Advanced Imaging in Femoroacetabular Impingement: Current State and Future Prospects

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Bittersohl, Bernd; Hosalkar, Harish S.; Hesper, Tobias; Tiderius, Carl Johan; Zilkens, Christoph; Krauspe, R?diger

2015-01-01

Symptomatic femoroacetabular impingement (FAI) is now a known precursor of early osteoarthritis (OA) of the hip. In terms of clinical intervention, the decision between joint preservation and joint replacement hinges on the severity of articular cartilage degeneration. The exact threshold during the course of disease progression when the cartilage damage is irreparable remains elusive. The intention behind radiographic imaging is to accurately identify the morphology of osseous structural abn...

Cam Femoroacetabular Impingement as a Possible Explanation of Recalcitrant Anterior Knee Pain

OpenAIRE

Sanchis-Alfonso, Vicente; Tey, Marc; Monllau, Joan Carles

2016-01-01

We present a case of a patient with chronic anterior knee pain (AKP) recalcitrant to conservative treatment who returned to our office for severe hip pain secondary to Cam femoroacetabular impingement (Cam FAI) at 10 months after the onset of knee pain. This case highlights the fact that the main problem is not in the patella but in the hip in some patients with AKP. We hypothesize that there is an external femoral rotation in order to avoid the impingement and therefore the hip pain in patie...

Diagnostic accuracy of clinical tests for the diagnosis of hip femoroacetabular impingement/labral tear

DEFF Research Database (Denmark)

Reiman, M P; Goode, A P; Cook, C E

2015-01-01

BACKGROUND: Surgery for hip femoroacetabular impingement/acetabular labral tear (FAI/ALT) is exponentially increasing despite lacking investigation of the accuracy of various diagnostic measures. Useful clinical utility of these measures is necessary to support diagnostic imaging and subsequent...

Radiographic Evidence of Femoroacetabular Impingement in Athletes With Athletic Pubalgia

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Economopoulos, Kostas J.; Milewski, Matthew D.; Hanks, John B.; Hart, Joseph M.; Diduch, David R.

2014-01-01

Background: Two of the most common causes of groin pain in athletes are femoroacetabular impingement (FAI) and athletic pubalgia. An association between the 2 is apparent, but the prevalence of radiographic signs of FAI in patients undergoing athletic pubalgia surgery remains unknown. The purpose of this study was to determine the prevalence of radiologic signs of FAI in patients with athletic pubalgia. Hypothesis: We hypothesized that patients with athletic pubalgia would have a high prevale...

Extracapsular approach for arthroscopic treatment of femoroacetabular impingement: clinical and radiographic results and complications

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Bruno Dutra Roos

2015-08-01

Full Text Available ABSTRACTOBJECTIVES: To evaluate the clinical and radiographic results and complications relating to patients undergoing arthroscopic treatment for femoroacetabular impingement by means of an extracapsular approach. METHODS: Between January 2011 and March 2012, 49 patients (50 hips underwent arthroscopic treatment for femoroacetabular impingement, performed by the hip surgery team of the Orthopedic Hospital of Passo Fundo, Rio Grande do Sul. Forty patients (41 hips fulfilled all the requirements for this study. The mean follow-up was 29.1 months. The patients were assessed clinically by means of the Harris Hip score, as modified by Byrd (MHHS, the Non-Arthritic Hip score (NAHS and the internal rotation of the hip. Their hips were also evaluated radiographically, with measurement of the CE angle, dimensions of the joint space, alpha angle, neck-head index, degree of arthrosis and presence of heterotopic ossification of the hip. RESULTS: Out of the 41 hips treated, 31 (75.6% presented good or excellent clinical results. There was a mean postoperative increase of 22.1 points for the MHHS, 21.5 for the NAHS and 16.4° for the internal rotation of the hip ( p< 0.001. Regarding the radiographic evaluation, correction to normal values was observed for the alpha angle and neck-head index, with a mean postoperative decrease of 32.9° and mean increase of 0.10, respectively ( p< 0.001. CONCLUSION: Arthroscopic treatment of femoroacetabular impingement by means of an extracapsular approach presented satisfactory clinical and radiographic results over a mean follow-up of 29.1 months, with few complications.

Femoroacetabular impingement mimicking avascular osteonecrosis on bone scintigraphy

International Nuclear Information System (INIS)

Suarez, Juan Pablo; Domínguez, María Luz; Nogareda, Zulema; Gómez, María Asunción; Muñoz, Jose

2016-01-01

Femoroacetabular impingement (FAI) is a structural abnormality of proximal femur and/or acetabulum. It has been recently described, and there are limited reports in nuclear medicine literature because bone scintigraphy is not listed in its diagnostic protocol, but it should be included on differential diagnosis when evaluating patients, with hip-related symptoms because it may be misinterpreted as degenerative changes or avascular necrosis, and its early treatment avoid progression to osteoarthritis. We describe the case of a male who suffered from hip pain. Bone planar scintigraphic appearance mimicked avascular necrosis, but single photon emission computed tomography (CT) imaging and CT examination confirmed the diagnosis of FAI

The effect of dynamic femoroacetabular impingement on pubic symphysis motion: a cadaveric study.

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Birmingham, Patrick M; Kelly, Bryan T; Jacobs, Robert; McGrady, Linda; Wang, Mei

2012-05-01

A link between femoroacetabular impingement and athletic pubalgia has been reported clinically. One proposed origin of athletic pubalgia is secondary to repetitive loading of the pubic symphysis, leading to instability and parasymphyseal tendon and ligament injury. Hypothesis/ The purpose of this study was to investigate the effect of simulated femoral-based femoroacetabular impingement on rotational motion at the pubic symphysis. The authors hypothesize that the presence of a cam lesion leads to increased relative symphyseal motion. Controlled laboratory study. Twelve hips from 6 fresh-frozen human cadaveric pelvises were used to simulate cam-type femoroacetabular impingement. The hips were held in a custom jig and maximally internally rotated at 90° of flexion and neutral adduction. Three-dimensional motion of the pubic symphysis was measured by a motion-tracking system for 2 states: native and simulated cam. Load-displacement plots were generated between the internal rotational torque applied to the hip and the responding motion in 3 anatomic planes of the pubic symphysis. As the hip was internally rotated, the motion at the pubic symphysis increased proportionally with the degrees of the rotation as well as the applied torque measured at the distal femur for both states. The primary rotation of the symphysis was in the transverse plane and on average accounted for more than 60% of the total rotation. This primary motion caused the anterior aspect of the symphyseal joint to open or widen, whereas the posterior aspect narrowed. At the torque level of 18.0 N·m, the mean transverse rotation in degrees was 0.89° ± 0.35° for the native state and 1.20° ± 0.41° for cam state. The difference between cam and the native groups was statistically significant (P pubalgia.

Multicentre study on capsular closure versus non-capsular closure during hip arthroscopy in Danish patients with femoroacetabular impingement (FAI)

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Dippmann, Christian; Kraemer, Otto; Lund, Bent

2018-01-01

in patients without additional risk factors for instability such as hypermobility or dysplasia of the hip. We hypothesised that capsular closure will lead to a superior outcome in hip arthroscopy for femoroacetabular impingement syndrome (FAIS) compared with non-capsular closure. METHODS AND ANALYSIS...... years and FAIS according to the Warwick agreement. Exclusion criteria are: previous hip surgery in either hip, previous conditions of Legg-Calvé-Perthes or slipped capital femoral epiphysis, malignant disease, recent hip or pelvic fractures, arthritis, Ehlers-Danlos or Marfan disease, recent (within 6...

Hip arthroscopy for femoroacetabular impingement

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Nasser, Rima; Domb, Benjamin

2018-01-01

The purpose of this article is to give a general overview of femoroacetabular impingement (FAI) and how it could be treated arthroscopically, with some details about indications, the procedure itself and some of the complications associated with the surgery. FAI is a dynamic condition of the hip that can be a source of pain and disability and could potentially lead to arthritis. When symptomatic, and if conservative treatment fails, FAI can be addressed surgically. The goal of surgical treatment for FAI is to recreate the spherical contour of the femoral head, improve femoral offset, normalize coverage of the acetabulum, repair/reconstruct chondral damage and repair/reconstruct the labrum to restore normal mechanics and joint sealing. Advances in equipment and technique have contributed to an increase in the number of hip arthroscopy procedures performed worldwide and have made it one of the more common treatment options for symptomatic FAI. Hip arthroscopy is a procedure with an extremely steep and long learning curve. Cite this article: EFORT Open Rev 2018;3:121-129. DOI: 10.1302/2058-5241.3.170041 PMID:29780619

Characterization of ossification of the posterior rim of acetabulum in the developing hip and its impact on the assessment of femoroacetabular impingement.

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Morris, William Z; Chen, Jason Y; Cooperman, Daniel R; Liu, Raymond W

2015-02-04

Many radiographic indices that are used to assess adolescents for femoroacetabular impingement rely on an ossified posterior acetabular wall. A recent study identified a secondary ossification center in the posterior rim of the acetabulum, the ossification of which may affect perceived acetabular coverage. The purpose of this study was to characterize ossification of the posterior rim of the acetabulum with use of a longitudinal radiographic study and quantify its impact on the radiographic assessment of femoroacetabular impingement. In this study, we utilized a historical collection of annual radiographs made in a population of healthy adolescents. Six hundred and twelve anteroposterior radiographs of the left hip of ninety-eight patients were reviewed to identify the appearance, duration, and fusion of the secondary ossification center in the posterior rim of the acetabulum. The center-edge angle was then measured before appearance and after fusion of the secondary ossification center in a subset of ten patients who had 40°), the use of radiographs in adolescents with incompletely ossified hips may lead to misinterpretation of acetabular coverage. In patients with open triradiate cartilage, magnetic resonance imaging may be considered for the assessment of femoroacetabular impingement. The posterior rim ossification sign is a normal finding in adolescent hip development and has important implications for the proper evaluation of femoroacetabular impingement. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

Impaired hip muscle strength in patients with femoroacetabular impingement syndrome.

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Kierkegaard, Signe; Mechlenburg, Inger; Lund, Bent; Søballe, Kjeld; Dalgas, Ulrik

2017-12-01

Patients with femoroacetabular impingement (FAI) experience hip pain as well as decreased function and lowered quality of life. The aim was to compare maximal isometric and isokinetic muscle strength (MVC) during hip flexion and extension and rate of force development (RFD) during extension between patients with FAI and a matched reference group. Secondary, the aim was to compare patient hips and subgroups defined by gender and age as well as to investigate associations between hip muscle strength and self-reported outcomes. Design Cross-sectional, comparative study Methods Sixty patients (36±9 years, 63% females) and 30 age and gender matched reference persons underwent MVC tests in an isokinetic dynamometer. During hip flexion and extension, patients' affected hip showed a strength deficit of 15-21% (phip of the patients was significantly weaker than their contralateral hip. RFD was significantly decreased for both patient hips compared to the reference group (phip muscle strength. Patients with FAI demonstrate decreased hip flexion and extension strength when compared to (1) reference persons and (2) their contralateral hip. There seems to be a gender specific affection which should be investigated further and addressed when planning training protocols. Furthermore, self-reported measures were associated with isometric muscle strength, which underlines the clinical importance of the reduced muscle strength. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Measuring hip muscle strength in patients with femoroacetabular impingement and other hip pathologies: A systematic review.

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Mayne, E; Memarzadeh, A; Raut, P; Arora, A; Khanduja, V

2017-01-01

The aim of this study was to systematically review the literature on measurement of muscle strength in patients with femoroacetabular impingement (FAI) and other pathologies and to suggest guidelines to standardise protocols for future research in the field. The Cochrane and PubMed libraries were searched for any publications using the terms 'hip', 'muscle', 'strength', and 'measurement' in the 'Title, Abstract, Keywords' field. A further search was performed using the terms 'femoroacetabular' or 'impingement'. The search was limited to recent literature only. A total of 29 articles were reviewed to obtain information on a number of variables. These comprised the type of device used for measurement, rater standardisation, the type of movements tested, body positioning and comparative studies of muscle strength in FAI versus normal controls. The studies found that hip muscle strength is lower in patients with FAI; this is also true for the asymptomatic hip in patients with FAI. Current literature on this subject is limited and examines multiple variables. Our recommendations for achieving reproducible results include stabilising the patient, measuring isometric movements and maximising standardisation by using a single tester and familiarising the participants with the protocol. Further work must be done to demonstrate the reliability of any new testing method.Cite this article: E. Mayne, A. Memarzadeh, P. Raut, A. Arora, V. Khanduja. Measuring hip muscle strength in patients with femoroacetabular impingement and other hip pathologies: A systematic review. Bone Joint Res 2017;6:66-72. DOI: 10.1302/2046-3758.61.BJR-2016-0081. © 2017 Khanduja et al.

Cam and Pincer Type of Femoroacetabular Impingement.

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Ersoy, Hale; Trane, R Nicholas; Pomeranz, Stephen J

Femoroacetabular impingement (FAI) has gained considerable attention for the past 20 years and has been accepted as a predisposing factor for early osteoarthritis in young patients, particularly in the population participating in sports. Patients with FAI typically present with deep, intermittent groin discomfort during or after activities involving repetitive or persistent hip flexion. Symptomatic improvement can be achieved from arthroscopic debridement of unstable cartilage flaps, shaving of cartilage irregularities, and surgical correction of deformity of the femoral head\\endash neck junction. Early and correct diagnosis of FAI has paramount importance for appropriate and timely management of the disorder before the development of osteoarthritis. Magnetic resonance (MR) imaging offers a noninvasive means of assessing the degree of damage to cartilage and adjacent labrum and bone and also evaluating the effectiveness of treatment. This article describes the morphologic types of FAI with emphasis on MR findings.

Cam Femoroacetabular Impingement as a Possible Explanation of Recalcitrant Anterior Knee Pain.

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Sanchis-Alfonso, Vicente; Tey, Marc; Monllau, Joan Carles

2016-01-01

We present a case of a patient with chronic anterior knee pain (AKP) recalcitrant to conservative treatment who returned to our office for severe hip pain secondary to Cam femoroacetabular impingement (Cam FAI) at 10 months after the onset of knee pain. This case highlights the fact that the main problem is not in the patella but in the hip in some patients with AKP. We hypothesize that there is an external femoral rotation in order to avoid the impingement and therefore the hip pain in patients with Cam FAI. This functional femoral rotation could provoke a patellofemoral imbalance that may be, in theory, responsible for patellofemoral pain in this particular patient. In our case, Cam FAI resolution was related to the resolution of AKP.

Conservative management of an elite ice hockey goaltender with femoroacetabular impingement (FAI): a case report

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MacIntyre, Kyle; Gomes, Brendan; MacKenzie, Steven; D’Angelo, Kevin

2015-01-01

Objective: To detail the presentation of an elite male ice hockey goaltender with cam-type femoroacetabular impingement (FAI) and acetabular labral tears. This case will outline the prevalence, clinical presentation, imaging criteria, pathomechanics, and management of FAI, with specific emphasis on the ice hockey goaltender. Clinical Features: A 22-year old retired ice hockey goaltender presented to a chiropractor after being diagnosed by an orthopaedic surgeon with MRI confirmed left longitudinal and chondral flap acetabular labral tears and cam-type femoroacetabular impingement (FAI). As the patient was not a candidate for surgical intervention, a multimodal conservative treatment approach including manual therapy, electroacupuncture and rehabilitation exercises were implemented. Summary: FAI is prevalent in ice hockey players, particularly with goaltenders. Both skating and position-dependent hip joint mechanics involved in ice hockey may exacerbate or contribute to acquired and congenital forms of symptomatic FAI. As such, practitioners managing this population must address sport-specific demands in manual therapy, rehabilitation and physical training, to improve functional outcomes and prevent future injury. PMID:26816416

Measuring hip muscle strength in patients with femoroacetabular impingement and other hip pathologies

OpenAIRE

Mayne, E; Memarzadeh, A; Raut, P; Arora, A; Khanduja, Vikas

2017-01-01

$\\textbf{Objectives}$ The aim of this study was to systematically review the literature on measurement of muscle strength in patients with femoroacetabular impingement (FAI) and other pathologies and to suggest guidelines to standardise protocols for future research in the field. $\\textbf{Methods}$ The Cochrane and PubMed libraries were searched for any publications using the terms ‘hip’, ‘muscle’, ‘strength’, and ‘measurement’ in the ‘Title, Abstract, Keywords’ field. A further sea...

Cam Femoroacetabular Impingement as a Possible Explanation of Recalcitrant Anterior Knee Pain

Directory of Open Access Journals (Sweden)

Vicente Sanchis-Alfonso

2016-01-01

Full Text Available We present a case of a patient with chronic anterior knee pain (AKP recalcitrant to conservative treatment who returned to our office for severe hip pain secondary to Cam femoroacetabular impingement (Cam FAI at 10 months after the onset of knee pain. This case highlights the fact that the main problem is not in the patella but in the hip in some patients with AKP. We hypothesize that there is an external femoral rotation in order to avoid the impingement and therefore the hip pain in patients with Cam FAI. This functional femoral rotation could provoke a patellofemoral imbalance that may be, in theory, responsible for patellofemoral pain in this particular patient. In our case, Cam FAI resolution was related to the resolution of AKP.

Femoroacetabular impingement: bone marrow oedema associated with fibrocystic change of the femoral head and neck junction

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James, S.L.J. [Department of Radiology, RNOH Stanmore, Stanmore, Middlesex (United Kingdom) and Department of Radiology, Royal Orthopaedic Hospital, Birmingham (United Kingdom)]. E-mail: jamesslj@email.com; Connell, D.A. [Department of Radiology, RNOH Stanmore, Stanmore, Middlesex (United Kingdom); O' Donnell, P. [Department of Radiology, RNOH Stanmore, Stanmore, Middlesex (United Kingdom); Saifuddin, A. [Department of Radiology, RNOH Stanmore, Stanmore, Middlesex (United Kingdom)

2007-05-15

Aim: To describe the association of bone marrow oedema adjacent to areas of fibrocystic change at the femoral head and neck junction in patients with femoroacetabular impingement. Materials and methods: The clinical and imaging findings in six patients with bone marrow oedema adjacent to an area of fibrocystic change at the femoral head and neck junction are presented. There were five males and one female (age range 19-42 years, mean age 34.5 years). Three patients were referred with a clinical suspicion of femoroacetabular impingement, two with suspected osteoid osteoma and one with a clinical diagnosis of sciatica. The volume of bone marrow oedema (grade 1: 0-25%, grade 2: 26-50%, grade 3: 51-75% and grade 4: 76-100% of the femoral neck width), presence of labral and articular cartilage abnormality, joint effusion, and femoral head and neck morphology were recorded. Results: Magnetic resonance imaging (MRI) identified fibrocystic change in the anterolateral aspect of the femoral head and neck junction in all cases (mean size 9 mm, range 5-14 mm, three multilocular and three unilocular cysts). The volume of oedema was variable (one grade 1, two grade 2, one grade 3 and two grade 4). All patients had abnormality of the anterosuperior labrum with five patients demonstrating chondral loss. An abnormal femoral head and neck junction was identified in five patients. Conclusion: The radiological finding of fibrocystic change at the anterosuperior femoral neck with or without bone marrow oedema should prompt the search for femoroacetabular impingement. Bone marrow oedema may rarely be identified adjacent to these areas of cystic change and should be considered in the differential diagnosis of bone marrow oedema in the femoral neck.

Femoroacetabular impingement: bone marrow oedema associated with fibrocystic change of the femoral head and neck junction

International Nuclear Information System (INIS)

James, S.L.J.; Connell, D.A.; O'Donnell, P.; Saifuddin, A.

2007-01-01

Aim: To describe the association of bone marrow oedema adjacent to areas of fibrocystic change at the femoral head and neck junction in patients with femoroacetabular impingement. Materials and methods: The clinical and imaging findings in six patients with bone marrow oedema adjacent to an area of fibrocystic change at the femoral head and neck junction are presented. There were five males and one female (age range 19-42 years, mean age 34.5 years). Three patients were referred with a clinical suspicion of femoroacetabular impingement, two with suspected osteoid osteoma and one with a clinical diagnosis of sciatica. The volume of bone marrow oedema (grade 1: 0-25%, grade 2: 26-50%, grade 3: 51-75% and grade 4: 76-100% of the femoral neck width), presence of labral and articular cartilage abnormality, joint effusion, and femoral head and neck morphology were recorded. Results: Magnetic resonance imaging (MRI) identified fibrocystic change in the anterolateral aspect of the femoral head and neck junction in all cases (mean size 9 mm, range 5-14 mm, three multilocular and three unilocular cysts). The volume of oedema was variable (one grade 1, two grade 2, one grade 3 and two grade 4). All patients had abnormality of the anterosuperior labrum with five patients demonstrating chondral loss. An abnormal femoral head and neck junction was identified in five patients. Conclusion: The radiological finding of fibrocystic change at the anterosuperior femoral neck with or without bone marrow oedema should prompt the search for femoroacetabular impingement. Bone marrow oedema may rarely be identified adjacent to these areas of cystic change and should be considered in the differential diagnosis of bone marrow oedema in the femoral neck

Clinical outcomes assessment in clinical trials to assess treatment of femoroacetabular impingement

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Harris-Hayes, Marcie; McDonough, Christine M; Leunig, Michael

2013-01-01

Patient-reported outcome measures are an important component of outcomes assessment in clinical trials to assess the treatment of femoroacetabular impingement (FAI). This review of disease-specific measures and instruments used to assess the generic quality of life and physical activity levels...... developed recently and have not been established in the literature. Although currently used generic and activity-level measures have limitations, as well, they should be considered, depending on the specific goals of the study. Additional research is needed to assess the properties of these measures fully...

Hip arthroscopy with labral repair for femoroacetabular impingement

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Dippmann, Christian; Thorborg, Kristian; Kraemer, Otto

2014-01-01

PURPOSE: The purpose of this study was to examine the progression of clinical outcomes 3, 6 and 12 months after hip arthroscopy with labral repair for femoroacetabular impingement (FAI). METHODS: From May 2009 to December 2011, 87 consecutive patients [55 females (median age 38, range 17-63) and 32...... males (median age 38, range 15-59)] underwent hip arthroscopy and labral repair, by the same experienced surgeon. Standardised, but unstructured, post-operative rehabilitation instructions were provided. Function and pain were evaluated using modified Harris Hip Score (mHHS) and visual analogue scale...... months with no additional changes from 6 to 12 months [22.6 (2.6)-27.9 (2.6), (n.s.)]. CONCLUSIONS: Improvements in function (mHHS) and pain (VAS) were seen in patients after hip arthroscopy with labral repair for FAI at 3, 6, and 12 months. While significant improvements occurred from 3 to 6 months...

The Role of Femoroacetabular Impingement in Core Muscle Injury/Athletic Pubalgia: Diagnosis and Management

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Strosberg, David S.; Ellis, Thomas J.; Renton, David B.

2016-01-01

Chronic groin pain in athletes represents a major diagnostic and therapeutic challenge in sports medicine. Two recognized causes of inguinal pain in the young adult athlete are core muscle injury/athletic pubalgia (CMI/AP) and femoroacetabular impingement (FAI). CMI/AP and FAI were previously considered to be two distinct entities, however recent studies have suggested both entities to frequently coincide in the athlete with groin pain. This article briefly discusses the role of femoroaceta...

Sports hernia and femoroacetabular impingement in athletes: A systematic review.

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Munegato, Daniele; Bigoni, Marco; Gridavilla, Giulia; Olmi, Stefano; Cesana, Giovanni; Zatti, Giovanni

2015-09-16

To investigate the association between sports hernias and femoroacetabular impingement (FAI) in athletes. PubMed, MEDLINE, CINAHL, Embase, Cochrane Controlled Trials Register, and Google Scholar databases were electronically searched for articles relating to sports hernia, athletic pubalgia, groin pain, long-standing adductor-related groin pain, Gilmore groin, adductor pain syndrome, and FAI. The initial search identified 196 studies, of which only articles reporting on the association of sports hernia and FAI or laparoscopic treatment of sports hernia were selected for systematic review. Finally, 24 studies were reviewed to evaluate the prevalence of FAI in cases of sports hernia and examine treatment outcomes and evidence for a common underlying pathogenic mechanism. FAI has been reported in as few as 12% to as high as 94% of patients with sports hernias, athletic pubalgia or adductor-related groin pain. Cam-type impingement is proposed to lead to increased symphyseal motion with overload on the surrounding extra-articular structures and muscle, which can result in the development of sports hernia and athletic pubalgia. Laparoscopic repair of sports hernias, via either the transabdominal preperitoneal or extraperitoneal approach, has a high success rate and earlier recovery of full sports activity compared to open surgery or conservative treatment. For patients with FAI and sports hernia, the surgical management of both pathologies is more effective than sports pubalgia treatment or hip arthroscopy alone (89% vs 33% of cases). As sports hernias and FAI are typically treated by general and orthopedic surgeons, respectively, a multidisciplinary approach for diagnosis and treatment is recommended for optimal treatment of patients with these injuries. The restriction in range of motion due to FAI likely contributes to sports hernias; therefore, surgical treatment of both pathologies represents an optimal therapy.

[The relationship between chronic hip pain and femoroacetabular impingement: an evaluation with clinical signs and radiography].

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Sahin, Namik; Atici, Teoman; Oztürk, Alpaslan; Ozkaya, Güven; Avcu, Bülent; Ozkan, Yüksel

2011-12-01

In this study, we investigated the rate of the clinical and radiographic findings of femoroacetabular impingement (FAI) in patients with chronic hip pain and compared the findings with those of a control group. The clinical and radiographic findings of FAI in 38 patients (group 1) having hip pain for more than three months were analyzed and compared with 42 controls (group 2). Internal rotation degrees were measured while the hips were at 90° flexion and impingement test was performed by rotating the hips internally at 90° flexion and adduction. The FAI findings were investigated on anteroposterior pelvis radiographs and cross-table lateral radiographs of the hip joint in both groups. The collum-diaphyseal angle, alpha angle and anterior offset ratio on the femoral side and the center-edge angle, acetabular index, extrusion index and crossover sign on the acetabular side were evaluated. The internal rotation degree of the painful hips were less than 20 degree in 18 (47.4%) patients in group 1 and in one (2.4%) patient in group 2 (pcam type FAI was 76.3% (n=29) in group 1 and 42.9% (n=18) in group 2 (p=0.002). Femoroacetabular impingement is one of the causes of chronic hip pain and if evaluated with suitable clinical and radiographic parameters, the rates of diagnosis may increase.

Core Muscle Injury/Sports Hernia/Athletic Pubalgia, and Femoroacetabular Impingement.

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Ross, James R; Stone, Rebecca M; Larson, Christopher M

2015-12-01

Core muscle injury/sports hernia/athletic pubalgia is an increasingly recognized source of pain, disability, and time lost from athletics. Groin pain among athletes, however, may be secondary to various etiologies. A thorough history and comprehensive physical examination, coupled with appropriate diagnostic imaging, may improve the diagnostic accuracy for patients who present with core muscular injuries. Outcomes of nonoperative management have not been well delineated, and multiple operative procedures have been discussed with varying return-to-athletic activity rates. In this review, we outline the clinical entity and treatment of core muscle injury and athletic pubalgia. In addition, we describe the relationship between athletic pubalgia and femoroacetabular impingement along with recent studies that have investigated the treatment of these related disorders.

Lower limb biomechanics in femoroacetabular impingement syndrome: a systematic review and meta-analysis.

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King, Matthew G; Lawrenson, Peter R; Semciw, Adam I; Middleton, Kane J; Crossley, Kay M

2018-05-01

(1) Identify differences in hip and pelvic biomechanics in patients with femoroacetabular impingement syndrome (FAIS) compared with controls during everyday activities (eg, walking, squatting); and (2) evaluate the effects of interventions on hip and pelvic biomechanics during everyday activities. Systematic review. Medline, CINAHL, EMBASE, Scopus and SPORTDiscus until February 2017. Primary aim: studies that investigated hip or pelvic kinematics and/or joint torques of everyday activities in patients with FAIS compared with the asymptomatic contralateral limb or a control group. Secondary aim: studies that evaluated effects of conservative or surgical interventions on patients with FAIS using pre-post or controlled clinical trial designs. Biomechanical data must have been collected using three-dimensional motion capture devices. Reporting quality was assessed using the Epidemiological Appraisal Instrument and data were pooled (standardised mean difference (SMD), 95% CI) where populations and primary outcomes were similar. Fourteen studies were included (11 cross-sectional and three pre/post intervention), varying between low and moderate reporting quality. Patients with FAIS walked with a lower: peak hip extension angle (SMD -0.40, 95% CI -0.71 to -0.09), peak internal rotation angle (-0.67, 95% CI -1.19 to -0.16) and external rotation joint torque (-0.71, 95% CI -1.07 to -0.35), and squatted to a lesser depth with no difference in hip flexion range. Pre/post intervention data were limited in number and quality, and to surgical cohorts. This review suggests that patients with FAIS may demonstrate hip biomechanical impairments during walking and squatting, with minimal literature available to comment on other tasks. The information presented in the review provides insight into the biomechanical differences associated with FAIS; however, the between-group differences were small to moderate. This information may aid in the development of management strategies for

Radiological diagnosis of femoroacetabular impingement

International Nuclear Information System (INIS)

Mamisch, T.C.; Werlen, S.; Trattnig, S.; Zilkens, C.; Kim, Y.J.; Siebenrock, K.A.; Bittersohl, B.

2009-01-01

Femoroacetabular impingements (FAI) are due to an anatomical disproportion between the proximal femur and the acetabulum which causes premature wear of the joint surfaces. An operation is often necessary in order to relieve symptoms such as limited movement and pain as well as to prevent or slow down the degenerative process. The result is dependent on the preoperative status of the joint with poor results for advanced arthritis of the hip joint. This explains the necessity for an accurate diagnosis in order to recognize early stages of damage to the joint. The diagnosis of FAI includes clinical examination, X-ray examination and magnetic resonance imaging (MRI). The standard X-radiological examination for FAI is carried out using two X-ray images, an anterior-posterior view of the pelvis and a lateral view of the proximal femur, such as the cross-table lateral or Lauenstein projections. It is necessary that positioning criteria are adhered to in order to avoid distortion artifacts. MRI permits an examination of the pelvis on three levels and should also include radial planned sequences for improved representation of peripheral structures, such as the labrum and peripheral cartilage. The use of contrast medium for a direct MR arthrogram has proved to be advantageous particularly for representation of labrum damage. The data with respect to cartilage imaging are still unclear. Further developments in technology, such as biochemical-sensitive MRI applications, will be able to improve the diagnosis of the pelvis in the near future. (orig.) [de

Surgical dislocation of the hip in patients with femoroacetabular impingement: Surgical techniques and our experience

Directory of Open Access Journals (Sweden)

Mladenović Marko

2015-01-01

Full Text Available Background/Aim. Arthrosis of the hip is the most common cause of a hip joint disorders. The aim of this study was to present our experience in the application of a safe surgical dislocation of the hip in patients with minor morphological changes in the hip joint, which, through the mechanism of femoroacetabular impingement, cause damage to the acetabular labrum and adjacent cartilage as an early sign of the hip arthrosis. Methods. We have operated 51 patients with different morphological bone changes in the hip area and resultant soft tissue damage of the acetabular labrum and its adjacent cartilage. Surgical technique that we applied in this group of patients, was adapted to our needs and capabilities and it was minimaly modified compared to the original procedure. Results. The surgical technique presented in this paper, proved to be a good method of treatment of bone and soft tissue pathomorphological changes of the hip in patients with femoroacetabular impingement. We had no cases with avascular necrosis of the femoral head, and two patients had nonunion of the greater trochanter, 9 patients developed paraarticular ossification, without subjective symptoms, while 3 patients suffered from postoperative pain in the groin during more energetic physical activities. Conclusion. Utilization of our partly modified surgical technique of controlled and safe dislocation of the hip can solve all the bone and soft tissue problems in patients with femoroacetibular impingement to stop already developed osteoarthritis of the hip or to prevent mild form of it.

A quantitative non-invasive assessment of femoroacetabular impingement with CT-based dynamic simulation - Cadaveric validation study Clinical diagnostics and imaging

NARCIS (Netherlands)

M.L. Röling (Maarten); M.I. Visser (Monique I); E.H.G. Oei (Edwin); P. Pilot (Peter); G.J. Kleinrensink (Gert Jan); R.M. Bloem (Rolf)

2015-01-01

textabstractBackground: Femoroacetabular impingement (FAI) is caused by an anatomic deviation of the acetabular rim or proximal femur, which causes chronic groin pain. Radiological identification of FAI can be challenging. Advances in imaging techniques with the use of computed tomography (CT) scan

Prevalence of Cam Morphology in Females with Femoroacetabular Impingement

Directory of Open Access Journals (Sweden)

David M Levy

2015-12-01

Full Text Available Cam and pincer are two common morphologies responsible for femoroacetabular impingement. Previous literature has reported that cam deformity is predominantly a male morphology, while being significantly less common in females. The purpose of this study was to determine the prevalence of cam morphology in female subjects diagnosed with symptomatic FAI. All females presenting to the senior author’s clinic diagnosed with symptomatic FAI between December 2006 and Cam and pincer are two common morphologies responsible for femoroacetabular impingement. Previous literature has reported that cam deformity is predominantly a male morphology, while being significantly less common in females. Cam morphology is commonly assessed with the alpha angle, measured on radiographs. The purpose of this study was to determine the prevalence of cam morphology utilizing the alpha angle in female subjects diagnosed with symptomatic FAI. All females presenting to the senior author’s clinic diagnosed with symptomatic FAI between December 2006 and January 2013 were retrospectively reviewed. Alpha (α angles were measured on AP (anteroposterior and lateral (Dunn 90°, cross-table lateral, and/or frog-leg lateral plain radiographs by two blinded physicians, and the largest measured angle was used. Using Gosvig et al.’s classification, alpha angle was characterized as (pathologic > 57°, borderline (51-56°, subtle (46-50°, very subtle (43-45°, or normal (≤42°. Three hundred and ninety-one patients (438 hips were analyzed (age 36.2 ± 12.3 years. Among the hips included, 35.6% were normal, 14.6% pathologic, 15.1% borderline, 14.6% subtle, and 20.1% very subtle. There was no correlation between alpha angle and patient age (R = 0.17 or body mass index (BMI (R = 0.05. The intraclass correlation coefficient (ICC for α-angle measurements was 0.84. Sixty-four percent of females in this cohort had an alpha angle > 42°. Subtle cam deformity plays a significant role in

Cam versus pincer femoroacetabular impingement. Which type is associated with more hip structural damage? : An exploratory cross-sectional study

NARCIS (Netherlands)

Anbar, Ashraf; Ragab, Yasser; Zeinhom, Fatma; El Shaarawy, Nashwa; Emad, Yasser; Abo-Elyoun, Ihab; Hussein, Hanan; Rasker, Johannes J.

Background: Femoroacetabular impingement (FAI) occurs as a conflict between the proximal femur and the acetabular rim. The purpose of this study was to evaluate MRI findings and look for correlations with pain intensity and duration in each type of FAI separately in an attempt to identify which type

Protocol for CT in the position of discomfort: preoperative assessment of femoroacetabular impingement - how we do it and what the surgeon wants to know

International Nuclear Information System (INIS)

Grabinski, Rafal; Ou, Daniel; Saunder, Kate; Rotstein, Andrew; Singh, Parminder; Pritchard, Michael; O'Donnell, John

2014-01-01

The use of computed tomography of the hip in a position of discomfort (CT-POD) in combination with 2D and 3D surface rendering is a technique increasingly used to aid in the assessment and confirmation of femoral and acetabular bony abnormalities related to femoroacetabular impingement. The purpose of this article is to describe this dynamic method of assessment. Patients referred by orthopaedic surgeons for assessment of femoroacetabular impingement as part of preoperative planning and patients who required postoperative assessment of residual bony abnormalities were selected. This article describes the CT-POD technique and the information required by the referring surgeon. CT-POD is a new technique that provides valuable preoperative and postoperative information to the surgeon.

The Role of Femoroacetabular Impingement in Core Muscle Injury/Athletic Pubalgia: Diagnosis and Management.

Science.gov (United States)

Strosberg, David S; Ellis, Thomas J; Renton, David B

2016-01-01

Chronic groin pain in athletes represents a major diagnostic and therapeutic challenge in sports medicine. Two recognized causes of inguinal pain in the young adult athlete are core muscle injury/athletic pubalgia (CMI/AP) and femoroacetabular impingement (FAI). CMI/AP and FAI were previously considered to be two distinct entities; however, recent studies have suggested both entities to frequently coincide in the athlete with groin pain. This article briefly discusses the role of FAI in CMI/AP and the diagnosis and management of this complex disease.

Incidence of greater trochanteric pain syndrome in patients suspected for femoroacetabular impingement evaluated using magnetic resonance arthrography of the hip.

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Pozzi, Grazia; Lanza, Ezio; Parra, Cleber Garcia; Merli, Ilaria; Sconfienza, Luca Maria; Zerbi, Alberto

2017-03-01

We evaluated the incidence of greater trochanter pain syndrome (GTPS) in patients who underwent magnetic resonance arthrography (MRA) of the hip for a suspected femoroacetabular impingement (FAI) syndrome. Hip MRA performed at our institution (3/2012-1/2014) were reviewed. The absence/presence of FAI (cam, pincer, and mixed) was noted. GTPS diagnosis was based on gluteus medius/minimus tendinopathy/tears, trochanteric bursitis, fascia lata thickening, and trochanter bone oedema/erosion. Subgroup analysis for age (under/over 40 years) and FAI type (cam, pincer, and mixed) was also performed. N = 189 patients were included (n = 125 males; age 39 ± 12 years). FAI was diagnosed in n = 133 (70, 4%): cam type, n = 85 (63, 9%); pincer type, n = 22 (16, 6%); and mixed type, n = 26 (19, 5%). N = 72 patients (38.1%) had tendinopathy, n = 14 (7.4%) had trochanter erosion, n = 31 (16.4%) had bursitis, n = 4 had bone oedema (2.1%), and n = 3 (1.6%) had fascia lata thickening, resulting in GTPS diagnosis in n = 74 patients (39.2%). The association of normal hip morphology/GTPS was significantly higher (P = 0.023) than that of FAI/GTPS. Under 40 years, GTPS incidence was higher in patients with normal hip and pincer-type FAI (P = 0.028). Over 40 years, no difference between patients with/without FAI (P = 0.119) was seen. GTPS was more frequently observed in patients with normal hip morphology than in patients with FAI, particularly in patients under 40.

The direct environmental impact of hip arthroscopy for femoroacetabular impingement: a surgical waste audit of five cases

OpenAIRE

de SA, Darren; Stephens, Kellee; Kuang, Michelle; Simunovic, Nicole; Karlsson, Jon; Ayeni, Olufemi R.

2016-01-01

Health care facilities produce significant waste (2200?kg/bed/year) creating 2% of greenhouse gas emissions and 1% total solid waste nationwide, with 20?70% of waste coming from operating rooms. We performed a waste audit of hip arthroscopy for femoroacetabular impingement (FAI) to understand its environmental impact and identify areas for greening practices. A waste audit of five hip arthroscopy procedures for FAI was performed. All waste was collected and separated into six waste streams in...

Herniation pits and their renaissance in association with femoroacetabular impingement

International Nuclear Information System (INIS)

Panzer, Stephonie; Augat, P.; Paracelsus Univ. Salzburg; Scheidler, J.

2010-01-01

Hernitation pits (HPs) of the femoral neck were first described in 1982. The purpose of this paper is to summarize the information concerning HPs published since then and to show their association with the diagnosis of femoroacetabular impingement (FAI) which has occurred within the last years. HPs are predominantly located at the anterior-superior femoral neck with a typical radiological appearance, which makes it possible to differentiate them from the numerous differential diagnoses mentioned. In the early publications HPs were described as a separate entity, while recent studies increasingly assign them to intra-osseous ganglia. In contrast to the early publications depicting HPs as an incidental finding, they are currently mainly mentioned in association with FAI and at the same time are partly considered to be a radiological indicator of FAI. In summary, HPs should always be recognized and documented because they may contribute to the diagnosis of FAI which is essential for preventing or delaying osteoarthritis of the hip joint in the early stage. (orig.)

Femoroacetabular impingement surgery

DEFF Research Database (Denmark)

Reiman, Michael P; Thorborg, Kristian

2015-01-01

both the examination and treatment of FAI does not appear to accommodate this exponential growth. In fact, the direction currently taken for FAI is similar to previously described paths of other orthopaedic and sports medicine pathologies (eg, shoulder impingement, knee meniscus tear) for which we have......Femoroacetabuler impingement (FAI) is becoming increasingly recognised as a potential pathological entity for individuals with hip pain. Surgery described to correct FAI has risen exponentially in the past 10 years with the use of hip arthroscopy. Unfortunately, the strength of evidence supporting...

Femoro-acetabular impingement and hip pain with conventionally normal x-rays.

LENUS (Irish Health Repository)

Baker, J F

2010-06-01

There has in recent years been a fundamental change in the understanding of hip pain in the young adult and hip pain without plain radiographic findings of arthritis. Pain in these groups has long represented a diagnostic and therapeutic challenge. With new appreciation of hip biomechanics, pathological processes and the arrival of modern imaging modalities we now have a greater understanding of non-arthritic hip pathology. One of the commonest yet least well recognized \\'new\\' diagnoses around the hip is femoro-acetabular impingement (FAI). FAI is a developmental condition of the hip joint that is associated with abnormal anatomical configuration and thus joint mechanics on either the femoral or acetabular sides or both. It is hypothesized to have a variety of precipitants and may ultimately lead to labral and chondral injury and what has previously been referred to as \\'primary\\' or \\'idiopathic\\' hip osteoarthritis.

[Athletic pubalgia and hip impingement].

Science.gov (United States)

Berthaudin, A; Schindler, M; Ziltener, J-L; Menetrey, J

2014-07-16

Athletic pubalgia is a painful and complex syndrom encountered by athletes involved in pivoting and cutting sports such as hockey and soccer. To date, there is no real consensus on the criteria for a reliable diagnostic, the different investigations, and the appropriate therapy. Current literature underlines intrinsic and extrinsic factors contributing to athletic pubalgia. This review article reports upon two novelties related to the issue: the importance and efficience of prevention program and the association of femoro-acetabular impingement with the pubalgia.

Subacromial impingement syndrome

NARCIS (Netherlands)

Umer, M.; Qadir, I.; Azam, M.

2012-01-01

Subacromial impingement syndrome (SAIS) represents a spectrum of pathology ranging from subacromial bursitis to rotator cuff tendinopathy and full-thickness rotator cuff tears. The relationship between subacromial impingement and rotator cuff disease in the etiology of rotator cuff injury is a

Personalised Hip Therapy: development of a non-operative protocol to treat femoroacetabular impingement syndrome in the FASHIoN randomised controlled trial.

Science.gov (United States)

Wall, Peter Dh; Dickenson, Edward J; Robinson, David; Hughes, Ivor; Realpe, Alba; Hobson, Rachel; Griffin, Damian R; Foster, Nadine E

2016-10-01

Femoroacetabular impingement (FAI) syndrome is increasingly recognised as a cause of hip pain. As part of the design of a randomised controlled trial (RCT) of arthroscopic surgery for FAI syndrome, we developed a protocol for non-operative care and evaluated its feasibility. In phase one, we developed a protocol for non-operative care for FAI in the UK National Health Service (NHS), through a process of systematic review and consensus gathering. In phase two, the protocol was tested in an internal pilot RCT for protocol adherence and adverse events. The final protocol, called Personalised Hip Therapy (PHT), consists of four core components led by physiotherapists: detailed patient assessment, education and advice, help with pain relief and an exercise-based programme that is individualised, supervised and progressed over time. PHT is delivered over 12-26 weeks in 6-10 physiotherapist-patient contacts, supplemented by a home exercise programme. In the pilot RCT, 42 patients were recruited and 21 randomised to PHT. Review of treatment case report forms, completed by physiotherapists, showed that 13 patients (62%) received treatment that had closely followed the PHT protocol. 13 patients reported some muscle soreness at 6 weeks, but there were no serious adverse events. PHT provides a structure for the non-operative care of FAI and offers guidance to clinicians and researchers in an evolving area with limited evidence. PHT was deliverable within the National Health Service, is safe, and now forms the comparator to arthroscopic surgery in the UK FASHIoN trial (ISRCTN64081839). ISRCTN 09754699. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Clinical trials in orthopaedics and the future direction of clinical investigations for femoroacetabular impingement

DEFF Research Database (Denmark)

Clohisy, John C; Kim, Young-Jo; Lurie, Jon

2013-01-01

to be further defined. To date, clinical research reports have included primarily surgical case series. Future clinical investigations are needed to establish improved clinical evidence to guide patient care. Most urgent is the need to better understand the potential role of standardized nonsurgical treatment......Femoroacetabular impingement (FAI) represents a heterogeneous group of disorders that affect a diverse patient population. The natural history of the disease, the role of nonsurgical management, the indications for surgery, optimal surgical techniques, and the predictors of treatment outcomes need...... options for FAI and to define the predictors of surgical and nonsurgical outcomes. Future randomized controlled trials and large observational cohort studies targeted at these clinical research deficiencies will strengthen the evidence and improve informed decision making regarding the management...

Hip arthroscopy versus open surgical dislocation for femoroacetabular impingement

Science.gov (United States)

Zhang, Dagang; Chen, Long; Wang, Guanglin

2016-01-01

Abstract Background: This meta-analysis aims to evaluate the efficacy and safety of hip arthroscopy versus open surgical dislocation for treating femoroacetabular impingement (FAI) through published clinical trials. Methods: We conducted a comprehensive literature search using PUBMED, EMBASE, and the Cochrane Central Register of Controlled Trials databases for relevant studies on hip arthroscopy and open surgical dislocation as treatment options for FAI. Results: Compared with open surgical dislocation, hip arthroscopy resulted in significantly higher Nonarthritic Hip Scores (NAHS) at 3- and 12-month follow-ups, a significant improvement in NAHS from preoperation to 3 months postoperation, and a significantly lower reoperation rate. Open surgical dislocation resulted in a significantly improved alpha angle by the Dunn view in patients with cam osteoplasty from preoperation to postoperation, compared with hip arthroscopy. This meta-analysis demonstrated no significant differences in the modified Harris Hip Score, Hip Outcome Score-Activities of Daily Living, or Hip Outcome Score-Sport Specific Subscale at 12 months of follow-up, or in complications (including nerve damage, wound infection, and wound dehiscence). Conclusion: Hip arthroscopy resulted in higher NAHS and lower reoperation rates, but had less improvement in alpha angle in patients with cam osteoplasty, than open surgical dislocation. PMID:27741133

A Novel Association between Femoroacetabular Impingement and Anterior Knee Pain.

Science.gov (United States)

Sanchis-Alfonso, Vicente; Tey, Marc; Monllau, Joan Carles

2015-01-01

Background. For a long time it has been accepted that the main problem in the anterior knee pain (AKP) patient is in the patella. Currently, literature supports the link between abnormal hip function and AKP. Objective. Our objective is to investigate if Cam femoroacetabular impingement (FAI) resolution is related to the outcome in pain and disability in patients with chronic AKP recalcitrant to conservative treatment associated with Cam FAI. Material and Methods. A retrospective study on 7 patients with chronic AKP associated with FAI type Cam was performed. Knee and hip pain were measured with the visual analogue scale (VAS), knee disability with the Kujala scale, and hip disability with the Nonarthritic Hip Score (NAHS). Results. The VAS knee pain score and VAS hip pain score had a significant improvement postoperatively. At final follow-up, there was significant improvement in all functional scores (Kujala score and NAHS). Conclusion. Our finding supports the link between Cam FAI and AKP in some young patients. Assessment of Cam FAI should be considered as a part of the physical examination of patients with AKP, mainly in cases with pain recalcitrant to conservative treatment.

