Current Insights On Imaging Techniques For Diagnosing Infection

Timely diagnosis of lower extremity infections is essential to providing effective treatment and preventing complications. Accordingly, these authors discuss the roles of various imaging modalities ranging from plain radiographs and nuclear imaging to computed tomography, magnetic resonance imaging and positron emission tomography.

The clinical presentation of infection can range from signs and symptoms that are obvious and easily confirmed to ones that are elusive and cause much consternation. Confronted with the challenge of diagnosing difficult infections, podiatrists must understand that time is of the essence.

The ability to identify an infectious process and initiate early intervention will lead to preferred outcomes relative to patient care. The failure to identify infection may lead to further tissue destruction, the spread of infection and possible loss of limb and life. In our litigious society, the inability or delay to properly identify infection has also served as the basis of malpractice cases.

The use of plain film radiography is the first line of imaging in virtually every clinical scenario for podiatrists. This modality is readily available in most offices and is inexpensive as well as efficient at providing much data in the assessment for infection. 

Physicians often question the timing of obtaining radiographs when it comes to assessing an infectious situation. One should always take radiographs initially if there is an index of suspicion that there is a gas producing organism or a deep infection where you suspect bone involvement. Physicians should consider radiographs in cases in which the patient is not responding to treatment or the situation is deteriorating clinically.

Baseline radiographs of diabetic patients with ulcerations may prove useful as they will confirm the absence of infection as well as provide comparisons should infection persist. However, it is not mandatory to take radiographs in cases of superficial infection. In these cases, the radiograph will provide little if any additional information beyond what you see clinically.

The use of digital radiographs (CR and DR) can greatly assist your evaluation for the potential of an infectious process. The ability to magnify, use negative imaging mode and adjust for radiographic contrast are options that are not available with standard plain film radiography.

Source: PodiatryToday.com http://www.podiatrytoday.com/current-insights-imaging-techniques-diagnosing-infection

U.S. MRI SPORTS IMAGING HAS UTAH'S FIRST EXTREMITY MRI

U.S. MRI Sports Imaging Acquires Utah’s First Extremity Machine

South Jordan, UT—U.S.  MRI diagnostic sports imaging in South Jordan has added a new GE optima mr430s to its medical facility at 10696 S. River Front Parkway.  U.S.  MRI is now the first and only medical facility in Utah to have this specialty scanner. According to U.S.  MRI CEO, Radd Berrett, the GE optima mr430s magnetic resonance imaging (MRI) system was specifically designed to be used on extremities such as arms or legs.  “GE’s new state-of-the-art system is much smaller, about the size of an ATM, and requires about one-fifth the space of a traditional full-body MRI system.  Patients actually sit or recline in a padded leather chair next to the scanner.  Only the targeted body part goes into the system.  As a result, patients are generally more comfortable than they would be in a full-body MRI, virtually eliminating claustrophobic conditions,”said.Berrett added that the new system is much faster, quieter and provides the highest quality digital images currently available in the marketplace.   He noted that the GE optima system uses a 1.5 tesla magnet. [tesla, also abbreviated as t, measures the strength of a magnetic field—1.5t magnets are generally considered the clinical standard for the industry.  Early MRI scanners that appeared in the 1970s operated at strengths of 0.6t.] “because of its anatomy-specific design, the system is able to pinpoint with great clarity the affected regions of the body, producing crystal-clear images aiding physician diagnosis,” Berrett said.  

US MRI

U.S.  MRI

In addition to its recently acquired GE optima mr430s system, U.S.  MRI also has the larger, traditional GE horizon MRI machine.  This unit is primarily used for MRI’s of the shoulder, hip, spine and brain, but also used to conduct functional MRI’s (aka fMRI’s) in diagnosing concussions, measure post traumatic real time brain activity and create treatment protocols following such injuries. According to Berrett, “U.S.  MRI has quietly become one of the nation’s leading concussion resources for professional and world-class athletes ranging from the national football league, national hockey league, major league baseball, major league soccer and the ultimate fighting championship.”Berrett said, “as the medical industry is undergoing so many changes, facilities like U.S.  MRI are strongly positioned to serve consumer needs.  At our office, MRI’s cost about 75 percent less than a typical hospital scan.  With big hospitals comes big overhead, and patients often end up paying much more than expected.  We make sure that our patients are never charged extra for facility, doctor, technician or interest costs.  This ultimately saves patients money, especially since so many insurance plans now have high deductibles.”U.S.  MRI patients do not need to be referred by a doctor to schedule an MRI (although Berrett said that numerous physicians and physical trainers throughout the state refer patients to his office daily).  Also, U.S. MRI accepts many insurance plans (Berrett suggests that potential patients call ahead to see if their plans are accepted and to see what is covered).U.S.  MRI is the official medical provider for the U.S.  ski team, U.S.  snowboard team and U.S. free skiing team.  Its medical staff includes fellowship-trained musculoskeletal, neuro and chiropractic radiologists.for more information, visit www.US-MRI.com

