Most authors recommend drawing the mechanical axis on a three-foot (90 cm) full leg length x-ray for accurate assessment of knee alignment. Three foot x-rays are difficult to perform and reproduce and involve undue radiation to the gonads. The purpose of this project is to propose a new radiographic technique whereby the mechanical axis of the knee can be assessed on a short A/P x-ray of the entire tibia. / Methodology. 21 normal adults and 25 patients with malaligned knees were investigated in the following manner--the patient was x-rayed in standing position with the legs positioned exactly parallel to one another and vertical to the floor. Under these circumstances, the ankles were apart by a distance (distance F$ sb1$) equal to the distance between the femoral heads (distance F). The mechanical axes were hence parallel to one another and parallel to the long axis of the x-ray cassette and vertical to the floor. Two separate x-rays were taken, a three-foot (90cm) long x-ray and a short x- ray of the entire tibia. The mechanical axis was determined on the 90 cm, three-foot long x-ray. / A vertical line drawn on the short x-ray starting from the centre of the ankle and extended upwards and parallel to the long axis of the x-ray cassette could accurately identify the mechanical axis of the knee using either technique. (Fig. 1) / The technique has been called the "Parallel Mechanical Axes X-ray Technique". It has been validated and it will be demonstrated that such an x-ray technique: (1) Standardizes positioning of the lower extremities. (2) Is a precise, easily controllable method to assess knee alignment. (3) A short x-ray of the entire tibia is sufficient, thus reducing the cost of x-rays by 50%. (4) Obviates the need to visualize the pelvis thus minimizing net radiation exposure. (5) May be used in clinics and smaller hospitals, since it requires simple and inexpensive x-ray facilities.

The interplay of structures in the finger that facilitate movement is complex and not yet fully understood. Subtle finger injuries are often missed during the initial assessment in the Emergency Department, because clinical examination of the acutely injured hand can be difficult. The consequences of unrecognized finger injuries can be devastating for the patient. Ultrasound imaging of tendons is a useful investigative tool although little has been published regarding the reliability of finger tendon measurements. The overall objective of this project was to establish if bedside ultrasound imaging of tendons was possible and useful in the setting of acute injury. The project was divided into two studies.In the first study, 65 apparently normal volunteers were scanned to allow the principal investigator to practise and refine the ultrasound technique. The dimensions of the Extensor Digitorum Longus and two flexor tendons combined (Flexor Digitorum Profundus and Flexor Digitorum Superficialis) were measured in both transverse and longitudinal sections. Fifteen of the volunteers had their left middle fingers scanned twice within 48 hours to establish the test to retest reliability of tendon measurement. The established scanning technique was simple to perform and the scans, including both static and real time images, were completed within five minutes. All volunteers were able to tolerate a full scan. Measurement of tendon width showed fair to good reliability (Intra class correlation [ICC] of flexor tendons = 0.66, ICC of extensor tendon = 0.54). However measurement of the depth of all the tendons was unreliable test to retest (ICC < 0.37).In the second study, 30 patients who presented to the Emergency Department at Lismore Base Hospital with hand injuries were scanned for evidence of tendon injury and tendon gliding restriction. The patient’s ability to tolerate ultrasound examination was investigated. The scan findings were compared with the clinical findings and then to the operation report or to the patient’s self reported outcome, one month after injury.Patients were willing to undergo ultrasound examination regardless of the extent of their injury. There was a significant difference (p = 0.04) in scan tolerance related to the site of injury with 50% of those with extensor surface injuries having completed scans in comparison to 36% with flexor surface injuries and 9.1% of finger tip injuries. Injury mechanism was not related to scan tolerance.Excluding a partial tendon laceration was technically difficult due to the presence of anisotropy artefact. However, all complete tendon lacerations were successfully identified prior to surgery. The gliding of the tendons was easy to visualize and abnormal gliding was found to be a marker of tendon injury.The overall results show that ultrasound imaging of finger tendons at the bedside in the Emergency Department is a feasible examination to perform. The addition of ultrasound examination, however, did not identify any cases of tendon injury not already suspected on routine clinical examination.Therefore, this pilot study suggests that routine use of ultrasound examination to detect finger tendon injury in the Emergency Department setting will not prove to be a useful investigation. There may be a role for ultrasound as a screening tool as the gliding of normal tendons differed noticeably from the gliding of injured tendons. The presence of normal tendon gliding may be helpful in identifying those patients that are safe to be discharged from the Emergency Department without further evaluation.