A Novel Association between Femoroacetabular Impingement and Anterior Knee Pain

Directory of Open Access Journals (Sweden)

Vicente Sanchis-Alfonso

2015-01-01

Full Text Available Background. For a long time it has been accepted that the main problem in the anterior knee pain (AKP patient is in the patella. Currently, literature supports the link between abnormal hip function and AKP. Objective. Our objective is to investigate if Cam femoroacetabular impingement (FAI resolution is related to the outcome in pain and disability in patients with chronic AKP recalcitrant to conservative treatment associated with Cam FAI. Material and Methods. A retrospective study on 7 patients with chronic AKP associated with FAI type Cam was performed. Knee and hip pain were measured with the visual analogue scale (VAS, knee disability with the Kujala scale, and hip disability with the Nonarthritic Hip Score (NAHS. Results. The VAS knee pain score and VAS hip pain score had a significant improvement postoperatively. At final follow-up, there was significant improvement in all functional scores (Kujala score and NAHS. Conclusion. Our finding supports the link between Cam FAI and AKP in some young patients. Assessment of Cam FAI should be considered as a part of the physical examination of patients with AKP, mainly in cases with pain recalcitrant to conservative treatment.

Preoperative physical examination and imaging of femoroacetabular impingement prior to hip arthroscopy-a systematic review.

Science.gov (United States)

Haldane, Chloe E; Ekhtiari, Seper; de Sa, Darren; Simunovic, Nicole; Ayeni, Olufemi R

2017-08-01

The purpose of this systematic review is to report current preoperative assessment for femoroacetabular impingement (FAI) including physical examination and imaging modalities prior to hip arthroscopy, and report current imaging measures used in the diagnosis of FAI. The electronic databases MEDLINE, EMBASE and PubMed were searched and screened in duplicate for relevant studies. Data regarding patient demographics, non-operative treatment, preoperative assessment including physical examination and imaging prior to hip arthroscopy were abstracted. Study quality was assessed in duplicate using the Methodological Index for Non-Randomized Studies criteria. Sixty-eight studies of fair quality evidence that involved a total of 5125 patients (5400 hips) were included. In total, 56% of all patients were male and mean age was 36 years (SD ± 10.0). Within physical examination, FADIR impingement testing was reported in 57% of patients. All included studies reported plain radiographic imaging as a component of preoperative assessment with anterior-posterior pelvis view being the most commonly reported view, followed by the cross-table lateral and Dunn views. Magnetic resonance imaging was obtained for 52% of included patients and computed tomography for 26% of patients. The most commonly reported measure within imaging for the diagnosis of cam type impingement was alpha angle (66%), whereas for pincer type impingement, the cross-over sign (48%) was most reported. Preoperative assessment is underreported in the FAI literature. Improved reporting is warranted to develop a more consistent and validated diagnostic algorithm for FAI to enhance patient selection. Level of evidence : Level IV, Systematic Review of Level I-IV Studies.

Preoperative physical examination and imaging of femoroacetabular impingement prior to hip arthroscopy—a systematic review

Science.gov (United States)

Haldane, Chloe E.; Ekhtiari, Seper; de SA, Darren; Simunovic, Nicole

2017-01-01

Abstract The purpose of this systematic review is to report current preoperative assessment for femoroacetabular impingement (FAI) including physical examination and imaging modalities prior to hip arthroscopy, and report current imaging measures used in the diagnosis of FAI. The electronic databases MEDLINE, EMBASE and PubMed were searched and screened in duplicate for relevant studies. Data regarding patient demographics, non-operative treatment, preoperative assessment including physical examination and imaging prior to hip arthroscopy were abstracted. Study quality was assessed in duplicate using the Methodological Index for Non-Randomized Studies criteria. Sixty-eight studies of fair quality evidence that involved a total of 5125 patients (5400 hips) were included. In total, 56% of all patients were male and mean age was 36 years (SD ± 10.0). Within physical examination, FADIR impingement testing was reported in 57% of patients. All included studies reported plain radiographic imaging as a component of preoperative assessment with anterior–posterior pelvis view being the most commonly reported view, followed by the cross-table lateral and Dunn views. Magnetic resonance imaging was obtained for 52% of included patients and computed tomography for 26% of patients. The most commonly reported measure within imaging for the diagnosis of cam type impingement was alpha angle (66%), whereas for pincer type impingement, the cross-over sign (48%) was most reported. Preoperative assessment is underreported in the FAI literature. Improved reporting is warranted to develop a more consistent and validated diagnostic algorithm for FAI to enhance patient selection. Level of evidence: Level IV, Systematic Review of Level I–IV Studies. PMID:28948032

Diagnosis of lesions of the acetabular labrum, of the labral-chondral transition zone, and of the cartilage in femoroacetabular impingement: Correlation between direct magnetic resonance arthrography and hip arthroscopy.

Science.gov (United States)

Crespo Rodríguez, A M; de Lucas Villarrubia, J C; Pastrana Ledesma, M A; Millán Santos, I; Padrón, M

2015-01-01

To determine the sensitivity and accuracy of direct MR arthrography in the diagnosis of intra-articular lesions associated with femoroacetabular impingement. We used direct MR arthrography to study 51 patients with femoroacetabular impingement who underwent arthroscopic hip surgery. Surgery demonstrated 37 labral tears, 44 lesions in the labral-chondral transitional zone, and 40 lesions of the articular cartilage. We correlated the findings at preoperative direct MR arthrography with those of hip arthroscopy and calculated the sensitivity, specificity, positive predictive value, negative predictive value, and validity index for direct MR arthrography. The sensitivity and specificity of MR arthrography were 94.5% and 100%, respectively, for diagnosing labral tears, 100% and 87.5%, respectively, for diagnosing lesions of the labral-chondral transition zone, and 92.5% and 54.5%, respectively, for diagnosing lesions of the articular cartilage. The negative predictive value of MR arthrography for lesions of the labral-chondral transitional zone was 100%. MR arthrography accurately defined extensive lesions of the cartilage and the secondary osseous changes (the main factor in poor prognosis), although its diagnostic performance was not so good in small chondral lesions. In patients with femoroacetabular impingement, direct MR arthrography can adequately detect and characterize lesions of the acetabular labrum and of the labral-chondral transitional zone as well as extensive lesions of the articular cartilage and secondary osseous changes. Copyright © 2013 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

High Rate of Return to Yoga for Athletes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome.

Science.gov (United States)

Frank, Rachel M; Ukwuani, Gift; Allison, Bradley; Clapp, Ian; Nho, Shane J

2018-02-01

Femoroacetabular impingement syndrome (FAIS) is most commonly diagnosed in patients who perform activities that require repetitive hip flexion and rotational loading. Yoga is an activity growing in popularity that involves these motions. The purpose of this study was to evaluate patients' ability to return to yoga after hip arthroscopy for FAIS. There would be a high rate of return to yoga after hip arthroscopy. Retrospective analysis. Level 4. Consecutive patients with FAIS who had identified themselves as participating in yoga and had undergone hip arthroscopy for the treatment of FAIS between 2012 and 2015 were reviewed. Demographic data were collected and assessed for all patients, as well as preoperative physical examination, imaging, and patient-reported outcome (PRO) scores, including the modified Harris Hip Score (mHHS), Hip Outcome Score Activities of Daily Living (HOS-ADL) and Sports-Specific (HOS-SS) subscales, and visual analog scale (VAS) for pain. Postoperatively, examination and PRO data were collected at a minimum 1 year after surgery, including a yoga-specific questionnaire. A total of 42 patients (90% female; mean age, 35 ± 9 years; mean body mass index, 23.1 ± 3.2 kg/m 2 ) were included. Thirty patients (71%) had to discontinue their yoga routine preoperatively because of hip-related symptoms at a mean 9.5 ± 8.2 months before surgery. After surgery, 39 patients (93%) were able to return to yoga at a mean 5.3 ± 2.2 months after surgery. Two of the 3 patients who did not return to yoga noted loss of interest as their reason for stopping, while 1 patient was unable to return because of persistent hip pain. Nineteen patients (45%) returned to a higher level of yoga practice, 17 patients (40%) returned to the same level, and 3 patients (7%) returned to a lower level. There was no difference in the number of hours spent practicing yoga per week pre- and postoperatively (2.7 ± 1.9 vs 2.5 ± 1.3 hours; P = 0.44). All patients demonstrated

Kinematic Differences During Single-Leg Step-Down Between Individuals With Femoroacetabular Impingement Syndrome and Individuals Without Hip Pain.

Science.gov (United States)

Lewis, Cara L; Loverro, Kari L; Khuu, Anne

2018-04-01

Study Design Controlled laboratory study, case-control design. Background Despite recognition that femoroacetabular impingement syndrome (FAIS) is a movement-related disorder, few studies have examined dynamic unilateral tasks in individuals with FAIS. Objectives To determine whether movements of the pelvis and lower extremities in individuals with FAIS differ from those in individuals without hip pain during a single-leg step-down, and to analyze kinematic differences between male and female participants within groups. Methods Individuals with FAIS and individuals without hip pain performed a single-leg step-down while kinematic data were collected. Kinematics were evaluated at 60° of knee flexion. A linear regression analysis assessed the main effects of group, sex, and side, and the interaction of sex by group. Results Twenty individuals with FAIS and 40 individuals without hip pain participated. Individuals with FAIS performed the step-down with greater hip flexion (4.9°; 95% confidence interval [CI]: 0.5°, 9.2°) and anterior pelvic tilt (4.1°; 95% CI: 0.9°, 7.3°) than individuals without hip pain. Across groups, female participants performed the task with more hip flexion (6.1°; 95% CI: 1.7°, 10.4°), hip adduction (4.8°; 95% CI: 2.2°, 7.4°), anterior pelvic tilt (5.8°; 95% CI: 2.6°, 9.0°), pelvic drop (1.4°; 95% CI: 0.3°, 2.5°), and thigh adduction (2.7°; 95% CI: 1.3°, 4.2°) than male participants. Conclusion The results of this study suggest that individuals with FAIS have alterations in pelvic motion during a dynamic unilateral task. The noted altered movement patterns in the FAIS group may contribute to the development of hip pain and may be due to impairments that are modifiable through rehabilitation. J Orthop Sports Phys Ther 2018;48(4):270-279. Epub 6 Mar 2018. doi:10.2519/jospt.2018.7794.

Methodological quality of systematic reviews addressing femoroacetabular impingement.

Science.gov (United States)

Kowalczuk, Marcin; Adamich, John; Simunovic, Nicole; Farrokhyar, Forough; Ayeni, Olufemi R

2015-09-01

As the body of literature on femoroacetabular impingement (FAI) continues to grow, clinicians turn to systematic reviews to remain current with the best available evidence. The quality of systematic reviews in the FAI literature is currently unknown. The goal of this study was to assess the quality of the reporting of systematic reviews addressing FAI over the last 11 years (2003-2014) and to identify the specific methodological shortcomings and strengths. A search of the electronic databases, MEDLINE, EMBASE and PubMed, was performed to identify relevant systematic reviews. Methodological quality was assessed by two reviewers using the revised assessment of multiple systematic reviews (R-AMSTAR) scoring tool. An intraclass correlation coefficient (ICC) with 95 % confidence intervals (CI) was used to determine agreement between reviewers on R-AMSTAR quality scores. A total of 22 systematic reviews were assessed for methodological quality. The mean consensus R-AMSTAR score across all studies was 26.7 out of 40.0, indicating fair methodological quality. An ICC of 0.931, 95 % CI 0.843-0.971 indicated excellent agreement between reviewers during the scoring process. The systematic reviews addressing FAI are generally of fair methodological quality. Use of tools such as the R-AMSTAR score or PRISMA guidelines while designing future systematic reviews can assist in eliminating methodological shortcomings identified in this review. These shortcomings need to be kept in mind by clinicians when applying the current literature to their patient populations and making treatment decisions. Systematic reviews of highest methodological quality should be used by clinicians when possible to answer clinical questions.

High Rate of Return to High-Intensity Interval Training After Arthroscopic Management of Femoroacetabular Impingement Syndrome.

Science.gov (United States)

Riff, Andrew J; Ukwuani, Gift; Clapp, Ian; Movassaghi, Kamran; Kelly, D Michael; Nho, Shane J

2018-06-01

Since the inception of CrossFit in 2000, the popularity of high-intensity interval training (HIIT) in the United States has risen dramatically. While HIIT is a highly efficient exercise for weight loss and improved conditioning, some literature reports injuries in up to 34% of HIIT participants. We sought to evaluate the functional and sports-specific results of hip arthroscopic surgery in recreational HIIT participants. To evaluate patients' ability to return to HIIT after hip arthroscopic surgery for femoroacetabular impingement syndrome (FAIS). Case series; Level of evidence, 4. Consecutive patients with FAIS who had identified themselves as participating in HIIT and had undergone hip arthroscopic surgery for the treatment of FAIS by a single fellowship-trained surgeon between 2012 and 2015 were reviewed. Demographic data; preoperative physical examination findings; preoperative imaging results; preoperative patient-reported outcome (PRO) scores including the modified Harris Hip Score (mHHS), Hip Outcome Score-Activities of Daily Living (HOS-ADL), Hip Outcome Score-Sports-Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain; and postoperative examination and PRO scores at a minimum 2 years after surgery, including a HIIT-specific questionnaire, were assessed for all patients. Thirty-two patients (13 male, 19 female) with a mean age of 34.7 ± 6.9 years (range, 21-49 years) were identified with a minimum 24-month follow-up. Among these, 22 participated in CrossFit, 4 in Shred415, 3 in Orangetheory, and 3 in self-directed cross-training including plyometrics. Preoperatively, 14 patients had discontinued HIIT because of activity-related hip complaints, 17 patients had scaled back involvement in HIIT, and 1 patient maintained her baseline routine. Postoperatively, 28 of 32 patients (88%) returned to HIIT at a mean of 9.8 ± 5.7 months after surgery (range, 3-24 months); 96% returned to HIIT at the same level as or better than before the injury. Fear

Diagnosis of shoulder impingement syndrome

International Nuclear Information System (INIS)

Hodler, J.

1996-01-01

This article reviews the pathogenesis and clinical and imaging findings in shoulder impingement syndrome. Different stages of impingement syndrome are described. Stage I relates to edema and hemorrhage of the supraspinatus tendon. Stage II is characterized by bursal inflammation and fibrosis, as well as tendinopathy. In stage III there is a tear of the rotator cuff. Clinical signs many overlap. Moreover, calcifying tendinitis, fractures and pain originating from the cervical spine may mimic shoulder impingement syndrome. Imaging is important for the exact diagnosis. Standard radiographs are the basis of imaging in shoulder impingement syndrome. They may demonstrate subchondral sclerosis of the major tuberosity, subacromial spurs, and form anomalies of the acromion. They are also important in the differential diagnosis of shoulder impingement syndrome and demonstrate calcifying tendinitis, fractures and neoplasm. Ultrasonography has found acceptance as a screening tool and even as a final diagnostic method by many authors. However, there is a high interobserver variability in the demonstration of rotator cuff tears. Its usefulness has therefore been questioned. MR imaging is probably the method of choice in the evaluation of the rotator cuff and surrounding structures. Several investigations have demonstrated that differentiation of early findings, such as tendinopathy versus partial tears, may be difficult with MR imaging. However, reproducibility for fullthickness tears appears to be higher than for sonography. Moreover, specificity appears to be superior to sonography. MR arthrography is not universally accepted. However, it allows for more exact differentiation of discrete findings and may be indicated in preoperative planning. Standard arthrography and CT have a limited role in the current assessment of the rotator cuff. (orig.) [de

Diagnostic Accuracy of Imaging Modalities and Injection Techniques for the Diagnosis of Femoroacetabular Impingement/Labral Tear

DEFF Research Database (Denmark)

Reiman, Michael P.; Thorborg, Kristian; Goode, Adam P.

2017-01-01

Background: Diagnosing femoroacetabular impingement/acetabular labral tear (FAI/ALT) and subsequently making a decision regarding surgery are based primarily on diagnostic imaging and intra-articular hip joint injection techniques of unknown accuracy. Purpose: Summarize and evaluate the diagnostic...... probability of disease was demonstrated. Positive imaging findings increased the probability that a labral tear existed by a minimal to small degree with the use of magnetic resonance imaging/magnetic resonance angiogram (MRI/MRA) and ultrasound (US) and by a moderate degree for CTA. Negative imaging findings...... decreased the probability that a labral tear existed by a minimal degree with the use of MRI and US, a small to moderate degree with MRA, and a moderate degree with CTA. Clinical Relevance: Although findings of the included studies suggested potentially favorable use of these modalities for the diagnosis...

Impingement syndrome of the shoulder

International Nuclear Information System (INIS)

Mayerhoefer, M.E.; Breitenseher, M.J.

2004-01-01

The impingement syndrome is a clinical entity characterized by shoulder pain due to primary or secondary mechanical irritation of the rotator cuff. The primary factors for the development of impingement are a curved or hook-shaped anterior acromion as well as subacromial osteophytes, which may lead to tearing of the supraspinatus tendon. Secondary impingement is mainly caused by calcific tendinopathy, glenohumeral instability, os acromiale and degenerative changes of the acromioclavicular joint. Conventional radiographs are initially obtained, mainly for evaluation of the bony structures of the shoulder. If available, sonography can be used for detection of lesions and tears of the rotator cuff. Finally, MR-imaging provides detailed information about the relationship of the acromion and the acromioclavicular joint to the rotator cuff itself. In many cases however, no morphologic cause for impingement syndrome can be found. While patients are initially treated conservatively, chronic disease usually requires surgical intervention. (orig.) [de

Coordination of deep hip muscle activity is altered in symptomatic femoroacetabular impingement.

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Diamond, Laura E; Van den Hoorn, Wolbert; Bennell, Kim L; Wrigley, Tim V; Hinman, Rana S; O'Donnell, John; Hodges, Paul W

2017-07-01

Diagnosis of femoroacetabular impingement (FAI) is increasing, yet the associated physical impairments remain poorly defined. This morphological hip condition can cause joint pain, stiffness, impaired function, and eventually hip osteoarthritis. This exploratory study compared coordination of deep hip muscles between people with and without symptomatic FAI using analysis of muscle synergies (i.e., patterns of activity of groups of muscles activated in synchrony) during gait. Fifteen individuals (11 males) with symptomatic FAI (clinical examination and imaging) and 14 age- and sex-comparable controls without morphological FAI underwent testing. Intramuscular fine-wire and surface electrodes recorded electromyographic activity of selected deep and superficial hip muscles. A non-negative matrix factorization algorithm extracted three synergies which were compared between groups. Information regarding which muscles were activated together in the FAI group (FAI group synergy vector) was used to reconstruct individual electromyography patterns and compare groups. Variance accounted for (VAF) by three synergies was less for the control (94.8 [1.4]%) than FAI (96.0 [1.0]%) group (p = 0.03). VAF of obturator internus was significantly higher in the FAI group (p = 0.02). VAF of the reconstructed individual electromyography patterns with the FAI or control group vector were significantly higher for the FAI group (p hip muscles in the synergy related to hip joint control during early swing differed between groups. This phase involves movement towards the impingement position, which has relevance for the interpretation of synergy differences and potential clinical importance. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1494-1504, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

SURGICAL TREATMENT FOR FEMOROACETABULAR IMPINGEMENT IN A GROUP THAT PERFORMS SQUATS.

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Polesello, Giancarlo Cavalli; Cinagawa, Eduardo Hitoshi Tsuge; Cruz, Paulo Daniel Sousa Santa; de Queiroz, Marcelo Cavalheiro; Borges, Cristian Jandrey; Junior, Walter Ricioli; Daniachi, Daniel; Guimarães, Rodrigo Pereira; Honda, Emerson Kiyoshi; Ono, Nelson Keiske

2012-01-01

Describe the results from arthroscopic surgical treatment on a group of patients who developed symptoms after repetitive physical activity of moving their hips in a position of hyperflexion, as in leg presses and squats. The study group comprised 47 individuals (48 hips) who developed the onset of painful symptoms associated with hip hyperflexion exercises (leg presses or squats) and underwent arthroscopic treatment. The patients were evaluated radiographically and clinically according to the "Harris Hip Score", as modified by Byrd (MHHS), pre and postoperatively, and were asked about their return to sports activities and the surgical findings. The mean preoperative and postoperative MHHS, respectively, were 60 points (SD 11.0, range 38.5 to 92.4) and 95.9 points (SD 7.7, range 63.8 to 100), with an increase of 35.9 points (P < 0.001). Regarding physical activity, 30 individuals (71.5%) resumed sports activities after surgery, and 25 of them (83.4%) at the previous level. Six patients (12.8%) did not resume activities because of persistent pain. During arthroscopy, 48 hips (100%) presented lesions of the acetabular labrum, and 41 hips (85.4%) had acetabular chondral lesions. The patients with painful symptoms after hip hyperflexion exercises associated with femoroacetabular impingement presented improvements after arthroscopic treatment.

Hip morphometry of femoroacetabular impingement pattern in patients with ankylosing spondylitis

Energy Technology Data Exchange (ETDEWEB)

Lee, Jong Yoon; Lee, Eu Gene; Choi, Jung Ah [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

2015-06-15

To analyze hip morphometry of femoroacetabular impingement (FAI) pattern in patients with ankylosing spondylitis (AS) and correlate them with sacroiliitis grades. 384 patients with AS were analyzed regarding demographics, radiologic signs of FAI for hip involvement, and sacroiliitis grades. FAI was classified into 3 types according to alpha angle, lateral center-edge angle and pistol grip deformity. Sacroiliitis was graded according to the New York criteria. Prevalence of FAI morphometry types was determined and evaluated for association with sacroiliitis grades. Statistical analysis regarding numerical variables, including age, sacroiliitis score using t-test, sacroiliitis score in three groups using Kruskal-Wallis test and Mann-Whitney U-test, corrected by Bonferroni methods for post hoc analysis was done. Among 384 patients, 141 (36.7%) had FAI morphometry. Male predominance was found in group with FAI pattern involvement (87.2%) (p = 0.000). Pincer type (20.6%) was the most common. Hip involvement group also showed greater sacroiliitis score (2.49 vs. 1.75, p = 0.000). Combined-type had greater sacroiliitis score compared with others (p = 0.002, 0.003). FAI morphometry was frequent in hips of AS patients (36.7%), especially pincer type, more frequent in male, and associated with significantly greater grade of sacroiliitis; combined type FAI pattern had greater sacroiliitis score.

Hip morphometry of femoroacetabular impingement pattern in patients with ankylosing spondylitis

International Nuclear Information System (INIS)

Lee, Jong Yoon; Lee, Eu Gene; Choi, Jung Ah

2015-01-01

To analyze hip morphometry of femoroacetabular impingement (FAI) pattern in patients with ankylosing spondylitis (AS) and correlate them with sacroiliitis grades. 384 patients with AS were analyzed regarding demographics, radiologic signs of FAI for hip involvement, and sacroiliitis grades. FAI was classified into 3 types according to alpha angle, lateral center-edge angle and pistol grip deformity. Sacroiliitis was graded according to the New York criteria. Prevalence of FAI morphometry types was determined and evaluated for association with sacroiliitis grades. Statistical analysis regarding numerical variables, including age, sacroiliitis score using t-test, sacroiliitis score in three groups using Kruskal-Wallis test and Mann-Whitney U-test, corrected by Bonferroni methods for post hoc analysis was done. Among 384 patients, 141 (36.7%) had FAI morphometry. Male predominance was found in group with FAI pattern involvement (87.2%) (p = 0.000). Pincer type (20.6%) was the most common. Hip involvement group also showed greater sacroiliitis score (2.49 vs. 1.75, p = 0.000). Combined-type had greater sacroiliitis score compared with others (p = 0.002, 0.003). FAI morphometry was frequent in hips of AS patients (36.7%), especially pincer type, more frequent in male, and associated with significantly greater grade of sacroiliitis; combined type FAI pattern had greater sacroiliitis score

Arthroscopy Up to Date: Hip Femoroacetabular Impingement.

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Khan, Moin; Habib, Anthony; de Sa, Darren; Larson, Christopher M; Kelly, Bryan T; Bhandari, Mohit; Ayeni, Olufemi R; Bedi, Asheesh

2016-01-01

To provide a comprehensive review and summary of the research published in Arthroscopy: The Journal of Arthroscopic and Related Surgery and The American Journal of Sports Medicine (AJSM) related to hip arthroscopy for femoroacetabular impingement (FAI). A comprehensive review was conducted in duplicate of Arthroscopy and AJSM from February 2012 to February 2015 for all articles related to FAI, and a quality assessment was completed for all included studies. Clinical outcomes were dichotomized into short-term (Arthroscopy and 44 studies in AJSM, primarily from North America (78.8%), that predominantly assessed clinical outcomes after arthroscopic hip surgery (46.1%). Seventy-one percent of Arthroscopy studies and 20.5% of AJSM studies were Level IV evidence. The modified Harris Hip Score (mHHS) was used by 81.5% of included studies. Pooled weighted mean mHHS values after arthroscopic surgery for FAI showed improvements at the midterm from 60.5 points (range, 56.6 to 83.6 points) to 80.5 points (range, 72.1 to 98.0 points) out of a possible 100 points. Pooled weighted outcomes for labral repair showed mean mHHS improvements from 63.8 points (range, 62.5 to 69.0 points) preoperatively to 86.9 points (range, 85.5 to 89.9 points) up to 24 months postoperatively. This comprehensive review of research published in Arthroscopy and AJSM over the past 3 years identified a number of key findings. Arthroscopic intervention results in improvements in functional outcomes at both the short-term and midterm for patients with symptomatic FAI in the absence of significant existing degenerative changes. Labral repair may result in improvements over labral debridement. The most commonly used outcome score was the mHHS for objective assessment of surgical success. There is a need for continued focus on improvement of methodologic quality and reporting of research pertaining to FAI. Level IV, systematic review of Level IV studies. Copyright © 2016 Arthroscopy Association of North

Protocol for a multicentre, parallel-arm, 12-month, randomised, controlled trial of arthroscopic surgery versus conservative care for femoroacetabular impingement syndrome (FASHIoN).

Science.gov (United States)

Griffin, D R; Dickenson, E J; Wall, P D H; Donovan, J L; Foster, N E; Hutchinson, C E; Parsons, N; Petrou, S; Realpe, A; Achten, J; Achana, F; Adams, A; Costa, M L; Griffin, J; Hobson, R; Smith, J

2016-08-31

Femoroacetabular impingement (FAI) syndrome is a recognised cause of young adult hip pain. There has been a large increase in the number of patients undergoing arthroscopic surgery for FAI; however, a recent Cochrane review highlighted that there are no randomised controlled trials (RCTs) evaluating treatment effectiveness. We aim to compare the clinical and cost-effectiveness of arthroscopic surgery versus best conservative care for patients with FAI syndrome. We will conduct a multicentre, pragmatic, assessor-blinded, two parallel arm, RCT comparing arthroscopic surgery to physiotherapy-led best conservative care. 24 hospitals treating NHS patients will recruit 344 patients over a 26-month recruitment period. Symptomatic adults with radiographic signs of FAI morphology who are considered suitable for arthroscopic surgery by their surgeon will be eligible. Patients will be excluded if they have radiographic evidence of osteoarthritis, previous significant hip pathology or previous shape changing surgery. Participants will be allocated in a ratio of 1:1 to receive arthroscopic surgery or conservative care. Recruitment will be monitored and supported by qualitative intervention to optimise informed consent and recruitment. The primary outcome will be pain and function assessed by the international hip outcome tool 33 (iHOT-33) measured 1-year following randomisation. Secondary outcomes include general health (short form 12), quality of life (EQ5D-5L) and patient satisfaction. The primary analysis will compare change in pain and function (iHOT-33) at 12 months between the treatment groups, on an intention-to-treat basis, presented as the mean difference between the trial groups with 95% CIs. The study is funded by the Health Technology Assessment Programme (13/103/02). Ethical approval is granted by the Edgbaston Research Ethics committee (14/WM/0124). The results will be disseminated through open access peer-reviewed publications, including Health Technology

What is the impingement-free range of motion of the asymptomatic hip in young adult males?

Science.gov (United States)

Larkin, Brian; van Holsbeeck, Marnix; Koueiter, Denise; Zaltz, Ira

2015-04-01

Femoroacetabular impingement is a recognized cause of chondrolabral injury. Although surgical treatment for impingement seeks to improve range of motion, there are very little normative data on dynamic impingement-free hip range of motion (ROM) in asymptomatic people. Hip ultrasound demonstrates labral anatomy and femoral morphology and, when used dynamically, can assist in measuring range of motion. The purposes of this study were (1) to measure impingement-free hip ROM until labral deflection is observed; and (2) to measure the maximum degree of sagittal plane hip flexion when further flexion is limited by structural femoroacetabular abutment. Forty asymptomatic adult male volunteers (80 hips) between the ages of 21 and 35 years underwent bilateral static and dynamic hip ultrasound examination. Femoral morphology was characterized and midsagittal flexion passive ROM was measured at two points: (1) at the initiation of labral deformation; and (2) at maximum flexion when the femur impinged on the acetabular rim. The mean age of the subjects was 28 ± 3 years and the mean body mass index was 25 ± 4 kg/m(2). Mean impingement-free hip passive flexion measured from full extension to initial labral deflection was 68° ± 17° (95% confidence interval [CI], 65-72). Mean maximum midsagittal passive flexion, measured at the time of bony impingement, was 96° ± 6° (95% CI, 95-98). Using dynamic ultrasound, we found that passive ROM in the asymptomatic hip was much less than the motion reported in previous studies. Measuring ROM using ultrasound is more accurate because it allows anatomic confirmation of terminal hip motion. Surgical procedures used to treat femoroacetabular impingement are designed to restore or increase hip ROM and their results should be evaluated in light of precise normative data. This study suggests that normal passive impingement-free femoroacetabular flexion in the young adult male is approximately 95°.

Subacromial impingement syndrome

Directory of Open Access Journals (Sweden)

Masood Umer

2012-05-01

Full Text Available Subacromial impingement syndrome (SAIS represents a spectrum of pathology ranging from subacromial bursitis to rotator cuff tendinopathy and full-thickness rotator cuff tears. The relationship between subacromial impingement and rotator cuff disease in the etiology of rotator cuff injury is a matter of debate. However the etiology is multi-factorial, and has been attributed to both extrinsic and intrinsic mechanisms. Management includes physical therapy, injections, and, for some patients, surgery. No high-quality RCTs are available so far to provide possible evidence for differences in outcome of different treatment strategies. There remains a need for high-quality clinical research on the diagnosis and treatment of SAIS.

Shoulder Girdle Muscles Endurance in Subjects with and without Impingement Syndrome

Directory of Open Access Journals (Sweden)

Afsoun Nodehi-Moghadam

2011-07-01

Full Text Available Objective: Any minimal alteration in performance and coordination of scapular and glenohumeral muscles has the potential to lead to shoulder joint dysfunction. The impingement syndrome has been reported as is the most common diagnosis of shoulder pain. The purpose of this study was to determine whether endurance deficits could be detected in patients with shoulder impingement. Materials & Methods: By convenient sampling 15 patients with impingement syndrome at average of 45.3 years of age and 15 healthy persons (age 45.8 years through a case–control design participated in the study. Endurance of glenohumeral and scapulothoracic muscles were tested with a hand held dynamometer. Independent t–test was used to statistically analyze different groups. Results: Compared to non–impaired subjects, those with impingement syndrome demonstrated a significantly lower endurance of external rotation, scaption and scapular abduction and upward rotation movements (P<0.05. In impingement syndrome patients, the external–to–internal rotator muscles endurance ratio was significantly lower than the control group (P<0.05. Conclusion: The result of the study suggests that endurance deficit of rotator cuff and scapular upward rotator muscles may be an important aspect of the impingement syndrome. Shoulder girdle muscles endurance should be considered in evaluation and physical therapy of impingement syndrome patients.

Radiographic evidence of femoroacetabular impingement in athletes with athletic pubalgia.

Science.gov (United States)

Economopoulos, Kostas J; Milewski, Matthew D; Hanks, John B; Hart, Joseph M; Diduch, David R

2014-03-01

Two of the most common causes of groin pain in athletes are femoroacetabular impingement (FAI) and athletic pubalgia. An association between the 2 is apparent, but the prevalence of radiographic signs of FAI in patients undergoing athletic pubalgia surgery remains unknown. The purpose of this study was to determine the prevalence of radiologic signs of FAI in patients with athletic pubalgia. We hypothesized that patients with athletic pubalgia would have a high prevalence of underlying FAI. Case series. Level 4. A retrospective review of all patients evaluated at our institution with athletic pubalgia who underwent surgical treatment (ie, for sports hernia) from 1999 to 2011 was performed. The radiographs of patients with athletic pubalgia were reviewed for radiographic signs of FAI. Alpha angles were measured using frog-leg lateral radiographs. Pincer lesions were identified by measuring the lateral center-edge angle and identifying the presence of a "crossover" sign on anteroposterior radiographs. Phone follow-up was performed 2 years or more after the initial sports hernia surgery to evaluate recurrent symptoms. Forty-three patients underwent 56 athletic pubalgia surgeries. Radiographic evidence of FAI was identified in at least 1 hip in 37 of 43 patients (86%). Cam lesions were identified in 83.7% of the population; the alpha angle averaged 66.7° ± 17.9° for all hips. Pincer lesions were present in 28% of the hips. Eight patients had recurrent groin pain, 3 patients had revision athletic pubalgia surgery, and 1 had hip arthroscopy. The study demonstrates a high prevalence of radiographic FAI in patients with athletic pubalgia. Underlying FAI may be a cause of continued groin pain after athletic pubalgia surgery. Patients with athletic pubalgia should be evaluated closely for FAI.

Patient Satisfaction Reporting for the Treatment of Femoroacetabular Impingement.

Science.gov (United States)

Kahlenberg, Cynthia A; Nwachukwu, Benedict U; Schairer, William W; McCormick, Frank; Ranawat, Anil S

2016-08-01

The purpose of this study was to evaluate how patient satisfaction after surgical femoroacetabular impingement (FAI) treatment is measured and reported in the current evidence base. A review of the MEDLINE database was performed. Clinical outcome studies of FAI that reported a measure of patient satisfaction were included. Patient demographics, clinical outcome scores, and patient satisfaction measures were extracted. The NewCastle Ottawa Scale (NOS) was used to grade quality. Statistical analysis was primarily descriptive. Twenty-six studies met inclusion criteria; the mean NOS score among included studies was 5.7. Most studies were level 3 or 4 (n = 25, 96.1%). A 0 to 10 numeric scale, described by some studies as a visual analog scale, was the most commonly used method to assess satisfaction (n = 21; 80.8%), and mean reported scores ranged from 6.8 to 9.2 out of 10. Four studies (15.4%) used an ordinal scale, and 1 study (3.8%) used willingness to undergo surgery again as the measure of satisfaction. None of the included studies assessed preoperative satisfaction or patient expectation. Pooled cohort analysis was limited by significant overlapping study populations. Predictors of patients' satisfaction identified in included studies were presence of arthritis and postoperative outcome scores. Patient satisfaction was not uniformly assessed in the literature. Most studies used a 0- to 10-point satisfaction scale, but none distinguished between the process of care and the outcome of care. Although satisfaction scores were generally high, the quality of the methodologies in the studies that reported satisfaction was low, and the studies likely included overlapping patient populations. More work needs to be done to develop standardized ways for assessing patient satisfaction after arthroscopic hip surgery and other procedures in orthopaedic sports medicine. Level III, systematic review of Level III studies. Copyright © 2016 Arthroscopy Association of North

Clinical radiation diagnostics of shoulder joint impingement syndrome

International Nuclear Information System (INIS)

Litvin, Yu.P.; Logvinenko, V.V.

2014-01-01

46 patients about an impingement are investigated by a syndrome of a humeral joint. Among them men was 28 (60,9 %) the person, women 18 (39,1 %). Middle age of the surveyed has made 52,6 ± 2,0 year. The traditional roentgenography is executed to all patients, a spiral computer tomography - 5 (10,9 %), an ultrasonography - 44 (95,7 %), a magnetic resonance imaging - 11 (23,9 %). Operative treatment is spent 16 (34,8 %) by the patient. Direct radial symptoms are what specify an impingement of a syndrome of a humeral joint in the reasons, indirect - symptoms of an inflammation both degenerate and dystrophic changes of structures of area of a humeral joint which are involved in pathological process. The best results are given by complex radial research at which it is possible to find out direct and indirect symptoms a syndrome impingement

The Physiotherapy for Femoroacetabular Impingement Rehabilitation STudy (physioFIRST): A Pilot Randomized Controlled Trial.

Science.gov (United States)

Kemp, Joanne L; Coburn, Sally L; Jones, Denise M; Crossley, Kay M

2018-04-01

Study Design A pilot double-blind randomized controlled trial (RCT). Background The effectiveness of physical therapy for femoroacetabular impingement syndrome (FAIS) is unknown. Objectives To determine the feasibility of an RCT investigating the effectiveness of a physical therapy intervention for FAIS. Methods Participants were 17 women and 7 men (mean ± SD age, 37 ± 8 years; body mass index, 25.4 ± 3.4 kg/m 2 ) with FAIS who received physical therapy interventions provided over 12 weeks. The FAIS-specific physical therapy group received personalized progressive strengthening and functional retraining. The control group received standardized stretching exercises. In addition, both groups received manual therapy, progressive physical activity, and education. The primary outcome was feasibility, including integrity of the protocol, recruitment and retention, outcome measures, randomization procedure, and sample-size estimate. Secondary outcomes included hip pain and function (international Hip Outcome Tool-33 [iHOT-33]) and hip muscle strength. Poststudy interviews were conducted to determine potential improvements for future studies. Results Twenty-four (100%) patients with known eligibility agreed to participate. Four patients (17%) were lost to follow-up. All participants and the tester remained blinded, and the control intervention was acceptable to participants. The between-group mean differences in change scores were 16 (95% confidence interval [CI]: -9, 38) for the iHOT-33 and 0.24 (95% CI: 0.02, 0.47) Nm/kg for hip adduction strength, favoring the FAIS-specific physical therapy group. Using an effect size of 0.61, between-group improvements for the iHOT-33 suggest that 144 participants are required for a full-scale RCT. Conclusion A full-scale RCT of physical therapy for FAIS is feasible. A FAIS-specific physical therapy program has the potential for a moderate to large positive effect on hip pain, function, and hip adductor strength. Level of Evidence

RETRACTED ARTICLE: Clinical effectiveness of continuous passive motion (CPM) following femoroacetabular impingement surgery in adolescents.

Science.gov (United States)

Hosalkar, Harish; Bomar, James D

2012-08-01

This study hypothesizes that the use of continuous passive motion (CPM) following open femoroacetabular impingement (FAI) surgery in the adolescent population improves clinical outcomes in terms of the modified Harris hip score (mHHS). Twenty-nine symptomatic adolescent FAI patients were postoperatively divided into one of three groups; no CPM, two days of inpatient CPM, and two weeks of CPM. mHHS was used preoperatively and postoperatively at six weeks, three months, six months, and nine months in all cases. Kruskal-Wallis (KW) analysis was performed to determine statistical differences in mHHS. mHHS was then re-evaluated using the Mann-Whitney test. There were no statistically significant differences in hip scores between the three groups preoperatively (p = 0.158). There were statistically significant differences (p CPM had the best outcome scores. The results of this study suggest that postoperative CPM use following open hip preservation surgery for symptomatic FAI in adolescents improves clinical outcomes. These benefits seem to be related to the duration of CPM. Retrospective comparative study, Level III. Patients treated one way compared with patients treated another way at the same institution.

Herniation pits in the femoral neck: a radiographic indicator of femoroacetabular impingement?

International Nuclear Information System (INIS)

Kim, Jin Ah; Park, Ji Seon; Ryu, Kyungnam; Jin, Wook

2011-01-01

The purpose was to assess the significance of herniation pits in the femoral neck for radiographic diagnosis of femoroacetabular impingement (FAI). Eighty hips in 62 patients (bilateral in 18) with neutral pelvic orientation were enrolled. Herniation pits were diagnosed when they were located at the anterosuperior femoral neck, close to the physis, and with a diameter of >3 mm. The five radiographic signs of FAI were used: lateral center edge angle (LCE) >39 , acetabular index (AI) ≤0, extrusion index (EI) <25%, acetabular retroversion, and pistol-grip deformity. Patients with radiographs suggesting FAI were retrospectively correlated with their clinical symptoms. Positive radiographic signs were observed in 7 hips with LCE, 7 with AI, and 80 with EI criteria. Only 3 hips out of 80 (3.8%) showed all of the signs. The acetabular retroversion and pistol-grip deformity were seen in 12/80 and 3/80 hips, respectively. The total number of hips that met radiographic criteria for FAI, including pincer type and cam type, was 18 (23%). However, none of these hips were clinically diagnosed with FAI. All symptomatic hips (11/80) presented only with nonspecific pain, and 2 hips out of 11 showed radiographic signs of FAI. The low frequency of positive radiographic signs suggesting FAI with related symptoms among patients with herniation pits suggests that herniation pits have limited significance in the diagnosis of FAI. Therefore it can be concluded that an incidental finding of herniation pits does not necessarily imply a correlation with FAI. (orig.)

Expressiveness and frequency differences of hip joint tissues pathomorphological changes in diseases complicated by femoroacetabular impingement syndrome

Directory of Open Access Journals (Sweden)

V. V. Grigorovsky

2013-12-01

Full Text Available Preface. Last years the increasing value in pathogenesis of hip joint osteoarthrosis (ОА both in adult patients and in children and teenagers is attached to articular surfaces congruence violation of the femoral head and acetabulum that is formed by articular cartilage and labrum, the last one by head movements in the maximum hip flexion and adduction enters in femoroacetabular impingement (FAI with edge of the head and allied site of the neck and is mechanically damaged. Purpose of the work. To establish hip joint tissues pathomorphological changes, to which FAI syndrome leads, and on the basis of graded expressiveness quantification of pathological changes to define differences of their occurrence frequency in groups of patients in some diseases with affected hip joint. Materials and research methods. 65 biopsies of hip joint tissues: proximal femoral epimetaphysis, acetabulum, acetabular lip and joint capsule –from patients with aseptic femoral head necrosis (АNFH and juvenile slipped femoral capital epiphysis (JSFCE. After study of qualitative features of hip joint tissues injury, some graded morphological indices characterizing conditions of affected joints, as occurrence frequencies of pathological changes of certain gradation, and also their comparison in groups of monitoring with calculation of their distinctions significance, were estimated. Results and their discussion. Clinical-pathomorphological research has revealed the various pathological changes shown by signs of discirculatory, chronic dystrophic-destructive and inflammatory processes in tissues of the femoral head, neck, acetabulum and joint capsule. FAI, causing secondary dystrophic-destructive changes in hip joint tissues, has different rates of development in various primary pathology: in JSCFE anatomic conditions of FAI develop faster, in АNFH – more slowly in the dynamics of secondary changes, the last ones do not differ statistically in various nosologies on rates

Shoulder impingement syndrome: diagnostic accuracy of magnetic resonance imaging and radiographic signs

International Nuclear Information System (INIS)

Williamson, M.P.; Chandnani, V.P.; Baird, D.E.; Deberardino, T.M.; Swenson, G.W.; Hansen, M.F.

1994-01-01

Shoulder impingement syndrome is commonly encountered in orthopaedics. In a blinded retrospective study, magnetic resonance imaging and roentgenographic signs in 41 patients with clinical signs of impingement syndrome were compared with 40 control patients. Statistically significant differences between the groups included the absence of subacromial fat, as well as the presence of a supraspinatus tear, subacromial osteophytes, and a decreased coracohumeral distance. Other signs reported to occur in patients with impingement syndrome did not vary significantly in the population studied. 20 refs., 12 figs

The demographic characteristics of high-level and recreational athletes undergoing hip arthroscopy for femoroacetabular impingement: a sports-specific analysis.

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Nawabi, Danyal H; Bedi, Asheesh; Tibor, Lisa M; Magennis, Erin; Kelly, Bryan T

2014-03-01

The purpose of this study was to determine differences in age, gender, and the need for bilateral surgery between high-level athletes grouped by sports with similar mechanical demands on the hip and recreational athletes undergoing hip arthroscopy for femoroacetabular impingement (FAI). By use of a hip-preservation center registry, a retrospective review of patients undergoing hip arthroscopy for FAI between March 2010 and April 2012 was performed. Athletes were categorized as high level (high school, collegiate, or professional) or recreational. We performed a subgroup analysis for high-level athletes, looking at differences among contact, cutting, impingement, overhead/asymmetric, endurance, and flexibility sports. The study included 288 high-level athletes and 334 recreational athletes. Being a high-level athlete was associated with a younger age (mean age, 20.2 years v 33.0 years; odds ratio, 0.69; P gender (61.5% v 53.6%; odds ratio, 1.75; P = .03). The percentage of high-level athletes undergoing bilateral surgery was higher than that of recreational athletes (28.4% v 15.9%); however, this association was found to be confounded by age on multivariate analysis. The most common sports for high-level athletes were soccer, hockey, and football. Athletes participating in cutting sports were significantly younger than athletes participating flexibility, contact, or impingement sports. When compared with recreational athletes undergoing arthroscopic treatment for FAI, high-level athletes are more likely to be younger, to be male, and to undergo bilateral surgery. When high-level athletes are grouped by the mechanical demands placed on the hip by their sport, athletes participating in cutting sports are more likely to be younger than those in the other groups. Level IV, case series. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Impingement syndrome of the shoulder; Schulterimpingement

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Mayerhoefer, M.E. [Klinische Abteilung fuer Osteologie, Klinik fuer Radiodiagnostik der Universitaet Wien (Austria); Klinische Abteilung Radiodiagnostik fuer chirurgische Faecher, Klinik fuer Radiodiagnostik der Universitaet Wien (Austria); Klinische Abteilung fuer Osteologie, Klinik fuer Radiodiagnostik der Universitaet, Waehringer Guertel 18-20, 1090, Wien (Austria); Breitenseher, M.J. [Klinische Abteilung fuer Osteologie, Klinik fuer Radiodiagnostik der Universitaet Wien (Austria); Waldviertelklinikum Horn (Austria)

2004-06-01

The impingement syndrome is a clinical entity characterized by shoulder pain due to primary or secondary mechanical irritation of the rotator cuff. The primary factors for the development of impingement are a curved or hook-shaped anterior acromion as well as subacromial osteophytes, which may lead to tearing of the supraspinatus tendon. Secondary impingement is mainly caused by calcific tendinopathy, glenohumeral instability, os acromiale and degenerative changes of the acromioclavicular joint. Conventional radiographs are initially obtained, mainly for evaluation of the bony structures of the shoulder. If available, sonography can be used for detection of lesions and tears of the rotator cuff. Finally, MR-imaging provides detailed information about the relationship of the acromion and the acromioclavicular joint to the rotator cuff itself. In many cases however, no morphologic cause for impingement syndrome can be found. While patients are initially treated conservatively, chronic disease usually requires surgical intervention. (orig.) [German] Das Impingementsyndrom ist ein klinisches Krankheitsbild multifaktorieller Genese, bei dem es primaer oder sekundaer zu einer schmerzhaften mechanischen Beeintraechtigung der Rotatorenmanschette kommt. Als primaere Faktoren gelten ein gebogener oder hakenfoermiger Vorderrand des Akromions oder von diesem entspringende Osteophyten, was zu Laesionen der Supraspinatussehne fuehren kann. Zu den sekundaeren Faktoren zaehlt man v. a. eine Tendinitis calcarea, eine glenohumerale Instabilitaet, ein Os acromiale sowie degenerative Veraenderungen im Bereich des Akromioklavikulargelenks. Bildgebend steht an erster Stelle ein Nativroentgen, mit dem sich die knoechernen Strukturen gut darstellen lassen. Falls vorhanden, kann in weiterer Folge die Sonographie Auskunft ueber den Zustand der Rotatorenmanschette geben. Mit der MRT schliesslich laesst sich die Beziehung von Akromion und gelenkassoziierten Strukturen zur Rotatorenmanschette

Editorial Commentary: The Downstream Effects of Limited Hip Rotation and Femoroacetabular Impingement on the Anterior Cruciate Ligament: Could a Little Hip Stretching Every Day (or Surgery) Keep the Knee Doctor Away?