History Is Made- NCAA College Wrestling

Kyle Dake, Cornell 4x Champ

As the lights go down on senior captains Kyle

Des Moines, Iowa — Cornell senior Kyle Dake chose the toughest possible path to history.

By betting on himself, Dake is in a class all his own.

Dake became the first wrestler in NCAA history to win four national titles at four weights Saturday night, and Penn State won the national championship for the third year in a row.

The 165-pound Dake beat defending champion David Taylor of Penn State 5-4, joining Cael Sanderson and Pat Smith as four-time NCAA champions.

"Kind of at a loss for words. Definitely amazing feeling. It's just you get to finally see all your hard work pay off," Dake said.

Penn State's Ed Ruth and Quentin Wright won titles in back-to-back matches to seal the fourth national crown for the Nittany Lions and their third under Sanderson.

Penn State NCAA 2013

Penn State had 123.5 points. Oklahoma State was second with 119.5 and Minnesota third with 103 points. 

But the team race took a backseat to Dake.

Wrestling fans had been salivating over the idea of a Dake-Taylor final since the day Dake announced his move to 165 pounds in the offseason.

Dake had won titles at 141, 149 and 157 pounds. He boldly jumped up a class knowing that Taylor, the 2012 Hodge Trophy winner as the nation's best wrestler, stood in his path.

The NCAA shifted its schedule to make the 165-pound matchup the finale, presumably to maximize a probable Dake-Taylor meeting.

It didn't disappoint.

Taylor took down Dake in 18 seconds for a quick 2-0 lead, but Dake answered with a takedown and an escape to jump ahead 4-2 after two periods.

NCAA Wrestling 2013

Dake was called for a late stall, tying it at 4l, but he used his advantage in riding time to close out Taylor.  

"Each weight class was a different obstacle, different challenges, and I just had to adapt. My ability to adapt really, really helped me accomplish that," Dake said.

Even though Taylor fell short, his teammates did not.

Penn State wrapped up the team crown when Wright upset top-seeded Dustin Kilgore of Kent State 8-6 at 197 pounds, giving the Nittany Lions an insurmountable lead over Oklahoma State.

Wright sealed the victory with a pair of impressive late takedowns of Kilgore, an NCAA champion in 2011 who had won 62 straight matches.

"I knew one of us had to take it upon our shoulders to get it and I thought 'Why not me? Let's go out there. Let's win this," Wright said.

Penn State began the day with a virtual lock on the title.

The Cowboys nearly stole the crown away.

Penn State held a 20.5-point lead over Oklahoma State to start Saturday's competition. But the Nittany Lions didn't have anyone who earned spots in Saturday morning's wrestleback session, and the Cowboys made up 17.5 points to cut the deficit to 114.5-111.5.

Chris Perry then gave Oklahoma State a 1-point lead with a win over Penn State's Matt Brown in the first title match, the 174-pound finals.

The Cowboys only held the lead for about 15 minutes, though.

They never got it back.

Ruth won his second straight national title with a 12-4 win over Robert Hamlin of Lehigh. Ruth finished with a takedown to clinch a major decision, giving the Nittany Lions a crucial extra team point.

"I looked over at the coaches and (they) were just saying 'Cut him. Cut him.' I was like, 'Oh wow, he must be going for a major then,'" Ruth said.

Jesse Delgado became the first 125-pound champion for Illinois, while Ohio State Logan Stieber won his second NCAA title at 133 pounds. Oklahoma's Kendrick Maple finished an unbeaten season with his first national crown at 141 pounds.  

Oklahoma State's Jordan Oliver scored a takedown in the final 12 seconds to beat Boise State's Jason Chamberlain 3-2 at 149 pounds. Iowa's Derek St. John gave the Hawkeyes their lone national champion at 157 pounds.

