Publications by authors named "Linda D"

12 Publications

  • Page 1 of 1

Inter-surgeon variability in the identification of clock face landmarks when placing suture anchors in arthroscopic Bankart repair.

Shoulder Elbow 2019 Dec 20;11(6):419-423. Epub 2018 Sep 20.

University of Toronto Orthopaedic Sports Medicine (UTOSM) Program, Division of Orthopaedics, Mount Sinai Hospital and Women's College Hospital, Toronto, Canada.

Background: The accuracy of surgeons in utilizing the clock face method for anchor placement has never been investigated. Our hypothesis was that shoulder arthroscopy surgeons would be able to place suture anchors at predetermined positions with accuracy and reliability.

Methods: Ten cadaveric shoulders were used. Five fellowship-trained shoulder arthroscopy surgeons were directed to place a suture anchor at 3:30, 4:30, and 5:30 clock in two shoulders each. The position of the anchors was determined with computed tomography. The accuracy of placement was calculated and data analyzed with one-way analysis of variance. The intraclass correlation coefficients were calculated.

Results: The overall accuracy was 57%. The accuracy of anchor placement at the 3:30 position was 40% (average position 2:24 o'clock), it was 50% at the 4:30 position (average position 3:42 o'clock) and 80% at the 5:30 position (average position 5:03 o'clock). No statistical difference in accuracy between the placement of the superior, middle, and inferior anchors (p = 0.145) was seen. The intraclass correlation coefficient for inter-surgeon reliability was 0.4 (fair) while the intraclass correlation coefficient for intra-surgeon reliability was 0.6 (moderate).

Discussion: The findings of this study suggest a moderate degree of accuracy and fair to moderate inter- and intra-surgeon reliability when using the clock face system to guide anchor placement.
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http://dx.doi.org/10.1177/1758573218797964DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7094062PMC
December 2019

Isolated peroneal tenosynovial lipoma arborescens: multimodality imaging features.

Skeletal Radiol 2017 Oct 28;46(10):1441-1446. Epub 2017 Jun 28.

Department of Radiology, University of California San Diego Medical Center, 200 West Arbor Drive, Mail Code 8756, San Diego, CA, 92103, USA.

Synovial lipoma arborescens is a rare and benign fatty proliferative lesion of the synovium that is most commonly seen within the suprapatellar pouch of the knee, but increasingly reported to involve tendon sheaths, including those of the ankle. We present the third known case of tenosynovial lipoma arborescens isolated to the peroneal tendon sheath without ankle joint involvement. To our knowledge, this is the first to report this entity utilizing a unique combination of radiographic, sonographic, and MR imaging, along with intraoperative and histologic correlation. Knowledge of this case is important when interpreting radiographic or sonographic images of this condition to raise the possibility of the rare entity of lipoma arborescens involving the peroneal tendon sheath.
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http://dx.doi.org/10.1007/s00256-017-2708-4DOI Listing
October 2017

Accuracy of non-arthrographic 3T MR imaging in evaluation of intra-articular pathology of the hip in femoroacetabular impingement.

Skeletal Radiol 2017 Mar 14;46(3):299-308. Epub 2016 Dec 14.

Department of Medical Imaging, Joint Department of Medical Imaging, Division of Musculoskeletal Imaging, University of Toronto, Toronto, Canada.

Objective: To investigate the accuracy of non-arthrographic 3-T MRI compared to hip arthroscopy in the assessment of labral and cartilaginous pathology in patients with suspected FAI.

Materials And Methods: Following IRB approval and waived consent, 42 consecutive cases of suspected FAI with non-arthrographic 3-T MRI and arthroscopy of the hip were reviewed. High-resolution TSE MR imaging was evaluated in consensus by two musculoskeletal radiologists, blinded to arthroscopic findings, for the presence of labral tears and articular cartilage lesions. Acetabular cartilage was categorized as normal, degeneration/fissuring, delamination, or denudation. MRI findings were compared to arthroscopy. Sensitivity, specificity, accuracy, and predictive values for MRI were calculated using arthroscopy as the standard of reference.