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Boykin, Robert E

2018-03-01

Patients with radiographic evidence of femoroacetabular impingement and decreased hip internal rotation have a higher rate of anterior cruciate ligament (ACL) tears. Limited internal rotation of the hip increases strain and potentially resultant fatigue failure of the ACL. Although causation has not been proven, a better understanding of the lower extremity kinetic chain may allow improved ACL prevention strategies through measures (operative or nonoperative) to improve rotation of the hip. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

High incidence of athletic pubalgia symptoms in professional athletes with symptomatic femoroacetabular impingement.

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Hammoud, Sommer; Bedi, Asheesh; Magennis, Erin; Meyers, William C; Kelly, Bryan T

2012-10-01

The purpose of this study was to identify the incidence of symptoms consistent with athletic pubalgia (AP) in athletes requiring surgical treatment for femoroacetabular impingement (FAI) and the frequency of surgical treatment of both AP and FAI in this group of patients. Thirty-eight consecutive professional athletes, with a mean age of 31 years, underwent arthroscopic surgery for symptomatic FAI that limited their ability to play competitively. In all cases a cam and/or focal rim osteoplasty with labral refixation or debridement was performed. In 1 case concomitant intramuscular lengthening of the psoas was performed. Retrospective data regarding prior AP surgery and return to play were collected. Thirty-two percent of patients had previously undergone AP surgery, and 1 patient underwent AP surgery concomitantly with surgical treatment of FAI. No patient returned to his previous level of competition after isolated AP surgery. Thirty-nine percent had AP symptoms that resolved with FAI surgery alone. Of the 38 patients, 36 returned to their previous level of play; all 12 patients with combined AP and FAI surgery returned to professional competition. The mean duration before return to play was 5.9 months (range, 3 to 9 months) after arthroscopic surgery. There is a high incidence of symptoms of AP in professional athletes with FAI of the hip. This study draws attention to the overlap of these 2 diagnoses and highlights the importance of exercising caution in diagnosing AP in a patient with FAI. Level IV, therapeutic, retrospective case series. Copyright © 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Accuracy of magnetic resonance studies in the detection of chondral and labral lesions in femoroacetabular impingement: systematic review and meta-analysis.

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Saied, A M; Redant, C; El-Batouty, M; El-Lakkany, M R; El-Adl, W A; Anthonissen, J; Verdonk, R; Audenaert, E A

2017-02-16

Several types of Magnetic resonance imaging (MRI) are commonly used in imaging of femoroacetabular impingement (FAI), however till now there are no clear protocols and recommendations for each type. The aim of this meta-analysis is to detect the accuracy of conventional magnetic resonance imaging (cMRI), direct magnetic resonance arthrography (dMRA) and indirect magnetic resonance arthrography (iMRA) in the diagnosis of chondral and labral lesions in femoroacetabular impingement (FAI). A literature search was finalized on the 17th of May 2016 to collect all studies identifying the accuracy of cMRI, dMRA and iMRA in diagnosing chondral and labral lesions associated with FAI using surgical results (arthroscopic or open) as a reference test. Pooled sensitivity and specificity with 95% confidence intervals using a random-effects meta-analysis for MRI, dMRA and iMRA were calculated also area under receiver operating characteristic (ROC) curve (AUC) was retrieved whenever possible where AUC is equivocal to diagnostic accuracy. The search yielded 192 publications which were reviewed according inclusion and exclusion criteria then 21 studies fulfilled the eligibility criteria for the qualitative analysis with a total number of 828 cases, lastly 12 studies were included in the quantitative meta-analysis. Meta-analysis showed that as regard labral lesions the pooled sensitivity, specificity and AUC for cMRI were 0.864, 0.833 and 0.88 and for dMRA were 0.91, 0.58 and 0.92. While in chondral lesions the pooled sensitivity, specificity and AUC for cMRI were 0.76, 0.72 and 0.75 and for dMRA were 0.75, 0.79 and 0.83, while for iMRA were sensitivity of 0.722 and specificity of 0.917. The present meta-analysis showed that the diagnostic test accuracy was superior for dMRA when compared with cMRI for detection of labral and chondral lesions. The diagnostic test accuracy was superior for labral lesions when compared with chondral lesions in both cMRI and dMRA. Promising results are

Overdiagnosing of femoroacetabular impingement: correlation between clinical presentation and computed tomography in symptomatic patients☆

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Canella, Richard Prazeres; Adam, Guilherme Pradi; de Castillo, Roberto André Ulhôa; Codonho, Daniel; Ganev, Gerson Gandhi; de Vicenzi, Luiz Fernando

2016-01-01

Objective To correlate the angles between the acetabulum and the proximal femur in symptomatic patients with femoroacetabular impingement (FAI), using computed tomography (CT). Methods We retrospectively evaluated 103 hips from 103 patients, using multislice CT to measure the acetabular age, acetabular version (in its supraequatorial portion and in its middle third), femoral neck version, cervical-diaphyseal and alpha angles and the acetabular depth. For the statistical analysis, we used the Pearson correlation coefficient. Results There were inverse correlations between the following angles: (1) acetabular coverage versus alpha angle (p = 0.019); (2) acetabular version (supraequatorial) versus alpha angle (p = 0.049). For patients with femoral anteversion lower than 15 degrees: (1) acetabular version (supraequatorial) versus alpha angle (p = 0.026); (2) acetabular version (middle third) versus alpha angle (p = 0.02). For patients with acetabular version (supraequatorial) lower than 10 degrees: (1) acetabular version (supraequatorial) versus alpha angle (p = 0.004); (2) acetabular version (middle third) versus alpha angle (p = 0.009). Conclusion There was a statistically significant inverse correlation between the acetabular version and alpha angles (the smaller the acetabular anteversion angle was, the larger the alpha angle was) in symptomatic patients, thus supporting the hypothesis that FAI occurs when cam and pincer findings due to acetabular retroversion are seen simultaneously, and that the latter alone does not cause FAI, which leads to overdiagnosis in these cases. PMID:27069890

Surgical dislocation of the hip and the management of femoroacetabular impingement: results of the Christchurch experience.

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Kempthorne, Joshua T; Armour, Paul C; Rietveld, John A; Hooper, Gary J

2011-06-01

Surgical dislocation of the hip has been developed to deal with the problems causing femoroacetabular impingement (FAI). This is a relatively recent procedure that was historically reserved for larger areas specializing in hip surgery. We hypothesized that surgical dislocation can be used for symptomatic FAI in a typical Australasian tertiary orthopaedic centre with acceptable results. This prospective study reviews the results of 53 surgical dislocations in this setting, looking particularly at functional outcomes and early complications. There were significant improvements in the Western Ontario and McMaster University Osteoarthritis Index score at 1, 2, 3 and 4 years post-operatively. Western Ontario and McMaster University Osteoarthritis Index scores increased by 23, 28, 34 and 35 points, respectively (P 0.0039). There was no significant improvement in hip range of motion. There were two (4%) early failures with conversion to total hip arthroplasty, and no cases of post-operative avascular necrosis of the femoral head. We believe that as the diagnosis of FAI and conservative nonarthroplasty surgery of the hip gains wider acceptance, it will become a procedure that should be offered to all appropriate patients in an attempt to delay or limit total hip arthroplasty in this young age group.

Hip arthroscopy for femoroacetabular impingement: the changing nature and severity of associated complications over time.

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Park, Myung-Sik; Yoon, Sun-Jung; Kim, Yong-Jin; Chung, Woo-Chul

2014-08-01

The aim of this study was to assess complications related to arthroscopy for femoroacetabular impingement (FAI) and how these complications have changed as we have gained more experience with this procedure. The authors reviewed 200 hips (197 patients). The average patient age was 44.64 years and the mean follow-up time was 28.2 months. All patients underwent hip arthroscopy in the supine position. Clinically, Modified Harris Hip Scores (MHHS) and patient satisfaction with outcome were used. We divided complications into 3 groups: Group 1 related to traction, group 2 related to surgical technique or implant failure, and group 3 related to outcomes. Clinically, the MHHS improved from 69.96 (±6.10) to 80.45 (±7.00), and patient satisfaction with the achieved outcome increased to 8.87 (±0.76). The overall complication rate was 15% (30 of 200 hips). Group 1 consisted of 4 patients with pudendal neuropraxia and 2 patients with ankle joint pain (P = .013). Group 2 consisted of 2 patients with lateral femoral cutaneous neuropraxia, 2 patients with iatrogenic labral perforations, one patient with a labral tear, and 4 patients with femoral head scuffs. There were 4 incidents of instrument breakage. Furthermore, 3 suture anchors failed, a second-degree burn occurred in one patient, and there was incomplete reshaping in 5 hips (P = .045). Group 3 included one patient with a snapping sound and heterotopic ossification. Second-look arthroscopy was performed for 5 hips. All the complications outlined in groups 1 and 2 are related to the learning curve and have statistical significance (P arthroscopy took different forms during the early learning period, but overall complication rates decreased along the learning curve. Surgical technique-related complications such as problems with suture anchors and the reshaping of cam impingements were also considered during the later stage. Level IV, therapeutic case series. Copyright © 2014 Arthroscopy Association of North America

Isometric and isokinetic hip strength and agonist/antagonist ratios in symptomatic femoroacetabular impingement.

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Diamond, Laura E; Wrigley, Tim V; Hinman, Rana S; Hodges, Paul W; O'Donnell, John; Takla, Amir; Bennell, Kim L

2016-09-01

This study investigated isometric and isokinetic hip strength in individuals with and without symptomatic femoroacetabular impingement (FAI). The specific aims were to: (i) determine whether differences exist in isometric and isokinetic hip strength measures between groups; (ii) compare hip strength agonist/antagonist ratios between groups; and (iii) examine relationships between hip strength and self-reported measures of either hip pain or function in those with FAI. Cross-sectional. Fifteen individuals (11 males; 25±5 years) with symptomatic FAI (clinical examination and imaging (alpha angle >55° (cam FAI), and lateral centre edge angle >39° and/or positive crossover sign (combined FAI))) and 14 age- and sex-matched disease-free controls (no morphological FAI on magnetic resonance imaging) underwent strength testing. Maximal voluntary isometric contraction strength of hip muscle groups and isokinetic hip internal (IR) and external rotation (ER) strength (20°/s) were measured. Groups were compared with independent t-tests and Mann-Whitney U tests. Participants with FAI had 20% lower isometric abduction strength than controls (p=0.04). There were no significant differences in isometric strength for other muscle groups or peak isokinetic ER or IR strength. The ratio of isometric, but not isokinetic, ER/IR strength was significantly higher in the FAI group (p=0.01). There were no differences in ratios for other muscle groups. Angle of peak IR torque was the only feature correlated with symptoms. Individuals with symptomatic FAI demonstrate isometric hip abductor muscle weakness and strength imbalance in the hip rotators. Strength measurement, including agonist/antagonist ratios, may be relevant for clinical management of FAI. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Sex Differences in Patients With CAM Deformities With Femoroacetabular Impingement: 3-Dimensional Computed Tomographic Quantification.

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Yanke, Adam B; Khair, M Michael; Stanley, Robert; Walton, David; Lee, Simon; Bush-Joseph, Charles A; Espinoza Orías, Alejandro; Espinosa Orias, Alejandro A; Inoue, Nozomu; Nho, Shane J

2015-12-01

To determine if significant differences exist between male and female CAM deformities using quantitative 3-dimensional (3D) volume and location analysis. Retrospective analysis of preoperative computed tomographic (CT) scans for 138 femurs (69 from male patients and 69 from female patients) diagnosed with impingement from November 2009 to November 2011 was completed. Those patients who presented with hip complaints and had a history, physical examination (limited range of motion, positive impingement signs), plain radiographs (anteroposterior pelvis, 90° Dunn view, false profile view), and magnetic resonance images consistent with femoroacetabular impingement (FAI) and in whom a minimum of 6 months of conservative therapy (oral anti-inflammatory agents, physical therapy, and activity modification) had failed were indicated for arthroscopic surgery and had a preoperative CT scan. Scans were segmented, converted to point cloud data, and analyzed with a custom-written computer program. Analysis included mean CAM height and volume, head radius, and femoral version. Differences were analyzed using an unpaired t test with significance set at P position ± the 2:51 o'clock position to the 3:28 o'clock position ± the 1:59 o'clock position, with an average span from the 3:06 o'clock position ± the 1:29 o'clock position (male patients, the 11:23 o'clock position ± the 0:46 o'clock position to the 3:05 o'clock position ± the 1:20 o'clock position; female patients, the 11:33 o'clock position ± the 0:37 o'clock position to the 2:27 o'clock position ± the 0:45 o'clock position). There were no differences in the posterior (P = .60) or anterior (P = .14) extent of CAM deformities. However, the span on the clock face of the CAM deformities varied when comparing men with women (male patients, the 3:43 o'clock position ± the 1:29 o'clock position; female patients, the 2:54 o'clock position ± the 1:09 o'clock position; P = .02). Our data show that female CAM deformities

Subacromial Impingement Syndrome Caused by a Voluminous Subdeltoid Lipoma

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Jean-Christophe Murray

2014-01-01

Full Text Available Subacromial impingement syndrome is a clinical diagnosis encompassing a spectrum of possible etiologies, including subacromial bursitis, rotator cuff tendinopathy, and partial- to full-thickness rotator cuff tears. This report presents an unusual case of subdeltoid lipoma causing extrinsic compression and subacromial impingement syndrome. The patient, a 60-year-old man, presented to our institution with a few years' history of nontraumatic, posteriorly localized throbbing pain in his right shoulder. Despite a well-followed 6-months physiotherapy program, the patient was still suffering from his right shoulder. The MRI scan revealed a well-circumscribed 6 cm × 2 cm × 5 cm homogenous lesion compatible with a subdeltoid intermuscular lipoma. The mass was excised en bloc, and subsequent histopathologic examination confirmed a benign lipoma. At 6-months follow-up, the patient was asymptomatic with a complete return to his activities. Based on this case and a review of the literature, a subacromial lipoma has to be included in the differential diagnosis of a subacromial impingement syndrome refractory to nonoperative treatment. Complementary imaging modalities are required only after a failed conservative management to assess the exact etiology and successfully direct the surgical treatment.

Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome

DEFF Research Database (Denmark)

Storgaard, Filip Holst; Pedersen, Christina Gravgaard; Jensen, Majbritt Lykke

Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome.......Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome....

Effectiveness of Kinesiotaping and Subacromial Corticosteroid Injection in Shoulder Impingement Syndrome.

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Şahin Onat, Şule; Biçer, Seda; Şahin, Zehra; Küçükali Türkyilmaz, Ayşegül; Kara, Murat; Özbudak Demir, Sibel

2016-08-01

The aim of this study was to investigate whether kinesiotaping or subacromial corticosteroid injection provides additional benefit when used with nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with shoulder impingement syndrome. Patients with shoulder impingement syndrome were divided into 3 groups as follows: NSAID group (n = 33), kinesiotaping group (kinesiotaping + NSAID) (n = 33), and injection group (subacromial corticosteroid injection + NSAID) (n = 33). Outcome measures including visual analog scale, shoulder ranges of motion, Shoulder Disability Questionnaire, and University of California-Los Angeles (UCLA) scale were evaluated before and after the treatment (fourth week). A total of 99 patients (21 male and 78 female patients) were enrolled in this study. Demographic and baseline clinical characteristics of the groups (except for body mass index and visual analog scale at night, both P = 0.05) were similar between the groups (all P > 0.05). Clinical parameters were found to have improved in the 3 groups (all P kinesiotaping and injection groups showed similar improvements (all P > 0.05), each group had better outcome than did the NSAID group as regards pain (activity visual analog scale), ranges of motion, and Shoulder Disability Questionnaire and UCLA scale scores (all P kinesiotaping or subacromial corticosteroid injection to NSAID treatment seems to have better/similar effectiveness in patients with shoulder impingement syndrome. Therefore, kinesiotaping might serve as an alternative treatment in case (injection of) corticosteroids are contraindicated. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES:: Upon completion of this article, the reader should be able to: (1) Delineate appropriate treatment options for shoulder impingement syndrome; (2) Identify treatment benefits of kinesiotaping and corticosteroid injections in shoulder impingement syndrome; and (3) Incorporate

Diagnosis of shoulder impingement syndrome; Diagnostik des Schulterimpingementsyndroms

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Hodler, J. [Orthopaedische Universitaetsklinik Balgrist, Zuerich (Switzerland)

1996-12-01

This article reviews the pathogenesis and clinical and imaging findings in shoulder impingement syndrome. Different stages of impingement syndrome are described. Stage I relates to edema and hemorrhage of the supraspinatus tendon. Stage II is characterized by bursal inflammation and fibrosis, as well as tendinopathy. In stage III there is a tear of the rotator cuff. Clinical signs many overlap. Moreover, calcifying tendinitis, fractures and pain originating from the cervical spine may mimic shoulder impingement syndrome. Imaging is important for the exact diagnosis. Standard radiographs are the basis of imaging in shoulder impingement syndrome. They may demonstrate subchondral sclerosis of the major tuberosity, subacromial spurs, and form anomalies of the acromion. They are also important in the differential diagnosis of shoulder impingement syndrome and demonstrate calcifying tendinitis, fractures and neoplasm. Ultrasonography has found acceptance as a screening tool and even as a final diagnostic method by many authors. However, there is a high interobserver variability in the demonstration of rotator cuff tears. Its usefulness has therefore been questioned. MR imaging is probably the method of choice in the evaluation of the rotator cuff and surrounding structures. Several investigations have demonstrated that differentiation of early findings, such as tendinopathy versus partial tears, may be difficult with MR imaging. However, reproducibility for fullthickness tears appears to be higher than for sonography. Moreover, specificity appears to be superior to sonography. MR arthrography is not universally accepted. However, it allows for more exact differentiation of discrete findings and may be indicated in preoperative planning. Standard arthrography and CT have a limited role in the current assessment of the rotator cuff. (orig.) [Deutsch] Grundlage des Impingementsyndroms ist eine Kompression des Supraspinatus am akromioklavikularen Bogen vor allem bei Flexion

Validity and test-retest reliability of manual goniometers for measuring passive hip range of motion in femoroacetabular impingement patients.

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Nussbaumer Silvio

2010-08-01

Full Text Available Abstract Background The aims of this study were to evaluate the construct validity (known group, concurrent validity (criterion based and test-retest (intra-rater reliability of manual goniometers to measure passive hip range of motion (ROM in femoroacetabular impingement patients and healthy controls. Methods Passive hip flexion, abduction, adduction, internal and external rotation ROMs were simultaneously measured with a conventional goniometer and an electromagnetic tracking system (ETS on two different testing sessions. A total of 15 patients and 15 sex- and age-matched healthy controls participated in the study. Results The goniometer provided greater hip ROM values compared to the ETS (range 2.0-18.9 degrees; P P Conclusions The present study suggests that goniometer-based assessments considerably overestimate hip joint ROM by measuring intersegmental angles (e.g., thigh flexion on trunk for hip flexion rather than true hip ROM. It is likely that uncontrolled pelvic rotation and tilt due to difficulties in placing the goniometer properly and in performing the anatomically correct ROM contribute to the overrating of the arc of these motions. Nevertheless, conventional manual goniometers can be used with confidence for longitudinal assessments in the clinic.

Shoulder impingement syndrome : evaluation of the causes with MRI

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Choi, Yong Ho; Song, In Sup; Chung, Hun Young; Yoon, Sang Jin; Kim, Yang Soo; Shim, Hyung Jin; Choi, Young Hee; Lee, Jong Beum; Lee, Yong Chul; Kim, Kun Sang [Chungang Univ. College of Medicine, Seoul (Korea, Republic of); Choi, Yun Sun [Eulji Hospital, College of Medicine, Seoul (Korea, Republic of)

1999-12-01

Various mechanical causes which induce shoulder impingement syndrome have been identified with the help of MRI. The aim of this study is to evaluate the incidence of such causes. A total of 54 patients with clinically confirmed shoulder impingement syndrome and a normal control group(n=20) without symptoms were included. We evaluated the incidence of hook shaped acromion, low lying acromion, downward slope of the acromion, subacromial spur, acromioclavicular joint hypertrophy, coracoacromial ligament hypertrophy, high cuff muscle bulk, and os acromiale. Among the 54 patients, the following conditions were present: acromioclavicular joint hypertrophy(n=36), coracoacromial ligament hypertrophy(n=20), subacromial spur(n=18), downward sloping of the acromion(n=16), hook shaped acromion(n=11), relatively high cuff muscle bulk(n=6), low lying acromion relative to the clavicle(n=3), and os acromiale(n=1). In the normal control group there were nine cases of acromioclavicular joint hypertrophy, nine of coracoacromial ligament hypertrophy, nine of downward sloping acromion, and three of low lying acromion, but hook shaped acromion, high cuff muscle bulk, and os acromiale were not found. Among 54 patients, the syndrome was due to five simultancous causes in one patient, four causes in two, three causes in 12, two causes in 22, and one cause in 17. Hook shaped acromion and subacromial spur are the statistically significant causes of shoulder impingement syndrome. In 69% of patients, the condition was due to more than one cause.

Shoulder impingement syndrome : evaluation of the causes with MRI

International Nuclear Information System (INIS)

Choi, Yong Ho; Song, In Sup; Chung, Hun Young; Yoon, Sang Jin; Kim, Yang Soo; Shim, Hyung Jin; Choi, Young Hee; Lee, Jong Beum; Lee, Yong Chul; Kim, Kun Sang; Choi, Yun Sun

1999-01-01

Various mechanical causes which induce shoulder impingement syndrome have been identified with the help of MRI. The aim of this study is to evaluate the incidence of such causes. A total of 54 patients with clinically confirmed shoulder impingement syndrome and a normal control group(n=20) without symptoms were included. We evaluated the incidence of hook shaped acromion, low lying acromion, downward slope of the acromion, subacromial spur, acromioclavicular joint hypertrophy, coracoacromial ligament hypertrophy, high cuff muscle bulk, and os acromiale. Among the 54 patients, the following conditions were present: acromioclavicular joint hypertrophy(n=36), coracoacromial ligament hypertrophy(n=20), subacromial spur(n=18), downward sloping of the acromion(n=16), hook shaped acromion(n=11), relatively high cuff muscle bulk(n=6), low lying acromion relative to the clavicle(n=3), and os acromiale(n=1). In the normal control group there were nine cases of acromioclavicular joint hypertrophy, nine of coracoacromial ligament hypertrophy, nine of downward sloping acromion, and three of low lying acromion, but hook shaped acromion, high cuff muscle bulk, and os acromiale were not found. Among 54 patients, the syndrome was due to five simultancous causes in one patient, four causes in two, three causes in 12, two causes in 22, and one cause in 17. Hook shaped acromion and subacromial spur are the statistically significant causes of shoulder impingement syndrome. In 69% of patients, the condition was due to more than one cause

The Horsens-Aarhus Femoro Acetabular Impingement (HAFAI) cohort: outcome of arthroscopic treatment for femoroacetabular impingement. Protocol for a prospective cohort study.

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Kierkegaard, Signe; Lund, Bent; Dalgas, Ulrik; Sørensen, Henrik; Søballe, Kjeld; Mechlenburg, Inger

2015-09-07

During the past decade, it has become increasingly more common to offer hip arthroscopic surgery when treating people with femoroacetabular impingement (FAI). Nevertheless, the latest reviews conclude that it still remains to be properly investigated how surgery affects the patients. Specifically, detailed information on the functional, muscular and mechanical impact of surgery in larger groups is lacking. Furthermore, the long-term outcome of the surgery is still to be investigated. In this prospective cohort study, a total of 60 patients with FAI scheduled for arthroscopic surgery will be followed and tested preoperatively, and again after 3, 6, 9 and 12 months. Assessment includes isokinetic dynamometry evaluating hip flexion and extension; evaluation of functional capacity in a three-dimensional motion laboratory; pain assessment; self-reported function, quality of life, expectation and satisfaction with the surgery; recording of previous and present sporting activities and accelerometry. In addition, data on surgical procedure, rehabilitation progress, adverse events and failure will be recorded. Patients will be compared with an age-matched and gender-matched reference group of 30 persons with no hip, knee, ankle or back problems. Long-term follow-up of this cohort may evaluate possible reoperations and development of hip osteoarthritis. Furthermore, analysis on how subgroups respond to the treatment could be performed together with identification of possible "non-responders". The study is approved by the Central Denmark Region Committee on Biomedical Research Ethics (Journal No 1-10-72-239-14). The results from this study will be presented at national and international congresses and published in peer-reviewed journals. NCT02306525. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Clinical application of arthroscopy in the diagnosis and treatment of anterior impingement syndrome of the ankle joint in physical workers.

Science.gov (United States)

Wu, Wen-Te; Chen, Zhi-Wei; Zhou, Yu-Cheng

2012-10-01

To evaluate the clinical application of arthroscopy in the diagnosis and treatment of anterior impingement syndrome of the ankle joint in physical workers. A retrospective study was carried out at the Department of Orthopedics, the First Hospital affiliated to Nanhua University, Hengyang, China from March 2005 to December 2011. Seventeen cases of anterior impingement syndrome of the ankle joint were confirmed, and treated through arthroscopy. All these patients conformed to regular follow-up postoperatively, and clinical details, as well as postoperative prognosis were retrieved and analyzed retrospectively. The efficacy was evaluated by the American Orthopedic Foot and Ankle Society (AOFAS) hindfoot-ankle scoring system, and pain relief was assessed by visual analogue scoring (VAS). Anterolateral impingement syndrome was found in 11 patients, anteromedial impingement syndrome in 4, while anterior impingement syndrome in 2 via arthroscopic examination. The VAS was reduced from 5.2-1.1, and the AOFAS score was elevated from 76.4-95.8 postoperatively; both of which demonstrated statistical differences when compared to preoperative scores. It was also found that concomitant cartilage damage was an indicator of poor prognosis in arthroscopic treatment of impingement syndrome of the ankle joint. Satisfactory results could be achieved for physical workers with anterior impingement syndrome treated by arthroscopy. As the cartilage damage is an indicator of poor prognosis, an early operation is advocated when the prognosis of anterior impingement syndrome is confirmed.

Evaluating healthcare resource utilization and outcomes for surgical hip dislocation and hip arthroscopy for femoroacetabular impingement.

Science.gov (United States)

de Sa, Darren; Horner, Nolan S; MacDonald, Austin; Simunovic, Nicole; Slobogean, Gerard; Philippon, Marc J; Belzile, Etienne L; Karlsson, Jon; Ayeni, Olufemi R

2016-12-01

Surgical hip dislocation (SHD) and hip arthroscopy are surgical methods used to correct deformity associated with femoroacetabular impingement (FAI). Though both of these approaches appear to benefit patients, no studies exist comparing healthcare resource utilization of the two surgical approaches. This systematic review examines the literature and the records of two surgeons to evaluate the resource utilization associated with treating symptomatic FAI via these two methods. EMBASE, MEDLINE and PubMed were searched for relevant articles. The articles were systematically screened, and data was abstracted in duplicate. To further supplement resource utilization data, a retrospective chart review of two surgeon's patient data (one using SHD and another using an arthroscopic approach) was completed. Experts in pharmacy, physiotherapy, radiology, anaesthesia, physiatry and the local hospital finance department were also consulted. There were 52 studies included with a total of 460 patients (535 hips) and 3886 patients (4147 hips) who underwent SHD and arthroscopic surgery for FAI, respectively. Regardless of approach, most patients treated for symptomatic FAI improved across various outcomes measures with low complication rates. Surgical time across all approaches was similar, averaging 118 ± 2 min. On a per patient basis, hip arthroscopy ($10,976) uses approximately 41 % of the resources of SHD ($24,379). There were no significant differences in outcomes for FAI treated with SHD or arthroscopy. However, with regard to healthcare resource utilization based on the OHIP healthcare system, hip arthroscopy uses substantially less resources than SHD within the first post-operative year. Systematic Review of Level IV Studies, Level IV.

Assessment of congruence and impingement of the hip joint in professional ballet dancers: a motion capture study.

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Charbonnier, Caecilia; Kolo, Frank C; Duthon, Victoria B; Magnenat-Thalmann, Nadia; Becker, Christoph D; Hoffmeyer, Pierre; Menetrey, Jacques

2011-03-01

Early hip osteoarthritis in dancers could be explained by femoroacetabular impingements. However, there is a lack of validated noninvasive methods and dynamic studies to ascertain impingement during motion. Moreover, it is unknown whether the femoral head and acetabulum are congruent in typical dancing positions. The practice of some dancing movements could cause a loss of hip joint congruence and recurrent impingements, which could lead to early osteoarthritis. Descriptive laboratory study. Eleven pairs of female dancer's hips were motion captured with an optical tracking system while performing 6 different dancing movements. The resulting computed motions were applied to patient-specific hip joint 3-dimensional models based on magnetic resonance images. While visualizing the dancer's hip in motion, the authors detected impingements using computer-assisted techniques. The range of motion and congruence of the hip joint were also quantified in those 6 recorded dancing movements. The frequency of impingement and subluxation varied with the type of movement. Four dancing movements (développé à la seconde, grand écart facial, grand écart latéral, and grand plié) seem to induce significant stress in the hip joint, according to the observed high frequency of impingement and amount of subluxation. The femoroacetabular translations were high (range, 0.93 to 6.35 mm). For almost all movements, the computed zones of impingement were mainly located in the superior or posterosuperior quadrant of the acetabulum, which was relevant with respect to radiologically diagnosed damaged zones in the labrum. All dancers' hips were morphologically normal. Impingements and subluxations are frequently observed in typical ballet movements, causing cartilage hypercompression. These movements should be limited in frequency. The present study indicates that some dancing movements could damage the hip joint, which could lead to early osteoarthritis.

MR imaging in the diagnosis of impingement syndrome

International Nuclear Information System (INIS)

Seeger, L.L.; Gold, R.H.; Bassett, L.W.; Ellman, H.

1986-01-01

The impingement syndrome is entrapment of the supraspinatus tendon by either the acromion, or a subacromial or acromioclavicular spur. Arthrography is normal during stages I (tendon inflammation) and II (fibrosis). The lack of objective findings often delays diagnosis until stage III (ischemic rotator cuff tear) is present. The purpose was to determine if MR imaging is useful in diagnosing this condition. T1-weighted surface coil scans were obtained on eight patients using a 0.3-T MR system. An axial scout allowed oblique alignment for imaging the osseous-soft tissue relationship and the supraspinatus tendon. MR is capable of displaying the specific pathologic anatomy of this disorder. Impinging spurs can be seen, and the adjacent tendon shows inferior displacement and abnormal signal intensity

Hip morphology predicts posterior hip impingement in a cadaveric model.

Science.gov (United States)

Morris, William Z; Fowers, Cody A; Weinberg, Douglas S; Millis, Michael B; Tu, Leigh-Anne; Liu, Raymond W

2018-05-01

Posterior hip impingement is a recently-identified cause of hip pain. The purpose of this study is to characterise posterior femoroacetabular and ischiofemoral impingement and identify its predisposing morphologic traits. Two hundred and six cadaveric hips were randomly selected and taken through controlled motion in two pure axes associated with posterior hip impingement: external rotation (through the mechanical axis) and adduction (coronal plane). The range of motion and location of impingement was noted for each specimen. Morphologic traits including femoral/acetabular version, and true neck-shaft angle (TNSA) were also measured. External rotation impingement occurred between the femoral neck and acetabulum in 83.0% of hips, and between the lesser trochanter and ischial tuberosity in 17.0%. Adduction impingement occurred between the lesser trochanter and ischial tuberosity in 78.6% of hips, and between the femoral neck and acetabulum in 21.4%. Multiple regression revealed that increased femoral/acetabular version predicted earlier external rotation and adduction impingement. Unstandardised betas ranging from -0.39 to -0.64 reflect that each degree of increased femoral/acetabular version individually accounts for a loss of external rotation or adduction of approximately half a degree before impingement ( p < 0.001 for each). Increased TNSA was associated with earlier adduction impingement only (unstandardised beta -0.35, p = 0.005). Relative femoral/acetabular anteversion was associated with earlier posterior hip impingement. Coxa valga was associated with earlier adduction impingement, but protective against external rotation impingement. These findings highlight the importance of monitoring correction during femoral/acetabular osteotomies, as overcorrection of retroversion may predispose to earlier posterior impingement.

Which is the most useful patient-reported outcome in femoroacetabular impingement? Test-retest reliability of six questionnaires.

Science.gov (United States)

Hinman, Rana S; Dobson, Fiona; Takla, Amir; O'Donnell, John; Bennell, Kim L

2014-03-01

The most reliable patient-reported outcomes (PROs) for people with femoroacetabular impingement (FAI) is unknown because there have been no direct comparisons of questionnaires. Thus, the aim was to evaluate the test-retest reliability of six existing PROs in a single cohort of young active people with hip/groin pain consistent with a clinical diagnosis of FAI. Young adults with clinical FAI completed six PRO questionnaires on two occasions, 1-2 weeks apart. The PROs were modified Harris Hip Score, Hip dysfunction and Osteoarthritis Score, Hip Outcome Score, Non-Arthritic Hip Score, International Hip Outcome Tool, Copenhagen Hip and Groin Outcome Score. 30 young adults (mean age 24 years, SD 4 years, range 18-30 years; 15 men) with stable symptoms participated. Intraclass correlation coefficient(3,1) values ranged from 0.73 to 0.93 (95% CI 0.38 to 0.98) indicating that most questionnaires reached minimal reliability benchmarks. Measurement error at the individual level was quite large for most questionnaires (minimal detectable change (MDC95) 12.4-35.6, 95% CI 8.7 to 54.0). In contrast, measurement error at the group level was quite small for most questionnaires (MDC95 2.2-7.3, 95% CI 1.6 to 11). The majority of the questionnaires were reliable and precise enough for use at the group level. Samples of only 23-30 individuals were required to achieve acceptable measurement variation at the group level. Further direct comparisons of these questionnaires are required to assess other measurement properties such as validity, responsiveness and meaningful change in young people with FAI.

Acromion types and role of corticosteroid with shoulder impingement syndrome

International Nuclear Information System (INIS)

Akram, M.; Gillani, S.F.U.S.; Awais, S.M.

2016-01-01

To determine the association between shoulder impingement and morphological characteristics of acromion and the role of sub-acromial injection of methylprednisolone in the short-term treatment for relieving pain and improve functional disability of these patients. Study Design: A descriptive study. Place and Duration of Study: Department of Orthopedic Surgery and Traumatology Unit-I (DOST-I), Mayo Hospital, Lahore, between November 2013 to June 2014. Methodology: All patients presented in OPD with shoulder pain were included as subjects and evaluated by clinical test and categorised using X-ray scapula Y-view. Patients with impingement syndrome were correlated with Bigliani types and offered intra-lesional injection into sub-acromial space with 2ml of xylocaine 2% and 40 mg of methylprednisolone using 22 gauge needle. The effectiveness was assessed in terms of relieving pain and good functional outcomes; and rotator cuff tear was clinically assessed among impingement positive patient. The pain was assessed using visual analogue score before and after the administration of the injection. Demographic variables for frequencies and their associations were analysed using SPSS version 20.0. Significance level was p<0.05. Among the 101 cases, there was no case of tear of rotator cuff tendon on clinical assessment. Majority of the patients (58.4%) were females with mean age of 31.38 +-1.13 years. Majority 57 (56.4%) of the patients had acromion type II (curved), which was the most common cause of shoulder impingement. Most had moderate pain. Thirty-four patients required intralesional steroid, which relieved the pain in 31 of them. Conclusion: Shoulder impingement syndrome without tear of rotator cuff tendon was found in younger age group between 40 to 45 years, which was relieved by intralesional corticosteroid administration. These patients had type II (curved) acromion, according to Bigliani classification. (author)

Fisioterapia no pós-operatório de correção artroscópica do impacto femoroacetabular = Physical therapy following femoroacetabular impingement arthroscopy

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Frasson, Viviane Bortoluzzi

2015-01-01

Full Text Available Introdução: Diferentes métodos para ganho de amplitude de movimento do quadril operado, descarga de peso sobre o membro operado e de retorno ao esporte são atualmente baseados na experiência clínica de alguns grupos de pesquisadores do Impacto Femoroacetabular. Entretanto, o protocolo ideal de Fisioterapia no pós-operatório de correção artroscópica do Impacto Femoroacetabular ainda não está estabelecido na literatura. Objetivo: Apresentar uma metodologia para a reabilitação pós-operatória do Impacto Femoroacetabular, descrevendo um protocolo com base na experiência dos autores e em conhecimentos biomecânicos. Descrição da experiência: O protocolo de reabilitação proposto é dividido em quatro fases: (1 fase de reabilitação imediata, que compreende a fase hospitalar e as duas semanas iniciais da reabilitação; (2 fase de retorno às atividades de vida diária, que abrange o primeiro mês de pós-operatório; (3 fase de reforço muscular específico e treino proprioceptivo e; (4 fase de preparo final para o retorno ao esporte. Os autores procuram apresentar neste artigo as bases científicas para as condutas propostas em cada uma das fases. Conclusão: O conhecimento da patologia, da biomecânica articular do quadril e das bases fisiológicas dos métodos e técnicas de fisioterapia é fundamental para propor um protocolo adequado na ausência de evidências científicas suficientes para dar suporte ao protocolo mais adequado

Influence of Tönnis Grade on Outcomes of Arthroscopic Management of Symptomatic Femoroacetabular Impingement.

Science.gov (United States)

Byrd, J W Thomas; Bardowski, Elizabeth A; Jones, Kay S

2018-05-19

To define the outcomes of arthroscopic correction of femoroacetabular impingement (FAI) based on Tönnis findings within a previously reported patient population, including a comparative analysis of Tönnis grade 0 and 1 versus grade 2 changes. Outcomes (modified Harris Hip Score [mHHS]) of a previously published study of arthroscopic correction of FAI were correlated with Tönnis grade. The inclusion criteria were the first 100 consecutive patients undergoing arthroscopic FAI correction with minimum 2-year follow-up. These procedures were performed between December 2003 and May 2006. Grades were determined independently by 2 experienced clinicians. Tönnis grades 0 and 1 were compared with Tönnis grade 2. Independent variables of sex and age were also evaluated. The average age of the entire group was 34.7 years (range, 13-76 years), with 66 male and 34 female patients. Of the patients, 17 had Tönnis grade 0, 49 had Tönnis grade 1, 29 had Tönnis grade 2, and 4 had Tönnis grade 3 (1 unknown). The average mHHS improvement for Tönnis grade 0 was 20.6 points; Tönnis grade 1, 22.2 points; Tönnis grade 2, 14.9 points; and Tönnis grade 3, 18.8 points. The improvement was statistically (P 8 points) significant across all Tönnis grades. There was no difference (P = .077) between Tönnis grades 0 and 1 (21.8 points) versus grade 2 (14.9 points). There was no difference based on sex or age. These data support that statistically and clinically meaningful successful patient-reported outcomes (mHHS) at 2 years can be encountered even in the presence of Tönnis grade 2 radiographic features. Neither age nor sex was an indicator of poorer results within similar Tönnis grades. Level III, case-control study. Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Return to Play After Hip Arthroscopic Surgery for Femoroacetabular Impingement in Professional Soccer Players.

Science.gov (United States)

Locks, Renato; Utsunomiya, Hajime; Briggs, Karen K; McNamara, Shannen; Chahla, Jorge; Philippon, Marc J

2018-02-01

Arthroscopic hip surgery has been shown to be effective in returning professional athletes back to play at a high level of performance in different sports. Limited information exists regarding professional soccer players and their return to play. To determine the rate and time to return to sport for professional soccer players after hip arthroscopic surgery for the treatment of femoroacetabular impingement (FAI) and to identify possible risk factors associated with a delay in returning to play. Case series; Level of evidence, 4. Professional soccer players who underwent hip arthroscopic surgery for FAI by a single surgeon between 2005 and 2015 were evaluated. Data retrieved from www.mlssoccer.com , www.fifa.com , www.transfermarkt.co.uk , and www.wikipedia.org included information on each player's professional career, participation on the national team, length of professional career before surgery, number of appearances (games) before surgery, time between surgery and first appearance in a professional game, and number of appearances after surgery. Other data were obtained from the patient's medical records. Twenty-four professional soccer players (26 hips) were included. The mean age at surgery was 25.0 ± 4.0 years (range, 19-32 years). A total of 96% of patients were able to return to play at the professional level. The mean time between surgery and the first professional game played was 9.2 months (range, 1.9-24.0 months). On average, players played in 70 games after surgery (range, 0-224). National team players were able to return to play significantly earlier than the rest of the players (median, 5.7 months vs 11.6 months, respectively; P = .018). Severe chondral damage and microfracture did not interfere with return to play. The arthroscopic management of FAI in symptomatic professional soccer players allowed 96% of them to return to play. Players with national team experience were able to return to play earlier than those without it. Severe chondral damage

Ischiofemoral impingement syndrome: a meta-analysis

Energy Technology Data Exchange (ETDEWEB)

Singer, Adam D.; Subhawong, Ty K.; Jose, Jean; Tresley, Jonathan; Clifford, Paul D. [Jackson Memorial Hospital, Department of Diagnostic Radiology, Section of Musculoskeletal Imaging, Miami, FL (United States)

2015-06-01

clinical findings. Using the proposed measurement thresholds may better identify patients with this impingement syndrome so that optimal treatment options can be pursued. (orig.)

Sonographic prevalence of groin hernias and adductor tendinopathy in patients with femoroacetabular impingement.

Science.gov (United States)

Naal, Florian D; Dalla Riva, Francesco; Wuerz, Thomas H; Dubs, Beat; Leunig, Michael

2015-09-01

Femoroacetabular impingement (FAI) is a common debilitating condition that is associated with groin pain and limitation in young and active patients. Besides FAI, various disorders such as hernias, adductor tendinopathy, athletic pubalgia, lumbar spine affections, and others can cause similar symptoms. To determine the prevalence of inguinal and/or femoral herniation and adductor insertion tendinopathy using dynamic ultrasound in a cohort of patients with radiographic evidence of FAI. Case series; Level of evidence, 4. This retrospective study consisted of 74 patients (36 female and 38 male; mean age, 29 years; 83 symptomatic hips) with groin pain and radiographic evidence of FAI. In addition to the usual diagnostic algorithm, all patients underwent a dynamic ultrasound examination for signs of groin herniation and tendinopathy of the proximal insertion of the adductors. Evidence of groin herniation was found in 34 hips (41%). There were 27 inguinal (6 female, 21 male) and 10 femoral (9 female, 1 male) hernias. In 3 cases, inguinal and femoral herniation was coexistent. Overall, 5 patients underwent subsequent hernia repair. Patients with groin herniation were significantly older than those without (33 vs 27 years, respectively; P = .01). There were no significant differences for any of the radiographic or clinical parameters. Tendinopathy of the proximal adductor insertion was detected in 19 cases (23%; 11 female, 8 male). Tendinopathy was coexistent with groin herniation in 8 of the 19 cases. There were no significant differences for any of the radiographic or clinical parameters between patients with or without tendinopathy. Patients with a negative diagnostic hip injection result were more likely to have a concomitant groin hernia than those with a positive injection result (80% vs 27%, respectively). Overall, 38 hips underwent FAI surgery with satisfactory outcomes in terms of score values and subjective improvement. The results demonstrate that groin

Open versus arthroscopic approach in the treatment of femoroacetabular impingement: a case–control study with two-years follow up

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Bruno Dutra Roos

Full Text Available Abstract Objective To compare clinical and imaging results and complications between patients treated for femoroacetabular impingement (FAI who underwent either anterior open surgery or an arthroscopic approach, with a minimum follow-up of two years. Methods This retrospective case–control study included patients submitted to FAI surgical treatment between November 2007 and March 2012. Patients treated with open surgery were compared with those treated with arthroscopy. Patients were clinically assessed by the modified Harris Hip Score, Non-Arthritic Hip Score, and internal hip rotation. Patients were radiographically assessed by the center-edge angle, joint space width, alpha angle, neck-head index, degree of arthrosis, and presence of heterotopic ossification of the hip. Results In the study period, 56 patients (58 hips with FAI were included; 16 underwent open surgery and 40 underwent arthroscopy. The 40 patients treated by the arthroscopic route had a mean follow-up of 29.1 months, and 75.6% presented good or excellent clinical results. The radiographic evaluation parameters progressed to normal levels. The 16 patients who underwent open surgery had a mean follow-up of 52 months, and 70.58% presented good or excellent clinical results. The radiographic evaluation parameters progressed to normal levels. Postoperative clinical and radiographic results were considered similar in both groups. Conclusions Arthroscopy and open surgery treatments for FAI provided comparable clinical and radiographic results. However, a higher rate of complications was observed in the open surgery group.

Reliability, Readability and Quality of Online Information about Femoracetabular Impingement

Directory of Open Access Journals (Sweden)

Fatih Küçükdurmaz

2015-07-01

Conclusion: According to our results, the websites intended to attract patients searching for information regarding femoroacetabular impingement are providing a highly accessible, readable information source, but do not appear to apply a comparable amount of rigor to scientific literature or healthcare practitioner websites in regard to matters such as citing sources for information, supplying methodology and including a publication date. This indicates that while these resources are easily accessed by patients, there is potential for them to be a source of misinformation.

Glyceryl trinitrate patches—An alternative treatment for shoulder impingement syndrome

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Yusuf Assem

2015-01-01

Full Text Available Transdermal glyceryl trinitrate patches have been investigated as an alternative therapeutic intervention for a range of tendinopathies, due to the ease of titration of dosage and the ease of their application. Glyceryl trinitrate has been inferred to reduce pain and inflammation secondary to their nitric oxide-producing action. Shoulder impingement syndrome is a soft tissue condition that manifests as anterior shoulder pain, weakness, and difficulty in daily activities. This review will evaluate the efficacy of glyceryl trinitrate patches in treating a variety of rotator cuff tendinopathies related to shoulder impingement, based on human and animal trials, and suggest its practical application in future trials and management.

Plain radiography in femoroacetabular impingement syndrome

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Matic Ciglič

2014-08-01

Full Text Available The aim of this article is to describe in detail the technique how to obtain radiographs with all the necessary information about hip pathology suggesting FAI. Radiographic factors of FAI and their significance are presented. Basic information about etiology, epidemiology and clinical presentation of FAI, together with current concept of its treatment, are provided as well. The problems regarding the timing of surgical intervention are also presented.

