical Sciences Lund, Orthopaedics, Lund University, Lund, Sweden; and Department of Orthopaedics, Helsingborg Hospital, Helsingborg, Sweden.

Objective: Hemarthrosis after knee trauma often indicates serious joint injury. Few studies have evaluated agreement between clinical examination and findings from magnetic resonance imaging (MRI). We aimed to describe the agreement between acute clinical examination and subacute MRI findings after acute knee trauma with hemarthrosis and the importance of the subspecialty of the examiner.

Design: Longitudinal cohort study. Agreement with MRI findings was evaluated by logistic regression.

Setting: Helsingborg hospital.

Patients: Thousand one hundred forty-five consecutive patients with hemarthrosis after knee trauma.

Interventions: Clinical examination and MRI.

Main Outcome Measures: agreement between clinical examination and findings from MRI. We considered the radiologist's report as the gold standard.

Results: Median time (25th, 75th percentile) from injury to clinical examination was 2 (1, 7) days, and from injury to imaging was 8 (5, 15) days. The overall sensitivity and specificity of clinical examination versus MRI for major ligament injury or lateral patella dislocation (LPD) were 70% [95% confidence interval 67-73) and 66% (61-72), respectively. Orthopedic subspecialist knee had the highest agreement with anterior cruciate ligament rupture (adjusted odds ratios were 1.7 (95% confidence interval 1.2-2.3), 1.9 (1.2-3.0) and 5.9 (3.7-9.5) for orthopedic trainees, orthopedic subspecialists other, and orthopedic subspecialist knee, respectively]. For other ligament injuries and LPD, we did not find statistically significant differences.

Conclusions: Clinical diagnosis after acute knee injury is relatively unreliable versus MRI findings even when performed by orthopedic specialists. However, the agreement is improved when the examination is performed by an orthopedic knee subspecialist.
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http://dx.doi.org/10.1097/JSM.0000000000000950DOI Listing
June 2021

Induction of activating transcription factor 3 (ATF3) by peripheral nerve compression.

Scand J Plast Reconstr Surg Hand Surg 2005 ;39(2):65-72

Department of Hand Surgery, Malmö University Hospital Malmö, Sweden.

Nuclear translocation of activating transcription factor 3 (ATF3), used as a marker for neuronal injury, was studied by immunocytochemistry in sensory neurons in dorsal root ganglia and locally along the sciatic nerve after severe chronic nerve compression in rats. In compressed nerves (application of a narrow silicone tube), ATF3 immunoreactivity was seen in the nucleus of sensory neurons and in Schwann cells below the compression at two and four weeks. Removal of the silicone tube (decompression) at two weeks did not affect the number of ATF3-positive cell nuclei in dorsal root ganglia. No ATF3 immunoreactivity was found in undamaged nerves on the other side. Functional variables (toe spreading and muscle force) were impaired at two weeks, with partial improvement at four weeks. Nerve compression induces nuclear translocation of ATF3, a transcription factor associated with survival and regeneration of sensory neurons. The response is related to duration of compression and partly correlated to function.
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http://dx.doi.org/10.1080/02844310410004892DOI Listing
August 2005
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