Results: Forty-two hips in 38 patients with a mean age of 29 (range 13-45 years) were assessed. Mean interval between MRI and arthroscopy was 154 days (range 27-472 days). MRI depicted 41 cases with labral tears (sensitivity 100%, specificity 50%, accuracy 98%, PPV 98%, NPV 100%), 11 cases with femoral cartilage abnormalities (sensitivity 85%, specificity 100%, accuracy 95%, PPV 100%, NPV 94%), and 36 cases with acetabular cartilage lesions (sensitivity 94% specificity 67%, accuracy 90%, PPV 94%, NPV 67%). Of the 36 cases with acetabular cartilage lesions on MRI, 7 were characterized as degeneration/fissuring, 26 as delamination, and 3 as denudation, with discordant results between MRI and arthroscopy for grading of articular cartilage in ten cases.

Conclusion: Non-arthrographic 3-T MR imaging is a highly accurate technique for evaluation of the labrum and cartilage in patients with clinically suspected FAI.
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http://dx.doi.org/10.1007/s00256-016-2551-zDOI Listing
March 2017

MR imaging of the spine and sacroiliac joints for spondyloarthritis: influence on clinical diagnostic confidence and patient management.

Radiology 2013 Oct 27;269(1):208-15. Epub 2013 Jun 27.

Departments of Rheumatology and Diagnostic Imaging, St. Joseph's Healthcare, 50 Charlton Ave East, Hamilton, ON, Canada L8N 2A6; Division of Rheumatology and Department of Radiology, McMaster University, Hamilton, Ont, Canada.

Purpose: To quantify the effect of magnetic resonance (MR) imaging of the spine and sacroiliac joints on clinical diagnostic confidence and to determine if MR imaging affects treatment of patients with axial spondyloarthritis.

Materials And Methods: This prospective observational study was approved by the research ethics board and included 55 consecutive patients referred by three rheumatologists for MR imaging of the spine and sacroiliac joints. Measures of diagnostic confidence for clinical features (inflammatory back pain, mechanical back pain, muscular back pain, radicular back pain, spondylitis, sacroiliitis, and other) and overall diagnoses were made by using a Likert scale both before and after MR imaging. Proposed treatment was similarly recorded before and after MR imaging interpretation. The McNemar test was performed to determine the change in diagnostic confidence and consequent effect on patient treatment.

Results: Diagnostic confidence for specific clinical features improved significantly after MR imaging for inflammatory back pain (14% vs 76%, before vs after; P < .001), mechanical back pain (4% vs 49%, P < .001), spondylitis (7% vs 76%, P < .001) and sacroiliitis (9% vs 87%, P < .001). Confidence for overall diagnoses also improved significantly after MR imaging for ankylosing spondylitis (29% vs 80%, P < .001), undifferentiated spondyloarthritis (58% vs 93%, P < .001) and osteoarthritis (29% vs 64%, P < .001). Of the 23 patients for whom tumor necrosis factor-α inhibitor (TNFi) therapy was recommended before MR imaging, 12 (52%) were prescribed TNFi therapy after MR imaging. Of the 32 patients for whom TNFi therapy was not recommended before MR imaging, 10 (31%) patients were prescribed TNFi therapy after MR imaging. Overall, 22 (40%) patients had a change in treatment recommendation regarding TNFi therapy after MR imaging.

Conclusion: MR imaging of the spine and sacroiliac joints significantly influences the diagnostic confidence of rheumatologists regarding clinical features and overall diagnoses of axial spondyloarthritis, and consequently significantly affects treatment plans.
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http://dx.doi.org/10.1148/radiol.13121675DOI Listing
October 2013

Radiology-pathology conference: cutaneous angiosarcoma of the leg.

Clin Imaging 2013 May-Jun;37(3):602-7. Epub 2012 Sep 13.