Methods on simple radiogaphy of impingement syndrome in shoulder joint

International Nuclear Information System (INIS)

Kweon, Dae Cheol; Kim, Moon Sun; Kim, Yong Seob; Chung, Kyung Mo

2000-01-01

To evaluation of patients who have shoulder impingement syndrome is by diagnostic radiography. Shoulder impingement is a problem which occurs in young, active individuals as well as older individuals. In fact, the pain is probably caused by repetitive stress placed on the shoulder joint either through recreational activities of your occupation. Impingement series approach to radiographic examination of the shoulder is take five projections. First anteroposterior oblique projection. Second standard anteroposterior projection. Third superoinferior axial projection. Fourth supraspinatus outlet projection offers a view of the outlet of the supraspinatus tendon unit as it passes under the coraacromial arch. Fifth anteroposterior 30 deg caudal projection will adequately demonstrate the anterior acromial spur or ossification in the coraacromial ligament and more reliable to demonstrate spurring of the anterior acromion than supraspinatus outlet projection. This decreased the need for additional radiographic veiws, reduces the patient's exposure to x-ray radiation and decreases use of film. This can lower the cost of the evaluation and improve patient satisfaction.=20

Methods on simple radiogaphy of impingement syndrome in shoulder joint

Energy Technology Data Exchange (ETDEWEB)

Kweon, Dae Cheol; Kim, Moon Sun; Kim, Yong Seob; Chung, Kyung Mo [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

2000-06-01

To evaluation of patients who have shoulder impingement syndrome is by diagnostic radiography. Shoulder impingement is a problem which occurs in young, active individuals as well as older individuals. In fact, the pain is probably caused by repetitive stress placed on the shoulder joint either through recreational activities of your occupation. Impingement series approach to radiographic examination of the shoulder is take five projections. First anteroposterior oblique projection. Second standard anteroposterior projection. Third superoinferior axial projection. Fourth supraspinatus outlet projection offers a view of the outlet of the supraspinatus tendon unit as it passes under the coraacromial arch. Fifth anteroposterior 30 deg caudal projection will adequately demonstrate the anterior acromial spur or ossification in the coraacromial ligament and more reliable to demonstrate spurring of the anterior acromion than supraspinatus outlet projection. This decreased the need for additional radiographic veiws, reduces the patient's exposure to x-ray radiation and decreases use of film. This can lower the cost of the evaluation and improve patient satisfaction.=20.

Etiology of the anterior ankle impingement syndrome: A descriptive anatomical study

NARCIS (Netherlands)

Tol, Johannes L.; van Dijk, C. Niek

2004-01-01

Background: In the anterior ankle impingement syndrome, recurrent traction to the anterior joint capsule is stated to be the cause of formation of talotibial osteophytes. This hypothesis involves the assumption that the osteophytes originate at the site where a capsular attachment is located. A soft

IMPINGEMENT-SYNDROME OF PERONEUS BREVIS TENDON AFTER CALCANEAL FRACTURES (MORPHOLOGICAL ASPECTS

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N. S. Konovalchuk

2017-01-01

Full Text Available Background. One of the main causes of pain in patients with consequences of calcaneal fractures is the lateral impingement syndrome. This term means lateral displacement of outer calcaneal wall at the moment of fracture, narrowing of anatomical space under the lateral malleolus and compression of soft tissues in this region, including tendons of short and long peroneal muscles. This leads to chronic traumatization of tendons, alteration of their normal tracking and development of tendinitis and tenosynovitis. At this moment there are no articles in foreign or Russian literature describing how prolonged traumatization influences the internal structure of the tendons. The purpose of this study was to evaluate the morphological changes in structure of peroneus brevis tendon after different duration of compression between outer wall of calcaneus and the tip of the lateral malleolus in patients with calcaneal malunion.Materials and methods. Fifteen patients with calcaneal malunion and lateral impingement syndrome were treated operatively between 2016 and 2017. To confirm the lateral impingement syndrome, the authors performed clinical examination and AP x-rays of ankle joint. Two peroneus brevis tendon specimens were obtained intraoperatively in each of 15 patients: one specimen from compressed and one from non-compressed area. Obtained specimens were histologically examined according to standard protocol.Results. Microscopically all specimens showed separation of collagen bundles with loose connective tissue degeneration, increase of vascularization and inflammation. The degree of these changes differed according to the compression duration. This allowed us to analyze the dynamics of these changes.Conclusion. The morphological changes in structure of peroneus brevis tendon during the compression between outer wall of calcaneus and the tip of the lateral malleolus correspond with dynamics of common pathologic reactions. Early stages showed signs of

Comparison of femoroacetabular impingement-related radiographic features in a convenience sample of Japanese patients with and without herniation pits

International Nuclear Information System (INIS)

Mineta, Kazuaki; Goto, Tomohiro; Wada, Keizo; Tamaki, Yasuaki; Hamada, Daisuke; Higashino, Kosaku; Sairyo, Koichi

2016-01-01

To examine the prevalence of herniation pits (HPs) and to evaluate differences in radiographic features related to femoroacetabular impingement - a hip disorder with abnormal abutment between the acetabulum and femur - between hips with and without HPs in a convenience sample of Japanese patients. We reviewed 1,178 hips on each side (695 men, 483 women; mean age, 58.2 years) using computed tomographic images. The radiological assessments of hip morphology were performed by measuring the lateral center edge angle, acetabular index, acetabular version, alpha angle, and femoral head-neck offset. HPs were defined as the round or oval cystic lesions surrounded by sclerotic bone located below the anterior femoral neck cortex. Intraclass and interclass reproducibility of all radiographic measurements was acceptable (ICC: 0.71-0.98). The prevalence of HPs was 13.9 % in all subjects and was significantly higher in men (18.1 %) than in women (7.8 %; p < 0.001). HPs were larger in male (p < 0.001) and elderly subjects (p < 0.005). In subjects with HPs, the alpha angle was larger and femoral head-neck offset and offset ratio were smaller in the cohort overall and in men. Logistic regression analysis revealed the association between radiological cam-type FAI and HPs in all subjects (odds ratio: 1.86, p < 0.001). We revealed the prevalence of HPs and showed it has a predilection for men in this Japanese cohort. Femoral head asphericity or small head-neck offset was more common in subjects with HPs than those without HPs. (orig.)

Impingement syndrome of the shoulder following double row suture anchor technique for arthroscopic rotator cuff repair: a case report

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Rambani Rohit

2009-06-01

Full Text Available Abstract Introduction Arthroscopic repair of the rotator cuff is a demanding surgery. Accurate placement of anchors is key to success. Case presentation A 38-year-old woman received arthroscopic repair of her rotator cuff using a double row suture anchor technique. Postoperatively, she developed impingement syndrome which resulted from vertical displacement of a suture anchor once the shoulder was mobilised. The anchor was removed eight weeks following initial surgery and the patient had an uneventful recovery. Conclusion Impingement syndrome following arthroscopic repair of the rotator cuffs using double row suture anchor has not been widely reported. This is the first such case where anchoring has resulted in impingement syndrome.

Physical examination tests for the diagnosis of femoroacetabular impingement. A systematic review.

Science.gov (United States)

Pacheco-Carrillo, Aitana; Medina-Porqueres, Ivan

2016-09-01

Numerous clinical tests have been proposed to diagnose FAI, but little is known about their diagnostic accuracy. To summarize and evaluate research on the accuracy of physical examination tests for diagnosis of FAI. A search of the PubMed, SPORTDiscus and CINAHL databases was performed. Studies were considered eligible if they compared the results of physical examination tests to those of a reference standard. Methodological quality and internal validity assessment was performed by two independent reviewers using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. The systematic search strategy revealed 298 potential articles, five of which articles met the inclusion criteria. After assessment using the QUADAS score, four of the five articles were of high quality. Clinical tests included were Impingement sign, IROP test (Internal Rotation Over Pressure), FABER test (Flexion-Abduction-External Rotation), Stinchfield/RSRL (Resisted Straight Leg Raise) test, Scour test, Maximal squat test, and the Anterior Impingement test. IROP test, impingement sign, and FABER test showed the most sensitive values to identify FAI. The diagnostic accuracy of physical examination tests to assess FAI is limited due to its heterogenecity. There is a strong need for sound research of high methodological quality in this area. Copyright © 2016 Elsevier Ltd. All rights reserved.

Specific or general exercise strategy for subacromial impingement syndrome-does it matter?

DEFF Research Database (Denmark)

Shire, Alison R; Stæhr, Thor A B; Overby, Jesper B

2017-01-01

Background Exercise is frequently suggested as a treatment option for patients presenting with symptoms of subacromial impingement syndrome. Some would argue implementing a specific exercise strategy with special focus on correction of kinematic deficits would be superior to general exercise stra...

A mountain among molehills: removing an impinging large femoral neck osteochondroma in a man with hereditary multiple exostoses.

LENUS (Irish Health Repository)

Fitzgerald, Conall W R

2014-01-01

A 31-year-old man with a history of hereditary multiple exostoses (HME) presented with persistent right groin pain and reduced hip range of movement. Examination demonstrated a positive FADIR (flexion, adduction and internal rotation) test suggesting femoroacetabular impingement (FAI). Investigations showed multiple sessile osteochondromata of the right femur with a dominant anterolateral femoral neck osteochondroma causing flexion block. The patient underwent an uncomplicated proximal femoral exostectomy. Six-week postoperative pain, range of movement and daily activity had greatly improved. This case highlights that even in the setting of multiple osteochondromata, excellent impingement relief can be achieved following selective proximal femoral exostectomy.

Subscapulais injuries associated with acromiohumeral instability in patients with shoulder impingement syndrome

Energy Technology Data Exchange (ETDEWEB)

Moon, Tae Young; Jeong, Hee Seok; Lee, Seung Jun; Jeong, Yeo Jin [Pusan National University Yangsan Hospital, Yangsan (Korea, Republic of)

2017-07-15

To evaluate the association of subscapularis (SSC) injuries with acromiohumeral instability (AHI) in patients with shoulder impingement syndrome with supraspinatus (SSP) tears. Pre-operative shoulder magnetic resonance images of 106 patients with subsequent arthroscopic confirmation of shoulder impingement syndrome were reviewed retrospectively. Patients with SSC injuries were divided into the following 3 groups: 1) those with no injury symbolized to the SSC[0] (n = 38), 2) those with partial injuries to the SSC[1] (n = 41), and 3) those with complete disruption of the SSC[2] (n = 27). AHI was categorized into 5 stages depending on the SSP lesions: partial tear or pretear tendinosis symbolized to the SSP[0] (n = 24) and according to retraction severity of the SSP tendon with complete tear such as SSP[1] (n = 19), SSP[2] (n = 27), SSP[3] (n = 29), and SSP[4] (n = 7). Also, AHI was divided into two groups such as the mild group summed with SSP plus SSP plus SSP and the severe group summed with SSP plus SSP, including 70 patients and 36 patients, respectively. Twenty-nine patients (63.0%) among 46 patients with SSC[0] and thirty-two patients (78.0%) among 41 patients with SSC[1] were related to mild AHI. Eighteen patients (66.7%) among 27 patients with SSC[2] were associated with severe AHI. The SSC injury groups were statistically significantly associated with AHI (estimate 0.207, standard error 0.057, p < 0.01). SSC injuries could be related to AHI in patients with shoulder impingement syndrome.

Arthroscopic Surgical Procedures Versus Sham Surgery for Patients With Femoroacetabular Impingement and/or Labral Tears: Study Protocol for a Randomized Controlled Trial (HIPARTI) and a Prospective Cohort Study (HARP).

Science.gov (United States)

Risberg, May Arna; Ageberg, Eva; Nilstad, Agnethe; Lund, Bent; Nordsletten, Lars; Løken, Sverre; Ludvigsen, Tom; Kierkegaard, Signe; Carsen, Sasha; Kostogiannis, Ioannis; Crossley, Kay M; Glyn-Jones, Sion; Kemp, Joanne L

2018-04-01

Study Design Study protocol for a randomized controlled trial and a prospective cohort. Background The number of arthroscopic surgical procedures for patients with femoroacetabular impingement syndrome (FAIS) has significantly increased worldwide, but high-quality evidence of the effect of such interventions is lacking. Objectives The primary objective will be to determine the efficacy of hip arthroscopic procedures compared to sham surgery on patient-reported outcomes for patients with FAIS (HIP ARThroscopy International [HIPARTI] Study). The secondary objective will be to evaluate prognostic factors for long-term outcome after arthroscopic surgical interventions in patients with FAIS (Hip ARthroscopy Prospective [HARP] Study). Methods The HIPARTI Study will include 140 patients and the HARP Study will include 100 patients. The international Hip Outcome Tool-33 will be the primary outcome measure at 1 year. Secondary outcome measures will be the Hip disability and Osteoarthritis Outcome Score, Arthritis Self-Efficacy Scale, fear of movement (Tampa Scale of Kinesiophobia), Patient-Specific Functional Scale, global rating of change score, and expectations. Other outcomes will include active hip range of motion, hip muscle strength tests, functional performance tests, as well as radiological assessments using radiographs and magnetic resonance imaging. Conclusion To determine the true effect of surgery, beyond that of placebo, double-blinded placebo-controlled trials including sham surgery are needed. The HIPARTI Study will direct future evidence-based treatment of FAIS. Predictors for long-term development and progression of degenerative changes in the hip are also needed for this young patient group with FAIS; hence, responders and nonresponders to treatment could be determined. J Orthop Sports Phys Ther 2018;48(4):325-335. doi:10.2519/jospt.2018.7931.

Correlations between the alpha angle and femoral head asphericity: Implications and recommendations for the diagnosis of cam femoroacetabular impingement

International Nuclear Information System (INIS)

Harris, Michael D.; Kapron, Ashley L.; Peters, Christopher L.; Anderson, Andrew E.

2014-01-01

Objective: To determine the strength of common radiographic and radial CT views for measuring true femoral head asphericity. Patients and methods: In 15 patients with cam femoroacetabular impingement (FAI) and 15 controls, alpha angles were measured by two observers using radial CT (0°, 30°, 60°, 90°) and digitally reconstructed radiographs (DRRs) for the: anterior–posterior (AP), standing frog-leg lateral, 45° Dunn with neutral rotation, 45° Dunn with 40° external rotation, and cross-table lateral views. A DRR validation study was performed. Alpha angles were compared between groups. Maximum deviation from a sphere of each subject was obtained from a previous study. Alpha angles from each view were correlated with maximum deviation. Results: There were no significant differences between alpha angles measured on radiographs and the corresponding DRRs (p = 0.72). Alpha angles were significantly greater in patients for all views (p ≤ 0.002). Alpha angles from the 45° Dunn with 40° external rotation, cross-table lateral, and 60° radial views had the strongest correlations with maximum deviation (r = 0.831; r = 0.823; r = 0.808, respectively). The AP view had the weakest correlation (r = 0.358). Conclusion: DRRs were a validated means to simulate hip radiographs. The 45° Dunn with 40° external rotation, cross-table lateral, and 60° radial views best visualized femoral asphericity. Although commonly used, the AP view did not visualize cam deformities well. Overall, the magnitude of the alpha angle may not be indicative of the size of the deformity. Thus, 3D reconstructions and measurements of asphericity could improve the diagnosis of cam FAI

Tratamento cirúrgico para impacto femoroacetabular em um grupo que realiza agachamento Surgical treatment for femoroacetabular impingement in a group that performs squats

Directory of Open Access Journals (Sweden)

Giancarlo Cavalli Polesello

2012-01-01

persistent pain. During arthroscopy, 48 hips (100% presented lesions of the acetabular labrum, and 41 hips (85.4% had acetabular chondral lesions. CONCLUSION: The patients with painful symptoms after hip hyperflexion exercises associated with femoroacetabular impingement presented improvements after arthroscopic treatment.

Hip shape is symmetric, non-dependent on limb dominance and gender-specific. Implications for femoroacetabular impingement. A 3D CT analysis in asymptomatic subjects

International Nuclear Information System (INIS)

Mascarenhas, Vasco V.; Rego, Paulo; Dantas, Pedro; Castro, Miguel; Jans, Lennart; Marques, Rui M.; Gouveia, Nelia; Consciencia, Jose G.; Soldado, Francisco; Ayeni, Olufemi R.

2018-01-01

To determine the reference intervals (RefInt) of the quantitative morphometric parameters of femoroacetabular impingement (FAI) in asymptomatic hips with computed tomography (CT) and determine their dependence on age, side, limb dominance and sex. We prospectively included 590 patients and evaluated 1111 hips with semi-automated CT analysis. We calculated overall, side- and sex-specific parameters for imaging signs of cam [omega and alpha angle (α )] and pincer-type morphology [acetabular version (ACvers), lateral centre-edge angle (LCEA) and cranio-caudal coverage]. Hip shape was symmetrical and did not depend on limb dominance. The 95% RefInt limits were sex-different for all cam-type parameters and extended beyond current abnormal thresholds. Specifically, the upper limits of RefInt for α at 12:00, 1:30 and 3:00 o'clock positions were 56 , 70 and 58 , respectively, and 45 for LCEA. Acetabular morphology varied between age groups, with a trend toward an LCEA/ACvers increase over time. Our morphometric measurements can be used to estimate normal hip morphology in asymptomatic individuals. Notably they extended beyond current thresholds used for FAI imaging diagnosis, which was most pronounced for cam-type parameters. We suggest the need to reassess α RefInt and consider a 60 threshold for the 12:00/3:00 positions and 65-70 for other antero-superior positions. (orig.)

Labral Reattachment in Femoroacetabular Impingement Surgery Results in Increased 10-year Survivorship Compared With Resection.

Science.gov (United States)

Anwander, Helen; Siebenrock, Klaus A; Tannast, Moritz; Steppacher, Simon D

2017-04-01

Since the importance of an intact labrum for normal hip function has been shown, labral reattachment has become the standard method for open or arthroscopic treatment of hips with femoroacetabular impingement (FAI). However, no long-term clinical results exist evaluating the effect of labral reattachment. A 2-year followup comparing open surgical treatment of FAI with labral resection versus reattachment was previously performed at our clinic. The goal of this study was to report a concise followup of these patients at a minimum of 10 years. We asked if patients undergoing surgical hip dislocation for the treatment of mixed-type FAI with labral reattachment compared with labral resection had (1) improved hip pain and function based on the Merle d'Aubigné-Postel score; and (2) improved survival at 10-year followup. Between June 1999 and July 2002, we performed surgical hip dislocation with femoral neck osteoplasty and acetabular rim trimming in 52 patients (60 hips) with mixed-type FAI. In the first 20 patients (25 hips) until June 2001, a torn labrum or a detached labrum in the area of acetabular rim resection was resected. In the next 32 patients (35 hips), reattachment of the labrum was performed. The same indications were used to perform both procedures during the periods in question. Of the 20 patients (25 hips) in the first group, 19 patients (95%) (24 hips [96%]) were available for clinical and/or radiographic followup at a minimum of 10 years (mean, 13 years; range, 12-14 years). Of the 32 patients (35 hips) in the second group, 29 patients (91%) (32 hips [91%]) were available for clinical and/or radiographic followup at a minimum of 10 years (mean, 12 years; range, 10-13 years). We used the anterior impingement test to assess pain. Function was assessed using the Merle d'Aubigné- Postel score and ROM. Survivorship calculation was performed using the method of Kaplan-Meier with failure defined as conversion to THA, progression of osteoarthritis (of one

Os acromiale causing shoulder impingement syndrome: a case report

International Nuclear Information System (INIS)

Romero, I.; Rodriguez, A.; Roca, M.; Garcia, Y.

2001-01-01

Shoulder impingement syndrome is caused by repeated mechanical trauma to the rotator cuff due to encroachment of the coracoacromial ligament; in most cases, it is a primary lesion. Os acromiale, an anatomic variant of the shoulder structures, is one of the predisposing factors for the development of this entity. We present a case of os acromiale complicated by complete rupture of the tendon of the supraspinatus muscle and luxation of the long head of the biceps tendon. We stress the importance of magnetic resonance in the study of this anatomic variant and in the detection of complications or associated lesions. (Author) 10 refs

Ultrasound measurement of rotator cuff thickness and acromio-humeral distance in the diagnosis of subacromial impingement syndrome of the shoulder.

Science.gov (United States)

Cholewinski, Jerzy J; Kusz, Damian J; Wojciechowski, Piotr; Cielinski, Lukasz S; Zoladz, Miroslaw P

2008-04-01

The usefulness of ultrasound measurements in the diagnosis of the subacromial impingement syndrome of the shoulder was evaluated. Fifty-seven patients with unilateral symptoms of the impingement syndrome underwent ultrasound examination of both shoulder joints, which included assessment of rotator cuff integrity, measurement of rotator cuff thickness and the distance between the infero-lateral edge of acromion and the apex of the greater tuberosity of humerus (AGT distance) in the standard ultrasonographic positions. As a control group, 36 volunteers (72 shoulders) with no history of shoulder pain were examined sonographically. Ultrasonographic assessment of humeral head elevation, measured as the AGT distance, proved to be useful in establishing the diagnosis of the subacromial impingement syndrome of the shoulder. A difference in rotator cuff thickness of more than 1.1 mm and a difference in the AGT distance of more than 2.1 mm between both shoulder joints may reflect dysfunction of rotator cuff muscles.

Preoperative conventional magnetic resonance images versus magnetic resonance arthrography of subacromial impingement syndrome

International Nuclear Information System (INIS)

Ahn, Sang Hyuk; Park, Jung Hwan; Moon, Tae Yong; Lee, In Sook; Lee, Seung Jun

2012-01-01

To evaluate the usefulness of conventional magnetic resonance images (MRI) for arthroscopic surgery in subacromial impingement syndrome of the shoulder, as an alternative to MR arthrography with additional T2 fat saturation images (MRA). The preoperative MRI of 77 patients (45 females, 32 males) (52 right, 25 left) and MRA of 34 patients (14 females, 20 males) (24 right, 10 left) with subsequent arthroscopic confirmation of subacromial impingement syndrome were reviewed retrospectively. The lesions requiring arthroscopic surgery were 95 subacromial spurs, 101 subacromial bursitis, and 51 full-thickness and 44 partial thickness tears of the supraspinatus among 111 cases for both studies. A two by two table was constructed in order to calculate the sensitivity and specificity of both studies against arthroscopic outcomes. Also we analyzed the false positive and false negative cases of the full-thickness tears individually. The detection rates of subacromial spur and bursitis and full and partial thickness tears of the supraspinatus were 91%, 94%, 77%, and 65% in MRI and 93%, 100%, 83%, and 77% in MRA respectively. Their specificities were 33%, 33%, 90%, and 76% in MRI and 50%, 75%, 100%, and 71% in MRA respectively. Eleven false negative cases in regards to MRI resulted in Ellman's grade 3 partial thickness tear (72.7%), mild bursitis (63.6%), greater tuberosity erosion (45.5%), and negative fluid signal of the glenohumeral joint (81.8%). Three false positive cases on the MRI were induced from errors with lower window depth and width on the imagings. Two false negative cases on MRA were induced from the adhesion between Ellman's grade 3 rim rent tear and the glenohumeral joint cavity. Conventional MR images could be used to decide the arthroscopic surgery in subacromial impingement syndrome, as an alternative to MR arthrography with additional T2 fat saturation images

Preoperative conventional magnetic resonance images versus magnetic resonance arthrography of subacromial impingement syndrome

Energy Technology Data Exchange (ETDEWEB)

Ahn, Sang Hyuk; Park, Jung Hwan; Moon, Tae Yong [Pusan National Univ. Yangsan Hospital, Yangsan (Korea, Republic of); Lee, In Sook; Lee, Seung Jun [Pusan National Univ. Hospital, Busan (Korea, Republic of)

2012-09-15

To evaluate the usefulness of conventional magnetic resonance images (MRI) for arthroscopic surgery in subacromial impingement syndrome of the shoulder, as an alternative to MR arthrography with additional T2 fat saturation images (MRA). The preoperative MRI of 77 patients (45 females, 32 males) (52 right, 25 left) and MRA of 34 patients (14 females, 20 males) (24 right, 10 left) with subsequent arthroscopic confirmation of subacromial impingement syndrome were reviewed retrospectively. The lesions requiring arthroscopic surgery were 95 subacromial spurs, 101 subacromial bursitis, and 51 full-thickness and 44 partial thickness tears of the supraspinatus among 111 cases for both studies. A two by two table was constructed in order to calculate the sensitivity and specificity of both studies against arthroscopic outcomes. Also we analyzed the false positive and false negative cases of the full-thickness tears individually. The detection rates of subacromial spur and bursitis and full and partial thickness tears of the supraspinatus were 91%, 94%, 77%, and 65% in MRI and 93%, 100%, 83%, and 77% in MRA respectively. Their specificities were 33%, 33%, 90%, and 76% in MRI and 50%, 75%, 100%, and 71% in MRA respectively. Eleven false negative cases in regards to MRI resulted in Ellman's grade 3 partial thickness tear (72.7%), mild bursitis (63.6%), greater tuberosity erosion (45.5%), and negative fluid signal of the glenohumeral joint (81.8%). Three false positive cases on the MRI were induced from errors with lower window depth and width on the imagings. Two false negative cases on MRA were induced from the adhesion between Ellman's grade 3 rim rent tear and the glenohumeral joint cavity. Conventional MR images could be used to decide the arthroscopic surgery in subacromial impingement syndrome, as an alternative to MR arthrography with additional T2 fat saturation images.

Femoroacetabular Impingement in Professional Football Players: Return to Play and Predictors of Career Length After Hip Arthroscopy.

Science.gov (United States)

Menge, Travis J; Bhatia, Sanjeev; McNamara, Shannen C; Briggs, Karen K; Philippon, Marc J

2017-07-01

Previous studies have shown hip arthroscopy to be a highly effective treatment for symptomatic femoroacetabular impingement (FAI) in a wide range of athletes; however, the rate of return to play and length of career after hip arthroscopy in professional football players are unknown. To determine how many athletes returned to professional football and the number of seasons they played after surgery. Case series; Level of evidence, 4. Fifty-one professional football players (60 hips) underwent hip arthroscopy for FAI between 2000 and 2014 by a single surgeon. Return to play was defined as competing in a preseason or regular season professional football game after surgery. Data were retrospectively obtained for each player from NFL.com , ESPN.com , individual team websites, and/or CFL.ca . We found that 87% (52/60) of the arthroscopic procedures allowed professional football players to return to play in a preseason or regular season game. Athletes who returned played an average of 38 games during 3.2 seasons after arthroscopy, with an average total career length of 7.4 seasons. Ninety-two percent (48/52) of players who returned had a minimum total career length of 3 years. When participants were analyzed by position, linemen were less likely to return after hip arthroscopy compared with other players (odds ratio 5.6; 95% CI, 1.1-35; P = .04). All quarterbacks and tight ends returned to play after surgery. No significant difference in return to play rate was found between athletes who underwent microfracture and those who did not (25% vs 38%, P = .698). Hip arthroscopy for treatment of FAI and associated pathologic abnormalities in professional football players resulted in a high rate of return to play. The study's findings demonstrate that 87% of the arthroscopic procedures allowed professional football players to return to play, linemen were less likely to return compared with other positions, and the presence of microfracture did not significantly affect the return

Protocol for a multi-centre randomised controlled trial comparing arthroscopic hip surgery to physiotherapy-led care for femoroacetabular impingement (FAI): the Australian FASHIoN trial.

Science.gov (United States)

Murphy, Nicholas J; Eyles, Jillian; Bennell, Kim L; Bohensky, Megan; Burns, Alexander; Callaghan, Fraser M; Dickenson, Edward; Fary, Camdon; Grieve, Stuart M; Griffin, Damian R; Hall, Michelle; Hobson, Rachel; Kim, Young Jo; Linklater, James M; Lloyd, David G; Molnar, Robert; O'Connell, Rachel L; O'Donnell, John; O'Sullivan, Michael; Randhawa, Sunny; Reichenbach, Stephan; Saxby, David J; Singh, Parminder; Spiers, Libby; Tran, Phong; Wrigley, Tim V; Hunter, David J

2017-09-26

Femoroacetabular impingement syndrome (FAI), a hip disorder affecting active young adults, is believed to be a leading cause of hip osteoarthritis (OA). Current management approaches for FAI include arthroscopic hip surgery and physiotherapy-led non-surgical care; however, there is a paucity of clinical trial evidence comparing these approaches. In particular, it is unknown whether these management approaches modify the future risk of developing hip OA. The primary objective of this randomised controlled trial is to determine if participants with FAI who undergo hip arthroscopy have greater improvements in hip cartilage health, as demonstrated by changes in delayed gadolinium-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) index between baseline and 12 months, compared to those who undergo physiotherapy-led non-surgical management. This is a pragmatic, multi-centre, two-arm superiority randomised controlled trial comparing hip arthroscopy to physiotherapy-led management for FAI. A total of 140 participants with FAI will be recruited from the clinics of participating orthopaedic surgeons, and randomly allocated to receive either surgery or physiotherapy-led non-surgical care. The surgical intervention involves arthroscopic FAI surgery from one of eight orthopaedic surgeons specialising in this field, located in three different Australian cities. The physiotherapy-led non-surgical management is an individualised physiotherapy program, named Personalised Hip Therapy (PHT), developed by a panel to represent the best non-operative care for FAI. It entails at least six individual physiotherapy sessions over 12 weeks, and up to ten sessions over six months, provided by experienced musculoskeletal physiotherapists trained to deliver the PHT program. The primary outcome measure is the change in dGEMRIC score of a ROI containing both acetabular and femoral head cartilages at the chondrolabral transitional zone of the mid-sagittal plane between baseline and

Radiographic findings of femoroacetabular impingement in National Football League Combine athletes undergoing radiographs for previous hip or groin pain.

Science.gov (United States)

Nepple, Jeffrey J; Brophy, Robert H; Matava, Matthew J; Wright, Rick W; Clohisy, John C

2012-10-01

The purpose of this study was to investigate the prevalence of radiographic findings of femoroacetabular impingement (FAI) in elite football players with a history of hip pain or groin injury who underwent radiographs. We performed a retrospective review of athletes undergoing hip radiography at the National Football League Combine from 2007 to 2009. Radiographs were obtained in athletes with a history of hip pain or injury. Anteroposterior pelvis and frog-lateral radiographs were obtained in 123 hips (107 players) that met our inclusion criteria. Radiographic indicators of cam-type FAI (alpha angle, head-neck offset ratio) and pincer-type FAI (acetabular retroversion, center-edge angle, acetabular inclination) were recorded. Findings were correlated with clinical factors (previous groin/hip pain, position, race, and body mass index). The most common previous injuries included groin strain (n = 57) and sports hernia/abdominal strain (n = 21). Markers of cam- and/or pincer-type FAI were present in 94.3% of hips (116 of 123). Radiographic evidence of combined cam- and pincer-type FAI was the most common (61.8%, 76 hips), whereas isolated cam-type FAI (9.8%, 12 hips) and pincer-type FAI (22.8%, 28 hips) were less common. The most common deformities included acetabular retroversion (71.5%) and an abnormal alpha angle (61.8%). A body mass index greater than 35 was associated with the presence of global overcoverage (46.2% v 17.3%, P = .025). Radiographic indicators of FAI are very common among athletes evaluated at the National Football League Scouting Combine subjected to radiographic examination for the clinical suspicion of hip disease. Elite football athletes with significant or recurrent pain about the hip should be evaluated clinically and radiographically for FAI, because pain from FAI may be falsely attributed to or may be present in addition to other disorders. Level IV, therapeutic case series. Copyright © 2012 Arthroscopy Association of North America

Risk of surgery for subacromial impingement syndrome in relation to neck-shoulder complaints and occupational biomechanical exposures

DEFF Research Database (Denmark)

Svendsen, Susanne Wulff; Dalbøge, Annett; Andersen, JH

2013-01-01

OBJECTIVES: The aim of this longitudinal study was to evaluate the risk of surgery for subacromial impingement syndrome (SIS) in relation to neck-shoulder complaints and occupational biomechanical shoulder exposures. METHODS: The study was based on the Musculoskeletal Research Database at the Dan......OBJECTIVES: The aim of this longitudinal study was to evaluate the risk of surgery for subacromial impingement syndrome (SIS) in relation to neck-shoulder complaints and occupational biomechanical shoulder exposures. METHODS: The study was based on the Musculoskeletal Research Database....... Using no neck-shoulder complaints and low shoulder load at baseline as a reference, no neck-shoulder complaints and high shoulder load showed an adjusted hazard ratio (HR adj) of 2.55 [95% confidence interval (95% CI) 1.59-4.09], while neck-shoulder complaints in combination with high shoulder load...

COMPARISON OF RANGE OF MOTION, STRENGTH, AND HOP TEST PERFORMANCE OF DANCERS WITH AND WITHOUT A CLINICAL DIAGNOSIS OF FEMOROACETABULAR IMPINGEMENT.

Science.gov (United States)

Kivlan, Benjamin R; Carcia, Christopher R; Christoforetti, John J; Martin, RobRoy L

2016-08-01

Dancers commonly experience anterior hip pain caused by femoroacetabular impingement (FAI) that interrupts training and performance in dance. A paucity of literature exists to guide appropriate evaluation and management of FAI among dancers. The purpose of this study was to determine if dancers with clinical signs of FAI have differences in hip range of motion, strength, and hop test performance compared to healthy dancers. Quasi-experimental, cohort comparison. Fifteen dancers aged between 18- 21 years with clinical signs of FAI that included anterior hip pain and provocative impingement tests were compared to 13 age-matched dancers for passive hip joint range of motion, isometric hip strength, and performance of the medial triple hop, lateral triple hop, and cross-over hop tests. No statistically significant differences in range of motion were noted for flexion (Healthy = 145° + 7°; FAI = 147° + 10°; p=0.59), internal rotation (Healthy = 63° + 7°; FAI = 61° + 11°; p=0.50), and external rotation (Healthy = 37° + 9°; FAI = 34° + 12°; p=0.68) between the two groups. Hip extension strength was significantly less in the dancers with FAI (224 + 55 Newtons) compared to the healthy group (293 ± 58 Newtons; F(1,26) = 10.2; p=0.004). No statistically significant differences were noted for flexion, internal rotation, external rotation, abduction, or adduction isometric strength. The medial triple hop test was significantly less in the FAI group (354 ± 43 cm) compared to the healthy group (410 ± 50 cm; F(1,26) = 10.3; p = 0.004). Similar results were observed for the lateral hop test, as the FAI group (294 ± 38 cm) performed worse than the healthy controls (344 ± 54cm; F(1,26) = 7.8; p = 0.01). There was no statistically significant difference between the FAI group (2.7 ± 0.92 seconds) and the healthy group (2.5 ± 0.75 seconds) on the crossover hop

Force steadiness, muscle activity, and maximal muscle strength in subjects with subacromial impingement syndrome

DEFF Research Database (Denmark)

Bandholm, Thomas; Rasmussen, Lars; Aagaard, Per

2006-01-01

physically active in spite of shoulder pain and nine healthy matched controls were examined to determine isometric and isokinetic submaximal shoulder-abduction force steadiness at target forces corresponding to 20%, 27.5%, and 35% of the maximal shoulder abductor torque, and maximal shoulder muscle strength......We investigated the effects of the subacromial impingement syndrome (SIS) on shoulder sensory-motor control and maximal shoulder muscle strength. It was hypothesized that both would be impaired due to chronic shoulder pain associated with the syndrome. Nine subjects with unilateral SIS who remained...

Avaliação da apresentação de sinais e sintomas de impacto femoroacetabular após epifisiólise do fêmur proximal Evaluation of presentation of signs and symptoms of femoroacetabular impingement after epiphysiolysis of the proximal femur

Directory of Open Access Journals (Sweden)

Fábio Peng Krüger

2011-04-01

Full Text Available OBJETIVO: Neste trabalho, procuramos avaliar se existe relação entre o grau de deslizamento da epifisiólise femoral proximal (EFP e a presença de impacto femoroacetabular (IFA. Ainda, analisou-se o arco de movimento do quadril (ADM em relação ao IFA, além de revisar a literatura sobre o assunto. MÉTODO: Foram analisados 19 casos de EFP em 15 pacientes tratados cirurgicamente com epifisiodese in situ com um parafuso canulado, com seguimento médio de 27 meses. Realizou-se a análise do grau de deslizamento da EFP pelos ângulos epimetafisário (âEM e coloepifisário (âCE da radiografia em perfil, dos sinais de impacto radiográficos na incidência anteroposterior, dos sintomas clínicos e do ADM do quadril. RESULTADOS: Evidenciou-se que o grau de deslizamento da EFP (através do âEM apresenta relação inversa estatisticamente significante com a presença de IFA no período médio de seguimento deste estudo. Ou seja, os pacientes que demonstraram um quadro sintomático de IFA apresentaram graus menores de deslizamento. Isso pode ser explicado pelo fato que o tipo de impacto que ocorre na EFP (came de inclusão ou de impacção depende do grau de deslizamento, e estes se apresentam de forma e cronologia diferentes. O ADM do quadril não apresentou relação com o IFA. CONCLUSÃO: Há relação entre o grau de deslizamento e a presença de IFA clínicoradiológica após EFP.OBJECTIVES: In this study, we sought to evaluate whether there is any relationship between the degree of epiphysiolysis of the proximal femur (EPF and the presence of femoroacetabular impingement (FAI. Hip range of motion (ROM was also analyzed in relation to FAI, and the literature on this topic was reviewed. METHODS: Nineteen cases of EPF in fifteen patients who had been treated surgically by means of in situ epiphysiodesis with a cannulated screw were evaluated. The mean follow-up was 27 months. The degree of EPF was analyzed using the epimetaphyseal and neck

Bilateral hip arthroscopy under the same anesthetic for patients with symptomatic bilateral femoroacetabular impingement: 1-year outcomes.

Science.gov (United States)

Mei-Dan, Omer; McConkey, Mark O; Knudsen, Joshua S; Brick, Matthew J

2014-01-01

The purpose of this study was to investigate whether, in patients with bilateral symptomatic femoroacetabular impingement, bilateral surgery under 1 anesthetic is safe and efficacious and allows a rapid return of function compared with staged procedures. Three groups were evaluated: in group 1 both hips were treated simultaneously, in group 2 both hips were treated in a staged fashion, and in group 3 a single hip was addressed. The outcome measures were anesthesia and surgical times; time in the hospital; visual analog scale score for pain on postoperative days 1, 3, 7, and 30; analgesic use; and time until the patient could bike, drive, perform office work, perform gym activities, run, and return to play. Midterm evaluation was performed with the Non-Arthritic Hip Score and Western Ontario and McMaster Universities Osteoarthritis Index score at 6 and 12 months postoperatively. We enrolled 76 patients (122 hips) in this study. There were 42 male and 34 female patients. The mean age was 33 years (range, 14 to 50 years), and the mean body mass index was 24 (range, 18 to 35). Group 1 comprised 26 patients (52 hips, 16 male and 10 female patients). Group 2 comprised 20 patients (40 hips, 13 male and 7 female patients), with a mean time between surgeries of 14.56 weeks. Group 3 comprised 33 patients (30 hips, 13 male and 17 female patients). No preoperative differences were found between the groups. The surgical and anesthesia times in group 1 were significantly longer than those in groups 2 and 3. We found no significant differences in postoperative visual analog scale scores, analgesic use, or length of hospital stay. Group 1 required more time before patients were able to ride a stationary bicycle (14.7 days in group 1, 7.8 days in group 2, and 8.5 days in group 3; P returned to driving, performing office work, or reporting a normal gait. Each group had significant improvements in the Western Ontario and McMaster Universities Osteoarthritis Index and Non

Evaluation of Labral Pathology and Hip Articular Cartilage in Patients with Femoroacetabular Impingement (FAI): Comparison of Multidetector CT Arthrography and MR Arthrography

International Nuclear Information System (INIS)

Sahin, Murat; Calisir, Cuneyt; Omeroglu, Hakan; Inan, Ulukan; Mutlu, Fezan; Kaya, Tamer

2014-01-01

To compare the multidetector computed tomography (MDCT) arthrography (CTa) and magnetic resonance (MR) arthrography (MRa) findings with surgical findings in patients with femoroacetabular impingement (FAI) and to evaluate the diagnostic performance of these methods. Labral pathology and articular cartilage were prospectively evaluated with MRa and CTa in 14 hips of 14 patients. The findings were evaluated by two musculoskeletal radiologists with 10 and 20 years of experience, respectively. Sensitivity, specificity, accuracy, and positive predictive value were determined using surgical findings as the standard of reference. While the disagreement between observers was recorded in two cases of labral tearing with MRa, there was a complete consensus with CTa. Disagreement between observers was found in four cases of femoral cartilage loss with both MRa and CTa. Disagreement was also recorded in only one case of acetabular cartilage loss with both methods. The percent sensitivity, specificity, and accuracy for correctly assessing the labral tearing were as follows for MRa/CTa, respectively: 100/100, 50/100, 86/100 (p<0.05). The same values for acetabular cartilage assessment were 89/56, 40/60, 71/71 (p>0.05) and for femoral cartilage assessment were 100/75, 90/70, 86/71 (p>0.05). Inter-observer reliability value showed excellent agreement for labral tearing with CTa (κ=1.0). Inter-observer agreement was substantial to excellent with regard to acetabular cartilage assessment with MRa and CTa (κ=0.76 for MRa and κ=0.86 for CTa) Inter-observer reliability with CTa is excellent for labral tearing assessment. CTa seems to have an equal sensitivity and a higher specificity than MRa for the detection of labral pathology. MRa is better, but not statistically significantly, in demonstrating acetabular and femoral cartilage pathology

MR-imaging of anterior tibiotalar impingement syndrome: Agreement, sensitivity and specificity of MR-imaging and indirect MR-arthrography

Energy Technology Data Exchange (ETDEWEB)

Haller, Joerg [Department of Radiology, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Ludwig Boltzmann Institute for Osteology, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Bernt, Reinhard [Department of Radiology, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria)]. E-mail: reinhard.bernt@wgkk.sozvers.at; Seeger, Thomas [Department of Trauma Surgery, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Weissenbaeck, Alexander [Department of Trauma Surgery, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Tuechler, Heinrich [Ludwig Boltzmann Institute for Hematology, Hanusch Hospital, Heinrich Collin-Strasse 30, A-1140 Vienna (Austria); Resnick, Donald [Department of Radiology, VA Medical Center, UCSD, 3350 La Jolla Village Dr, San Diego, CA 92161 (United States)

2006-06-15

Objective: To clarify the role of MR-imaging in the diagnosis of anterior ankle impingement syndromes. Materials and methods: We prospectively examined 51 consecutive patients with chronic ankle pain by MR-imaging. Arthroscopy was performed in 29 patients who previously underwent non-enhanced MR-imaging; in 11 patients, indirect MR-arthrography additionally was performed. MR-examinations were correlated with clinical findings; MR and arthroscopy scores were statistically compared, agreement was measured. Results: Arthroscopy demonstrated granulation tissue in the lateral gutter (38%) and anterior recess (31%), lesions of the anterior tibiofibular (31%) and the anterior talofibular ligament (21%) as well as intraarticular bodies (10%). Stenosing tenosynovitis and a ganglionic cyst were revealed as extraarticular causes for chronic ankle pain by MR-examination (17%). Agreement of MR-imaging and arthroscopy was fair for the anterior talofibular ligament and the anterior joint cavity (kappa 0.40). Major discrepancy was found for non-enhanced MR scans (kappa 0.49) when compared with indirect MR-arthrography (kappa 0.03) in the anterior cavity. The sensitivity for lesions of the anterior talofibular and calcaneofibular ligament and the anterior cavity (0.91-0.87) detected by MR-imaging was superior in comparison to lesions of the anterior tibiofibular ligament and anteromedial cavity (0.50-0.24). Conclusion: MR-imaging provides additional information about the mechanics of chronic ankle impingement rather than an accurate diagnosis of this clinical entity. The method is helpful in differentiating extra- from intra-articular causes of ankle impingement. Indirect MR-arthrography has little or no additional value in patients with ankle impingement syndrome.

MR-imaging of anterior tibiotalar impingement syndrome: Agreement, sensitivity and specificity of MR-imaging and indirect MR-arthrography

International Nuclear Information System (INIS)

Haller, Joerg; Bernt, Reinhard; Seeger, Thomas; Weissenbaeck, Alexander; Tuechler, Heinrich; Resnick, Donald

2006-01-01

Objective: To clarify the role of MR-imaging in the diagnosis of anterior ankle impingement syndromes. Materials and methods: We prospectively examined 51 consecutive patients with chronic ankle pain by MR-imaging. Arthroscopy was performed in 29 patients who previously underwent non-enhanced MR-imaging; in 11 patients, indirect MR-arthrography additionally was performed. MR-examinations were correlated with clinical findings; MR and arthroscopy scores were statistically compared, agreement was measured. Results: Arthroscopy demonstrated granulation tissue in the lateral gutter (38%) and anterior recess (31%), lesions of the anterior tibiofibular (31%) and the anterior talofibular ligament (21%) as well as intraarticular bodies (10%). Stenosing tenosynovitis and a ganglionic cyst were revealed as extraarticular causes for chronic ankle pain by MR-examination (17%). Agreement of MR-imaging and arthroscopy was fair for the anterior talofibular ligament and the anterior joint cavity (kappa 0.40). Major discrepancy was found for non-enhanced MR scans (kappa 0.49) when compared with indirect MR-arthrography (kappa 0.03) in the anterior cavity. The sensitivity for lesions of the anterior talofibular and calcaneofibular ligament and the anterior cavity (0.91-0.87) detected by MR-imaging was superior in comparison to lesions of the anterior tibiofibular ligament and anteromedial cavity (0.50-0.24). Conclusion: MR-imaging provides additional information about the mechanics of chronic ankle impingement rather than an accurate diagnosis of this clinical entity. The method is helpful in differentiating extra- from intra-articular causes of ankle impingement. Indirect MR-arthrography has little or no additional value in patients with ankle impingement syndrome

Shouldering the blame for impingement: the rotator cuff continuum ...

African Journals Online (AJOL)

The aim of this article was to summarise recent research on shoulder impingement and rotator cuff pathology. A continuum model of rotator cuff pathology is described, and the challenges of accurate clinical diagnosis, imaging and best management discussed. Keywords: shoulder impingement syndrome, subacromial ...

Variability and Comprehensiveness of North American Online Available Physical Therapy Protocols Following Hip Arthroscopy for Femoroacetabular Impingement and Labral Repair.

Science.gov (United States)

Cvetanovich, Gregory L; Lizzio, Vincent; Meta, Fabien; Chan, Derek; Zaltz, Ira; Nho, Shane J; Makhni, Eric C

2017-11-01

To assess comprehensiveness and variability of postoperative physical therapy protocols published online following hip arthroscopy for femoroacetabular impingement (FAI) and/or labral repair. Surgeons were identified by the International Society for Hip Arthroscopy "Find a Surgeon" feature in North America (http://www.isha.net/members/, search August 10, 2016). Exclusion criteria included nonsurgeons and protocols for conditions other than hip arthroscopy for FAI and/or labral tear. Protocols were identified by review of surgeons' personal and departmental websites and evaluated for postoperative restrictions, rehabilitation components, and the time points for ending restrictions and initiating activities. Of 111 surgeons available online, 31 (27.9%) had postoperative hip arthroscopy physical therapy protocols available online. Bracing was used in 54.8% (17/31) of protocols for median 2-week duration (range, 1-6 weeks). Most protocols specified the initial postoperative weight-bearing status (29/31, 93.5%), most frequently partial weight-bearing with 20 pounds foot flat (20/29, 69.0%). The duration of weight-bearing restriction was median 3 weeks (range, 2-6) for FAI and median 6 weeks (range, 3-8) for microfracture. The majority of protocols specified initial range of motion limitations (26/31, 83.9%) for median 3 weeks (range, 1.5-12). There was substantial variation in the rehabilitation activities and time points for initiating activities. Time to return to running was specified by 20/31 (64.5%) protocols at median 12 weeks (range, 6-19), and return to sport timing was specified by 13/31 (41.9%) protocols at median 15.5 weeks (range, 9-23). There is considerable variability in postoperative physical therapy protocols available online following hip arthroscopy for FAI, including postoperative restrictions, rehabilitation activities, and time points for activities. This information offers residents, fellows, and established hip arthroscopists a centralized

Subacromial impingement in patients with whiplash injury to the cervical spine

Directory of Open Access Journals (Sweden)

Giddins Grey E

2008-06-01

Full Text Available Abstract Background Impingement syndrome and shoulder pain have been reported to occur in a proportion of patients following whiplash injuries to the neck. In this study we aim to examine these findings to establish the association between subacromial impingement and whiplash injuries to the cervical spine. Methods and results We examined 220 patients who had presented to the senior author for a medico-legal report following a whiplash injury to the neck. All patients were assessed for clinical evidence of subacromial impingement. 56/220 patients (26% had developed shoulder pain following the injury; of these, 11/220 (5% had clinical evidence of impingement syndrome. Only 3/11 patients (27% had the diagnosis made prior to evaluation for their medico-legal report. In the majority, other clinicians had overlooked the diagnosis. The seatbelt shoulder was involved in 83% of cases (p Conclusion After a neck injury a significant proportion of patients present with shoulder pain, some of whom have treatable shoulder pathology such as impingement syndrome. The diagnosis is, however, frequently overlooked and shoulder pain is attributed to pain radiating from the neck resulting in long delays before treatment. It is important that this is appreciated and patients are specifically examined for signs of subacromial impingement after whiplash injuries to the neck. Direct seatbelt trauma to the shoulder is one possible explanation for its aetiology.