Minnesota heavyweight Tony Nelson repeated as the national champion.

This was the first NCAA meet since the International Olympic Committee's recommendation that wrestling not be included in the 2020 Games.

There's since been a lot of talk about modernizing a sport rooted in antiquity — and upgraded wrestler introductions for the finals were a big hit to the sellout crowd.

The athletes burst through puffs of smoke amid dimmed lights and blaring heavy metal music, their names displayed with colorful lighting. The end of every finals match was marked by four plumes of smoke emanating from each corner of the stage.

The final bursts of white smoke blew for Dake, who finished a brilliant career with an unprecedented title.  

"The college wrestling book, I finished it. I finished it with coming out on top," Dake said.

Source: Cornell Sun ; Syracuse.com/blog

UFC 158 GSP vs Diaz What the Match Up Looks Like

I am a huge GSP fan, and I have been awaiting this match up for some time.  It is finally here and I for one am stoked.  So much fuel has been thrown onto the fire of the long-awaited showdown between reigning Ultimate Fighting Championship welterweight titleholder Georges St. Pierre and former Strikeforce champion Nick Diaz. The contrasting personalities that verbally sparred on the teleconference foreshadow clear stylistic differences between the two highly skilled and physically fit fighters. The incumbent is a tireless technician who excels across the board in skill metrics -- a true mixed martial artist. The challenger is a bold and dangerous striker-grappler, whose brawler mentality belies a sophisticated, multi-pronged attack. The fight for which fans have been calling for years will finally go down at UFC 158 on Saturday at the Bell Centre in Montreal. 

Starting at the beginning of the Tale of Tape, we see two fighters in the range of their physical peaks, with not much of an age difference. Though St. Pierre has a slightly longer reach, but Diaz counters by being a natural left-hander. Over the years, however, St. Pierre has effectively learned to switch stances, depending on the opponent and strategy. Though slightly younger, Diaz has the longer and more diverse fighting career, including a win in the boxing ring in 2005.

The biggest differentials here are Diaz’s finish rate and layoff. Diaz is a finisher, by strikes or submission; he is a dangerous competitor who hates hearing the judges’ scorecards as much as UFC President Dana White. However, some may argue that the quality of his opponents has been lower than St. Pierre’s, given that more of Diaz’s career was spent in other promotions. Perhaps his finishing instinct will be less effective at the highest levels of the fight game.

In contrast to his last fight, St. Pierre is now the more current competitor after defeating Carlos Condit less than four months ago. Diaz, on the other hand, is coming off of a loss and a suspension that has kept him out of competition since his own five-round fight with Condit way back in early February 2012, more than one year ago. Conditioning does not appear to be a problem for Diaz, however, as he competes in endurance sports recreationally and has been highly motivated training for this fight. Still, it does raise questions about how long it will take for him to get comfortable again in the cage. In his prior fight with Condit, Diaz struggled with his opponent’s long-range fighting style and was only successful closing the distance late in the bout. Against St. Pierre, he will need to figure out a game plan quickly in order to avoid succumbing to the champion’s notoriously methodical, bell-to-bell style.

Source: Sherdog.com

Holland Second in Arosa World Cup | USSA

Holland Second in Arosa World Cup | USSA

AROSA, Switzerland (March 9) – Nate Holland (Squaw Valley, CA) took his first World Cup podium of the season with a second place finish in the World Cup snowboardcross Saturday. In the finals Holland used the third jump to launch past Australia’s Alex Pullin to lead, but Pullin lurched ahead of Holland at the finish, winning by an inch or less. Faye Gulini (Salt Lake City, UT) pulled out the best U.S. women's finish with the seventh spot after winning the U.S. title at the Sprint Grand Prix at Canyons last week. Canada’s Dominique Maltais took the win for the women.

Here it is... The Sochi Olympic Halfpipe

Men’s Slalom sweeps Mammoth! #USSA #Mensslalom #Mammoth

Best American Skier - Lindsey Vonn

Outside Magazine: Our February issue is going out to subscribers and newsstands now. Featuring: Lindsey Vonn, the best American skier, male or female, in the sport; gluten-free beer that actually tastes good; the next Kelly Slater; adventure-tested new cars and SUVs; and more. See the full line-up (and a larger image) here:http://bit.ly/UZRUFk