The interplay of structures in the finger that facilitate movement is complex and not yet fully understood. Subtle finger injuries are often missed during the initial assessment in the Emergency Department, because clinical examination of the acutely injured hand can be difficult. The consequences of unrecognized finger injuries can be devastating for the patient. Ultrasound imaging of tendons is a useful investigative tool although little has been published regarding the reliability of finger tendon measurements. The overall objective of this project was to establish if bedside ultrasound imaging of tendons was possible and useful in the setting of acute injury. The project was divided into two studies.In the first study, 65 apparently normal volunteers were scanned to allow the principal investigator to practise and refine the ultrasound technique. The dimensions of the Extensor Digitorum Longus and two flexor tendons combined (Flexor Digitorum Profundus and Flexor Digitorum Superficialis) were measured in both transverse and longitudinal sections. Fifteen of the volunteers had their left middle fingers scanned twice within 48 hours to establish the test to retest reliability of tendon measurement. The established scanning technique was simple to perform and the scans, including both static and real time images, were completed within five minutes. All volunteers were able to tolerate a full scan. Measurement of tendon width showed fair to good reliability (Intra class correlation [ICC] of flexor tendons = 0.66, ICC of extensor tendon = 0.54). However measurement of the depth of all the tendons was unreliable test to retest (ICC < 0.37).In the second study, 30 patients who presented to the Emergency Department at Lismore Base Hospital with hand injuries were scanned for evidence of tendon injury and tendon gliding restriction. The patient’s ability to tolerate ultrasound examination was investigated. The scan findings were compared with the clinical findings and then to the operation report or to the patient’s self reported outcome, one month after injury.Patients were willing to undergo ultrasound examination regardless of the extent of their injury. There was a significant difference (p = 0.04) in scan tolerance related to the site of injury with 50% of those with extensor surface injuries having completed scans in comparison to 36% with flexor surface injuries and 9.1% of finger tip injuries. Injury mechanism was not related to scan tolerance.Excluding a partial tendon laceration was technically difficult due to the presence of anisotropy artefact. However, all complete tendon lacerations were successfully identified prior to surgery. The gliding of the tendons was easy to visualize and abnormal gliding was found to be a marker of tendon injury.The overall results show that ultrasound imaging of finger tendons at the bedside in the Emergency Department is a feasible examination to perform. The addition of ultrasound examination, however, did not identify any cases of tendon injury not already suspected on routine clinical examination.Therefore, this pilot study suggests that routine use of ultrasound examination to detect finger tendon injury in the Emergency Department setting will not prove to be a useful investigation. There may be a role for ultrasound as a screening tool as the gliding of normal tendons differed noticeably from the gliding of injured tendons. The presence of normal tendon gliding may be helpful in identifying those patients that are safe to be discharged from the Emergency Department without further evaluation.

[Truncated abstract] Purpose: Permanent prostate brachytherapy (PPB) as a treatment option for prostate cancer requires implantation of 80-150 radioactive iodine-125 (I-125)

Thesis (M.Sc.). / Title from title page of PDF (viewed 2008/01/30). Written for the Medical Physics Unit, Faculty of Medicine. Includes bibliographical references.

Thesis (M. S.)--Mechanical Engineering, Georgia Institute of Technology, 2008. / Committee Chair: Nolan Hertel; Committee Member: Armin Ansari; Committee Member: Chris Wang; Committee Member: Rebecca Howell.

Thesis (M.H.A.)--University of Michigan, 1978.

Thesis (Ph.D.)--University of Illinois at Urbana-Champaign, 2008. / Source: Dissertation Abstracts International, Volume: 69-05, Section: B, page: 3217. Advisers: Kyekyoon Kim; Phillip H. Geil. Includes bibliographical references (leaves 85-93) Available on microfilm from Pro Quest Information and Learning.

Thesis (M.H.A.)--University of Michigan, 1959.

Thesis (M.H.A.)--University of Michigan, 1971.