The Effect of Platelet-Rich Plasma (PRP on Improvement in Pain and Symptoms of Shoulder Subacromial Impingement Syndrome

Directory of Open Access Journals (Sweden)

Parisa Nejati

2015-08-01

Full Text Available Abstract Background: Subacromial impingement is one of the most common complaints of shoulder. Treatments include avoiding of painful activities, oral anti-pain drugs, physical therapy modalities, corticosteroid injection and exercise therapy. Some studies have shown that platelet- rich plasma(PRP is effective on tendinitis and tearing of tendons, ligaments and muscles, but evidence that has proved PRP as a conservative treatment in shoulder pathologies is very limited. This study aims to investigate the effect of PRP injection on relieving pain and improving daily function of patients with shoulder impingement syndrome. Materials and Methods: In this clinical trial study, patients older than 40 with pain more than three months were included. If they had three of four positive diagnostic clinical tests of shoulder impingement that were confirmed by shoulder MRI, could be injected PRP twice. The time between injections was 1 month. Pain was measured by visual analog scale (VAS and function was measured by two questionnaires named disabilities of the arm, shoulder and hand (DASH and western Ontario rotator cuff index (WORC. Range of motion (ROM of shoulder was measured in five directions by goniometry . All of these parameters were evaluated before intervention and in 1, 3, 6 months later. Results: with due attention to a six-month folloe-up, PRR injection was effective in pain reduction and improvement of patient's function (p<0.05. Shoulder Rom increased in all directions except external rotation and the power of shoulder muscles was evidently improved statistically in flexion, abduction and internal toration. Conclusion: PRP injection could effectively reduce pain and improve daily activities in patients with shoulder impingement syndrome.

Test-Retest Reliability of Handgrip Strength as an Outcome Measure in Patients With Symptoms of Shoulder Impingement Syndrome.

Science.gov (United States)

Savva, Christos; Mougiaris, Paraskevas; Xadjimichael, Christoforos; Karagiannis, Christos; Efstathiou, Michalis

The purpose of this study was to investigate the degree of test-retest reliability of grip strength measurement using a hand dynamometer in patients with shoulder impingement syndrome. A total of 19 patients (10 women and 9 men; mean ± standard deviation age, 33.2 ± 12.9 years; range 18-59 years) with shoulder impingement syndrome were measured using a hand dynamometer by the same data collector in 2 different testing sessions with a 7-day interval. During each session, patients were encouraged to exert 3 maximal isometric contractions on the affected hand and the mean value of the 3 efforts (measured in kilogram-force [Kgf]) was used for data analysis. The intraclass correlation coefficient (ICC 2,1 ) as well as the standard error of measurement (SEM) and Bland-Altman plot were used to estimate the degree of test-retest reliability and the measurement error, respectively. Grip strength data analysis revealed an ICC 2,1 score of 0.94, which, based on the Shrout classification, is considered as excellent test-retest reliability of grip strength measurement. The small values of SEMs reported in both sessions (SEM 1 , 2.55 Kgf; SEM 2 , 2.39 Kgf) and the small width of the 95% limits of agreement in the Bland-Altman plot (ranging from -7.39 Kgf to 7.03 Kgf) reflected the measurement precision and the narrow variation of the differences during the 2 testing sessions. Results from this study identified excellent test-retest reliability of grip strength measurement in shoulder impingement syndrome, indicating its potential use as an outcome measure in clinical practice. Copyright © 2018. Published by Elsevier Inc.

Pain, activities of daily living and sport function at different time points after hip arthroscopy in patients with femoroacetabular impingement: a systematic review with meta-analysis.

Science.gov (United States)

Kierkegaard, Signe; Langeskov-Christensen, Martin; Lund, Bent; Naal, Florian D; Mechlenburg, Inger; Dalgas, Ulrik; Casartelli, Nicola C

2017-04-01

To investigate pain, activities of daily living (ADL) function, sport function, quality of life and satisfaction at different time points after hip arthroscopy in patients with femoroacetabular impingement (FAI). Systematic review with meta-analysis. Weighted mean differences between preoperative and postoperative outcomes were calculated and used for meta-analysis. EMBASE, MEDLINE, SportsDiscus, CINAHL, Cochrane Library, and PEDro. Studies that evaluated hip pain, ADL function, sport function and quality of life before and after hip arthroscopy and postoperative satisfaction in patients with symptomatic FAI. Twenty-six studies (22 case series, 3 cohort studies, 1 randomised controlled trial (RCT)) were included in the systematic review and 19 in the meta-analysis. Clinically relevant pain and ADL function improvements were first reported between 3 and 6 months, and sport function improvements between 6 months and 1 year after surgery. It is not clear when quality of life improvements were first achieved. On average, residual mild pain and ADL and sport function scores lower than their healthy counterparts were reported by patients following surgery. Postoperative patient satisfaction ranged from 68% to 100%. On average, patients reported earlier pain and ADL function improvements, and slower sport function improvements after hip arthroscopy for FAI. However, average scores from patients indicate residual mild hip pain and/or hip function lower than their healthy counterparts after surgery. Owing to the current low level of evidence, future RCTs and cohort studies should investigate the effectiveness of hip arthroscopy in patients with FAI. CRD42015019649. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Experimentally induced cam impingement in the sheep hip.

Science.gov (United States)

Siebenrock, Klaus A; Fiechter, Ruth; Tannast, Moritz; Mamisch, Tallal C; von Rechenberg, Brigitte

2013-04-01

Sheep hips have a natural non-spherical femoral head similar to a cam-type deformity in human beings. By performing an intertrochanteric varus osteotomy, cam-type femoro-acetabular impingement (FAI) during flexion can be created. We tested the hypotheses that macroscopic lesions of the articular cartilage and an increased Mankin score (MS) can be reproduced by an experimentally induced cam-type FAI in this ovine in vivo model. Furthermore, we hypothesized that the MS increases with longer ambulatory periods. Sixteen sheep underwent unilateral intertrochanteric varus osteotomy of the hip with the non-operated hip as a control. Four sheep were sacrificed after 14, 22, 30, and 38-weeks postoperatively. We evaluated macroscopic chondrolabral alterations, and recorded the MS, based on histochemical staining, for each ambulatory period. A significantly higher prevalence of macroscopic chondrolabral lesions was found in the impingement zone of the operated hips. The MS was significantly higher in the acetabular/femoral cartilage of the operated hips. Furthermore, these scores increased as the length of the ambulatory period increased. Cam-type FAI can be induced in an ovine in vivo model. Localized chondrolabral degeneration of the hip, similar to that seen in humans (Tannast et al., Clin Orthop Relat Res 2008; 466: 273-280; Beck et al., J Bone Joint Surg Br 2005; 87: 1012-1018), can be reproduced. This experimental sheep model can be used to study cam-type FAI. Copyright © 2012 Orthopaedic Research Society.

Effectiveness of Standardized Physiotherapy Exercises for Patients With Difficulty Returning to Usual Activities After Decompression Surgery for Subacromial Impingement Syndrome

DEFF Research Database (Denmark)

Christiansen, David Høyrup; Frost, Poul; Falla, Deborah

2016-01-01

BACKGROUND: Little is known about the effectiveness of exercise programs after decompression surgery for subacromial impingement syndrome. For patients with difficulty returning to usual activities, special efforts may be needed to improve shoulder function. OBJECTIVE: The purpose of this study w...

Radiotherapy for shoulder impingement; Bestrahlung beim Impingementsyndrom des Schultergelenks

Energy Technology Data Exchange (ETDEWEB)

Adamietz, B. [Universitaetsklinikum Erlangen (Germany). Inst. fuer Radiologie; Sauer, R.; Keilholz, L. [Universitaetsklinikum Erlangen (Germany). Strahlentherapeutische Klinik

2008-05-15

Background and Purpose: Up to now, degenerative shoulder diseases were summarized by the term 'periarthritis humeroscapularis'. Actual shoulder diseases can be differentiated etiopathologically according to a primary and secondary impingement syndrome. Narrowing of the subacromial space, which is caused by an osseous shape variant, leads to primary impingement. Secondary impingement develops, when the subacromial space is reduced by swelling tissue below the osseous shoulder roof. This study aimed for the exact diagnosis to indicate therapy and to classify the results according to the Constant score. Patients and Methods: From August 1999 to September 2002, 102 patients with 115 shoulder joint conditions underwent radiation therapy (RT). All joints received two RT series (6 x 0.5 Gy/series) applied in two to three weekly fractions, totaling a dosage of 6.0 Gy (250 kV, 15 mAs, 1-mm Cu filter). The second RT course started 6 weeks after the end of the first. 115 shoulders were examined before RT, 6 weeks after the second RT course and, finally, during the follow-up from January to May 2003. Results: Pain relief was achieved in 94/115 shoulder joints (82%) after 18-month follow-up (median). A significant difference existed between secondary impingement and primary/non-impingement according to response. Tendinosis calcarea, bursitis subdeltoidea, tendovaginitis of the long biceps tendon, and capsulitis adhaesiva responded well to therapy. Conclusion: Shoulder diseases of secondary impingement demonstrate a good response to RT. Less or no benefit was found in primary impingement syndrome or complete rotator cuff disruption and acute shoulder injuries, respectively. (orig.)

[Arthroscopic therapy of ankle joint impingement syndrome after operation of ankle joint fracture dislocation].

Science.gov (United States)

Feng, Zhibin; Mi, Kun; Wei, Renzhi; Liu, Wu; Wang, Bin

2011-07-01

To study the operative procedure and the effectiveness of arthroscopic therapy for ankle joint impingement syndrome after operation of ankle joint fracture dislocation. Between March 2008 and April 2010, 38 patients with ankle joint impingement syndrome after operation of ankle joint fracture dislocation were treated. Among them, there were 28 males and 10 females with an average age of 28 years (range, 18 to 42 years). The time from internal fixation to admission was 12-16 months (mean, 13.8 months). There were pressing pain in anterolateral and anterior ankle. The dorsal extension ranged from -20 to -5 degrees (mean, -10.6 degrees), and the palmar flexion was 30-40 degrees (mean, 35.5 degrees). The total score was 48.32 +/- 9.24 and the pain score was 7.26 +/- 1.22 before operation according to American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score system. The X-ray films showed osteophyte formation in anterior tibia and talus; MRI showed cartilage injury in 22 cases. Arthroscopic intervention included removing osteophytes, debriding fabric scars and synovial membrane tissues, and removing osteochondral fragments. Arthroscopic microfracture technique was used in 22 patients with cartilage injury. All incisions healed primarily. Thirty-eight cases were followed up 10-26 months (mean, 16 months). At last follow-up, 26 patients had normal range of motion (ROM); the dorsal extension was 15-25 degrees (mean, 19.6 degrees) and the palmar flexion was 35-45 degrees (mean, 40.7 degrees). Eight patients had mild limited ROM; the dorsal extension was 5-15 degrees (mean, 7.2 degrees) and the palmar flexion was 35-45 degrees (mean, 39.5 degrees). Four patients had mild limited ROM and pain in posterior portion of the ankle after a long walking (3-4 hours); the dorsal extension was 0-5 degrees (mean, 2.6 degrees) and the palmar flexion was 35-40 degrees (mean, 37.5 degrees). The total score was 89.45 +/- 9.55 and the pain score was 1.42 +/- 1.26 after

The Use of Physiotherapy among Patients with Subacromial Impingement Syndrome

DEFF Research Database (Denmark)

Christiansen, David Høyrup; Frost, Poul; Frich, Lars Henrik

2016-01-01

BACKGROUND: Physiotherapy with exercises is generally recommended in the treatment of patients with subacromial impingement syndrome (SIS). OBJECTIVE: We aimed to investigate the use of physiotherapy in patients with SIS in Danish hospital settings as part of initial non-surgical treatment...... and after SIS-related surgery and to evaluate to which extent sex, socio-demographic and clinical factors predict the use of physiotherapy. METHODS: Using national health registers, we identified 57,311 patients who had a first hospital contact with a diagnosis of ICD-10, groups M75.1-75.9, 1 July 2007...... to 30 June 2011. Records of physiotherapy were extracted within 52 weeks after first contact (or until surgery), and for surgically treated patients within 26 weeks after surgery. Predictors of the use of physiotherapy after first contact and after surgery were analysed as time-to-event. RESULTS: Within...

Síndrome de pinzamiento femoroacetabular en deportista veterano

OpenAIRE

F. Jiménez Borrero; C. Cuenca-González

2015-01-01

El síndrome de pinzamiento femoroacetabular (PFA) es una patología común en el adulto joven deportista que cada vez está tomando más relevancia y que se caracteriza por una inadecuada relación femoroacetabular, con una clínica dolorosa e incapacitante de larga evolución, que puede simular otras patologías de la cadera, motivo por el cual, se debe realizar una anamnesis y una exhaustiva exploración física que nos oriente hacia esta patología, confirmando la sospecha diagnóstica mediante prueba...

Anterior internal impingement of the shoulder in rugby players and other overhead athletes

Directory of Open Access Journals (Sweden)

Siddharth R. Shah, MBBS, MSc Sports Medicine (UK, MRCS-Ed

2017-04-01

Conclusion: This series of anterior internal impingement, which we believe is the largest in the literature to date, demonstrates the value of an to assess and successfully treat overhead athletes with anterior impingement syndrome.

Magnetic Resonance Imaging of Rotator Cuff Tears in Shoulder Impingement Syndrome

International Nuclear Information System (INIS)

Freygant, Magdalena; Dziurzyńska-Białek, Ewa; Guz, Wiesław; Samojedny, Antoni; Gołofit, Andrzej; Kostkiewicz, Agnieszka; Terpin, Krzysztof

2014-01-01

Shoulder joint is a common site of musculoskeletal pain caused, among other things, by rotator cuff tears due to narrowing of subacromial space, acute trauma or chronic shoulder overload. Magnetic resonance imaging (MRI) is an excellent modality for imaging of soft tissues of the shoulder joint considering a possibility of multiplanar image acquisition and non-invasive nature of the study. The aim of this study was to evaluate the prevalence of partial and complete rotator cuff tears in magnetic resonance images of patients with shoulder impingement syndrome and to review the literature on the causes and classification of rotator cuff tears. We retrospectively analyzed the results of 137 shoulder MRI examinations performed in 57 women and 72 men in Magnetic Resonance facility of the Department of Radiology and Diagnostic Imaging at the St. Jadwiga the Queen Regional Hospital No. 2 in Rzeszow between June 2010 and February 2013. Examinations were performed using Philips Achieva 1.5T device, including spin echo and gradient echo sequences with T1-, T2- and PD-weighted as well as fat saturation sequences in transverse, frontal and sagittal oblique planes. Patients were referred from hospital wards as well as from outpatient clinics of the subcarpathian province. The most frequently reported injuries included partial supraspinatus tendon tear and complete tearing most commonly involved the supraspinatus muscle tendon. The smallest group comprised patients with complete tear of subscapularis muscle tendon. Among 137 patients in the study population, 129 patients suffered from shoulder pain, including 57 patients who reported a history of trauma. There was 44% women and 56% men in a group of patients with shoulder pain. Posttraumatic shoulder pain was predominantly reported by men, while women comprised a larger group of patients with shoulder pain not preceded by injury. Rotator cuff injury is a very common pathology in patients with shoulder impingement syndrome

Synovial plicae of the hip: evaluation using MR arthrography in patients with hip pain

International Nuclear Information System (INIS)

Bencardino, Jenny T.; La Rocca Vieira, Renata; Kassarjian, Ara; Schwartz, Richard; Mellado, Jose M.; Kocher, Mininder

2011-01-01

The appearance and distribution of the intra-articular plicae of the hip have been addressed in few reports in the anatomic and radiological literature. This study aims to determine the prevalence of visible synovial hip plicae using MR arthrography and to measure the association of visible synovial hip plicae with MR arthrographic diagnosis of labral tears, femoroacetabular impingement, and osteoarthritis. Following institutional review board approval, 63 direct MR arthrographic examinations of the hip in 61 patients with a clinical history of hip pain were retrospectively reviewed by two experienced musculoskeletal radiologists in consensus. The following variables were measured using a binary system (0 = absent; 1 = present): labral plica, neck plica, ligamental plica, labral tear, femoroacetabular impingement, and osteoarthritis. The surgical reports and arthroscopic images of 10 patients were reviewed. Statistical analysis was performed using the Fisher's exact test. In all 63 cases at least one plica was visualized on MR-arthrographic images. Labral, neck, and ligamental plicae were found with a prevalence of 76, 97, and 78%, respectively. There was no statistically significant association between the presence of labral tears, femoroacetabular impingement, and osteoarthritis among patients with visible labral, neck, and ligamental plicae. The prevalence of labral tears, femoroacetabular impingement, and osteoarthritis in our patient population was 79, 28, and 28%, respectively. The presence of intra-articular plicae was the only MR-arthrographic finding in 5 of our 63 symptomatic cases. Visible labral, neck, and/or ligamental plicae are highly prevalent on MR-arthrographic images of the hip performed in the setting of hip pain. There was no statistically significant association between the presence of labral tears, femoroacetabular impingement, and osteoarthritis and visible labral, neck, and ligamental plicae. (orig.)

The relationship of strength and muscle balance to shoulder pain and impingement syndrome in elite quadriplegic wheelchair rugby players.

Science.gov (United States)

Miyahara, M; Sleivert, G G; Gerrard, D F

1998-04-01

Wheelchair athletes are susceptible to injuries related to overuse of the shoulder, in particular shoulder impingement syndrome. The present study examined the relationship of shoulder pain to demographic details, isokinetic strength and muscle balance in 8 elite quadriplegic rugby players. Demographic data were collected using personal interviews and each subject was clinically examined for signs of impingement syndrome by a physician. In addition each subject underwent bilateral isokinetic strength testing of the shoulder at 60 and 180 deg/s for abduction/adduction and internal/external rotation. A series of step-wise multiple discriminant analysis successfully predicted clinical symptoms from demographic, muscular strength and balance data. In particular, there was a significant deficit in adductor strength and this was related to shoulder pain and wasting of the scapular muscles. This strength deficit may be due to the high level of spinal lesions in the quadriplegic population. The level of spinal lesion may contribute to the aetiology of shoulder pathology in quadriplegia, and differentiate it from that observed in able-bodied athletes who exhibit weak abductors.

Indications and Outcomes for Microfracture as an Adjunct to Hip Arthroscopy for Treatment of Chondral Defects in Patients With Femoroacetabular Impingement: A Systematic Review.

Science.gov (United States)

MacDonald, Austin E; Bedi, Asheesh; Horner, Nolan S; de Sa, Darren; Simunovic, Nicole; Philippon, Marc J; Ayeni, Olufemi R

2016-01-01

To evaluate the indications, preoperative workup outcomes, and postoperative rehabilitation of patients with femoroacetabular impingement (FAI) receiving microfracture as an adjunct to hip arthroscopy for chondral defects. The electronic databases MEDLINE, EMBASE, and PubMed were searched and screened in duplicate for studies involving patients with FAI treated arthroscopically with microfracture of the hip for chondral defects either solely or as an adjunct to hip arthroscopy. Data regarding indications, investigations, outcomes, and postoperative rehabilitation were abstracted from eligible studies. The references of included studies were additionally searched, and descriptive statistics are provided. There were 12 studies included in this review, involving 267 patients. With the exception of a single, one-patient case report, 11 of the 12 studies reported positive outcomes after hip arthroscopy with microfracture. Only 0.7% of the total patients experienced a complication, and 1.1% required further surgery on the basis of outcomes evaluated at a mean follow-up of 29.5 (range, 4 to 60) months across the studies. Eight of 12 studies discussed the preoperative workup of these patients, with X-rays and magnetic resonance imaging being the most common preoperative imaging used. There was little reported on weight-bearing status during postoperative rehabilitation. The outcomes reported in the literature after hip arthroscopy with microfracture for chondral defects are, in general, positive, with a very low percentage of patients requiring further surgery or experiencing complications. The most common indication used in the literature for microfracture is a full-thickness, focal chondral defect (Outerbridge grade IV). The vast majority of literature recommends limited weight bearing after microfracture; however, there was significant variation among the specific rehabilitation protocols used. More research is needed to explore what indications and postoperative

Diagnostic imaging of shoulder impingement

International Nuclear Information System (INIS)

Merl, T.; Weinhardt, H.; Oettl, G.; Lenz, M.; Riel, K.A.

1996-01-01

Magnetic resonance imaging is a method that has been advancing in the last few years to the modality of choice for diagnostic evaluation of the bone joints, as the method is capable of imaging not only the ossous but also the soft tissue components of the joint. MRI likewise has become an accepted method for diagnostic evaluation of syndromes of the shoulder, with high diagnostic accuracy in detecting rotator cuff lesions, or as an efficient MRI arthrography for evaluation of the instability or lesions of the labrocapsular complex. In the evaluation of early stages of shoulder impingement, the conventional MRI technique as a static technique yields indirect signs which in many cases do not provide the diagnostic certainty required in order to do justice to the functional nature of the syndrome. In these cases, functional MRI for imaging of the arm in abducted position and in rotational movement may offer a chance to early detect impingement and thus identify patients who will profit from treatment at an early stage [de

Does taping in addition to physiotherapy improve the outcomes in subacromial impingement syndrome? A systematic review.

Science.gov (United States)

Saracoglu, Ismail; Emuk, Yusuf; Taspinar, Ferruh

2018-04-01

Taping is used with or without other interventions for many purposes, especially to manage pain and improve functional activity in patients with shoulder pain. The aim of this review was to determine whether any taping technique in addition to physiotherapy care is more effective than physiotherapy care alone in patients with shoulder impingement syndrome. A systematic search of Cochrane Database of Systematic Review, MEDLINE (EBSCO), Physiotherapy Evidence Database (PEDro), CINAHL (EBSCO), PUBMED, AMED, EMBASE (OVID), The Kinesio Kinesio® Taping Method, Kinesio® Tex Tape UK and International websites ( www.kinesiotaping.co.uk ; www.kinesiotaping.com ) was conducted to June 2015. The outcome measures were pain, disability, range of motion and muscle strength. As data were not suitable for meta-analysis, narrative synthesis were applied. Three randomized controlled trials and one controlled trial (135 patients) were included. The results were conflicting and weak on the effectiveness of taping as an adjunct therapy for improvement of pain, disability, range of motion and muscle strength. Clinical taping in addition to physiotherapy interventions (e.g. exercise, electrotherapy, and manual therapy) might be an optional modality for managing patients with shoulder impingement syndrome, especially for the initial stage of the treatment; however, we need further robust, placebo controlled and consistent studies to prove whether it is more effective than physiotherapy interventions without taping.

The Effect of Theraband Training on Position Sense of Internal and External Rotator Muscles in Male Athletes with Shoulder Impingement Syndrome

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Ramin Moharrami

2015-10-01

Full Text Available Objective: This study evaluated the effect of theraband training on Position sense of internal and external rotator muscles in male athletes with shoulder impingement syndrome. Materials & Methods: In this semi-experimental interventional study 30 cases of men with Shoulder syndrome with age range of 20 to 30 years participated. They were divided in test and control groups, each group including 15 people through non-random and purposeful method Biodex System 3 Made in America was used to measure position sense of internal and external rotator muscles. For data analysis independent 7 paired t-test was used in SPSS software (version 21. Results: The experimental group showed significant improvement after six weeks of theraband training in the internal and external rotator muscles in three 90,45,0 degree angle at a significance level of 0.05 (P=0.05. Conclusion: The results of this study showed that of theraband training resulted in improved position sense of internal and external rotator muscles in male athletes with impingement syndrome thus, the benefits of these exercises can be used widely in team sports and also for easy and quick rehabilitation of patients.

Acetabular labral tears in patients with sports injury.

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Kang, Chan; Hwang, Deuk-Soo; Cha, Soo-Min

2009-12-01

We wanted to investigate acetabular labral tears and their correlation with femoroacetabular impingement in patients with sports injury. Among 111 patients who were diagnosed with the acetabular labral tears after arthroscopic treatment from January 2004 to December 2007, we selected 41 patients with sports injury. There were 12 cases of Taekwondo injury, 5 of golf injury, 4 of soccer injury, 3 of gymnastics injury, 2 of Hapkido injury, 2 of aerobics injury, 2 of rock-climbing injury, 2 of fitness training injury and 9 of other sports injuries. We checked the subtypes of acetabular labral tears and the accompanying femoroacetabular impingement. For the cases with accompanying femoroacetabular impingement, we investigated the subtypes according to the types of sports, gender and age. At last follow-up, we checked the Harris Hip Score (HHS), the Hip Outcome Score (HOS) sports scale and the percentage of patients who returned to their sports activity. The average age of symptomatic onset was 26 years (range, 12 to 65 years). The ratio of males to females was 29 : 12. An average duration of the hip pain was 17 months (range, 1 to 60 months). The degenerative type of acetabular labral tears was the most prevalent with 32 cases (78%), and there were 9 cases (22%) of the partial tear type. Thirty cases (73%) were accompanied by femoroacetabular impingement. The average age of the 23 cases (56%) of the cam-type was 23 years (range, 12 to 48 years), and it was more likely to occur in men (87%) and for people practicing martial arts such as Taekwondo or Hapkido. An average age of the 5 cases (12%) of the pincer-type was 26 (range, 16 to 43 years), it usually occurred in women (60%) and for non-martial arts such as golf and gymnastics. There were 2 cases of the mixed type (cam + pincer-type). At 27 months follow-up, the HHS was 61 to 92 points, the HOS sports scale increased 43 to 75%, and the rate of returning to sports was 71%. In spite of the early expression of symptoms

Local Infiltration Analgesia Compared With Epidural and Intravenous PCA After Surgical Hip Dislocation for the Treatment of Femoroacetabular Impingement in Adolescents.

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Novais, Eduardo N; Kestel, Lauryn; Carry, Patrick M; Sink, Ernest; Strupp, Kim

2018-01-01

Open treatment of femoroacetabular impingement (FAI) through a surgical hip dislocation (SHD) approach has been reported to allow for improvement in pain and function. However, the approach require a trochanteric osteotomy and may be associated with high level of pain after surgery. Currently, there is no systematic approach for pain management after SHD for treatment of FAI. A retrospective chart review was used to collect data from 121 subjects (12 to 21 y and below) who received periarticular local infiltration analgesia (LIA, n=20), epidural analgesia (n=72), or intravenous patient-controlled analgesia (PCA, n=29) after SHD from January 2003 to June 2014. Verbal pain scores, opioid consumption, incidence of side effects/complications, and length of hospital stay (LOS) were recorded. All nonopioid medications with analgesic potential were included in the statistical models as potential confounding variables RESULTS:: Twelve hours after surgery, the odds of moderate/severe pain were higher in the PCA group (odds ratio, 20.5; 95% confidence interval (CI), 1.7-243.8; P=0.0166] and epidural group (odds ratio, 5.2; 95% CI, 0.7-92.0; P=0.3218) compared with the LIA group. There was no difference in pain scores across all groups 1 hour (P=0.0675) or 24 hours (P=0.3473) postoperatively. Total opioid consumption in the LIA group was 59.8% (95% CI, 15.0%-81.0%; P=0.0175) lower than the total opioid consumption in the epidural group and 60.7% (95% CI, 17.3-81.3; P=0.0144) lower than the total opioid consumption in the PCA group. LOS was increased in the epidural (mean difference, 22.1; 95% CI, 6.8-37.4 h; P=0.0051) and PCA (mean difference, 16 h; 95% CI, 1-31.5 h; P=0.0367) groups relative to the LIA group. There was 0 (0%) complication in the LIA group compared with 11 (15.3%) in the epidural group. LIA was more effective at controlling pain 12 hours after surgery in comparison with PCA with similar pain control to epidural. LIA was associated with significantly lower

The reliability of three-dimensional scapular attitudes in healthy people and people with shoulder impingement syndrome

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Hébert Luc J

2007-06-01

Full Text Available Abstract Background Abnormal scapular displacements during arm elevation have been observed in people with shoulder impingement syndrome. These abnormal scapular displacements were evaluated using different methods and instruments allowing a 3-dimensional representation of the scapular kinematics. The validity and the intrasession reliability have been shown for the majority of these methods for healthy people. However, the intersession reliability on healthy people and people with impaired shoulders is not well documented. This measurement property needs to be assessed before using such methods in longitudinal comparative studies. The objective of this study is to evaluate the intra and intersession reliability of 3-dimensional scapular attitudes measured at different arm positions in healthy people and to explore the same measurement properties in people with shoulder impingement syndrome using the Optotrak Probing System. Methods Three-dimensional scapular attitudes were measured twice (test and retest interspaced by one week on fifteen healthy subjects (mean age 37.3 years and eight subjects with subacromial shoulder impingement syndrome (mean age 46.1 years in three arm positions (arm at rest, 70° of humerothoracic flexion and 90° of humerothoracic abduction using the Optotrak Probing System. Two different methods of calculation of 3-dimensional scapular attitudes were used: relative to the position of the scapula at rest and relative to the trunk. Intraclass correlation coefficient (ICC and standard error of measure (SEM were used to estimate intra and intersession reliability. Results For both groups, the reliability of the three-dimensional scapular attitudes for elevation positions was very good during the same session (ICCs from 0.84 to 0.99; SEM from 0.6° to 1.9° and good to very good between sessions (ICCs from 0.62 to 0.97; SEM from 1.2° to 4.2° when using the method of calculation relative to the trunk. Higher levels of

The evaluation of the effectiveness of occupational therapy, using its different programs for the people who are experiencing shoulder impingement syndrome

OpenAIRE

Sadauskytė, Sigita

2015-01-01

S. Sadauskytė: The evaluation of the effectiveness of occupational therapy, using its different programs for the people who are experiencing shoulder impingement syndrome. A Master‘s thesis. Research supervisor is dr. E. Sendžikaitė; Institute of sports, Faculty of nursing, Medical Academy,Lithuanian University of Health Sciences, – Kaunas, 2015.

Ultrasound elastography-based assessment of the elasticity of the supraspinatus muscle in impingement syndrome: does elastography has any diagnostic value?

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Demirel, Adnan; Baykara, Murat; Koca, Tuba Tülay; Berk, Ejder

2018-06-01

Ultrasound elastography (UE) is a new ultrasound-based imaging technique that provides information about elasticity and stiffness of tissues. This cross-sectional study aimed to identify the diagnostic importance of UE in supraspinatus impingement syndrome. Forty-one subjects, aged 38-70 years, were included in the study. UE was used to determine the elasticity of the supraspinatus muscle. The strain ratio was calculated as the evaluation criteria to measure the elasticity of the muscle. High strain ratio indicated low elasticity. The measurements were made by the blinded radiologist while the patients sat with their shoulder in a neutral position. The diagnostic value of the strain ratio was evaluated using the receiver operating characteristic (ROC) analysis. The mean strain value of the supraspinatus muscle on the intact and pathological shoulders determined by UE was 0.74 ± 0.33 and 0.31 ± 0.24, respectively. A low strain ratio value in the supraspinatus muscle on the side with impingement syndrome was measured. When the test variable was evaluated as "strain ratio" according to ROC curve analysis, it was found to be above the reference line [0.849 (> 0.5)] (P = 0.00). When the cutoff value was selected as 0.495, the sensitivity and specificity were found to be 75.6 and 78% (the strain ratio value > 0.495), respectively. Measurement of strain ratio with UE can be used as a noninvasive, inexpensive, and practical diagnostic test for the shoulder impingement disease.

Diagnostic Accuracy of Imaging Modalities and Injection Techniques for the Diagnosis of Femoroacetabular Impingement/Labral Tear: A Systematic Review With Meta-analysis.

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Reiman, Michael P; Thorborg, Kristian; Goode, Adam P; Cook, Chad E; Weir, Adam; Hölmich, Per

2017-09-01

Diagnosing femoroacetabular impingement/acetabular labral tear (FAI/ALT) and subsequently making a decision regarding surgery are based primarily on diagnostic imaging and intra-articular hip joint injection techniques of unknown accuracy. Summarize and evaluate the diagnostic accuracy and clinical utility of various imaging modalities and injection techniques relevant to hip FAI/ALT. Systematic review with meta-analysis. A computer-assisted literature search was conducted of MEDLINE, CINAHL, and EMBASE databases using keywords related to diagnostic accuracy of hip joint pathologic changes. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used for the search and reporting phases of the study. Quality assessment of bias and applicability was conducted using the Quality of Diagnostic Accuracy Studies (QUADAS) tool. Random effects models were used to summarize sensitivities (SN), specificities (SP), likelihood ratios (+LR and -LR), diagnostic odds ratios (DOR), and respective confidence intervals (CI). The search strategy and assessment for risk of bias revealed 25 articles scoring above 10/14 on the items of the QUADAS. Four studies investigated FAI, and the data were not pooled. Twenty articles on ALT qualified for meta-analysis. Pretest probability of ALT in the studies in this review was 81% (72%-88%), while the pretest probability of FAI diagnosis was 74% (95% CI, 51%-91%). The meta-analysis showed that computed tomography arthrography (CTA) demonstrated the strongest overall diagnostic accuracy: pooled SN 0.91 (95% CI, 0.83-0.96); SP 0.89 (95% CI, 0.74-0.97); +LR 6.28 (95% CI, 2.78-14.21); -LR 0.11 (95% CI, 0.06-0.21); and DOR 64.38 (95% CI, 19.17-216.21). High pretest probability of disease was demonstrated. Positive imaging findings increased the probability that a labral tear existed by a minimal to small degree with the use of magnetic resonance imaging/magnetic resonance angiogram (MRI/MRA) and ultrasound (US

Evaluation of articular cartilage in patients with femoroacetabular impingement (FAI) using T2* mapping at different time points at 3.0 Tesla MRI: a feasibility study

International Nuclear Information System (INIS)

Apprich, S.; Mamisch, T.C.; Welsch, G.H.; Bonel, H.; Siebenrock, K.A.; Dudda, M.; Kim, Y.J.; Trattnig, S.

2012-01-01

To define the feasibility of utilizing T2* mapping for assessment of early cartilage degeneration prior to surgery in patients with symptomatic femoroacetabular impingement (FAI), we compared cartilage of the hip joint in patients with FAI and healthy volunteers using T2* mapping at 3.0 Tesla over time. Twenty-two patients (13 females and 9 males; mean age 28.1 years) with clinical signs of FAI and Toennis grade ≤ 1 on anterior-posterior x-ray and 35 healthy age-matched volunteers were examined at a 3 T MRI using a flexible body coil. T2* maps were calculated from sagittal- and coronal-oriented gradient-multi-echo sequences using six echoes (TR 125, TE 4.41/8.49/12.57/16.65/20.73/24.81, scan time 4.02 min), both measured at beginning and end of the scan (45 min time span between measurements). Region of interest analysis was manually performed on four consecutive slices for superior and anterior cartilage. Mean T2* values were compared among patients and volunteers, as well as over time using analysis of variance and Student's t-test. Whereas quantitative T2* values for the first measurement did not reveal significant differences between patients and volunteers, either for sagittal (p = 0.644) or coronal images (p = 0.987), at the first measurement, a highly significant difference (p ≤ 0.004) was found for both measurements with time after unloading of the joint. Over time we found decreasing mean T2* values for patients, in contrast to increasing mean T2* relaxation times in volunteers. The study proved the feasibility of utilizing T2* mapping for assessment of early cartilage degeneration in the hip joint in FAI patients at 3 Tesla to predict possible success of joint-preserving surgery. However, we suggest the time point for measuring T2* as an MR biomarker for cartilage and the changes in T2* over time to be of crucial importance for designing an MR protocol in patients with FAI. (orig.)

Co-occurrence of outlet impingement syndrome of the shoulder and restricted range of motion in the thoracic spine - a prospective study with ultrasound-based motion analysis

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Fuchs-Winkelmann Susanne

2010-06-01

Full Text Available Abstract Background Shoulder complaints, and especially the outlet-impingement syndrome, are a common condition. Among other things, poor posture has been discussed as a cause. A correlation between impingement syndrome and restricted mobility of the thoracic spine (T has been described earlier, but there has been no motion analysis of the thoracic spine to show these correlations. In the present prospective study, we intended to find out whether there is a significant difference in the thoracic sagittal range of motion (ROM between patients with a shoulder outlet impingement syndrome and a group of patients who had no shoulder pathology. Secondly, we wanted to clarify whether Ott's sign correlates with ultrasound topometric measurements. Methods Two sex- and age-matched groups (2 × n = 39 underwent a clinical and an ultrasound topometric examination. The postures examined were sitting up straight, sitting in maximal flexion and sitting in maximal extension. The disabilities of the arm, shoulder and hand (DASH score (obtained by means of a self-assessment questionnaire and the Constant score were calculated. Lengthening and shortening of the dorsal projections of the spine in functional positions was measured by tape with Ott's sign. Results On examination of the thoracic kyphosis in the erect seated posture there were no significant differences between the two groups (p = 0.66. With ultrasound topometric measurement it was possible to show a significantly restricted segmental mobility of the thoracic spine in the study group compared with the control group (p = 0.01. An in-depth look at the mobility of the subsegments T1-4, T5-8 and T9-12 revealed that differences between the groups in the mobility in the lower two sections of the thoracic spine were significant (T5-8: p = 0.03; T9-12: p = 0.02. The study group had an average Constant score of 35.1 points and the control group, 85.5 (p Conclusion The mobility of the thoracic spine should

Rehabilitation after labral repair and femoroacetabular decompression: criteria-based progression through the return to sport phase.

Science.gov (United States)

Wahoff, Michael; Dischiavi, Steve; Hodge, Jenna; Pharez, Joseph D

2014-11-01

Rehabilitation following hip arthroscopy for femoroacetabular impingement (FAI) and labral-chondral dysfunction has evolved rapidly over the past 15 years. There have been multiple commentaries published on rehabilitation following hip arthroscopy without any published standardized objective criteria to address the advancement of the athlete through the phases of rehabilitation. The purpose of this clinical commentary is to describe a criteria driven algorithm for safe integration and return to sport rehabilitation following hip arthroscopy. The criteria based program allows for individuality of the athlete while providing guidance from early post-operative phases through late return to sport phases of rehabilitation. Emphasis is placed on the minimum criteria to advance including healing restraints, patient reported outcomes, range of motion, core and hip stability, postural control, symmetry with functional tasks and gait, strength, power, endurance, agility, and sport-specific tasks. Evidence to support the criteria will be offered as available. Despite limitations, this clinical commentary will offer a guideline for safe return to sport for the athlete while identifying areas for further investigation. 5.

Síndrome de pinzamiento femoroacetabular en deportista veterano

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F. Jiménez Borrero

2015-12-01

Full Text Available El síndrome de pinzamiento femoroacetabular (PFA es una patología común en el adulto joven deportista que cada vez está tomando más relevancia y que se caracteriza por una inadecuada relación femoroacetabular, con una clínica dolorosa e incapacitante de larga evolución, que puede simular otras patologías de la cadera, motivo por el cual, se debe realizar una anamnesis y una exhaustiva exploración física que nos oriente hacia esta patología, confirmando la sospecha diagnóstica mediante pruebas complementarias como la radiografía de pelvis y la resonancia magnética (RM. El tratamiento, en general, es quirúrgico. Debemos realizar un diagnóstico temprano ya que es una causa de artrosis precoz en el adulto joven.

[Effectiveness of physiotherapy on painful shoulder impingement syndrome].

Science.gov (United States)

Gomora-García, Mónica; Rojano-Mejía, David; Solis-Hernández, José Luis; Escamilla-Chávez, Carolina

2016-01-01

Painful shoulder impingement syndrome is one of the first reasons for care in rehabilitation centres. As the evidence regarding the effectiveness of physical measures as adjuvant treatment is limited, the aim of this study was to determine the effectiveness of physiotherapy on shoulder pain. A retrospective and analytical study was conducted using the medical records of patients with shoulder pain who attended in a rehabilitation centre from October 2010 to September 2011. The demographic and clinical data were collected, and the clinical improvement was determined as: complete, incomplete, or no improvement. Chi squared was used to determine whether there were differences between the different modalities of physiotherapy, as well as the level of improvement. The study included a total of 181 patients, with a mean age of 54.3 years, and a mean of 4.6 months of onset of pain. The physiotherapy treatments included: warm compresses plus interferential current (60.2%), and warm compresses plus ultrasound (17.1%). Just over half (53.6%) obtained a moderate recovery, 36.4% slight improvement, and 9.9% no improvement. No significant differences were found between the different forms of therapy. The supervised rehabilitation program consists of 9 sessions of physiotherapy. A functional improvement of 90% was obtained, without finding any statistical differences between the therapies used. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

Impingement syndrome and rotator cuff tears: US findings in 140 patients

International Nuclear Information System (INIS)

Malvestiti, Oreste; Scorsolini, Alessandro; Ratti, Francesco; Ferraris, Giuseppe; Columbaro, Guido; Mariani, Claudio

1997-01-01

The authors investigated the role of rotator cuff impingement in causing tears of supraspinatus and biceps tendons and the comparative reliability of plain radiography and sonography (US). One hundred forty patients with symtoms referrable to the rotator cuff were examined with plain radiography and US of the shoulder. The differential diagnosis must distinguish all these common causes of shoulder dysfunction and cuff problems from other conditions. The authors conclude that US and plain radiography are accurate routine tests of rotator cuff integrity and rotator cuff impingement

Evaluation of articular cartilage in patients with femoroacetabular impingement (FAI) using T2* mapping at different time points at 3.0 Tesla MRI: a feasibility study.

Science.gov (United States)

Apprich, S; Mamisch, T C; Welsch, G H; Bonel, H; Siebenrock, K A; Kim, Y-J; Trattnig, S; Dudda, M

2012-08-01

To define the feasibility of utilizing T2* mapping for assessment of early cartilage degeneration prior to surgery in patients with symptomatic femoroacetabular impingement (FAI), we compared cartilage of the hip joint in patients with FAI and healthy volunteers using T2* mapping at 3.0 Tesla over time. Twenty-two patients (13 females and 9 males; mean age 28.1 years) with clinical signs of FAI and Tönnis grade ≤ 1 on anterior-posterior x-ray and 35 healthy age-matched volunteers were examined at a 3 T MRI using a flexible body coil. T2* maps were calculated from sagittal- and coronal-oriented gradient-multi-echo sequences using six echoes (TR 125, TE 4.41/8.49/12.57/16.65/20.73/24.81, scan time 4.02 min), both measured at beginning and end of the scan (45 min time span between measurements). Region of interest analysis was manually performed on four consecutive slices for superior and anterior cartilage. Mean T2* values were compared among patients and volunteers, as well as over time using analysis of variance and Student's t-test. Whereas quantitative T2* values for the first measurement did not reveal significant differences between patients and volunteers, either for sagittal (p = 0.644) or coronal images (p = 0.987), at the first measurement, a highly significant difference (p ≤ 0.004) was found for both measurements with time after unloading of the joint. Over time we found decreasing mean T2* values for patients, in contrast to increasing mean T2* relaxation times in volunteers. The study proved the feasibility of utilizing T2* mapping for assessment of early cartilage degeneration in the hip joint in FAI patients at 3 Tesla to predict possible success of joint-preserving surgery. However, we suggest the time point for measuring T2* as an MR biomarker for cartilage and the changes in T2* over time to be of crucial importance for designing an MR protocol in patients with FAI.

Hip Imaging in Athletes: Sports Imaging Series.

Science.gov (United States)

Agten, Christoph A; Sutter, Reto; Buck, Florian M; Pfirrmann, Christian W A

2016-08-01

Hip or groin pain in athletes is common and clinical presentation is often nonspecific. Imaging is a very important diagnostic step in the work-up of athletes with hip pain. This review article provides an overview on hip biomechanics and discusses strategies for hip imaging modalities such as radiography, ultrasonography, computed tomography, and magnetic resonance (MR) imaging (MR arthrography and traction MR arthrography). The authors explain current concepts of femoroacetabular impingement and the problem of high prevalence of cam- and pincer-type morphology in asymptomatic persons. With the main focus on MR imaging, the authors present abnormalities of the hip joint and the surrounding soft tissues that can occur in athletes: intraarticular and extraarticular hip impingement syndromes, labral and cartilage disease, microinstability of the hip, myotendinous injuries, and athletic pubalgia. (©) RSNA, 2016.

The clinical and sonographic effects of kinesiotaping and exercise in comparison with manual therapy and exercise for patients with subacromial impingement syndrome: a preliminary trial.

Science.gov (United States)

Kaya, Derya Ozer; Baltaci, Gul; Toprak, Ugur; Atay, Ahmet Ozgur

2014-01-01

The purpose of this study was to compare the effects of manual therapy with exercise to kinesiotaping with exercise for patients with subacromial impingement syndrome. Randomized clinical before and after trial was used. Fifty-four patients diagnosed as having subacromial impingement syndrome who were referred for outpatient treatment were included. Eligible patients (between 30 and 60 years old, with unilateral shoulder pain) were randomly allocated to 2 study groups: kinesiotaping with exercise (n = 28) or manual therapy with exercise (n = 26). In addition, patients were advised to use cold packs 5 times per day to control for pain. Visual analog scale for pain, Disability of Arm and Shoulder Questionnaire for function, and diagnostic ultrasound assessment for supraspinatus tendon thickness were used as main outcome measures. Assessments were applied at the baseline and after completing 6 weeks of related interventions. At the baseline, there was no difference between the 2 group characteristics (P > .05). There were significant differences in both groups before and after treatment in terms of pain decrease and improvement of Disability of Arm and Shoulder Questionnaire scores (P .05). The only difference between the groups was at night pain, resulting in favor of the kinesiotaping with exercise group (P kinesiotaping with exercise and manual therapy with exercise. Both treatments may have similar results in reducing pain and disability in subacromial impingement in 6 weeks. Copyright © 2014 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

PERBANDINGAN ANTARA KOMBINASI LATIHAN STABILISASI BAHU DAN TRAKSI HUMERUS KE INFERIOR DENGAN KOMBINASI LATIHAN FUNGSIONAL BAHU DAN TRAKSI HUMERUS KE INFERIOR DALAM MENURUNKAN DISABILITAS BAHU DAN LENGAN PADA SUBACROMIAL IMPINGEMENT SYNDROME MAHASISWA AKAD

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Mawaddah -

2015-08-01

Full Text Available Shoulder impingement causing interference on the motion of the shoulder joint activities and result in functional activity disorder. These injuries usually are caused by faulty movement, overuse, poor posture, occupational factors and trauma. This will cause a burden on one part of the body and cause imbalances in anatomy, which will eventually lead to disruption of the body that experienced work. This study aimed to investigate the effect of functional shoulder exercise and traction humerus to inferior with shoulder stabilization exercises and traction humerus to inferior to the decline in the shoulder and arm disabilities in subacromial impingement syndrome. This research method was experimental clinical trials with pre test and post test group design. Population student Academy Physiotherapy Widya Husada Semarang, which consists of 3 men and 12 women, aged between 18-21 years, divided into two groups. Group I was given Shoulder Stabilization exercises and Traction humerus to Inferior (n=7 and group II Functional Shoulder Exercise and Traction humerus to Inferior (n=8. This research was conducted for 3 weeks. Measurement of the value of disability shoulder and arm by using the Shoulder Pain and Disability Index (SPADI. The test results on the group I average value pre 34.17, SB = 6.31, and the average value of post 11.54, SB = 4.02, p = 0.001 found significant differences obtained test results paired sample t-test, and testing group II average value pre 40.18, SB = 3.53, and the average value of post 7.82, SB = 1.57, p = 0.001 found significant differences obtained test results paired sample t-test. Comparison of Group I and II, p = 0.005 there were significant differences, test results obtained independent sample t-test. Conclusions: The combination of shoulder stabilization exercises and traction humerus to inferior can reduce disability shoulder and arm on subacromial impingement syndrome. The combination functional shoulder exercise and

Femoral Head Avascular Necrosis Is Not Caused by Arthroscopic Posterolateral Femoroplasty.