Department of Radiology, McMaster University, Hamilton, Ontario, Canada.

Cutaneous angiosarcoma is a rare aggressive vascular neoplasm with a poor prognosis, seen usually in the elderly population in a background of chronic lymphedema. We present a case of cutaneous angiosarcoma of the leg without any chronic lymphedema with clinicoradiological and histological correlation.
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http://dx.doi.org/10.1016/j.clinimag.2012.08.005DOI Listing
November 2013

MRI of the metatarsophalangeal joints: improved assessment with toe traction and MR arthrography.

AJR Am J Roentgenol 2013 Apr;200(4):868-71

Teleradiology and Education Center, University of California, San Diego, 8899 University Center Ln, Ste 370, San Diego, CA 92122, USA.

Objective: This study evaluates the impact of toe traction and direct MR arthrography on the assessment of articular cartilage and plantar plates of the first and second metatarsophalangeal joints. MRI of five cadaveric feet was obtained utilizing four techniques: before arthrography without and with traction and after arthrography without and with traction.

Conclusion: The combination of toe traction and MR arthrography is perceived to be superior in the articular cartilage and plantar plate evaluation.
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http://dx.doi.org/10.2214/AJR.12.9164DOI Listing
April 2013

The utility of multidetector computed tomography for detection of parathyroid disease in the setting of primary hyperparathyroidism.

Can Assoc Radiol J 2012 May 28;63(2):100-8. Epub 2011 Sep 28.

Department of Radiology, McMaster University, Hamilton, Ontario, Canada.

Purpose: The aim of this study was to evaluate the accuracy of multidetector computed tomography (MDCT) in the detection of parathyroid adenoma and hyperplasia in the setting of primary hyperparathyroidism.

Methods: Records of 48 patients with biochemically confirmed primary hyperparathyroidism, who underwent preoperative imaging with 16- or 64-slice contrast-enhanced MDCT and subsequent successful parathyroidectomy over a 3-year period, were reviewed. Two radiologists, blinded to the operative and histologic findings, independently evaluated multiplanar computed tomographic images for all patients.

Results: On pathologic examination, 63 abnormal glands were confirmed in 41 female and 7 male patients (mean age, 63 years). Of the 63 abnormal glands, 40 were adenomatous and 23 were hyperplastic. MDCT demonstrated an 88% (95% confidence interval [CI], 77%-99%) positive predictive value for localizing abnormal hyperfunctioning parathyroid glands. The sensitivity of MDCT in detecting single-gland disease was 80% (95% CI, 68%-92%); whereas the specificity for ruling out hyperfunctioning parathyroid tissue, either adenomatous or hyperplastic, was 75% (95% CI, 51%-99%). The sensitivity for exclusively localizing parathyroid hyperplasia was 17% (95% CI, 2%-33%). The parathyroid adenomas were substantially larger and heavier than their hyperplastic counterparts, with an average weight of 1.51 g (range, 0.08-6.00 g) and 0.42 g (range, 0.02-2.0 g) for adenoma and hyperplasia, respectively.

Conclusions: Contrast-enhanced MDCT demonstrated an 88% positive predictive value for localizing adenomatous and hyperplastic parathyroid glands. The poor sensitivity for detection of multigland disease was likely a result of the smaller size and weight of the abnormal hyperplastic glands.
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http://dx.doi.org/10.1016/j.carj.2010.12.002DOI Listing
May 2012

Multimodality imaging of peripheral neuropathies of the upper limb and brachial plexus.

Radiographics 2010 Sep;30(5):1373-400

Department of Radiology, McMaster University, Hamilton, Ontario, Canada.