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Rupp, Robert E; Rupp, Sasha N

2016-05-01

This study was conducted to identify the risk of avascular necrosis of the femoral head after arthroscopic femoroplasty extending to the posterolateral femoral neck, the source of the primary blood supply to the femoral head. Cam lesions of femoroacetabular impingement are typically anterior along the junction of the femoral head and neck. However, anatomic variations can involve the posterolateral vascular region of the femoral head and neck. Femoroplasty involving this vascular region can lead to injury to the blood supply to the femoral head, with subsequent avascular necrosis. If the posterolateral portion of the cam lesion is preserved, persistent femoroacetabular impingement may occur. A retrospective review identified 112 patients who underwent arthroscopic femoroplasty for femoroacetabular impingement over a 2-year period. Of these patients, 14 had femoroplasty that extended to the posterolateral femoral head. Of this group, 5 had undergone magnetic resonance imaging (MRI) after femoroplasty and the other 9 were contacted to undergo MRI of the hip to evaluate for avascular necrosis. A radiologist and the senior author evaluated all MRI scans specifically for avascular necrosis of the femoral head. All procedures were performed by the senior author. Mean age of the 14 patients (8 women and 6 men) with femoroplasty that extended into the posterolateral vascular region of the femoral head was 44 years (range, 23-69 years). All 14 patients underwent MRI evaluation of the affected hip a mean of 25 months (range, 7-44 months) after femoroplasty. No MRI scans showed evidence of avascular necrosis of the femoral head. Femoroplasty of the posterolateral vascular region of the femoral head is not associated with avascular necrosis. Patients with femoroacetabular impingement and a cam lesion extending to the posterolateral femoral head can undergo femoroplasty of this region without the development of avascular necrosis. [Orthopedics. 2016; 39(3):177-180.]. Copyright

Cam-type femoral-acetabular impingement: is the alpha angle the best MR arthrography has to offer?

International Nuclear Information System (INIS)

Lohan, Derek G.; Seeger, Leanne L.; Motamedi, Kambiz; Sayre, James; Hame, Sharon

2009-01-01

In our institutional experience, determination of the alpha (α) angle at MR arthrography as an indicator of the likelihood of cam-type femoroacetabular impingement (FAI) is fraught with inconsistency. The aims of this study were to quantify the degree of variability in and calculate the diagnostic accuracy of the α angle in suggesting a diagnosis of cam impingement, to determine the accuracy of a positive clinical impingement test, and to suggest alternative MR arthrographic measures of femoral head-neck overgrowth and determine their diagnostic utilities. We carried out a retrospective analysis of MR arthrographic studies performed during a 4-year period, combined with chart analysis, which allowed identification of 78 patients in whom surgical correlation was also available. The status of a preoperative clinical impingement test was also noted. Patients were designated as having cam-type FAI (Group A, n = 39) if intra-operative femoral head-neck junction bony osteochondroplasty/arthoscopic femoral debridement was performed. Group B (n = 39) acted as controls. Three radiologists independently and blindly performed a series of measurements (α angle and two newly proposed measurements) in each patient on two separate occasions. An α angle of greater than 55 was considered indicative of the presence of cam-type FAI. Performance values for α angle measurement were poor for each observer. There was considerable (up to 30% of the mean value) intra-observer variability between the first and second α angle measurements for each subject. Binary logistic regression analysis confirmed that the α angle is of no value in predicting the presence or absence of cam-FAI. A statistically significant difference existed between Groups A and B with regard to the newly proposed anterior femoral distance (AFD; p = 0.004). Using an AFD value of 3.60 mm or greater as being indicative of the presence of cam-FAI yields a 0.67 performance measure (95% confidence interval 0

Physical Therapy Protocol After Hip Arthroscopy: Clinical Guidelines Supported by 2-Year Outcomes.

Science.gov (United States)

Domb, Benjamin G; Sgroi, Terrance A; VanDevender, Jeremy C

2016-07-01

Femoroacetabular impingement (FAI) was first described by Ganz in 2003 and is a significant cause of decreased function and mobility. Femoroacetabular impingement must be treated in an individualized, goal-oriented, stepwise fashion. This protocol was developed with biomechanical considerations of soft tissue and bony structures surrounding the hip joint. The PubMed database was searched for scientific and review articles from the years 2000 to 2015 utilizing the search terms: hip rehabilitation, femoroacetabular impingement, and arthroscopy. Clinical review. Level 5. Five hundred ninety-five of 738 patients were available for follow-up showing improvement from preoperative to 2-year follow-up of 61.29 to 82.02 for modified Harris Hip Score (mHHS), 62.79 to 83.04 for Hip Outcome Score-Activities of Daily Living (HOS-ADL), 40.96 to 70.07 for Hip Outcome Score-Sport-Specific Subscale (HOS-SSS), and 57.97 to 80.41 for Non-Arthritic Hip Score (NAHS); visual analog scale (VAS) scores decreased from 5.86 preoperatively to 2.94 postoperatively. Following a structured, criteria-based program, appropriate patients undergoing hip arthroscopy may achieve excellent outcomes and return to full independent activities of daily living as well as sport. © 2016 The Author(s).

Perspectives on fish impingement

International Nuclear Information System (INIS)

Sharma, R.K.

1977-01-01

Data on fish impingement and related parameters are being gathered at a large number of power stations throughout the country at substantial monetary and manpower costs. A national survey of fish impingement at power plants was conducted and much of the information compiled in a standardized format--an effort that we think will aid in planning improvements in the design, siting, and operation of the cooling-water intakes. This paper examines the objectives of the fish impingement studies, monitoring programs, variables affecting fish impingement, siting and design criteria, state-of-the-art of screening systems, and suggestions for meeting 316(b) requirements. It also discusses where the emphasis should be placed in future fish-impingement related activities

Can hip impingement be mistaken for tendon pain in the groin? A long-term follow-up of tenotomy for groin pain in athletes.

Science.gov (United States)

Sansone, Mikael; Ahldén, Mattias; Jonasson, Pall; Thomeé, Roland; Falk, Anders; Swärd, Leif; Karlsson, Jón

2014-04-01

There are several reports on the association between pubalgia and intra-articular hip disorders. The purpose of this study was to evaluate the long-term outcome in athletes who underwent tenotomy due to long-standing groin pain. A secondary purpose was evaluating the frequency of femoro-acetabular impingement (FAI) and its impact on the long-term outcome. Thirty-two high-level male athletes treated with adductor tenotomy, rectus abdominis tenotomy or both were included. At a median follow-up time of 6 years after the tenotomy, the subjects underwent standardised clinical examination, plain radiographs, completed web-based health-related patient-reported outcomes, including iHOT12, HAGOS (six subscales), EQ-5D (two subscales), HSAS for physical activity level and a VAS for overall hip function. Furthermore, patient satisfaction and return to sports were documented. Twenty-four of the 32 (75 %) athletes were satisfied with the outcome of the tenotomy, and 22 of the athletes (69 %) were able to return to their pre-injury sport. Before the long-term follow-up, two of these satisfied athletes had undergone repeat surgery (one hip arthroscopy due to FAI and one repeat tenotomy). Of the 24 satisfied athletes, eight (33 %) had a positive hip impingement test at the follow-up. Of the remaining eight athletes not satisfied with the outcome, only one returned to their pre-injury sport and three had undergone hip arthroscopy prior to follow-up. Five had positive hip impingement tests which was significantly more frequently than in the satisfied group (p = 0.008). The group with a positive hip impingement test reported significantly more pain and symptoms, more hip problems during sports and physical activity, as well as lower hip-related quality of life according to the HAGOS scores (p pubalgia yielded a satisfactory long-term outcome, with three of four athletes being able to return to their pre-injury sport. The athletes that did not return to their pre-injury sport had

The diagnostic performance of non-contrast 3-Tesla magnetic resonance imaging (3-T MRI) versus 1.5-Tesla magnetic resonance arthrography (1.5-T MRA) in femoro-acetabular impingement

Energy Technology Data Exchange (ETDEWEB)

Crespo-Rodríguez, Ana M., E-mail: anacresporodriguez@gmail.com [Department of Radiology, Hospital Universitario Puerta de Hierro Majadahonda, c/ Joaquín Rodrigo 2, Majadahonda 28222, Madrid (Spain); De Lucas-Villarrubia, Jose C., E-mail: jclucasv@hotmail.com [Department of Orthopaedics and Traumatology at the Hospital Universitario Puerta de Hierro Majadahonda, c/ Joaquín Rodrigo 2, Majadahonda 28222, Madrid (Spain); Pastrana-Ledesma, Miguel, E-mail: m.pastrana@telefonica.net [Department of Radiology, Hospital Universitario Puerta de Hierro Majadahonda, c/ Joaquín Rodrigo 2, Majadahonda 28222, Madrid (Spain); Hualde-Juvera, Ana, E-mail: ana.hualdej@salud.madrid.org [Department of Radiology, Hospital Universitario Puerta de Hierro Majadahonda, c/ Joaquín Rodrigo 2, Majadahonda 28222, Madrid (Spain); Méndez-Alonso, Santiago, E-mail: smendez.sma@gmail.com [Department of Radiology, Hospital Universitario Puerta de Hierro Majadahonda, c/ Joaquín Rodrigo 2, Majadahonda 28222, Madrid (Spain); Padron, Mario, E-mail: mario.padron@clinicacemtro.com [Department of Radiology, Clínica Cemtro, Avda Ventisquero de la Condesa 42 Madrid 28035, Madrid (Spain)

2017-03-15

Highlights: • High resolution sequences at 3-T MRI extend accuracy in hip assessment without any need for intra-articular injection of contrast media. • As compared to 1.5-T MRA, 3-T non-contrast MRI of the hip improves the patient experience and avoids the potential risks of an invasive procedure and contrast media. • Avoiding the need for arthrographic procedures in the Radiology Department improves patient throughput and reduces costs. - Abstract: Objective: The aim of this study was to evaluate the diagnostic accuracy of 3-T non-contrast MRI versus 1.5-T MRA for assessing labrum and articular cartilage lesions in patients with clinical suspicion of femoro-acetabular impingement (FAI). Subjects and methods: Fifty patients (thirty men and twenty women, mean age 42.5 years) underwent 1.5-T MRA, 3-T MRI and arthroscopy on the same hip. An optimized high-resolution proton density spin echo pulse sequence was included in the 3-T non-contrast MRI protocol. Results: The 3-T non-contrast MRI identified forty-two of the forty-three arthroscopically proven tears at the labral-chondral transitional zone (sensitivity, 97.7%; specificity, 100%; positive predictive value (PPV), 100%; negative predictive value (NPV), 87.5%; accuracy 98%). With 1.5-T MRA, forty-four tears were diagnosed. However, there was one false positive (sensitivity, 100%; specificity, 85.7%; PPV, 97.7%; NPV, 100%; accuracy 98%). Agreement between arthroscopy and MRI, whether 3-T non-contrast MRI or 1.5-T MRA, as to the degree of chondral lesion in the acetabulum was reached in half of the patients and in the femur in 76% of patients. Conclusion: Non-invasive assessment of the hip is possible with 3-T MR magnet. 3-T non-contrast MRI could replace MRA as the workhorse technique for assessing hip internal damage. MRA would then be reserved for young adults with a strong clinical suspicion of FAI but normal findings on 3-T non-contrast MRI. When compared with 1.5-T MRA, optimized sequences with 3-T non

The diagnostic performance of non-contrast 3-Tesla magnetic resonance imaging (3-T MRI) versus 1.5-Tesla magnetic resonance arthrography (1.5-T MRA) in femoro-acetabular impingement

International Nuclear Information System (INIS)

Crespo-Rodríguez, Ana M.; De Lucas-Villarrubia, Jose C.; Pastrana-Ledesma, Miguel; Hualde-Juvera, Ana; Méndez-Alonso, Santiago; Padron, Mario

2017-01-01

Highlights: • High resolution sequences at 3-T MRI extend accuracy in hip assessment without any need for intra-articular injection of contrast media. • As compared to 1.5-T MRA, 3-T non-contrast MRI of the hip improves the patient experience and avoids the potential risks of an invasive procedure and contrast media. • Avoiding the need for arthrographic procedures in the Radiology Department improves patient throughput and reduces costs. - Abstract: Objective: The aim of this study was to evaluate the diagnostic accuracy of 3-T non-contrast MRI versus 1.5-T MRA for assessing labrum and articular cartilage lesions in patients with clinical suspicion of femoro-acetabular impingement (FAI). Subjects and methods: Fifty patients (thirty men and twenty women, mean age 42.5 years) underwent 1.5-T MRA, 3-T MRI and arthroscopy on the same hip. An optimized high-resolution proton density spin echo pulse sequence was included in the 3-T non-contrast MRI protocol. Results: The 3-T non-contrast MRI identified forty-two of the forty-three arthroscopically proven tears at the labral-chondral transitional zone (sensitivity, 97.7%; specificity, 100%; positive predictive value (PPV), 100%; negative predictive value (NPV), 87.5%; accuracy 98%). With 1.5-T MRA, forty-four tears were diagnosed. However, there was one false positive (sensitivity, 100%; specificity, 85.7%; PPV, 97.7%; NPV, 100%; accuracy 98%). Agreement between arthroscopy and MRI, whether 3-T non-contrast MRI or 1.5-T MRA, as to the degree of chondral lesion in the acetabulum was reached in half of the patients and in the femur in 76% of patients. Conclusion: Non-invasive assessment of the hip is possible with 3-T MR magnet. 3-T non-contrast MRI could replace MRA as the workhorse technique for assessing hip internal damage. MRA would then be reserved for young adults with a strong clinical suspicion of FAI but normal findings on 3-T non-contrast MRI. When compared with 1.5-T MRA, optimized sequences with 3-T non

Effect of Adding Interferential Current in an Exercise and Manual Therapy Program for Patients With Unilateral Shoulder Impingement Syndrome: A Randomized Clinical Trial.

Science.gov (United States)

Gomes, Cid André Fidelis de Paula; Dibai-Filho, Almir Vieira; Moreira, William Arruda; Rivas, Shirley Quispe; Silva, Emanuela Dos Santos; Garrido, Ana Claudia Bogik

The purpose of this study was to measure the additional effect of adding interferential current (IFC) to an exercise and manual therapy program for patients with unilateral shoulder impingement syndrome. Forty-five participants were randomly assigned to group 1 (exercise and manual therapy), group 2 (exercise and manual therapy + IFC), or group 3 (exercise and manual therapy + placebo ultrasound). Individuals participated in 16 treatment sessions, twice a week for 8 weeks. The primary outcome of the study was total score of the Shoulder Pain and Disability Index (SPADI). The secondary outcomes were the pain and disability subscales of SPADI, Numeric Rating Scale, and Pain-Related Self-Statement Scale. Adjusted between-group mean differences (MDs) and 95% confidence intervals (CIs) were calculated using linear mixed models. After 16 treatment sessions, statistically significant but not clinically important differences were identified in favor of the exercise and manual therapy program alone in the SPADI-total (group 1 vs group 2, MD 11.12 points, 95% CI 5.90-16.35; group 1 vs group 3, MD 13.43 points, 95% CI 8.21-18.65). Similar results were identified for secondary outcomes. The addition of IFC does not generate greater clinical effects in an exercise and manual therapy program for individuals with unilateral shoulder impingement syndrome. Copyright © 2018. Published by Elsevier Inc.

Guideline for diagnosis and treatment of subacromial pain syndrome

NARCIS (Netherlands)

Diercks, Ronald; Bron, Carel; Dorrestijn, Oscar; Meskers, Carel; Naber, René; de Ruiter, Tjerk; Willems, Jaap; Winters, Jan; van der Woude, Henk Jan

Treatment of "subacromial impingement syndrome" of the shoulder has changed drastically in the past decade. The anatomical explanation as "impingement" of the rotator cuff is not sufficient to cover the pathology. "Subacromial pain syndrome", SAPS, describes the condition better. A working group

Coupled Lagrangian impingement spray model for doublet impinging injectors under liquid rocket engine operating conditions

Directory of Open Access Journals (Sweden)

Qiang WEI

2017-08-01

Full Text Available To predict the effect of the liquid rocket engine combustion chamber conditions on the impingement spray, the conventional uncoupled spray model for impinging injectors is extended by considering the coupling of the jet impingement process and the ambient gas field. The new coupled model consists of the plain-orifice sub-model, the jet-jet impingement sub-model and the droplet collision sub-model. The parameters of the child droplet are determined with the jet-jet impingement sub-model using correlations about the liquid jet parameters and the chamber conditions. The overall model is benchmarked under various impingement angles, jet momentum and off-center ratios. Agreement with the published experimental data validates the ability of the model to predict the key spray characteristics, such as the mass flux and mixture ratio distributions in quiescent air. Besides, impinging sprays under changing ambient pressure and non-uniform gas flow are investigated to explore the effect of liquid rocket engine chamber conditions. First, a transient impingement spray during engine start-up phase is simulated with prescribed pressure profile. The minimum average droplet diameter is achieved when the orifices work in cavitation state, and is about 30% smaller than the steady single phase state. Second, the effect of non-uniform gas flow produces off-center impingement and the rotated spray fan by 38°. The proposed model suggests more reasonable impingement spray characteristics than the uncoupled one and can be used as the first step in the complex simulation of coupling impingement spray and combustion in liquid rocket engines.

Coupled Lagrangian impingement spray model for doublet impinging injectors under liquid rocket engine operating conditions

Institute of Scientific and Technical Information of China (English)

Qiang WEI; Guozhu LIANG

2017-01-01

To predict the effect of the liquid rocket engine combustion chamber conditions on the impingement spray,the conventional uncoupled spray model for impinging injectors is extended by considering the couplingof the jet impingement process and the ambient gas field.The new coupled model consists of the plain-orifice sub-model,the jet-jet impingement sub-model and the droplet collision sub-model.The parameters of the child droplet are determined with the jet-jet impingement sub-model using correlations about the liquid jet parameters and the chamber conditions.The overall model is benchmarked under various impingement angles,jet momentum and offcenter ratios.Agreement with the published experimental data validates the ability of the model to predict the key spray characteristics,such as the mass flux and mixture ratio distributions in quiescent air.Besides,impinging sprays under changing ambient pressure and non-uniform gas flow are investigated to explore the effect of liquid rocket engine chamber conditions.First,a transient impingement spray during engine start-up phase is simulated with prescribed pressure profile.The minimum average droplet diameter is achieved when the orifices work in cavitation state,and is about 30％ smaller than the steady single phase state.Second,the effect of non-uniform gas flow produces off-center impingement and the rotated spray fan by 38°.The proposed model suggests more reasonable impingement spray characteristics than the uncoupled one and can be used as the first step in the complex simulation of coupling impingement spray and combustion in liquid rocket engines.

Impingement: an annotated bibliography

International Nuclear Information System (INIS)

Uziel, M.S.; Hannon, E.H.

1979-04-01

This bibliography of 655 annotated references on impingement of aquatic organisms at intake structures of thermal-power-plant cooling systems was compiled from the published and unpublished literature. The bibliography includes references from 1928 to 1978 on impingement monitoring programs; impingement impact assessment; applicable law; location and design of intake structures, screens, louvers, and other barriers; fish behavior and swim speed as related to impingement susceptibility; and the effects of light, sound, bubbles, currents, and temperature on fish behavior. References are arranged alphabetically by author or corporate author. Indexes are provided for author, keywords, subject category, geographic location, taxon, and title

Shoulder functionality after manual therapy in subjects with shoulder impingement syndrome: a case series.

Science.gov (United States)

Heredia-Rizo, Alberto Marcos; López-Hervás, Antonia; Herrera-Monge, Patricia; Gutiérrez-Leonard, Ana; Piña-Pozo, Fernando

2013-04-01

The aim of the study was to identify the differences in functionality of the upper limb in subjects suffering from shoulder impingement syndrome after intervention by two manual therapy protocols. Randomized, single-blind study with a sample of 22 subjects (58 ± 10.86 years old) divided into two groups. The conventional-group (n = 11) received mobilizations of the shoulder and the experimental-group (n = 11) was treated with soft tissue techniques in the cervical and upper thoracic regions. These two groups received electrotherapy and postural advices. The treatment lasted three weeks (15 daily sessions of 1 h and 30 min). Both active and passive range of motion (ROM) and self-perceived functionality of the upper limb (DASH questionnaire) were measured. The experimental group showed a significant improvement in the DASH scores and both groups improved mobility in the intra-group comparison pre-intervention versus post-intervention (p .05). Our results suggest that a combined treatment with electrotherapy, postural hygiene and manual therapy, regardless of the protocol, improves shoulder mobility and functionality. Copyright © 2012 Elsevier Ltd. All rights reserved.

Femoroacetabular cam-type impingement: Diagnostic sensitivity and specificity of radiographic views compared to radial MRI

International Nuclear Information System (INIS)

Domayer, S.E.; Ziebarth, K.; Chan, J.; Bixby, S.; Mamisch, T.C.; Kim, Y.J.

2011-01-01

Purpose: To retrospectively assess the diagnostic sensitivity of 45° Dunn view and cross-table lateral radiographs for the assessment of cam deformity by comparison with radial MRI. Materials and methods: 60 cases with radiographs (38 a–p and 45° Dunn views, 22 a–p and cross-table lateral views) and radial MRI were assessed. Alpha angle measurements were obtained both for radiographs and radial MRI. Statistics included frequency analysis, bivariate linear correlation analyses of MRI and radiograph measurements and cross-table analyses testing for the sensitivity and specificity of radiographs for the detection of an alpha angle larger than 55°. Results: 53.3% had the maximum alpha angle in the superior–anterior aspect of the femoral head–neck junction. Cam deformity was found in 45/60 cases (75%) in radial MRI. Pearson correlation demonstrated the Dunn view was most accurate for the superior–anterior aspect (.772, P < .001). The cross-table lateral views were best suited for the anterior–superior aspect (.511, P < .05). The sensitivity for cam deformity in the Dunn view was 96.4% vs. 70.6% in the cross-table lateral view. Conclusion: The 45° Dunn view can improve the first line of impingement diagnostics. Radial MRI however remains indispensable for pre-operative planning and the evaluation of symptomatic cases without obvious deformity.

Internal Impingement of the Shoulder: A Risk of False Positive Test Outcomes in External Impingement Tests?

Directory of Open Access Journals (Sweden)

Tim Leschinger

2017-01-01

Full Text Available Background. External impingement tests are considered as being particularly reliable for identifying subacromial and coracoid shoulder impingement mechanisms. The purpose of the present study was to evaluate if these tests are likely to provoke an internal shoulder impingement mechanism which, in cases of a pathologic condition, can lead to a positive test result. Method. In 37 subjects, the mechanical contact between the glenoid rim and the rotator cuff (RC was measured quantitatively and qualitatively in external impingement test positions using an open MRI system. Results. Mechanical contact of the supraspinatus with the posterosuperior glenoid was present in 30 subjects in the Neer test. In the Hawkins test, the subscapularis was in contact with the anterosuperior glenoid in 33 subjects and the supraspinatus in 18. In the horizontal impingement test, anterosuperior contact of the supraspinatus with the glenoid was identified in 35 subjects. Conclusion. The Neer, Hawkins, and horizontal impingement tests are likely to provoke the mechanism of an internal shoulder impingement. A posterosuperior internal impingement mechanism is being provoked predominately in the Neer test. The Hawkins test narrows the distance between the insertions of the subscapularis and supraspinatus and the anterosuperior labrum, which leads to an anterosuperior impingement mechanism.

Endoscopic Pubic Symphysectomy for Athletic Osteitis Pubis.

Science.gov (United States)

Matsuda, Dean K; Sehgal, Bantoo; Matsuda, Nicole A

2015-06-01

Osteitis pubis is a common form of athletic pubalgia associated with femoroacetabular impingement. Endoscopic pubic symphysectomy was developed as a less invasive option than open surgical curettage for recalcitrant osteitis pubis. This technical note demonstrates the use of the anterior and suprapubic portals in the supine lithotomy position for endoscopic burr resection of pubic symphyseal fibrocartilage and hyaline endplates. Key steps include use of the suprapubic portal for burr resection of the posteroinferior symphysis and preservation of the posterior and arcuate ligaments. Endoscopic pubic symphysectomy is a minimally invasive bone-conserving surgery that retains stability and may be useful in the treatment of recalcitrant osteitis pubis or osteoarthritis. It nicely complements arthroscopic surgery for femoroacetabular impingement and may find broader application in this group of co-affected athletes.

Magnetic Resonance Imaging of Nonneoplastic Musculoskeletal Pathologies in the Pelvis.

Science.gov (United States)

Alapati, Sindhura; Wadhwa, Vibhor; Komarraju, Aparna; Guidry, Carey; Pandey, Tarun

2017-06-01

Musculoskeletal pathologies in the pelvis encompass a wide variety of lesions including femoroacetabular impingement, athletic pubalgia, ischiofemoral impingement, and apophyseal avulsion injuries. Magnetic resonance imaging is the noninvasive imaging modality of choice for the diagnosis and management of these lesions. In this article, the authors discuss the nonneoplastic musculoskeletal lesions in the pelvis, with illustrations and relevant case examples. Copyright © 2017 Elsevier Inc. All rights reserved.

Surgery for subacromial impingement syndrome in relation to intensities of occupational mechanical exposures across 10-year exposure time windows

DEFF Research Database (Denmark)

Dalbøge, Annett; Frost, Poul; Andersen, Johan Hviid

2018-01-01

OBJECTIVES: We aimed to identify intensities of occupational mechanical exposures (force, arm elevation and repetition) that do not entail an increased risk of surgery for subacromial impingement syndrome (SIS) even after prolonged durations of exposure. Additionally, we wanted to evaluate...... if exposure to hand-arm vibration (HAV) is an independent risk factor. METHODS: We used data from a register-based cohort study of the entire Danish working population (n=2 374 403). During follow-up (2003-2008), 14 118 first-time events of surgery for SIS occurred. For each person, we linked register...... of exposure at specific intensities above minimal (low, medium and high). We used a logistic regression technique equivalent to discrete survival analysis adjusting for cumulative effects of other mechanical exposures. RESULTS: We found indications of safe exposure intensities for repetition (median angular...

The MR imaging features of the posterior intermalleolar ligament in patients with posterior impingement syndrome of the ankle

International Nuclear Information System (INIS)

Fiorella, D.

1999-01-01

Objective. To describe the MR imaging features of the posterior intermalleolar ligament (IML) in patients with posterior impingement syndrome (PIS) of the ankle.Design and patients. Three patients (one male and two females, 13-25 years of age) are presented. Each patient presented clinically with symptoms of PIS of the ankle. Plain film examination was negative for a structural cause of the PIS in all patients. MR images were obtained with a 1.5 T scanner using an extremity coil. Clinical data and, in one patient, findings at ankle arthroscopy, were correlated with the results of MR imaging.Results. Ankle MR images from the three patients with a clinical diagnosis of PIS are presented. Findings in all patients included: (1) absence of another structural cause of the PIS (i.e., an os trigonum, trigonal process, fracture, loose bodies, etc.), (2) identification of the IML as a structure discrete from the posterior talofibular and tibiofibular ligaments, and (3) prominence of the IML as indicated by (a) identification of the IML in three different imaging planes, and (b) a caliber of the IML comparable to that of the conventional posterior ankle ligaments visualized in the same imaging plane. Arthroscopic resection of a meniscoid IML resulted in resolution of the PIS in one of the patients presented.Conclusions. MR imaging is an effective means of investigating the IML as a potential cause of PIS. The identification of a prominent IML in the absence of another structural cause of PIS indicates that impingement of the IML is the most likely cause of PIS. (orig.)

The MR imaging features of the posterior intermalleolar ligament in patients with posterior impingement syndrome of the ankle

Energy Technology Data Exchange (ETDEWEB)

Fiorella, D. [Duke Univ. Medical Center, Durham, NC (United States). Dept. of Radiology; Duke Univ., Durham, NC (United States). Medical Center; Helms, C.A. [Duke Univ. Medical Center, Durham, NC (United States). Dept. of Radiology; Nunley, J.A. II [Dept. of Orthopedic Surgery, Duke University Medical Center, Durham, NC (United States)

1999-10-01

Objective. To describe the MR imaging features of the posterior intermalleolar ligament (IML) in patients with posterior impingement syndrome (PIS) of the ankle.Design and patients. Three patients (one male and two females, 13-25 years of age) are presented. Each patient presented clinically with symptoms of PIS of the ankle. Plain film examination was negative for a structural cause of the PIS in all patients. MR images were obtained with a 1.5 T scanner using an extremity coil. Clinical data and, in one patient, findings at ankle arthroscopy, were correlated with the results of MR imaging.Results. Ankle MR images from the three patients with a clinical diagnosis of PIS are presented. Findings in all patients included: (1) absence of another structural cause of the PIS (i.e., an os trigonum, trigonal process, fracture, loose bodies, etc.), (2) identification of the IML as a structure discrete from the posterior talofibular and tibiofibular ligaments, and (3) prominence of the IML as indicated by (a) identification of the IML in three different imaging planes, and (b) a caliber of the IML comparable to that of the conventional posterior ankle ligaments visualized in the same imaging plane. Arthroscopic resection of a meniscoid IML resulted in resolution of the PIS in one of the patients presented.Conclusions. MR imaging is an effective means of investigating the IML as a potential cause of PIS. The identification of a prominent IML in the absence of another structural cause of PIS indicates that impingement of the IML is the most likely cause of PIS. (orig.)

Anterolateral ankle impingement in adolescents: outcomes of nonoperative and operative treatment.

Science.gov (United States)

Edmonds, Eric W; Chambers, Reid; Kaufman, Elizabeth; Chambers, Henry G

2010-03-01

Ankle sprains in adolescents usually resolve with conservative management but a few patients may develop ankle impingement syndrome. There have been adult studies addressing surgical treatment of this pathology, but our study evaluated the surgical management of anterolateral ankle impingement in adolescents by comparing their outcomes after nonoperative treatment and subsequent surgical intervention. Thirteen patients (children and adolescents) diagnosed with ankle impingement by history, physical examination, and magnetic resonance imaging during a 9-year period at our institution underwent eventual arthroscopic debridement. A retrospective chart review of these patients was performed and they were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) functional rating scale on 3 separate occasions: (1) initial presentation, (2) termination of nonoperative management, and (3) final postoperative follow-up visit. Thirteen adolescents (11 girls and 2 boys; 14 ankles) with a mean age of 15.6 (11.9-18.3) years met the inclusion criteria; of these, all had arthroscopic surgery. Mean duration of reported symptoms was 9.6 (4-15) months and mean duration of nonoperative management (physical therapy, activity modifications) was 6.9 (2-12) months. The mean AOFAS rating (out of 100 total) at initial presentation was 68.4 (40-84) and after nonoperative management was no better with a mean of 68.2 (63-76). The mean AOFAS rating at final follow-up was 90.6 (52-100), which was statistically significant (Pankle impingement in the adolescent population.

Fish impingement at Montecello Nuclear Plant

International Nuclear Information System (INIS)

Grotbeck, L.M.; Bechthold, J.L.

1975-01-01

To properly evaluate total impact of power generation facilities on aquatic systems, it is necessary to perform site specific fish impingement studies. Intake and screen approach velocities should not be averaged when considering potential screen impingement problems because of wide vertical and horizontal variation in velocity which tend to trap fish. It was estimated that 2,952 fish were impinged during 4 months of sampling with 90.9% of these comprised of black bullheads (Ictalurus melas) and black crappies (Pomoxis nigromaculatus). Distinct relationships can be found between number of impinging fish and river flow, percentage river diverted through the plant, water temperature, and the time of year. For the months of June, July, August, and September, approx 55% of all impingement occurs in June

Mastering the Physical Examination of the Athlete's Hip.

Science.gov (United States)

Trofa, David P; Mayeux, Sophie E; Parisien, Robert L; Ahmad, Christopher S; Lynch, T Sean

In this review, we describe precise methods for evaluating the athlete's hip or groin with an emphasis on recognizing the most common extra-articular and intra-articular pathologies, including adductor strains, athletic pubalgia, osteitis pubis, and femoroacetabular impingement with labral tears.

MAGNETIC RESONANCE IMAGING EVALUATION OF ROTATOR CUFF IMPINGEMENT

Directory of Open Access Journals (Sweden)

Chandrakanth K. S

2017-06-01

Full Text Available BACKGROUND Shoulder pain is a common clinical problem. Impingement syndrome of the shoulder is believed to be the most common cause of shoulder pain. The term ‘impingement syndrome’ was first used by Neer to describe a condition of shoulder pain associated with chronic bursitis and partial thickness tear of Rotator Cuff (RC. The incidence of Rotator Cuff (RC tear is estimated to be about 20.7% in the general population. This study is intended to analyse various extrinsic and intrinsic causes of shoulder impingement. MATERIALS AND METHODS 110 consecutive patients referred for MRI with clinical suspicion of shoulder impingement were prospectively studied. All the patients were evaluated for Rotator Cuff (RC degeneration and various extrinsic factors that lead to degeneration like acromial shape, down-sloping acromion, Acromioclavicular (AC joint degeneration and acromial enthesophyte. Intrinsic factors like degeneration and its correlation with age of the patients were evaluated. RESULTS Of the total 110 patients, 19 (17.3% patients had FT RC tear and 31 (28.2% had PT (both bursal and articular surface tears. There was no statistically significant correlation (p=0.76 between acromion types and RC tear. Down-sloping acromion and enthesophytes had statistically significant association with RC tear (p=0.008 and 0.008, respectively. Statistically significant (0.008 correlation between the severity of AC joint degeneration and RC tears was noted. AC joint degeneration and RC pathologies also showed a correlation with the age of the patients with p values of <0.001 and 0.001, respectively. CONCLUSION No statistically significant correlation between RC pathologies with hooked acromion was found, that makes the role played by hooked acromion in FT RC tear questionable. AC joint degeneration association with RC tear is due to the association of both RC tear and AC joint degeneration with age of the patient. Down-sloping acromion, AC joint degeneration

Guideline for diagnosis and treatment of subacromial pain syndrome: a multidisciplinary review by the Dutch Orthopaedic Association

NARCIS (Netherlands)

Diercks, R.; Bron, C.; Dorrestijn, O.; Meskers, C.; Naber, R.; Ruiter, T. de; Willems, J.; Winters, J.; Woude, H.J. van der; et al.,

2014-01-01

Treatment of "subacromial impingement syndrome" of the shoulder has changed drastically in the past decade. The anatomical explanation as "impingement" of the rotator cuff is not sufficient to cover the pathology. "Subacromial pain syndrome", SAPS, describes the condition better. A working group

Hamstring Injury After Swimming in a Patient With Multiple Hereditary Osteochondromatosis.

Science.gov (United States)

Dönmez, Gürhan; Özçakar, Levent; Korkusuz, Feza

2016-09-01

Reported here is a 20-year-old male suffered a hamstring strain after a prolonged bout of swimming. After ultrasound imaging, the patient's injury was considered to be the result of nearby osteochondromas. Case reports have been previously published concerning anterior cruciate ligament injury, rotator cuff tears, subacromial impingement, or femoroacetabular impingement in multiple osteochondromatosis. However, to the best of our knowledge, this is the first reported case of a hamstring injury secondary to an osteochondroma.

Fluorescence Imaging Study of Impinging Underexpanded Jets

Science.gov (United States)

Inman, Jennifer A.; Danehy, Paul M.; Nowak, Robert J.; Alderfer, David W.

2008-01-01

An experiment was designed to create a simplified simulation of the flow through a hole in the surface of a hypersonic aerospace vehicle and the subsequent impingement of the flow on internal structures. In addition to planar laser-induced fluorescence (PLIF) flow visualization, pressure measurements were recorded on the surface of an impingement target. The PLIF images themselves provide quantitative spatial information about structure of the impinging jets. The images also help in the interpretation of impingement surface pressure profiles by highlighting the flow structures corresponding to distinctive features of these pressure profiles. The shape of the pressure distribution along the impingement surface was found to be double-peaked in cases with a sufficiently high jet-exit-to-ambient pressure ratio so as to have a Mach disk, as well as in cases where a flow feature called a recirculation bubble formed at the impingement surface. The formation of a recirculation bubble was in turn found to depend very sensitively upon the jet-exit-to-ambient pressure ratio. The pressure measured at the surface was typically less than half the nozzle plenum pressure at low jet pressure ratios and decreased with increasing jet pressure ratios. Angled impingement cases showed that impingement at a 60deg angle resulted in up to a factor of three increase in maximum pressure at the plate compared to normal incidence.

Anterolateral Ankle Impingement Syndrome (review)%踝关节前外侧撞击综合征的研究进展

Institute of Scientific and Technical Information of China (English)

闵红巍; 刘克敏

2014-01-01

临床将踝关节扭伤后无骨折脱位，反复出现踝关节前外侧肿痛称为踝关节前外侧撞击综合征，为慢性踝关节疼痛的主要病因之一，受到广泛关注。本文就其发病机制、临床表现、诊断及治疗进行综述。%Ankle sprain without fracture or dislocation, accompanied by repeated ankle swelling is called as Anterolateral Ankle Im-pingement Syndrome. It is a major reason of chronic ankle pain and received extensive attention. This paper summarized its pathogenesis, clinical manifestations, diagnosis and treatment.

Danish Hip Arthroscopy Registry

DEFF Research Database (Denmark)

Mygind-Klavsen, Bjarne; Lund, Bent; Nielsen, Torsten Grønbech

2018-01-01

PURPOSE: Predictors of outcome after femoroacetabular impingement (FAI) surgery are not well-documented. This study presents data from the Danish Hip Arthroscopy Registry (DHAR) for such analyses. The purpose of this study was to identify predictors of poor outcome after FAI surgery in a Danish FAI...

Sports hernia/athletic pubalgia: evaluation and management.

Science.gov (United States)

Larson, Christopher M

2014-03-01

Sports hernia/athletic pubalgia has received increasing attention as a source of disability and time lost from athletics. Studies are limited, however, lacking consistent objective criteria for making the diagnosis and assessing outcomes. PubMed database through January 2013 and hand searches of the reference lists of pertinent articles. Review article. Level 5. Nonsurgical outcomes have not been well reported. Various surgical approaches have return-to-athletic activity rates of >80% regardless of the approach. The variety of procedures and lack of outcomes measures in these studies make it difficult to compare one surgical approach to another. There is increasing evidence that there is an association between range of motion-limiting hip disorders (femoroacetabular impingement) and sports hernia/athletic pubalgia in a subset of athletes. This has added increased complexity to the decision-making process regarding treatment. An association between femoroacetabular impingement and athletic pubalgia has been recognized, with better outcomes reported when both are managed concurrently or in a staged manner.

Fish impingement at Lake Michigan power plants

International Nuclear Information System (INIS)

Sharma, R.K.; Freeman, R.F.; Spigarelli, S.A.

1976-01-01

A study was initiated in 1974 to survey the magnitude and to evaluate the impact of fish impingement at 20 power plants on the Great Lakes. Data on impingement rates, site characteristics, intake designs and operational features have been collected and analyzed. Interpretive analyses of these data are in progress. The objectives of this study were: to summarize fish impingement data for Lake Michigan (16/20 plants surveyed are on Lake Michigan); to assess the significance of total and source-related mortalities on populations of forage and predator species; and to expand the assessment of power plant impingement to include all water intakes on Lake Michigan. Data are tabulated

Performance of jet impingement in unglazed air collectors

Energy Technology Data Exchange (ETDEWEB)

Belusko, M.; Saman, W.; Bruno, F. [Institute for Sustainable Systems and Technologies, University of South Australia, Mawson Lakes Boulevard, Mawson Lakes, SA 5095 (Australia)

2008-05-15

Jet impingement is effective at improving the heat transfer between air and a heated surface. Studies have shown that jet impingement can marginally improve the thermal efficiency of a glazed collector. However, little attention has been placed on applying jet impingement to an unglazed solar air collector. This paper presents a theoretical and experimental investigation identifying the performance characteristics of jet impingement. Overall, jet impingement was able to improve the thermal efficiency of the collector by 21%. An increase in the pressure loss was also measured but found to be small. The flow distribution of jets along the collector was the most significant factor in determining the efficiency. Increasing the hole spacing was found to improve the efficiency. (author)

The use of evidence-based practices for the management of shoulder impingement syndrome among Indian physical therapists: a cross-sectional survey

Directory of Open Access Journals (Sweden)

Vandana Phadke

2015-12-01

Full Text Available ABSTRACT Background: The understanding of the pathomechanics of shoulder impingement has evolved over the years. Likewise, assessment techniques and effective treatment strategies have also been developed. Physical therapists should keep up-to-date on the current evidence. Objective: This study explored the practices currently used by Indian physical therapists for the assessment and management of shoulder impingement syndrome (SIS. Method: Using an online questionnaire, therapists were asked to declare the causes, methods of assessment and their choices of physical therapy techniques for the management of SIS. The proportions of therapists using different techniques were analyzed descriptively, and comparisons across gender, experience level, and training were made. Data were analyzed to see if the choices of respondents compared with their responses for etiology. Results: A total of 211 responses were analyzed. Most respondents (>75% believed that overuse and abnormal motion/posture are the most significant causes of SIS. However, fewer respondents reported assessing posture (60.2% and dyskinesis, especially in women (24.2%. Ninety-four percent of the respondents reported using exercises, but exercise prescription was rather generic. Therapists additionally trained in the techniques of joint mobilization or taping declared using these techniques more frequently. The use of interferential therapy and ultrasound was reported by 89.5% and 98.4% of respondents, respectively Conclusion: Most therapists declared awareness of current recommended practices, but patient assessment, exercise prescription, and use of electrotherapy modalities were only partially based on current evidence. The study helps to identify gaps in current physical therapy approaches to SIS in India.

Oblique radiograph for the detection of bone spurs in anterior ankle impingement

International Nuclear Information System (INIS)

Dijk, Niek C. van; Wessel, Ronald N.; Tol, Johannes L.; Maas, M.

2002-01-01

Objective: The aim of this study was to develop a radiographic view to detect anteromedial talotibial osteophytes that remain undetected on standard radiographs. Design and patients: In 10 cadaver specimens the maximal size was measured of anteromedial tibial osteophytes that remain undetected on a standard lateral radiograph projection, due to the presence of the anteromedial tibial rim. The average projection of the most prominent anterolateral tibial rim over the anteromedial rim was found to be 7.3 mm. A 7 mm barium-clay osteophyte was attached to this anteromedial rim of the distal tibia. Anteromedial osteophytes become most prominent on an oblique view, in which the radiographic beam is tilted into a 45 craniocaudal direction with the leg in 30 external rotation. This oblique view was compared with the findings of arthroscopic surgery in 25 consecutive patients with anterior ankle impingement syndrome. Results: Medially located tibial and talar osteophytes remained undetected on a standard lateral projection and became visible on the oblique anteromedial impingement (AMI) radiograph. Anterolateral tibial and talar osteophytes were well detected on a standard lateral radiograph projection but were invisible on the AMI view. There was a high correlation between the location of the osteophyte and the location of symptoms and the findings at arthroscopy. Conclusion: A combination of lateral and oblique radiographs can be used to differentiate between anteromedial and anterolateral bony ankle impingement. (orig.)

Temporally stratified sampling programs for estimation of fish impingement

International Nuclear Information System (INIS)

Kumar, K.D.; Griffith, J.S.

1977-01-01

Impingement monitoring programs often expend valuable and limited resources and fail to provide a dependable estimate of either total annual impingement or those biological and physicochemical factors affecting impingement. In situations where initial monitoring has identified ''problem'' fish species and the periodicity of their impingement, intensive sampling during periods of high impingement will maximize information obtained. We use data gathered at two nuclear generating facilities in the southeastern United States to discuss techniques of designing such temporally stratified monitoring programs and their benefits and drawbacks. Of the possible temporal patterns in environmental factors within a calendar year, differences among seasons are most influential in the impingement of freshwater fishes in the Southeast. Data on the threadfin shad (Dorosoma petenense) and the role of seasonal temperature changes are utilized as an example to demonstrate ways of most efficiently and accurately estimating impingement of the species

MRI features of posterior ankle impingement syndrome in ballet dancers: a review of 25 cases

Energy Technology Data Exchange (ETDEWEB)

Peace, K.A.L. E-mail: kalpeace@hotmail.com; Hillier, J.C.; Hulme, A.; Healy, J.C

2004-11-01

AIM: To describe the magnetic resonance imaging (MRI) features of posterior ankle impingement syndrome (PAIS) in classical ballet dancers. MATERIALS AND METHODS: A retrospective review was undertaken of 25 MRI examinations of the ankle performed on 23 ballet dancers over a 26-month period. Images were examined for the presence of osseous and soft-tissue anatomical variants at the posterior ankle and imaging signs of PAIS. All patients presented with symptoms and signs suggestive of PAIS including posterior ankle pain, swelling and stiffness during plantar flexion. RESULTS: Anatomical variants predisposing to PAIS including as os trigonum and tuberosity arising from the superior calcaneum were clearly depicted. The most common imaging feature of PAIS in our series was high T2 signal posterior to the talocalcaneal joint indicating synovitis (n=25). Thickening of the posterior capsule (n=13) and tenosynovitis of flexor hallucis longus (n=17) were also common. An os trigonum was an infrequent finding (n=7). Bone marrow oedema, commonly in the posterior talus (n=10) or in a patchy distribution (n=10) was often noted. CONCLUSION: MRI is a useful diagnostic tool in PAIS, and in the present series, clearly demonstrates the anatomical variants and range of osseous and soft-tissue abnormalities associated with this condition. Prospective studies are needed to understand the significance and importance of individual MRI findings in producing the symptoms of PAIS.

MRI features of posterior ankle impingement syndrome in ballet dancers: a review of 25 cases

International Nuclear Information System (INIS)

Peace, K.A.L.; Hillier, J.C.; Hulme, A.; Healy, J.C.