The peripheral nerves of the upper limb are affected by a number of entrapment and compression neuropathies. These discrete syndromes involve the brachial plexus as well as the musculocutaneous, axillary, suprascapular, ulnar, radial, and median nerves. Clinical examination and electrophysiologic studies are the traditional mainstay of diagnostic work-up; however, ultrasonography and magnetic resonance imaging provide spatial information regarding the affected nerve and its surroundings, often assisting in narrowing the differential diagnosis and guiding treatment. Imaging is particularly valuable in complex cases with discrepant nerve function test results. Familiarity with the clinical features of various peripheral neuropathies of the upper extremity, the relevant anatomy, and the most common sites and causes of nerve entrapment assists in diagnosis and treatment.
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http://dx.doi.org/10.1148/rg.305095169DOI Listing
September 2010

Hippocampus abdominalis.

Can Assoc Radiol J 2009 Jun;60(3):166-7

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http://dx.doi.org/10.1016/j.carj.2009.02.033DOI Listing
June 2009

Bilateral tight swollen legs: diagnosis and discussion.

Skeletal Radiol 2009 Jul;38(7):709-10, 729-30

Department of Diagnostic Imaging, St. Joseph's Healthcare and McMaster University, Hamilton, Ontario L8N 2A6, Canada.

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http://dx.doi.org/10.1007/s00256-009-0694-xDOI Listing
July 2009

Mechanism of the elevation in cardiolipin during HeLa cell entry into the S-phase of the human cell cycle.

Biochem J 2009 Jan;417(2):573-82

Department of Pharmacology and Therapeutics, Center for Research and Treatment of Atherosclerosis, Center on Aging, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.

CL (cardiolipin) is a key phospholipid involved in ATP generation. Since progression through the cell cycle requires ATP we examined regulation of CL synthesis during S-phase in human cells and investigated whether CL or CL synthesis was required to support nucleotide synthesis in S-phase. HeLa cells were made quiescent by serum depletion for 24 h. Serum addition resulted in substantial stimulation of [methyl-(3)H]thymidine incorporation into cells compared with serum-starved cells by 8 h, confirming entry into the S-phase. CL mass was unaltered at 8 h, but increased 2-fold by 16 h post-serum addition compared with serum-starved cells. The reason for the increase in CL mass upon entry into S-phase was an increase in activity and expression of CL de novo biosynthetic and remodelling enzymes and this paralleled the increase in mitochondrial mass. CL de novo biosynthesis from D-[U-(14)C]glucose was elevated, and from [1,3-(3)H]glycerol reduced, upon serum addition to quiescent cells compared with controls and this was a result of differences in the selection of precursor pools at the level of uptake. Triascin C treatment inhibited CL synthesis from [1-(14)C]oleate but did not affect [methyl-(3)H]thymidine incorporation into HeLa cells upon serum addition to serum-starved cells. Barth Syndrome lymphoblasts, which exhibit reduced CL, showed similar [methyl-(3)H]thymidine incorporation into cells upon serum addition to serum-starved cells compared with cells from normal aged-matched controls. The results indicate that CL de novo biosynthesis is up-regulated via elevated activity and expression of CL biosynthetic genes and this accounted for the doubling of CL seen during S-phase; however, normal de novo CL biosynthesis or CL itself is not essential to support nucleotide synthesis during entry into S-phase of the human cell cycle.
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http://dx.doi.org/10.1042/BJ20080650DOI Listing
January 2009

Assessing preoperative information-was it enough?

Authors:
D Linda H Susan

Plast Surg Nurs 1984 ;4(4):120-6

The study examined the preoperative instruction given to clients in a private orthopedic postoperative recall practice. The study further examined what factors these postoperative clients felt were important and/or deleted preoperatively.Findings showed that eighty-eight per cent of the participants knew their diagnosis and felt that their operation was fully explained to them Ninety-two percent claimed to have adequate pain relief. Of the twenty-five participants in this study, twenty-one had no answers to questions now that they did not already have preoperatively.The assumption that the clients did not have adequate preoperative instruction to prepare them well for the postoperative period was not strongly supported.This study suggests there may have been a reluctance on the part of the clients to be critical of the care given by their surgeon under whose care they remained at the time of the interviews.
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http://dx.doi.org/10.1097/00006527-198400440-00004DOI Listing
October 2015