2004-01-01

AIM: To describe the magnetic resonance imaging (MRI) features of posterior ankle impingement syndrome (PAIS) in classical ballet dancers. MATERIALS AND METHODS: A retrospective review was undertaken of 25 MRI examinations of the ankle performed on 23 ballet dancers over a 26-month period. Images were examined for the presence of osseous and soft-tissue anatomical variants at the posterior ankle and imaging signs of PAIS. All patients presented with symptoms and signs suggestive of PAIS including posterior ankle pain, swelling and stiffness during plantar flexion. RESULTS: Anatomical variants predisposing to PAIS including as os trigonum and tuberosity arising from the superior calcaneum were clearly depicted. The most common imaging feature of PAIS in our series was high T2 signal posterior to the talocalcaneal joint indicating synovitis (n=25). Thickening of the posterior capsule (n=13) and tenosynovitis of flexor hallucis longus (n=17) were also common. An os trigonum was an infrequent finding (n=7). Bone marrow oedema, commonly in the posterior talus (n=10) or in a patchy distribution (n=10) was often noted. CONCLUSION: MRI is a useful diagnostic tool in PAIS, and in the present series, clearly demonstrates the anatomical variants and range of osseous and soft-tissue abnormalities associated with this condition. Prospective studies are needed to understand the significance and importance of individual MRI findings in producing the symptoms of PAIS

Effectiveness of individualized physiotherapy on pain and functioning compared to a standard exercise protocol in patients presenting with clinical signs of subacromial impingement syndrome. A randomized controlled trial

Directory of Open Access Journals (Sweden)

de Bie Rob A

2010-06-01

Full Text Available Abstract Background Shoulder impingement syndrome is a common musculoskeletal complaint leading to significant reduction of health and disability. Physiotherapy is often the first choice of treatment although its effectiveness is still under debate. Systematic reviews in this field highlight the need for more high quality trials to investigate the effectiveness of physiotherapy interventions in patients with subacromial impingement syndrome. Methods/Design This randomized controlled trial will investigate the effectiveness of individualized physiotherapy in patients presenting with clinical signs and symptoms of subacromial impingement, involving 90 participants aged 18-75. Participants are recruited from outpatient physiotherapy clinics, general practitioners, and orthopaedic surgeons in Germany. Eligible participants will be randomly allocated to either individualized physiotherapy or to a standard exercise protocol using central randomization. The control group will perform the standard exercise protocol aiming to restore muscular deficits in strength, mobility, and coordination of the rotator cuff and the shoulder girdle muscles to unload the subacromial space during active movements. Participants of the intervention group will perform the standard exercise protocol as a home program, and will additionally be treated with individualized physiotherapy based on clinical examination results, and guided by a decision tree. After the intervention phase both groups will continue their home program for another 7 weeks. Outcome will be measured at 5 weeks and at 3 and 12 months after inclusion using the shoulder pain and disability index and patients' global impression of change, the generic patient-specific scale, the average weekly pain score, and patient satisfaction with treatment. Additionally, the fear avoidance beliefs questionnaire, the pain catastrophizing scale, and patients' expectancies of treatment effect are assessed. Participants

Exercises versus arthroscopic decompression in patients with subacromial impingement: a randomised, controlled study in 90 cases with a one year follow up

DEFF Research Database (Denmark)

Haahr, J. P.; Ostergaard, S.; Dalsgaard, J.

2005-01-01

, the difference being non-significant. No group differences in mean pain and dysfunction score improvement were found. CONCLUSIONS: Surgical treatment of rotator cuff syndrome with subacromial impingement was not superior to physiotherapy with training. Further studies are needed to qualify treatment choice...

Impingement jet cooling in gas turbines

CERN Document Server

Amano, R S

2014-01-01

Due to the requirement for enhanced cooling technologies on modern gas turbine engines, advanced research and development has had to take place in field of thermal engineering. Impingement jet cooling is one of the most effective in terms of cooling, manufacturability and cost. This is the first to book to focus on impingement cooling alone.

Impingement of juvenile and adult fishes during cooling water withdrawal

International Nuclear Information System (INIS)

McFarlane, R.W.

1978-01-01

Juvenile and adult fishes are impinged upon trash removal screens as Savannah River water is withdrawn for use on the Savannah River Plant (SRP). Thirty-six species of fish, representing half of all riverine species known from the area, were impinged on the screens at three SRP pumping stations during 1977. Based on the average of 11.2 fish impinged per day, annual impingement is estimated to be 4088 fish. SRP thus ranks third lowest for impingement recently reported for 33 electric power plants

Unsuspected reason for sciatica in Bertolotti's syndrome.

Science.gov (United States)

Shibayama, M; Ito, F; Miura, Y; Nakamura, S; Ikeda, S; Fujiwara, K

2011-05-01

Patients with Bertolotti's syndrome have characteristic lumbosacral anomalies and often have severe sciatica. We describe a patient with this syndrome in whom standard decompression of the affected nerve root failed, but endoscopic lumbosacral extraforaminal decompression relieved the symptoms. We suggest that the intractable sciatica in this syndrome could arise from impingement of the nerve root extraforaminally by compression caused by the enlarged transverse process.

Sports Hernia/Athletic Pubalgia

Science.gov (United States)

Larson, Christopher M.

2014-01-01

Context: Sports hernia/athletic pubalgia has received increasing attention as a source of disability and time lost from athletics. Studies are limited, however, lacking consistent objective criteria for making the diagnosis and assessing outcomes. Evidence Acquisition: PubMed database through January 2013 and hand searches of the reference lists of pertinent articles. Study Design: Review article. Level of Evidence: Level 5. Results: Nonsurgical outcomes have not been well reported. Various surgical approaches have return-to–athletic activity rates of >80% regardless of the approach. The variety of procedures and lack of outcomes measures in these studies make it difficult to compare one surgical approach to another. There is increasing evidence that there is an association between range of motion–limiting hip disorders (femoroacetabular impingement) and sports hernia/athletic pubalgia in a subset of athletes. This has added increased complexity to the decision-making process regarding treatment. Conclusion: An association between femoroacetabular impingement and athletic pubalgia has been recognized, with better outcomes reported when both are managed concurrently or in a staged manner. PMID:24587864

Empirical model of impingement impact. Environmental Sciences Division publication No. 1289

International Nuclear Information System (INIS)

Barnthouse, L.W.; DeAngelis, D.L.; Christensen, S.W.

1979-01-01

A simple model, derived from Ricker's (1975) theory of fisheries dynamics, that can be used to estimate the impact of impingement of juvenile fish by power plants on year-class abundance in vulnerable species is described. The only data required are estimates of the initial number of impingeable juveniles, the number impinged, and the rate of total mortality during the period of vulnerability. The impact of impingement is expressed in the model as the conditional mortality rate, rather than the more commonly used exploitation rate. The conditional mortality rate is superior as a measure of impact for two reasons: it accounts for the differential impact of impinging fish of different ages, and it is numerically equivalent to the fractional reduction in year-class abundance due to impingement. We present an application of the model using the 1974 year-class of the Hudson River striped bass population as an example. We then show how the model can be modified to account for seasonal fluctuations in the rate of impingement, discuss the effect of these fluctuations on the calculated impact, and discuss the influence on model output of errors in the measurement of abundance, impingement, and total mortality. It is evident from this analysis that estimates of impingement impact are as sensitive to errors in estimates of population size and mortality as to estimates of the number of fish impinged. Thus, it is not possible to reliably estimate the impact of impingement on a vulnerable fish species unless a substantial effort is devoted to population studies

Diagnostic performance of susceptibility-weighted magnetic resonance imaging for the assessment of sub-coracoacromial spurs causing subacromial impingement syndrome.

Science.gov (United States)

Nörenberg, Dominik; Armbruster, Marco; Bender, Yi-Na; Walter, Thula; Ebersberger, Hans U; Diederichs, Gerd; Hamm, Bernd; Ockert, Ben; Makowski, Marcus R

2017-03-01

To evaluate the potential of susceptibility-weighted-magnetic-resonance-imaging (SWMR) for the detection of sub-coracoacromial spurs in patients with clinically suspected subacromial impingement syndrome (SAIS), compared to standard MR-sequences and radiographs. Forty-four patients with suspected SAIS were included. All patients underwent radiography, standard MRI of the shoulder and SWMR. Radiograph-based identification of sub-coracoacromial spurs served as goldstandard. Radiographs identified twenty-three spurs in twenty-three patients. Twenty-one patients without spur formation served as reference group. Detection rate, sensitivity/specificity and interobserver-agreements were calculated. Linear regression was applied to determine the relationship between size measurements on radiographs and MRI. Detection rates for spurs on standard MRI and SWMR were 47.8 % and 91.3 % compared to radiography (pformation in patients with SAIS and is superior to standard MR-sequences using radiography as goldstandard. • SWMR has the potential to reliably identify sub-coracoacromial spurs without radiation exposure. • SWMR provides comparable detection rates to conventional radiography for sub-coracoacromial spur formation. • SWMR yields higher detection rates compared to standard-MR regarding sub-coracoacromial spur formation. • SWMR can be implemented in routine shoulder MRI protocols.

Atomization of Impinging Droplets on Superheated Superhydrophobic Surfaces

Science.gov (United States)

Emerson, Preston; Crockett, Julie; Maynes, Daniel

2017-11-01

Water droplets impinging smooth superheated surfaces may be characterized by dynamic vapor bubbles rising to the surface, popping, and causing a spray of tiny droplets to erupt from the droplet. This spray is called secondary atomization. Here, atomization is quantified experimentally for water droplets impinging superheated superhydrophobic surfaces. Smooth hydrophobic and superhydrophobic surfaces with varying rib and post microstructuring were explored. Each surface was placed on an aluminum heating block, and impingement events were captured with a high speed camera at 3000 fps. For consistency among tests, all events were normalized by the maximum atomization found over a range of temperatures on a smooth hydrophobic surface. An estimate of the level of atomization during an impingement event was created by quantifying the volume of fluid present in the atomization spray. Droplet diameter and Weber number were held constant, and atomization was found for a range of temperatures through the lifetime of the impinging droplet. The Leidenfrost temperature was also determined and defined to be the lowest temperature at which atomization ceases to occur. Both atomization and Leidenfrost temperature increase with decreasing pitch (distance between microstructures).

Calculations of slurry pump jet impingement loads

International Nuclear Information System (INIS)

Wu, T.T.

1996-01-01

This paper presents a methodology to calculate the impingement load in the region of a submerged turbulent jet where a potential core exits and the jet is not fully developed. The profile of the jet flow velocities is represented by a piece-wise linear function which satisfies the conservation of momentum flux of the jet flow. The adequacy of the of the predicted jet expansion is further verified by considering the continuity of the jet flow from the region of potential core to the fully developed region. The jet impingement load can be calculated either as a direct impingement force or a drag force using the jet velocity field determined by the methodology presented

Experimental investigation of submerged single jet impingement using Cu–water nanofluid

International Nuclear Information System (INIS)

Li Qiang; Xuan Yimin; Yu Feng

2012-01-01

Jet impingement cooling is a vital technique for thermal management of electronic devices of high-heat-flux by impinging fluid on a heater surface due to its high local heat transfer rates. In this paper, two types of Cu–water nanofluids (Cu particles with 25 nm diameter or 100 nm) are introduced into submerged single jet impingement cooling system as the working fluid. The heat transfer features of the nanofluids were experimentally investigated. The effects of the nanoparticle concentration, Reynolds number, nozzle-to-plate distance, fluid temperature, and nanoparticle diameter on the heat transfer performances of the jet impingement of nanofluids are discussed. The experimental results show that the suspended nanoparticles remarkably increase the convective heat transfer coefficient of the base fluid. The convective heat transfer coefficient of Cu–water nanofluid with the volume fraction of 3.0% has 52% higher than the pure water. The experiments also revealed that the suspended nanoparticles brought almost no extra addition of pressure drop in both submerged single jet impingement. In addition, by considering the effects of the suspended nanoparticles as well as the condition of impinging jet, a new heat transfer correlation of nanofluids for the submerged single jet impingement has been proposed. - Highlights: ► Cu–water nanofluids are introduced into submerged single jet impingement. ► The affecting parameters on the heat transfer performances of nanofluids are discussed. ► New heat transfer correlation of nanofluid for single jet impingement is proposed.

Four-jet impingement: Noise characteristics and simplified acoustic model

International Nuclear Information System (INIS)

Brehm, C.; Housman, J.A.; Kiris, C.C.; Barad, M.F.; Hutcheson, F.V.

2017-01-01

Highlights: • Large eddy simulation of unique four jet impingement configuration. • Characterization of flow features using POD, FFT, and wavelet decomposition. • Noise source identification utilizing causality method. • Development of simplified acoustic model utilizing equivalent source method. • Comparison with experimental data from BENS experiment. - Abstract: The noise generation mechanisms for four directly impinging supersonic jets are investigated employing implicit large eddy simulations with a higher-order weighted essentially non-oscillatory scheme. Although these types of impinging jet configurations have been used in many experiments, a detailed investigation of the noise generation mechanisms has not been conducted before. The flow field is highly complex and contains a wide range of temporal and spatial scales relevant for noise generation. Proper orthogonal decomposition is utilized to characterize the unsteady nature of the flow field involving unsteady shock oscillations, large coherent turbulent flow structures, and the sporadic appearance of vortical flow structures in the center of the four-jet impingement region. The causality method based on Lighthills acoustic analogy is applied to link fluctuations of flow quantities inside the source region to the acoustic pressure in the far field. It will be demonstrated that the entropy fluctuation term plays a vital role in the noise generation process. Consequently, the understanding of the noise generation mechanisms is employed to develop a simplified acoustic model of the four-jet impingement device by utilizing the equivalent source method. Finally, three linear acoustic four-jet impingement models of the four-jet impingement device are used as broadband noise sources inside an engine nacelle and the acoustic scattering results are validated against far-field acoustic experimental data.

Supersonic impinging jet noise reduction using a hybrid control technique

Science.gov (United States)

Wiley, Alex; Kumar, Rajan

2015-07-01

Control of the highly resonant flowfield associated with supersonic impinging jet has been experimentally investigated. Measurements were made in the supersonic impinging jet facility at the Florida State University for a Mach 1.5 ideally expanded jet. Measurements included unsteady pressures on a surface plate near the nozzle exit, acoustics in the nearfield and beneath the impingement plane, and velocity field using particle image velocimetry. Both passive control using porous surface and active control with high momentum microjet injection are effective in reducing nearfield noise and flow unsteadiness over a range of geometrical parameters; however, the type of noise reduction achieved by the two techniques is different. The passive control reduces broadband noise whereas microjet injection attenuates high amplitude impinging tones. The hybrid control, a combination of two control methods, reduces both broadband and high amplitude impinging tones and surprisingly its effectiveness is more that the additive effect of the two control techniques. The flow field measurements show that with hybrid control the impinging jet is stabilized and the turbulence quantities such as streamwise turbulence intensity, transverse turbulence intensity and turbulent shear stress are significantly reduced.

Investigation of impingement attack mechanism of copper alloy condenser tubes

Energy Technology Data Exchange (ETDEWEB)

Fukumura, Takuya; Nakajima, Nobuo; Arioka, Koji; Totsuka, Nobuo; Nakagawa, Tomokazu [Institute of Nuclear Safety System Inc., Mihama, Fukui (Japan)

2001-09-01

In order to investigate generation and growth mechanisms of impingement attacks of sea water against copper alloy condenser tubes used in condensers of nuclear power plants, we took out condenser tubes from actual condensers, cut them into several pieces and carried out several material tests mainly for impinged spots. In addition water flow inside of a pit was analyzed. From the results of the investigation, it was found that all of impingement attacks were found in the marks left by sessile organisms and none were found in downstream of the marks as frequently proposed so far. At the pits generated inside the marks, iron coating was striped and zinc content was deficient in some cases. Combining these data and the result of flow analysis, we considered the following mechanism of the impingement attacks: sessile organisms clinging to the surface of the condenser tube and growth, occlusion of the tube, extinction and decomposition of sessile organisms, pollution corrosion under the organisms and cavity formation, occlusion removal by the cleaning, generation of impingement attacks by flow collision inside the cavity, growth of the impingement attacks. (author)

Inter- and intrarater reliability of goniometry and hand held dynamometry for patients with subacromial impingement syndrome.

Science.gov (United States)

Fieseler, Georg; Laudner, Kevin G; Irlenbusch, Lars; Meyer, Henrike; Schulze, Stephan; Delank, Karl-Stefan; Hermassi, Souhail; Bartels, Thomas; Schwesig, René

2017-12-01

The purpose of this study was to examine the intra- and interrater reliability of measuring shoulder range of motion (ROM) and strength among patients diagnosed with subacromial impingement syndrome (SAIS). Twenty-five patients (14 female patients; mean age, 60.4± 7.84 years) diagnosed with SAIS were assessed to determine the intrarater reliability for glenohumeral ROM. Twenty-five patients (16 female patients; mean age, 60.4± 7.80 years) and 76 asymptomatic volunteers (52 female volunteers; mean age, 29.4± 14.1 years) were assessed for interrater reliability. Dependent variables were active shoulder ROM and isometric strength. Intrarater reliability was fair-to-excellent for the SAIS patients (intraclass correlation coefficient [ICC], 0.52-0.97; standard error of measurement [SEM], 4.4°-9.9° N; coefficient of variation [CV], 7.1%-44.9%). Based on the ICC, 11 of 12 parameters (92%) displayed an excellent reliability (ICC> 0.75). The interrater reliability showed fair-to-excellent results (SAIS patients: ICC, 0.13-0.98; SEM, 2.3°-8.8°; CV, 3.6%-37.0%; controls: ICC, 0.11-0.96; SEM, 3.0°-35.4°; CV, 5.6%-26.4%). In accordance with the intrarater reliability, glenohumeral adduction ROM was the only parameter with an ICC below 0.75 for both samples. Painful shoulder ROM in the SAIS patients showed no influence on the quality of reliability for measurement. Therefore, these protocols should be considered reliable assessment techniques in the prevention, diagnosis, and treatment of painful shoulder conditions such as SAIS.

Direct Flame Impingement

Energy Technology Data Exchange (ETDEWEB)

None

2005-09-01

During the DFI process, high velocity flame jets impinge upon the material being heated, creating a high heat transfer rate. As a result, refractory walls and exhaust gases are cooler, which increases thermal efficiency and lowers NOx emissions. Because the jet nozzles are located a few inches from the load, furnace size can be reduced significantly.

Thermal-hydraulic performance of convective boiling jet array impingement

International Nuclear Information System (INIS)

Jenkins, R; De Brún, C; Kempers, R; Lupoi, R; Robinson, A J

2016-01-01

Jet impingement boiling is investigated with regard to heat transfer and pressure drop performance using a novel laser sintered 3D printed jet impingement manifold design. Water was the working fluid at atmospheric pressure with inlet subcooling of 7 o C. The convective boiling performance of the impinging jet system was investigated for a flat copper target surface for 2700≤Re≤5400. The results indicate that the heat transfer performance of the impinging jet is independent of Reynolds number for fully developed boiling. Also, the investigation of nozzle to plate spacing shows that low spacing delays the onset of nucleate boiling causing a superheat overshoot that is not observed with larger gaps. However, no sensitivity to the gap spacing was measured once boiling was fully developed. The assessment of the pressure drop performance showed that the design effectively transfers heat with low pumping power requirements. In particular, owing to the insensitivity of the heat transfer to flow rate during fully developed boiling, the coefficient of performance of jet impingement boiling in the fully developed boiling regime deteriorates with increased flow rate due to the increase in pumping power flux. (paper)

Current concepts in the diagnosis and treatment of shoulder impingement

Directory of Open Access Journals (Sweden)

Bijayendra Singh

2017-01-01

Full Text Available Subacromial impingement syndrome (SIS is a very common cause of shoulder pain in the young adults. It can cause debilitating pain, dysfunction, and affects the activities of daily living. It represents a spectrum of pathology ranging from bursitis to rotator cuff tendinopathy which can ultimately lead to degenerative tear of the rotator cuff. Various theories and concepts have been described and it is still a matter of debate. However, most published studies suggest that both extrinsic and intrinsic factors have a role in the development of SIS. The management is controversial as both nonoperative and operative treatments have shown to provide good results. This article aims to provide a comprehensive current concepts review of the pathogenesis, etiologies, clinical diagnosis, appropriate use of investigations, and discussion on the management of SIS.

Magnetic resonance imaging of hip joint cartilage and labrum

Directory of Open Access Journals (Sweden)

Christoph Zilkens

2011-09-01

Full Text Available Hip joint instability and impingement are the most common biomechanical risk factors that put the hip joint at risk to develop premature osteoarthritis. Several surgical procedures like periacetabular osteotomy for hip dysplasia or hip arthroscopy or safe surgical hip dislocation for femoroacetabular impingement aim at restoring the hip anatomy. However, the success of joint preserving surgical procedures is limited by the amount of pre-existing cartilage damage. Biochemically sensitive MRI techniques like delayed Gadolinium Enhanced MRI of Cartilage (dGEMRIC might help to monitor the effect of surgical or non-surgical procedures in the effort to halt or even reverse joint damage.

Analysis of impingement impacts on Hudson River fish populations

International Nuclear Information System (INIS)

Barnthouse, L.W.; van Winkle, W.

1988-01-01

Impacts of impingement, expressed as reductions in year-class abundance, were calculated for six Hudson River fish populations. Estimates were made for the 1974 and 1975 year classes of white perch, striped bass, Atlantic tomcod, and American shad, and the 1974 year classes of alewife and blueback herring. The maximum estimated reductions in year-class abundance were less than 5% for all year classes except the 1974 and 1975 white perch year classes and the 1974 striped bass year class. Only for white perch were the estimates greater than 10% per year. For striped bass, the 146,000 fish from the 1974 year class that were killed by impingement could have produced 12,000-16,000 5-year-old fish or 270-300 10-year-olds. Also estimated were the reductions in mortality that could have been achieved had closed-cycle cooling systems been installed at one or more of three power plants (Bowline point, Indian Point, and Roseton) and had the screen-wash systems at Bowline Point and Indian Point been modified to improve the survival of impinged fish. Closed-cycle cooling at all three plants would have reduced impingement impacts on white perch, striped bass, and Atlantic tomcod by 75% or more; installation of closed-cycle cooling at Indian Point alone would have reduced impingement impacts on white perch and Atlantic tomcod by 50%-80%. Modified traveling screens would have been less effective than closed-cycle cooling, but still would have reduced impingement impacts on white perch by roughly 20%. 23 refs., 1 fig., 3 tabs

Trochanteric impingement: is it a source of pain after THR?

Directory of Open Access Journals (Sweden)

Mark J. Isaacson, DO

2015-09-01

Full Text Available While uncommon, trochanteric-pelvic impingement may lead to significant lateral hip pain. We defined “impingement distance” as the radiographic distance from the medial aspect of the greater trochanter and the corresponding lateral edge of the acetabular bone or component and compared this to the contralateral normal hip. We present two painful total hip replacement (THR cases, each featuring a patient with severe lateral hip pain when walking and sitting. Both patients had diminished femoral offset and trochanteric-pelvic clearance, compared to the contralateral normal hip. The impingement distance was increased an average of 10 mm with the exchange to a longer femoral head. Both patients had immediate and complete pain relief with operative treatment to increase the impingement distance.

Cumulative occupational shoulder exposures and surgery for subacromial impingement syndrome: a nationwide Danish cohort study.

Science.gov (United States)

Dalbøge, Annett; Frost, Poul; Andersen, Johan Hviid; Svendsen, Susanne Wulff

2014-11-01

The primary aim was to examine exposure-response relationships between cumulative occupational shoulder exposures and surgery for subacromial impingement syndrome (SIS), and to compare sex-specific exposure-response relationships. The secondary aim was to examine the time window of relevant exposures. We conducted a nationwide register study of all persons born in Denmark (1933-1977), who had at least 5 years of full-time employment. In the follow-up period (2003-2008), we identified first-time events of surgery for SIS. Cumulative exposure estimates for a 10-year exposure time window with a 1-year lag time were obtained by linking occupational codes with a job exposure matrix. The exposure estimates were expressed as, for example, arm-elevation-years in accordance with the pack-year concept of tobacco consumption. We used a multivariable logistic regression technique equivalent to discrete survival analysis. The adjusted OR (ORadj) increased to a maximum of 2.1 for arm-elevation-years, repetition-years and force-years, and to 1.5 for hand-arm-vibration-years. Sex-specific exposure-response relationships were similar for men and women, when assessed using a relative risk scale. The ORadj increased gradually with the number of years contributing to the cumulative exposure estimates. The excess fraction was 24%. Cumulative occupational shoulder exposures carried an increase in risk of surgery for SIS with similar exposure-response curves for men and women. The risk of surgery for SIS increased gradually, when the period of exposure assessment was extended. In the general working population, a substantial fraction of all first-time operations for SIS could be related to occupational exposures. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Effectiveness of telerehabilitation programme following surgery in shoulder impingement syndrome (SIS): study protocol for a randomized controlled non-inferiority trial.

Science.gov (United States)

Pastora-Bernal, Jose-Manuel; Martín-Valero, Rocío; Barón-López, Francisco Javier; García-Gómez, Oscar

2017-02-23

Shoulder pain is common in society, with high prevalence in the general population. Shoulder impingement syndrome (SIS) is the most frequent cause. Patients suffer pain, muscle weakness and loss of movement in the affected joint. Initial treatment is predominantly conservative. The surgical option has high success rates and is often used when conservative strategy fails. Traditional physiotherapy and post-operative exercises are needed for the recovery of joint range, muscle strength, stability and functionality. Telerehabilitation programmes have shown positive results in some orthopaedic conditions after surgery. Customized telerehabilitation intervention programmes should be developed to recover shoulder function after SIS surgery. The objective of this study is to evaluate the feasibility and effectiveness of a telerehabilitation intervention compared with usual care in patients after subacromial decompression surgery. We will compare an intervention group receiving videoconferences and a telerehabilitation programme to a control group receiving traditional physiotherapy intervention in a single-blind, randomized controlled non-inferiority trial study design. Through this study, we will further develop our preliminary data set and practical experience with the telerehabilitation programmes to evaluate their effectiveness and compare this with traditional intervention. We will also explore patient satisfaction and cost-effectiveness. Patient enrolment is ongoing. ClinicalTrials.gov, NCT02909920 . 14 September 2016.

Impinging jets - a short review on strategies for heat transfer enhancement

Science.gov (United States)

Nastase, Ilinca; Bode, Florin

2018-02-01

In industrial applications, heat and mass transfer can be considerably increased using impinging jets. A large number of flow phenomena will be generated by the impinging flow, such as: large scale structures, large curvature involving strong shear and normal stresses, stagnation in the wall boundary layers, heat transfer with the impinged wall, small scale turbulent mixing. All these phenomena are highly unsteady and even if nowadays a substantial number of studies in the literature are dedicated, the impinging jets are still not fully understood due to the highly unsteady nature and more over due to great difficulty of performing detailed numerical and experimental investigations.

Rotational effects on impingement cooling

Science.gov (United States)

Epstein, A. H.; Kerrebrock, J. L.; Koo, J. J.; Preiser, U. Z.

1987-01-01

The present consideration of rotation effects on heat transfer in a radially exhausted, impingement-cooled turbine blade model gives attention to experimental results for Reynolds and Rossby numbers and blade/coolant temperature ratio values that are representative of small gas turbine engines. On the basis of a model that encompasses the effects of Coriolis force and buoyancy on heat transfer, bouyancy is identified as the cause of an average Nusselt number that is 20-30 percent lower than expected from previous nonrotating data. A heuristic model is proposed which predicts that the impingement jets nearest the blade roots should deflect inward, due to a centripetal force generated by their tangential velocity counter to the blade motion. Potentially serious thermal stresses must be anticipated from rotation effects in the course of blade design.

Shear layer characteristics of supersonic free and impinging jets

Science.gov (United States)

Davis, T. B.; Kumar, R.

2015-09-01

The initial shear layer characteristics of a jet play an important role in the initiation and development of instabilities and hence radiated noise. Particle image velocimetry has been utilized to study the initial shear layer development of supersonic free and impinging jets. Microjet control employed to reduce flow unsteadiness and jet noise appears to affect the development of the shear layer, particularly near the nozzle exit. Velocity field measurements near the nozzle exit show that the initially thin, uncontrolled shear layer develops at a constant rate while microjet control is characterized by a rapid nonlinear thickening that asymptotes downstream. The shear layer linear growth rate with microjet control, in both the free and the impinging jet, is diminished. In addition, the thickened shear layer with control leads to a reduction in azimuthal vorticity for both free and impinging jets. Linear stability theory is used to compute unstable growth rates and convection velocities of the resultant velocity profiles. The results show that while the convection velocity is largely unaffected, the unstable growth rates are significantly reduced over all frequencies with microjet injection. For the case of the impinging jet, microjet control leads to near elimination of the impingement tones and an appreciable reduction in broadband levels. Similarly, for the free jet, significant reduction in overall sound pressure levels in the peak radiation direction is observed.

Practicality of profile-wire screen in reducing entrainment and impingement

International Nuclear Information System (INIS)

Hanson, B.N.; Bason, W.H.; Beitz, B.E.; Charles, K.E.

1978-01-01

Experimental studies indicated that 1.01-mm slot profile-wire well screen operated at an intake velocity of 15.24 cm/s virtually eliminated impingement of fishes larger than 15 mm fork length (FL). Intake velocities as high as 53.34 cm/s produced low impingement. Tests of fish less than 40 mm FL held near a functioning intake (15.24 cm/s) for as long as 3 hr yielded no impingement or stress. Many striped bass between 8 and 17 mm FL were capable of resisting impingement at more than 30.48 cm/s velocity for longer than 30 min; larger specimens (12 to 17 mm) showed excellent ability to escape when impinged. The screen excluded virtually all striped bass eggs from the cooling water. Preliminary egg mortality studies indicate that at least 95% survival can be expected at an approach velocity of 15.24 cm/s and impingement durations up to 2 min. Fouling studies showed that screens were highly resistant to clogging, essentially self-cleaning in a current, and easily backwashed. In-situ studies in the Chesapeake and Delaware Canal have shown that a 61.0- x 76.2-cm, 1.01-mm-slot screen is capable of providing its designed capacity for weeks without backwashing or cleaning. Biofouling proved to be the greatest operational problem. Entrainment samples from the in-situ intake have shown significant reductions in organisms/m 3 of filtered versus ambient water

Experimental and Computational Study of Underexpanded Jet Impingement Heat Transfer

Science.gov (United States)

Rufer, Shann J.; Nowak, Robert J.; Daryabeigi, Kamran; Picetti, Donald

2009-01-01

An experiment was performed to assess CFD modeling of a hypersonic-vehicle breach, boundary-layer flow ingestion and internal surface impingement. Tests were conducted in the NASA Langley Research Center 31-Inch Mach 10 Tunnel. Four simulated breaches were tested and impingement heat flux data was obtained for each case using both phosphor thermography and thin film gages on targets placed inside the model. A separate target was used to measure the surface pressure distribution. The measured jet impingement width and peak location are in good agreement with CFD analysis.

ARTHROSCOPIC TREATMENT OF ANTERIOR IMPINGEMENT IN THE ANKLE

Directory of Open Access Journals (Sweden)

Martin Mikek

2004-12-01

Full Text Available Background. Anterior soft tissue impingement is a common cause of chronic pain in the ankle. The preferred method of operative treatment is an arthroscopic excision of hypertrophic fibrous and synovial tissue in the anterior part of the ankle joint.Methods. We present the results of arthroscopic treatment of anterior ankle impingement in group of 14 patients.Results. Subjective improvement after the procedure was observed in all patients and 13 of them (93% were without any symptoms after the operation. One patient reported of intermittent pain, especially when walking on uneven grounds.Conclusions. We conclude that arthroscopic excision of hypertrophic synovial tissue in the anterior part of the ankle which causes the symptoms of impingement is a minimally invasive procedure that is both safe and reliable. When used for appropriate indications, an improvement can be expected in over 90% of patients.

Impact of impingement on the Hudson River white perch population

International Nuclear Information System (INIS)

Barnthouse, L.W.; Van Winkle, W.

1980-01-01

The impact of power plant impingement on the 1974 and 1975 year classes of the Hudson River white perch population is assessed using a simple model derived from Ricker's theory of fisheries dynamics. The impact of impingement is expressed in the model as the conditional mortality rate, rather than as the more commonly used exploitation rate. Since the calculated impact is sensitive to errors in the estimation of population size and total mortality, ranges of probable values of these quantities are used to compute upper and lower bounds on the fractional reduction in abundance of each year class. Best estimates of abundance and mortality are used to compute the conditional impingement mortality rate separately for each plant and month. The results are used to assess the relative impacts of white perch impingement at six Hudson River power plants and to identify the seasons during which the impact is highest

Experimental study on boiling heat transfer to an impinging jet on a hot block

International Nuclear Information System (INIS)

Kamata, Choko

1997-01-01

Previous studies on boiling heat transfer by impinging jets are mainly concerned with the impinging point by using small heat transfer surfaces of about 20 mm. An experimental study of the boiling heat transfer to an impinging water jet on a massive hot block is made. The upward heating surface is made of copper. Its diameter and nozzle diameter are 80 mm and 2.2 mm, respectively. The velocity of the impinging jet was varied from 0.6 to 2.1 m/s. Saturated water normally impinged on the heating surface, flowed radially, and subsequently dispersed into the atmosphere. The present study clarifies that heat transfer characteristics vary with the temperature of heat transfer surface, and also with the distance from the impinging point. (author)

Noise characteristics and flow field of an impinging jet on a conical obstacle

Energy Technology Data Exchange (ETDEWEB)

Liu, Xin; Xie, Junlong; Shu, Shuiming; Zhang, Yi, E-mail: hustxjl@163.com [School of Energy and Power Engineering, Huazhong University of Science and Technology, Wuhan, 430074 (China)

2017-12-15

The noise characteristics and flow field of a low-speed impinging jet on a conical obstacle have been numerically simulated using the kinetic energy transport subgrid-scale model of the large-eddy simulation method. Noise measurement is carried out to validate the proposed simulation method. The effects of the impinging distance on the development, separation and diffusion of vortices on the back of the conical obstacle are investigated. The jet structure is better preserved and the vorticity value becomes larger as the impinging distance increases. Simulation results of the noise spectrums and overall sound pressure level (OASPL) agree well with the experimental data. The noise spectrums are analyzed and combined with simulation results for the flow field. When the impinging distance is small, the main acoustic sources with the broadband characteristic consist of the dipole source produced by pressure fluctuation on the surface of the obstacle, and the quadrupole source produced by vortices. As the impinging distance increases, the quadrupole source becomes the major acoustic source with low-frequency characteristics. In addition, the OASPL of the impinging jet is obtained at different impinging distances. (paper)

Comparison of Endotoxin Exposure Assessment by Bioaerosol Impinger and Filter-Sampling Methods

OpenAIRE

Duchaine, Caroline; Thorne, Peter S.; Mériaux, Anne; Grimard, Yan; Whitten, Paul; Cormier, Yvon

2001-01-01

Environmental assessment data collected in two prior occupational hygiene studies of swine barns and sawmills allowed the comparison of concurrent, triplicate, side-by-side endotoxin measurements using air sampling filters and bioaerosol impingers. Endotoxin concentrations in impinger solutions and filter eluates were assayed using the Limulus amebocyte lysate assay. In sawmills, impinger sampling yielded significantly higher endotoxin concentration measurements and lower variances than filte...

MR imaging of nerve root impingement in the lumbar spine

International Nuclear Information System (INIS)

Teresi, L.M.; Bradley, W.G. Jr.; Bloze, A.E.; Davis, S.J.; Amster, J.; Berger, P.E.

1990-01-01

This paper determines the relationship between MR imaging findings of nerve root impingement, presenting symptoms, and physical examination findings, and physiologic data (DSEP and EMG) in a population of patients presented with classic radicular symptoms. Fifty-eight patients presenting with classic radicular pain were studied with MR imaging, DSER, and EMG, MR imaging was performed with a GE Signa imaging system with use of T1- and T2-weighted sequences and 5-mm-thick sections. Nerve root impingement in the subarticular recess (the root exiting the next lowest level) was distinguished from nerve root impingement in the superior intervertebral foramen (the root exiting the same level)

Impact of impingement on the Hudson River white perch population. Final report

Energy Technology Data Exchange (ETDEWEB)

Barnthouse, L.W.; Van Winkle, W.; Kirk, B.L.; Vaughan, D.S.

1982-02-01

This report summarizes a series of analyses of the magnitude and biological significance of the impingement of white perch at the Indian Point Nuclear Generating Station and other Hudson River power plants. Included in these analyses were evaluations of: (1) two independent lines of evidence relating to the magnitude of impingement impacts on the Hudson River white perch population; (2) the additional impact caused by entrainment of white perch; (3) data relating to density-dependent growth among young-of-the-year white perch; (4) the feasibility of performing population-level analyses of impingement impacts on the white perch populations of Chesapeake Bay and the Delaware River; and (5) the feasibility of using simple food chain and food web models to evaluate community-level effects of impingement and entrainment. Estimated reductions in the abundances of the 1974 and 1975 white perch year classes, caused by impingement and entrainment, were high enough that the possibility of adverse long-term effects cannot be excluded.

A study on the velocity characteristics of the spray formed by two impinging jets

International Nuclear Information System (INIS)

Choo, Yeon Jun; Seo, Kwi Hyun; Kang, Bo Seon

2001-01-01

In this study, the velocity characteristics of liquid elements formed by two impinging jets is analysed using double pulse image capturing technique. For the droplets formed by low speed impinging jets, the droplet velocities are higher with smaller azimuthal and impingement angle. The maximum droplet velocities are about 25% lower than jet velocity. With an increase of azimuthal angle, the shedding angles increases but remains lower than azimuthal angle. The velocities of ligaments formed by high speed impinging jets gradually decreases with an increase of azimuthal angle. The maximum ligament velocities are about 40% lower than jet velocity. Higher impingement angles produce lower ligament velocities. The shedding angles of ligament almost increases with the same value of azimuthal angle, which implies that the moving direction of ligaments is radial from the origin as the impingement point

Apollo Video Photogrammetry Estimation Of Plume Impingement Effects

Science.gov (United States)

Immer, Christopher; Lane, John; Metzger, Philip T.; Clements, Sandra

2008-01-01

The Constellation Project's planned return to the moon requires numerous landings at the same site. Since the top few centimeters are loosely packed regolith, plume impingement from the Lander ejects the granular material at high velocities. Much work is needed to understand the physics of plume impingement during landing in order to protect hardware surrounding the landing sites. While mostly qualitative in nature, the Apollo Lunar Module landing videos can provide a wealth of quantitative information using modem photogrammetry techniques. The authors have used the digitized videos to quantify plume impingement effects of the landing exhaust on the lunar surface. The dust ejection angle from the plume is estimated at 1-3 degrees. The lofted particle density is estimated at 10(exp 8)- 10(exp 13) particles per cubic meter. Additionally, evidence for ejection of large 10-15 cm sized objects and a dependence of ejection angle on thrust are presented. Further work is ongoing to continue quantitative analysis of the landing videos.

Trailing edge cooling using angled impingement on surface enhanced with cast chevron arrangements

Science.gov (United States)

Lee, Ching-Pang; Heneveld, Benjamin E.; Brown, Glenn E.; Klinger, Jill

2015-05-26

A gas turbine engine component, including: a pressure side (12) having an interior surface (34); a suction side (14) having an interior surface (36); a trailing edge portion (30); and a plurality of suction side and pressure side impingement orifices (24) disposed in the trailing edge portion (30). Each suction side impingement orifice is configured to direct an impingement jet (48) at an acute angle (52) onto a target area (60) that encompasses a tip (140) of a chevron (122) within a chevron arrangement (120) formed in the suction side interior surface. Each pressure side impingement orifice is configured to direct an impingement jet at an acute angle onto an elongated target area that encompasses a tip of a chevron within a chevron arrangement formed in the pressure side interior surface.

The jet impingement phase of molten core-concrete interactions

International Nuclear Information System (INIS)

Sienicki, J.J.; Spencer, B.W.

1986-01-01

Scoping calculations have been carried out demonstrating that a significant and abrupt reduction in the corium temperature may be realized when molten corium drains as a jet from a localized breach in the RPV lower head to impinge upon the concrete basemat. The temperature decrease may range from a value of ∼170 K (∼140 K) for limestone (basaltic) aggregate concrete to a value approaching the initial corium superheat depending upon whether the forced convection impingement heat flux is assumed to be controlled by either thermal conduction across a slag film layer or the temperature boundary condition represented by a corium crust. The magnitude of the temperature reduction remains significant as the initial corium temperature, impinging corium mass, and initial localized breach size are varied over their range of potential values

EVALUATION OF PRESENTATION OF SIGNS AND SYMPTOMS OF FEMOROACETABULAR IMPINGEMENT AFTER EPIPHYSIOLYSIS OF THE PROXIMAL FEMUR.

Science.gov (United States)

Krüger, Fábio Peng; de Britto, Paulo Sérgio Gérzon; Neto, Lauro Machado; Schwartsmann, Carlos Roberto

2011-01-01

The long-bone fractures occur most frequently in the tibial shaft. Adequate treatment of such fractures avoids consolidation failure, skewed consolidation and reoperation. To classify these fractures, the AO/OTA classification method is still used, but it is worthwhile getting to know the Ellis classification method, which also includes assessment of soft-tissue injuries. There is often an association with compartmental syndrome, and early diagnosis can be achieved through evaluating clinical parameters and constant clinical monitoring. Once the diagnosis has been made, fasciotomy should be performed. It is always difficult to assess consolidation, but the RUST method may help in this. Radiography is assessed in two projections, and points are scored for the presence of the fracture line and a visible bone callus. Today, the dogma of six hours for cleaning the exposed fracture is under discussion. It is considered that an early start to intravenous antibiotic therapy and the lesion severity are very important. The question of early or late closure of the lesion in an exposed fracture has gone through several phases: sometimes early closure has been indicated and sometimes late closure. Currently, whenever possible, early closure of the lesion is recommended, since this diminishes the risk of infection. Milling of the canal when the intramedullary nail is introduced is still a controversial subject. Despite strong personal positions in favor of milling, studies have shown that there may be some advantage in relation to closed fractures, but not in exposed fractures.

Modelling of soft impingement during solidification

Indian Academy of Sciences (India)

TECS

soft impingement problem and related to shape instability by constitutional supercooling theory. This analysis ... the context of the stir casting process, it has been pointed ... This transformation when applied to Fick's second law gives the ...

Hydrodynamics and PIV study in the impingement zone formed by a droplet train

Science.gov (United States)

Kanjirakat, Anoop; Sadr, Reza; Zhang, Taolue; Muthusamy, Jayaveera; Alvarado, Jorge; Texas A; M University at Qatar Collaboration; Texas A; M University College Station Collaboration

2016-11-01

Droplet impingement is encountered in numerous technical applications, such as ink jet printing, spray cooling, and fuel injection in internal combustion engines. Even though many studies in droplet impingement were conducted in past, not many have measured the near-wall velocities in the droplet impingement zone. With the goal of gaining a better understanding of the hydrodynamics in the impingement zone, well-controlled experiments are performed in combination with micro-PIV measurements and numerical simulations. Hydrodynamics of HFE-7100 droplets generated using a piezoelectric droplet generator, impinging on a pre-wetted surface is investigated. Micro-PIV studies in the high-velocity impingement zone are performed using one-micron meter fluorescent particles dispersed in HFE-7100 along with the double exposed images. Three-dimensional and 2D-axisymmetric numerical modeling for a transient droplet crown development is performed. The interface between the gas and the liquid is modeled using a Volume of Fluid (VOF) method. Numerical simulation results obtained are observed to be in good agreement with that of the experimental observations. Supported by National Priority Research Program (NPRP) of Qatar National Research Fund (QNRF), Grant No.: NPRP 6-1304-2-525.

Modular jet impingement assemblies with passive and active flow control for electronics cooling

Energy Technology Data Exchange (ETDEWEB)

Zhou, Feng; Dede, Ercan Mehmet; Joshi, Shailesh

2016-09-13

Power electronics modules having modular jet impingement assembly utilized to cool heat generating devices are disclosed. The modular jet impingement assemblies include a modular manifold having a distribution recess, one or more angled inlet connection tubes positioned at an inlet end of the modular manifold that fluidly couple the inlet tube to the distribution recess and one or more outlet connection tubes positioned at an outlet end of the modular manifold that fluidly coupling the outlet tube to the distribution recess. The modular jet impingement assemblies include a manifold insert removably positioned within the distribution recess and include one or more inlet branch channels each including an impinging slot and one or more outlet branch channels each including a collecting slot. Further a heat transfer plate coupled to the modular manifold, the heat transfer plate comprising an impingement surface including an array of fins that extend toward the manifold insert.

Comparative analysis of arthroscopic debridement in osseous versus soft tissue anterior ankle impingement.

Science.gov (United States)

Devgan, Ashish; Rohilla, Rajesh; Tanwar, Milind; Jain, Aditya; Siwach, Karan; Devgan, Radika

2016-01-01

Arthroscopic debridement has been a gold standard procedure for anterior ankle impingement, both in cases of osseous and soft tissue impingement. There is sparse literature on comparative outcome with respect to functional results between the two types of impingement post-arthroscopic debridement. Our study included 14 patients diagnosed as cases of anterior ankle impingement on the basis of clinical and radiological examination. They were segregated into two groups (on the basis of cause of impingement (osseous versus soft tissue)). Both groups were treated by arthroscopic debridement. Primary outcome was patient satisfaction, which was assessed by Likert scale and clinical outcomes were measured using AOFAS ankle-hind foot scale, VAS score, range of motion and time to return to pre-injury activity level in both groups. Mean follow-up was of 15 months where eleven patients reported an excellent recovery, two patients had good recovery while one patient reported poor outcome. Mean AOFAS ankle hind foot scale improved from 50.5 preoperatively to 85.71 postoperatively (statistically significant; p value - 0.0001). Mean Likert scale value post-operative was 4.21. VAS score showed significant improvement in patients of both the groups. Range of motion was slightly better in soft tissue impingement type with a relatively shorter time to return to sports or preinjury activity level as compared to osseous impingement group. The patients in both the groups had comparable outcomes with no statistically significant difference with regard to patient satisfaction and clinical outcome.

The impact of subacromial impingement syndrome on muscle activity patterns of the shoulder complex: a systematic review of electromyographic studies

Directory of Open Access Journals (Sweden)

Smith Toby O

2010-03-01

Full Text Available Abstract Background Subacromial impingement syndrome (SIS is a commonly reported cause of shoulder pain. The purpose of this study was to systematically review the literature to examine whether a difference in electromyographic (EMG activity of the shoulder complex exists between people with SIS and healthy controls. Methods Medline, CINAHL, AMED, EMBASE, and grey literature databases were searched from their inception to November 2008. Inclusion, data extraction and trial quality were assessed in duplicate. Results Nine studies documented in eleven papers, eight comparing EMG intensity and three comparing EMG onset timing, representing 141 people with SIS and 138 controls were included. Between one and five studies investigated each muscle totalling between 20 and 182 participants. The two highest quality studies of five report a significant increase in EMG intensity in upper trapezius during scaption in subjects with SIS. There was evidence from 2 studies of a delayed activation of lower trapezius in patients with SIS. There was otherwise no evidence of a consistent difference in EMG activity between the shoulders of subjects with painful SIS and healthy controls. Conclusions A difference may exist in EMG activity within some muscles, in particular upper and lower trapezius, between people with SIS and healthy controls. These muscles may be targets for clinical interventions aiding rehabilitation for people with SIS. These differences should be investigated in a larger, high quality survey and the effects of therapeutically targeting these muscles in a randomised controlled trial.

Physics of Particle Entrainment Under the Influence of an Impinging Jet

Science.gov (United States)

2008-12-01

Approved for public release; distribution unlimited 1 PHYSICS OF PARTICLE ENTRAINMENT UNDER THE INFLUENCE OF AN IMPINGING JET Robert Haehnel...Ing. Wesen. Heft 361). Phares, D.J., Smedley , G.T. and Flagan, R.C. (2000) "The wall shear stress produced by the normal impingement of a jet on a

Reliability of impingement sampling designs: An example from the Indian Point station

International Nuclear Information System (INIS)

Mattson, M.T.; Waxman, J.B.; Watson, D.A.

1988-01-01

A 4-year data base (1976-1979) of daily fish impingement counts at the Indian Point electric power station on the Hudson River was used to compare the precision and reliability of three random-sampling designs: (1) simple random, (2) seasonally stratified, and (3) empirically stratified. The precision of daily impingement estimates improved logarithmically for each design as more days in the year were sampled. Simple random sampling was the least, and empirically stratified sampling was the most precise design, and the difference in precision between the two stratified designs was small. Computer-simulated sampling was used to estimate the reliability of the two stratified-random-sampling designs. A seasonally stratified sampling design was selected as the most appropriate reduced-sampling program for Indian Point station because: (1) reasonably precise and reliable impingement estimates were obtained using this design for all species combined and for eight common Hudson River fish by sampling only 30% of the days in a year (110 d); and (2) seasonal strata may be more precise and reliable than empirical strata if future changes in annual impingement patterns occur. The seasonally stratified design applied to the 1976-1983 Indian Point impingement data showed that selection of sampling dates based on daily species-specific impingement variability gave results that were more precise, but not more consistently reliable, than sampling allocations based on the variability of all fish species combined. 14 refs., 1 fig., 6 tabs

Impingement of water droplets on wedges and diamond airfoils at supersonic speeds

Science.gov (United States)

Serafini, John S

1953-01-01

An analytical solution has been obtained for the equations of motion of water droplets impinging on a wedge in a two-dimensional supersonic flow field with a shock wave attached to the wedge. The closed-form solution yields analytical expressions for the equation of the droplet trajectory, the local rate of impingement and the impingement velocity at any point on the wedge surface, and the total rate of impingement. The analytical expressions are utilized to determine the impingement on the forward surfaces of diamond airfoils in supersonic flow fields with attached shock waves. The results presented include the following conditions: droplet diameters from 2 to 100 microns, pressure altitudes from sea level to 30,000 feet, free-stream static temperatures from 420 degrees to 460 degrees R. Also, free-stream Mach numbers from 1.1 to 2.0, semi-apex angles for the wedge from 1.14 degrees to 7.97 degrees, thickness-to-chord ratios for the diamond airfoil from 0.02 to 0.14, chord lengths from 1 to 20 feet, and angles of attack from zero to the inverse tangent of the airfoil thickness-to-chord ratio.

Knowledge of practising radiographers of the supraspinatus outlet projection for shoulder impingement syndrome in the Eastern Cape, South Africa

International Nuclear Information System (INIS)

Williams, R.; Morton, D.G.

2016-01-01

Background/Aim: There are many projections in plain film imaging to demonstrate the specific aspects of the anatomy of the shoulder. However, reproducing the required projections can be challenging especially if radiographers are not familiar with the projections and their evaluation criteria. The aim of the study was to explore and describe the knowledge of practising radiographers regarding the supraspinatus outlet projection for shoulder impingement syndrome. Method: A quantitative, exploratory and descriptive design was followed. The population served as the sample and included all the practising radiographers in the public and private hospitals of a metropolitan municipality in the Eastern Cape, South Africa. A total of 84 respondents completed the structured, self-administered questionnaire. Results: The data revealed that in many cases, the majority of radiographers in the study, due to inadequate knowledge levels would not be able to produce an optimal radiographic image of the supraspinatus outlet. The results of the chi-squares indicated statistically significant differences (p < 0.05) between public and private hospitals regarding certain aspects of the scapular Y projection and SOP. Conclusion: It was found that the radiographers in the study had inadequate knowledge of scapular Y projections and SOPs in relation to SIS. Therefore, it is essential to ensure that radiographers are updated on their knowledge of radiographic practice on a continuous basis. - Highlights: • Many radiographers unable to produce an optimal image of the supraspinatus outlet. • Radiographers had poor knowledge of scapular Y and supraspinatus outlet projections. • It is essential that radiographers update their knowledge of radiographic practice.

Transverse jet-cavity interactions with the influence of an impinging shock

International Nuclear Information System (INIS)

Zare-Behtash, H.; Lo, K.H.; Kontis, K.; Ukai, T.; Obayashi, S.

2015-01-01

Highlights: • Experimental study of shock-jet-cavity in a supersonic freestream is conducted. • Shock impingement at the cavity leading edge lifts the shear layer, encouraging momentum transfer. • Shock impingement close to the jet location increases the number of smaller turbulent structures. - Abstract: For high-speed air breathing engines, fuel injection and subsequent mixing with air is paramount for combustion. The high freestream velocity poses a great challenge to efficient mixing both in macroscale and microscale. Utilising cavities downstream of fuel injection locations, as a means to hold the flow and stabilise the combustion, is one mechanism which has attracted much attention, requiring further research to study the unsteady flow features and interactions occurring within the cavity. In this study we combine the transverse jet injection upstream of a cavity with an impinging shock to see how this interaction influences the cavity flow, since impinging shocks have been shown to enhance mixing of transverse jets. Utilising qualitative and quantitative methods: schlieren, oilflow, PIV, and PSP the induced flowfield is analysed. The impinging shock lifts the shear layer over the cavity and combined with the instabilities generated by the transverse jet creates a highly complicated flowfield with numerous vertical structures. The interaction between the oblique shock and the jet leads to a relatively uniform velocity distribution within the cavity

Investigation of vertical liquid film width upon impingement on flat plate

International Nuclear Information System (INIS)

Kim, Won J.; Son, Hyung M.; Suh, Kune Y.

2003-01-01

In the early, high pressure phase during a Large-Break Loss-Of-Coolant Accident (LBLOCA), the Emergency Core Cooling (ECC) water of the Direct Vessel Injection (DVI) system is supplied from the Safety Injection Tank (SIT). After the shortage of the SIT, the In-containment Refueling Water Storage Tank (IRWST) supplies water to the safety system. Velocity of the injection flow varies during the process from the initial value of over 10 m/s in the blowdown phase to 2∼3 m/s in the later phase of reflood. During the safety injection, such important phenomena are observed as impingement, bypass, entrainment and sweepout, and condensation. The impingement is referred to the case where the ECC water is injected to strike on the reactor inner vessel. Accordingly, the water generates a liquid film to form a ridge on the wall. The liquid film then flows down the wall due to gravity. This impingement is interrupted by the steam-water mixture bypass flow to the break. The bypass, in turn, is affected by the impingement. This study is intended to understand the impinged water flow behavior neglecting such secondary effects as the temperature-dependent thermodynamic properties and the reactor vessel curvature. An emphasis is put on interpreting the results of visual inspection to understand the underlying mechanism of rather complex turbulent flow in the downcomer

Slipped upper femoral epiphysis: Outcome after in situ fixation and capital realignment technique

Directory of Open Access Journals (Sweden)

Sanjay Arora

2013-01-01

Results: Clinical outcome as assessed by Merle d′ Aubigne score was excellent in 6, good in 10, fair in 6 and poor in 1. Half of the in situ fixation patients underwent osteoplasty procedure for femoroacetabular impingement and 5 more were symptomatic. The head neck offset and α angle after in situ pinning were -1.12 ± 3 mm and 66.05 ± 9.7°, respectively and this improved to 8.7 mm and 49°, respectively, after osteoplasty. One child in the pinning group had chondrolysis. Eight patients with severe slip underwent capital realignment. Mean followup was 20.15 months. The anterior head neck offset and α angle were corrected to 6.8 ± 1.72 mm and 44.6 ± 7.0° mm, respectively. Two children with unstable slip in the capital realignment group had avascular necrosis which was diagnosed at presentation by bone scan. Conclusion: High BMI, vitamin D deficiency and endocrine disorders are associated with SUFE in India and should be evaluated as some of these are amenable to prevention and treatment. Most patients treated with in situ pinning developed femoroacetabular impingement. The early results after capital realignment procedure are encouraging and help to avoid a second procedure which is needed in a majority of patients who underwent in situ pinning.

Numerical modeling of normal turbulent plane jet impingement on solid wall

Energy Technology Data Exchange (ETDEWEB)

Guo, C.Y.; Maxwell, W.H.C.

1984-10-01

Attention is given to a numerical turbulence model for the impingement of a well developed normal plane jet on a solid wall, by means of which it is possible to express different jet impingement geometries in terms of different boundary conditions. Examples of these jets include those issuing from VTOL aircraft, chemical combustors, etc. The two-equation, turbulent kinetic energy-turbulent dissipation rate model is combined with the continuity equation and the transport equation of vorticity, using an iterative finite difference technique in the computations. Peak levels of turbulent kinetic energy occur not only in the impingement zone, but also in the intermingling zone between the edges of the free jet and the wall jet. 20 references.

Computations of droplet impingement on airfoils in two-phase flow

International Nuclear Information System (INIS)

Kim, Sang Dug; Song, Dong Joo

2005-01-01

The aerodynamic effects of leading-edge accretion can raise important safety concerns since the formulation of ice causes severe degradation in aerodynamic performance as compared with the clean airfoil. The objective of this study is to develop a numerical simulation strategy for predicting the particle trajectory around an MS-0317 airfoil in the test section of the NASA Glenn Icing Research Tunnel and to investigate the impingement characteristics of droplets on the airfoil surface. In particular, predictions of the mean velocity and turbulence diffusion using turbulent flow solver and continuous random walk method were desired throughout this flow domain in order to investigate droplet dispersion. The collection efficiency distributions over the airfoil surface in simulations with different numbers of droplets, various integration time-steps and particle sizes were compared with experimental data. The large droplet impingement data indicated the trends in impingement characteristics with respect to particle size; the maximum collection efficiency located at the upper surface near the leading edge, and the maximum value and total collection efficiency were increased as the particle size was increased. The extent of the area impinged on by particles also increased with the increment of the particle size, which is similar as compared with experimental data

Entrainment and impingement of aquatic fauna at cooling water system of Madras Atomic Power Station (MAPS)

International Nuclear Information System (INIS)

Barath Kumar, S.; Das, N.P.I.; Satpathy, K.K.

2015-01-01

Marine organisms get impinged to the intake screens of Madras Atomic Power Station (MAPS) due to the suction force of the cooling water system of the power plant. The present work has studied the loss of aquatic organism at MAPS due to impingement at cooling water screens. In total 67 species of marine faunas impinged on the water intake screens of MAPS during the study. The proportion of fish, shrimp, crab, jellyfish and others, with respect to the total biomass of impinged organisms are 1.59 % (33 species), 0.30% (9), 2.77 % (16), 95.10% (3) and 0.24% (4), respectively. Jellyfishes were observed to be the largest entrained group covering around 44.85% of individual and constituting almost 94.82 % of biomass recorded during the study period and sea nettle jelly (Chrysaora quinquecirrha) was impinged with highest frequency. The diel study shows higher impingement occurred during night time, on full moon day and at low tides in contrast to their counterparts. Fishes accounts for 14.84 % of individual count and mere 1.67 % of biomass. Totally 33 number of fish species were observed. The highest impinged species were pony fishes (Secutor ruconius, Secutor insidiator, Photopectoralis bindus, Alepes kleinii and Leiognathus equulus) (21% occurrence). These few entrained fishes are mostly very small in size and have less commercial value. The total loss of marine fauna by impingement during study period was estimated to be 4779 (or 463.46 kg). The present data when compared with the impingement data from other coastal power plants, shows that the impinged fish biomass at MAPS cooling water system is much less than the other temperate and tropical power plants. (author)

The Use of Physiotherapy among Patients with Subacromial Impingement Syndrome: Impact of Sex, Socio-Demographic and Clinical Factors

Science.gov (United States)

Christiansen, David Høyrup; Frost, Poul; Frich, Lars Henrik; Falla, Deborah; Svendsen, Susanne Wulff

2016-01-01

Background Physiotherapy with exercises is generally recommended in the treatment of patients with subacromial impingement syndrome (SIS). Objective We aimed to investigate the use of physiotherapy in patients with SIS in Danish hospital settings as part of initial non-surgical treatment and after SIS-related surgery and to evaluate to which extent sex, socio-demographic and clinical factors predict the use of physiotherapy. Methods Using national health registers, we identified 57,311 patients who had a first hospital contact with a diagnosis of ICD-10, groups M75.1–75.9, 1 July 2007 to 30 June 2011. Records of physiotherapy were extracted within 52 weeks after first contact (or until surgery), and for surgically treated patients within 26 weeks after surgery. Predictors of the use of physiotherapy after first contact and after surgery were analysed as time-to-event. Results Within 52 weeks after first contact, 43% of the patients had physiotherapy and 30% underwent surgery. Within 26 weeks after surgery, 80% had a record of physiotherapy. After first contact and after surgery, exercise was part of physiotherapy in 65% and 84% of the patients, respectively. A public hospital contact, physiotherapy before hospital contact, administrative region, female sex, a diagnosis of other or unspecified disorders (M75.8-M75.9), and surgical procedure predicted higher use of physiotherapy. Low education level predicted slightly lower use of physiotherapy after first contact, but not after surgery. Conclusion In patients with SIS in Danish hospital settings, physiotherapy was more often used after surgery than as part of initial non-surgical treatment. The use of physiotherapy was less common among men than women, whereas unequal use of physiotherapy in relation to education level was not noticeable. The use of physiotherapy with exercises in initial non-surgical treatment was relatively limited. PMID:26954692

Acute bone marrow edema of the hip: role of MR imaging

International Nuclear Information System (INIS)

Karantanas, Apostolos H.

2007-01-01

Acute bone marrow edema of the hip is a diagnostic challenge for both radiologists and clinicians. Marrow edema is often seen in patients with hip pain and restriction of motion. In patients with acute non-traumatic hip pain, whose radiographs are negative or inconclusive, MR imaging is the imaging study of choice. MR imaging is the most sensitive and specific imaging technique for detecting transient osteoporosis and osteonecrosis, as well as for detecting and staging fractures and microfractures. MR imaging is able to show marrow involvement in various inflammatory disorders and to diagnose reactive marrow edema from femoroacetabular impingment and greater trochanteric pain syndrome. In patients with septic arthritis, it may also depict associated marrow edema and suggest its reactive or infectious origin. For the neoplastic disorders, although plain radiographs should be the initial examination, MR imaging may follow for assessing extension to the surrounding soft tissues and/or associated pathologic fracture, facilitating thus the treatment planning. Computed tomography is more accurate compared with MR imaging in diagnosing intra-articular osteoid osteomas. (orig.)

Acute bone marrow edema of the hip: role of MR imaging

Energy Technology Data Exchange (ETDEWEB)

Karantanas, Apostolos H. [University Hospital, Department of Radiology, Stavrakia, Heraklion, Crete (Greece)

2007-09-15

Acute bone marrow edema of the hip is a diagnostic challenge for both radiologists and clinicians. Marrow edema is often seen in patients with hip pain and restriction of motion. In patients with acute non-traumatic hip pain, whose radiographs are negative or inconclusive, MR imaging is the imaging study of choice. MR imaging is the most sensitive and specific imaging technique for detecting transient osteoporosis and osteonecrosis, as well as for detecting and staging fractures and microfractures. MR imaging is able to show marrow involvement in various inflammatory disorders and to diagnose reactive marrow edema from femoroacetabular impingment and greater trochanteric pain syndrome. In patients with septic arthritis, it may also depict associated marrow edema and suggest its reactive or infectious origin. For the neoplastic disorders, although plain radiographs should be the initial examination, MR imaging may follow for assessing extension to the surrounding soft tissues and/or associated pathologic fracture, facilitating thus the treatment planning. Computed tomography is more accurate compared with MR imaging in diagnosing intra-articular osteoid osteomas. (orig.)

Diagnostic performance of susceptibility-weighted magnetic resonance imaging for the assessment of sub-coracoacromial spurs causing subacromial impingement syndrome

Energy Technology Data Exchange (ETDEWEB)

Noerenberg, Dominik; Armbruster, Marco [Munich University Hospitals Campus Grosshadern, Department of Clinical Radiology, Munich (Germany); Bender, Yi-Na; Walter, Thula; Diederichs, Gerd; Hamm, Bernd [Charite - University Medicine Berlin, Department of Radiology, Berlin (Germany); Ebersberger, Hans U. [Heart Center Munich-Bogenhausen, Department of Cardiology and Intensive Care Medicine, Munich (Germany); Ockert, Ben [Munich University Hospitals Campus Grosshadern, Department of Trauma and Orthopedic Surgery, Shoulder and Elbow Service, Munich (Germany); Makowski, Marcus R. [Charite - University Medicine Berlin, Department of Radiology, Berlin (Germany); King' s College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom)

2017-03-15

To evaluate the potential of susceptibility-weighted-magnetic-resonance-imaging (SWMR) for the detection of sub-coracoacromial spurs in patients with clinically suspected subacromial impingement syndrome (SAIS), compared to standard MR-sequences and radiographs. Forty-four patients with suspected SAIS were included. All patients underwent radiography, standard MRI of the shoulder and SWMR. Radiograph-based identification of sub-coracoacromial spurs served as goldstandard. Radiographs identified twenty-three spurs in twenty-three patients. Twenty-one patients without spur formation served as reference group. Detection rate, sensitivity/specificity and interobserver-agreements were calculated. Linear regression was applied to determine the relationship between size measurements on radiographs and MRI. Detection rates for spurs on standard MRI and SWMR were 47.8 % and 91.3 % compared to radiography (p<0.001). SWMR demonstrated a sensitivity of 97.7 % (CI=0.92-1) and a specificity of 91.3 % (CI=0.788-1) for the identification of spurs. Standard MR-sequences achieved a sensitivity of 47.8 % (CI=0.185-0.775) and a specificity of 80.8 % (CI=0.642-0.978). Size measurements between SWMR and radiography showed a good correlation (R{sup 2}=0.75;p<0.0001), while overestimating lesion size (5.7±1.2 mm; 4.3±1.3 mm;p<0.0001). Interobserver-agreement for spurs was high on SWMR (R{sup 2}=0.74;p<0.0001), but low on standard MRI (R{sup 2}=0.24;p<0.0001). SWMR allows a reliable detection of sub-coracoacromial spur formation in patients with SAIS and is superior to standard MR-sequences using radiography as goldstandard. (orig.)

Diagnostic performance of susceptibility-weighted magnetic resonance imaging for the assessment of sub-coracoacromial spurs causing subacromial impingement syndrome

International Nuclear Information System (INIS)

Noerenberg, Dominik; Armbruster, Marco; Bender, Yi-Na; Walter, Thula; Diederichs, Gerd; Hamm, Bernd; Ebersberger, Hans U.; Ockert, Ben; Makowski, Marcus R.

2017-01-01

To evaluate the potential of susceptibility-weighted-magnetic-resonance-imaging (SWMR) for the detection of sub-coracoacromial spurs in patients with clinically suspected subacromial impingement syndrome (SAIS), compared to standard MR-sequences and radiographs. Forty-four patients with suspected SAIS were included. All patients underwent radiography, standard MRI of the shoulder and SWMR. Radiograph-based identification of sub-coracoacromial spurs served as goldstandard. Radiographs identified twenty-three spurs in twenty-three patients. Twenty-one patients without spur formation served as reference group. Detection rate, sensitivity/specificity and interobserver-agreements were calculated. Linear regression was applied to determine the relationship between size measurements on radiographs and MRI. Detection rates for spurs on standard MRI and SWMR were 47.8 % and 91.3 % compared to radiography (p<0.001). SWMR demonstrated a sensitivity of 97.7 % (CI=0.92-1) and a specificity of 91.3 % (CI=0.788-1) for the identification of spurs. Standard MR-sequences achieved a sensitivity of 47.8 % (CI=0.185-0.775) and a specificity of 80.8 % (CI=0.642-0.978). Size measurements between SWMR and radiography showed a good correlation (R 2 =0.75;p<0.0001), while overestimating lesion size (5.7±1.2 mm; 4.3±1.3 mm;p<0.0001). Interobserver-agreement for spurs was high on SWMR (R 2 =0.74;p<0.0001), but low on standard MRI (R 2 =0.24;p<0.0001). SWMR allows a reliable detection of sub-coracoacromial spur formation in patients with SAIS and is superior to standard MR-sequences using radiography as goldstandard. (orig.)

Anterior ankle impingement after tendo-Achilles lengthening for long-standing equinus deformity in residual poliomyelitis.

Science.gov (United States)

Sung, Ki Hyuk; Chung, Chin Youb; Lee, Kyoung Min; Lee, Seung Yeol; Park, Moon Seok

2013-09-01

This study was performed to investigate anterior ankle impingement after tendo-Achilles lengthening for long-standing equinus deformity in patients with residual poliomyelitis and to investigate whether the severity of preoperative equinus deformity affected the occurrence of symptomatic anterior impingement. Twenty-seven consecutive patients (mean age, 43.8 ± 9.4 years) with residual poliomyelitis who underwent tendo-Achilles lengthening for equinus foot deformity were included. On lateral foot-ankle weight-bearing radiographs, the tibiocalcaneal angle, plantigrade angle, and McDermott grade were measured and the presence of anterior blocking spur was evaluated. Eleven patients (40.7%) had anterior ankle impingement on radiographic findings preoperatively and 24 patients (88.9%) at latest follow-up. There was a significant difference in McDermott grade between preoperative and latest follow-up (P poliomyelitis had anterior ankle impingement after tendo-Achilles lengthening for long-standing equinus deformity, and the presence of symptomatic anterior ankle impingement was significantly associated with the severity of the equinus deformity. Therefore, for residual poliomyelitis patients with severe long-standing equinus deformity, surgeons should consider the possibility of a subsequent anterior procedure for anterior impingement after tendo-Achilles lengthening. Level IV, retrospective case series.

An experimental study of the supersonic, dual, coaxial jets impinging on an inclined flat plate

International Nuclear Information System (INIS)

Kim, Jung Bae; Lee, Jun Hee; Woo, Sun Hoon; Kim, Heuy Dong

2002-01-01

The impinging supersonic jets have been applied for rocket launching system, thrust control, gas turbine blade cooling, etc. Recently the supersonic, dual, coaxial jets are being extensively used in many diverse fields of industrial processes since they lead to more improved performance, compared with the conventional supersonic jets impinging on an object. In the present study, experimentation is carried out to investigate the supersonic, dual, coaxial jets impinging on an inclined flat plate. A convergent-divergent nozzle with a design Mach number of 2.0 and annular sonic nozzle are used to make the dual, coaxial jet flows. The angle of the impinging flat plate is varied from 30 .deg. to 60 .deg. and the distance between the dual coaxial nozzle and flat plate is also varied. Detailed pressures on the impinging plate are measured to analyze the flow fields, which are also visualized using Schlieren optical method

Cartilage status in FAI patients - results from the Danish Hip Arthroscopy Registry (DHAR)

DEFF Research Database (Denmark)

Lund, Bent; Nielsen, Torsten Grønbech; Lind, Martin

2017-01-01

management is not fully elucidated. This study from the Danish Hip Arthroscopy Registry (DHAR) will try to show data on the cartilage status from a large cohort. Data from a national registry potentially represent large amounts of population-based epidemiological information from multiple centres...... severe acetabular cartilage injury. DISCUSSION: The majority of patients with femoroacetabular impingement (FAI) undergoing hip arthroscopy have significant cartilage changes at the time of surgery primarily at the acetabulum and to a lesser degree at the femoral head. During FAI surgery the majority...

Impinging jet spray formation using non-Newtonian liquids

Science.gov (United States)

Rodrigues, Neil S.

Over the past two decades there has been a heightened interest in implementing gelled propellants for rocket propulsion, especially for hypergolic bi-propellants such as monomethylhydrazine (MMH) and nitrogen tetroxide oxidizer (NTO). Due to the very high level of toxicity of hypergolic liquid rocket propellants, increasing safety is an important area of need for continued space exploration and defense operations. Gelled propellants provide an attractive solution to meeting the requirements for safety, while also potentially improving performance. A gelling agent can be added to liquid propellants exhibiting Newtonian behavior to transform the liquid into a non-Newtonian fluid with some solid-like behavior, i.e. a gel. Non-Newtonian jet impingement is very different from its Newtonian counterpart in terms of fluid flow, atomization, and combustion. This is due to the added agents changing physical properties such as the bulk rheology (viscosity) and interfacial rheology (surface tension). Spray characterization of jet impingement with Newtonian liquids has been studied extensively in existing literature. However, there is a scarcity in literature of studies that consider the spray characterization of jet impingement with gelled propellants. This is a rather critical void since a major tradeoff of utilizing gelled propellants is the difficulty with atomization due to the increased effective viscosity. However, this difficulty can be overcome by using gels that exhibit shear-thinning behavior---viscosity decreases with increasing strain rate. Shear-thinning fluids are ideal because they have the distinct advantage of only flowing easily upon pressure. Thereby, greatly reducing the amount of propellant that could be accidentally leaked during both critical functions such as liftoff or engagement in the battlefield and regular tasks like refilling propellant tanks. This experimental work seeks to help resolve the scarcity in existing literature by providing drop size

Development of a clinically relevant impingement test method for a mobile bearing lumbar total disc replacement.

Science.gov (United States)

Siskey, Ryan; Peck, Jonathan; Mehta, Hitesh; Kosydar, Allison; Kurtz, Steven; Hill, Genevieve

2016-09-01

Total disc arthroplasty is an alternative therapy to spinal fusion for the treatment of neck or low back pain and is hypothesized to reduce the risk of disease progression to the adjacent spinal levels. Radiographic and retrieval analyses of various total disc replacements (TDRs) have shown evidence of impingement damage. Impingement of TDRs can occur when the device reaches the limits of its functional range of motion, causing contact between peripheral regions of the device. Impingement can be associated with increased wear and mechanical damage; however, impingement conditions are not simulated in current standardized mechanical bench test methods. This study explored the test conditions necessary to apply clinically relevant impingement loading to a lumbar TDR in vitro. An experimental protocol was developed and evaluated using in vivo retrievals for qualitative and quantitative validation. Retrieval analysis was conducted on a set of 11 size 3 retrieved Charité devices using American Society for Testing and Materials F561 as a guide. The impingement range of motion was determined using a combination of modeling and experiments, and was used as an input in vitro testing. A 1-million cycle in vitro test was then conducted, and the in vitro samples were characterized using methods similar to the retreived devices. All in vitro tested samples exhibited impingement regions and damage patterns consistent with retrieved devices. Consistent with the retrievals, the impingement damage on the rim was a combination of abrasive wear and plastic deformation. Micro computed tomography (microCT) was used to quantitatively assess rim damage due to impingement. Rim penetration was statistically lower in the retrievals when compared with both in vitro groups. Rim elongation was comparable among all groups. The simulated-facet group had statistically greater angular rim deformations than the retrieval group and the no-facet group. Results demonstrate that clinically relevant

Sampling designs and methods for estimating fish-impingement losses at cooling-water intakes

International Nuclear Information System (INIS)

Murarka, I.P.; Bodeau, D.J.

1977-01-01

Several systems for estimating fish impingement at power plant cooling-water intakes are compared to determine the most statistically efficient sampling designs and methods. Compared to a simple random sampling scheme the stratified systematic random sampling scheme, the systematic random sampling scheme, and the stratified random sampling scheme yield higher efficiencies and better estimators for the parameters in two models of fish impingement as a time-series process. Mathematical results and illustrative examples of the applications of the sampling schemes to simulated and real data are given. Some sampling designs applicable to fish-impingement studies are presented in appendixes

Analysis of factors influencing the impingement of threadfin shad (Dorosoma pretenense) at power plants in the southeastern United States

International Nuclear Information System (INIS)

Loar, J.M.; Griffith, J.S.; Kumar, K.D.

1977-01-01

Data on intake design and location, plant operating procedures, water quality, numbers of fish impinged, and sampling procedures were analyzed for 27 fossil-fueled and 5 nuclear power plants located on inland waters in the southeastern United States. Small (less than 9 cm) clupeids, especially threadfin shad (Dorosoma pretenense), comprised the majority of the fish impinged at these facilities. The parameter that was most strongly associated with shad impingement was water temperature. Maximum impingement rates occurred during the winter when intake temperatures dropped below 10 0 C. Analyses of differences in impingement rates between plants failed to adequately demonstrate that the magnitude of impingement at a particular plant was the result of any site-specific characteristics associated with intake design or location. High approach velocities at the traveling screens did not necessarily result in high levels of impingement. Results obtained from inter-unit comparisons at several plants indicate that unit and screen differences do exist, but it is unclear from existing data whether or not such inter-unit differences determine the magnitude of impingement losses or merely affect the distribution of impinged fish at a given intake structure. Recommendations for monitoring fish impingement include the identification of impinged fish by species, collection of data on water temperatures and various plant operational parameters, periodic analyses of localized velocity regimes near the intake, and frequent estimates of the relative density of the fish population in the vicinity of the intake

Experimental observations and modelling of thermal history within a steel plate during water jet impingement

International Nuclear Information System (INIS)

Liu, Z.D.; Fraser, D.; Samarasekera, I.V.; Lockhart, G.T.

2002-01-01

In order to investigate heat transfer of steel plates under a water jet impingement and to further simulate runout table operation in a hot strip mill, a full-scale pilot runout table facility was designed and constructed at the University of British Columbia (UBC). This paper describes the experimental details, data acquisition and data handling techniques for steel plates during water jet impingement by one circular water jet from an industrial header. Recorded visual observations at the impinging surface were obtained. The effects of cooling water temperature and impingement velocity on the heat transfer from a steel plate were studied. A two-dimensional finite element method-based transient inverse heat conduction model was developed. With the help of the model, heat fluxes and heat transfer coefficients along the impinging surface under various cooling conditions were calculated. The microstructural evolution of the steel plate was also investigated for the varying cooling conditions. Samples were obtained from each plate, polished, etched and then photographed. (author)

Spray Formation of Herschel-Bulkley Fluids using Impinging Jets

Science.gov (United States)

Rodrigues, Neil; Gao, Jian; Chen, Jun; Sojka, Paul E.

2015-11-01

The impinging jet spray formation of two non-Newtonian, shear-thinning, Herschel-Bulkley fluids was investigated in this work. The water-based gelled solutions used were 1.0 wt.-% agar and 1.0 wt.-% kappa carrageenan. A rotational rheometer and a capillary viscometer were used to measure the strain-rate dependency of viscosity and the Herschel-Bulkley Extended (HBE) rheological model was used to characterize the shear-thinning behavior. A generalized HBE jet Reynolds number Rej , gen - HBE was used as the primary parameter to characterize the spray formation. A like-on-like impinging jet doublet was used to produce atomization. Shadowgraphs were captured in the plane of the sheet formed by the two jets using a CCD camera with an Nd:YAG laser beam providing the back-illumination. Typical behavior for impinging jet atomization using Newtonian liquids was not generally observed due to the non-Newtonian, viscous properties of the agar and kappa carrageenan gels. Instead various spray patterns were observed depending on Rej , gen - HBE. Spray characteristics of maximum instability wavelength and sheet breakup length were extracted from the shadowgraphs. Multi-University Research Initiative Grant Number W911NF-08-1-0171.

Role of coherent structures in supersonic impinging jetsa)

Science.gov (United States)

Kumar, Rajan; Wiley, Alex; Venkatakrishnan, L.; Alvi, Farrukh

2013-07-01

This paper describes the results of a study examining the flow field and acoustic characteristics of a Mach 1.5 ideally expanded supersonic jet impinging on a flat surface and its control using steady microjets. Emphasis is placed on two conditions of nozzle to plate distances (h/d), of which one corresponds to where the microjet based active flow control is very effective in reducing flow unsteadiness and near-field acoustics and the other has minimal effectiveness. Measurements include unsteady pressures, nearfield acoustics using microphone and particle image velocimetry. The nearfield noise and unsteady pressure spectra at both h/d show discrete high amplitude impinging tones, which in one case (h/d = 4) are significantly reduced with control but in the other case (h/d = 4.5) remain unaffected. The particle image velocimetry measurements, both time-averaged and phase-averaged, were used to better understand the basic characteristics of the impinging jet flow field especially the role of coherent vortical structures in the noise generation and control. The results show that the flow field corresponding to the case of least control effectiveness comprise well defined, coherent, and symmetrical vortical structures and may require higher levels of microjet pressure supply for noise suppression when compared to the flow field more responsive to control (h/d = 4) which shows less organized, competing (symmetrical and helical) instabilities.

Revision hip preservation surgery with hip arthroscopy: clinical outcomes.

Science.gov (United States)

Domb, Benjamin G; Stake, Christine E; Lindner, Dror; El-Bitar, Youseff; Jackson, Timothy J

2014-05-01

To analyze and report the clinical outcomes of a cohort of patients who underwent revision hip preservation with arthroscopy and determine predictors of positive and negative outcomes. During the study period from April 2008 to December 2010, all patients who underwent revision hip preservation with arthroscopy were included. This included patients who had previous open surgery and underwent revision with arthroscopy. Patient-reported outcome (PRO) scores were obtained preoperatively and at 3-month, 1-year, 2-year, and 3-year follow-up time points. Any revision surgeries and conversions to total hip arthroplasty were noted. A multiple regression analysis was performed to look for positive and negative predictive factors for improvement in PROs after revision hip arthroscopy. Forty-seven hips in 43 patients had completed 2 years' follow-up or needed total hip arthroplasty. The mean length of follow-up was 29 months (range, 24 to 47 months). Of the hips, 31 (66%) had either unaddressed or incompletely treated femoroacetabular impingement. There was a significant improvement in all PRO scores at a mean of 29 months after revision (P arthroscopy can achieve moderately successful outcomes and remains a viable treatment strategy after failed primary hip preservation surgery. Preoperative predictors of success after revision hip arthroscopy include segmental labral defects, unaddressed or incompletely addressed femoroacetabular impingement, heterotopic ossification, and previous open surgery. Level IV, therapeutic case series. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Internal- and External-Rotation Peak Toque in Little League Baseball Players With Subacromial Impingement Syndrome: Improved by Closed Kinetic Chain Shoulder Training.

Science.gov (United States)

Lee, Dong-Rour; Kim, Laurentius Jongsoon

2016-08-01

Many studies have explored closed kinetic chain (CKC) shoulder exercises (SEs) with a sling because they are safer and more effective than open-chain exercises, especially in early stages of treatment. However, the application of CKC SE in youth baseball players has rarely been attempted, although teenage baseball players also experience shoulder pain. To investigate the effects of CKC SE on the peak torque of shoulder internal rotation (IR) and external rotation (ER) in youth baseball players. Single-group pretest, posttest. Biomechanics laboratory. 23 Little League Baseball players with subacromial impingement syndrome. The CKC SE with a sling was CKC shoulder-flexion exercise, extension exercise, IR exercise, and ER exercise. This exercise regimen was conducted 2 or 3 times/wk for 8 wk. The peak torque of shoulder IR and ER was measured using an isokinetic dynamometer. Concentric shoulder rotation was performed, with 5 repetitions at an angular velocity of 60°/s and 15 at 180°/s. The IR and ER peak torque significantly increased at each angular velocity after the exercise program. In particular, the increase in IR and ER peak torque values was statistically significant at an angular velocity of 180°/s. CKC SE was effective in increasing shoulder IR and ER strength, demonstrating its potential benefits in the prevention and treatment of shoulder injury. In addition, increased IR peak torque appears to improve throwing velocity in baseball players.

Experimental and numerical investigation of liquid jet impingement on superhydrophobic and hydrophobic convex surfaces

International Nuclear Information System (INIS)

Kibar, Ali

2017-01-01

Experiments and numerical simulations were carried out to examine the vertical impingement a round liquid jet on the edges of horizontal convex surfaces that were either superhydrophobic or hydrophobic. The experiments examine the effects on the flow behaviour of curvature, wettability, inertia of the jet, and the impingement rate. Three copper pipes with outer diameters of 15, 22, and 35 mm were investigated. The pipes were wrapped with a piece of a Brassica oleracea leaf or a smooth Teflon sheet, which have apparent contact angles of 160° and 113°. The Reynolds number ranged from 1000 to 4500, and the impingement rates of the liquid jets were varied. Numerical results show good agreement with the experimental results for explaining flow and provide detailed information about the impingement on the surfaces. The liquid jet reflected off the superhydrophobic surfaces for all conditions. However, the jet reflected or deflected off the hydrophobic surface, depending on the inertia of the jet, the curvature of the surface, and the impingement rate. The results suggest that pressure is not the main reason for the bending of the jet around the curved hydrophobic surface. (paper)

Experimental and numerical investigation of liquid jet impingement on superhydrophobic and hydrophobic convex surfaces

Energy Technology Data Exchange (ETDEWEB)

Kibar, Ali, E-mail: alikibar@kocaeli.edu.tr [Department of Mechanical and Material Technologies, Kocaeli University, Arslanbey Campus, 41285, Kocaeli (Turkey)

2017-02-15

Experiments and numerical simulations were carried out to examine the vertical impingement a round liquid jet on the edges of horizontal convex surfaces that were either superhydrophobic or hydrophobic. The experiments examine the effects on the flow behaviour of curvature, wettability, inertia of the jet, and the impingement rate. Three copper pipes with outer diameters of 15, 22, and 35 mm were investigated. The pipes were wrapped with a piece of a Brassica oleracea leaf or a smooth Teflon sheet, which have apparent contact angles of 160° and 113°. The Reynolds number ranged from 1000 to 4500, and the impingement rates of the liquid jets were varied. Numerical results show good agreement with the experimental results for explaining flow and provide detailed information about the impingement on the surfaces. The liquid jet reflected off the superhydrophobic surfaces for all conditions. However, the jet reflected or deflected off the hydrophobic surface, depending on the inertia of the jet, the curvature of the surface, and the impingement rate. The results suggest that pressure is not the main reason for the bending of the jet around the curved hydrophobic surface. (paper)

The Relationship Between Pulsatile Flow Impingement and Intraluminal Thrombus Deposition in Abdominal Aortic Aneurysms.

Science.gov (United States)

Lozowy, Richard J; Kuhn, David C S; Ducas, Annie A; Boyd, April J

2017-03-01

Direct numerical simulations were performed on four patient-specific abdominal aortic aneurysm (AAA) geometries and the resulting pulsatile blood flow dynamics were compared to aneurysm shape and correlated with intraluminal thrombus (ILT) deposition. For three of the cases, turbulent vortex structures impinged/sheared along the anterior wall and along the posterior wall a zone of recirculating blood formed. Within the impingement region the AAA wall was devoid of ILT and remote to this region there was an accumulation of ILT. The high wall shear stress (WSS) caused by the impact of vortexes is thought to prevent the attachment of ILT. WSS from impingement is comparable to peak-systolic WSS in a normal-sized aorta and therefore may not damage the wall. Expansion occurred to a greater extent in the direction of jet impingement and the wall-normal force from the continuous impact of vortexes may contribute to expansion. It was shown that the impingement region has low oscillatory shear index (OSI) and recirculation zones can have either low or high OSI. No correlation could be identified between OSI and ILT deposition since different flow dynamics can have similar OSI values.

Surgery for subacromial impingement syndrome in relation to intensities of occupational mechanical exposures across 10-year exposure time windows.

Science.gov (United States)

Dalbøge, Annett; Frost, Poul; Andersen, Johan Hviid; Svendsen, Susanne Wulff

2018-03-01

We aimed to identify intensities of occupational mechanical exposures (force, arm elevation and repetition) that do not entail an increased risk of surgery for subacromial impingement syndrome (SIS) even after prolonged durations of exposure. Additionally, we wanted to evaluate if exposure to hand-arm vibration (HAV) is an independent risk factor. We used data from a register-based cohort study of the entire Danish working population (n=2 374 403). During follow-up (2003-2008), 14 118 first-time events of surgery for SIS occurred. For each person, we linked register-based occupational codes (1993-2007) to a general population job exposure matrix to obtain year-by-year exposure intensities on measurement scales for force, upper arm elevation >90° and repetition and expert rated intensities of exposure to HAV. For 10-year exposure time windows, we calculated the duration of exposure at specific intensities above minimal (low, medium and high). We used a logistic regression technique equivalent to discrete survival analysis adjusting for cumulative effects of other mechanical exposures. We found indications of safe exposure intensities for repetition (median angular velocity 90° >2 min/day implied an increased risk reaching ORs of 1.7 and 1.5 after 10 years at low intensities. No associations were found for HAV. We found indications of safe exposure intensities for repetition. Any intensities of force and upper arm elevation >90° above minimal implied an increased risk across 10-year exposure time windows. No independent associations were found for HAV. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Hot air impingement on a flat plate using Large Eddy Simulation (LES) technique

Science.gov (United States)

Plengsa-ard, C.; Kaewbumrung, M.

2018-01-01

Impinging hot gas jets to a flat plate generate very high heat transfer coefficients in the impingement zone. The magnitude of heat transfer prediction near the stagnation point is important and accurate heat flux distribution are needed. This research studies on heat transfer and flow field resulting from a single hot air impinging wall. The simulation is carried out using computational fluid dynamics (CFD) commercial code FLUENT. Large Eddy Simulation (LES) approach with a subgrid-scale Smagorinsky-Lilly model is present. The classical Werner-Wengle wall model is used to compute the predicted results of velocity and temperature near walls. The Smagorinsky constant in the turbulence model is set to 0.1 and is kept constant throughout the investigation. The hot gas jet impingement on the flat plate with a constant surface temperature is chosen to validate the predicted heat flux results with experimental data. The jet Reynolds number is equal to 20,000 and a fixed jet-to-plate spacing of H/D = 2.0. Nusselt number on the impingement surface is calculated. As predicted by the wall model, the instantaneous computed Nusselt number agree fairly well with experimental data. The largest values of calculated Nusselt number are near the stagnation point and decrease monotonically in the wall jet region. Also, the contour plots of instantaneous values of wall heat flux on a flat plate are captured by LES simulation.

Quantitative and qualitative analyses of subacromial impingement by kinematic open MRI.

Science.gov (United States)

Tasaki, Atsushi; Nimura, Akimoto; Nozaki, Taiki; Yamakawa, Akira; Niitsu, Mamoru; Morita, Wataru; Hoshikawa, Yoshimitsu; Akita, Keiichi

2015-05-01

Quantitative and qualitative kinematic analyses of subacromial impingement by 1.2T open MRI were performed to determine the location of impingement and the involvement of the acromioclavicular joint. In 20 healthy shoulders, 10 sequential images in the scapular plane were taken in a 10-s pause at equal intervals from 30° to maximum abduction in neutral and internal rotation. The distances between the rotator cuff (RC) and the acromion and the acromioclavicular joint were measured. To comprehend the positional relationships, cadaveric specimens were also observed. Although asymptomatic, the RC came into contact with the acromion and the acromioclavicular joint in six and five cases, respectively. The superior RC acted as a depressor for the humeral head against the acromion as the shoulder elevated. The mean elevation angle and distance at the closest position between the RC and the acromion in neutral rotation were 93.5° and 1.6 mm, respectively, while those between the RC and the acromioclavicular joint were 86.7° and 2.0 mm. When comparing this distance and angle, there was no significant difference between the RC to the acromion and to the acromioclavicular joint. The minimum distance between the RC and the acromion was significantly shorter than that between the greater tuberosity and the acromion. The location of RC closest to the acromion and the acromioclavicular joint differed significantly. Although asymptomatic, contact was found between the RC and the acromion and the acromioclavicular joint. The important role of the RC to prevent impingement was observed, and hence, dysfunction of the RC could lead to impingement that could result in a RC lesion. The RC lesions may differ when they are caused by impingement from either the acromion or the acromioclavicular joint.

Influence of thermal gradient on gas turbine combustor wall using impingement/effusion cooling techniques: CHT CFD predictions

Directory of Open Access Journals (Sweden)

A. M. El-jummah

2017-04-01

Full Text Available Internal wall heat transfer relevant to impingement/effusion cooling techniques was investigated using conjugate heat transfer (CHT computational fluid dynamics (CFD with ANSYS Fluent and ICEM commercial software. This work concentrates on the development of CHT CFD design procedures that are applicable to combustor wall and turbine blade heat transfer optimisation in gas turbine (GT. It specifically modelled and compares two configuration which are specifically relevant to the impingement and effusion holes density n (m-2 and is the ratio of the hole pitch X2. The configurations investigated are equal and unequal impingement and effusion holes density n (m-2, respectively, whereby in each case the variation in the number of cooling holes were carried out. The ratio of impingement and effusion number of holes/m2 (or hole density n, investigated were impingement/effusion: 4306/4306 and 1076/4306, respectively. The geometries were for impingement wall, hole pitch X to diameter D, X/D ratio of ~ 11 but different number of holes N for both n geometries, at a constant offset effusion wall, hole X/D of 4.7 of the same N for both the two configurations. The model geometries have a constant impingement gap of 8 mm with both impingement and effusion walls at 6.35 mm thick Nimonic - 75 material and were computed for varied air mass flux G from 0.1 - 0.94 kg/sm2. Symmetrical applications were employed in modelling each of the geometry, whereby for the impingement hole, only quarter of one hole was modelled, while for the effusion side the holes were either quarter or half modelled. The two n geometries were computed with k - ɛ turbulence model using standard wall functions, which also applies to all G. The predicted locally surface X2 (or hole square area average heat transfer coefficient (HTC h values compared with with previously published experimental data showed good agreement. The reduced internal gap flow recirculation with reduced heat transfer to

Hofteartroskopi

DEFF Research Database (Denmark)

Lund, Bent; Søballe, Kjeld; Winge, Søren

2011-01-01

This review article describes the role of hip arthroscopy and the development of the technique over the past decade. The refinement of this technique has led to the discovery of ''new'' diseases of the hip joint. Recently, femoro-acetabular impingement (FAI) has been proposed as a source of soft...... tissue dysfunction, motion loss, and early osteoarthritis in the hip. Recognition of FAI is important, as failure to address this underlying pathology may lead to early onset osteoarthritis and subsequent hip replacement. The preliminary results after hip arthroscopy are described....

Hip joint pathology

DEFF Research Database (Denmark)

Tijssen, M; van Cingel, R E H; de Visser, E

2017-01-01

The purpose of this retrospective cohort study was to (a) describe the clinical presentation of femoroacetabular impingement (FAI) and hip labral pathology; (b) describe the accuracy of patient history and physical tests for FAI and labral pathology as confirmed by hip arthroscopy. Patients (18......-65 years) were included if they were referred to a physical therapist to gather pre-operative data and were then diagnosed during arthroscopy. Results of pre-operative patient history and physical tests were collected and compared to arthroscopy. Data of 77 active patients (mean age: 37 years) were...

Pollutant emission and noise radiation from open and impinging inverse diffusion flames

International Nuclear Information System (INIS)

Choy, Y.S.; Zhen, H.S.; Leung, C.W.; Li, H.B.

2012-01-01

Highlights: ► The effect of burner geometry (d air and S) on inverse diffusion flames is studied. ► With fixed air/fuel supplies, a smaller d air curtails NO x emission but augments noise radiation. ► With fixed air/fuel supplies, a larger S reduces NO x emission but increases noise radiation. ► Both NO x emission and noise radiation are maximum under stoichiometric combustion. ► Impinging flames are nosier than corresponding open flames due to the mirror effect of the plate. -- Abstract: This paper reports an experimental investigation of the pollutant emission and noise radiation characteristics of both open and impinging inverse diffusion flames (IDFs), produced by five burners of different air port diameter (d air = 5, 6 and 6.84 mm) and air-to-fuel spacing (S = 8, 11.5 and 15 mm). The effects of d air , S, overall equivalence ratio φ and nozzle-to-plate spacing H on the pollutant emissions of CO and NO x and the noise radiation are examined. The results show that at fixed air flow rate, a smaller d air curtails NO x emission but augments noise radiation, indicative of a role played by turbulence, which tends to decrease pollutant emission and increase noise radiation. A larger S reduces NO x emission but increases noise radiation, indicating that different flame zones may be responsible for pollutant emission and noise radiation. When the IDF is under stoichiometric φ = 1.6, both the NO x emission and noise radiation are highest, as a result of maximum heat release rate. A comparison of EINO x for the open and impinging IDFs shows that the impinging IDFs emit more NO x probably due to the absence of NO reburning. The impinging IDFs have higher noise radiation than the corresponding open IDFs. A higher level of noise radiation from the impinging IDFs is observed as the target plate is brought closer to the burner.

Outdoor Performance Analysis of a Photovoltaic Thermal (PVT) Collector with Jet Impingement and Compound Parabolic Concentrator (CPC).

Science.gov (United States)

Jaaz, Ahed Hameed; Hasan, Husam Abdulrasool; Sopian, Kamaruzzaman; Kadhum, Abdul Amir H; Gaaz, Tayser Sumer; Al-Amiery, Ahmed A

2017-08-01

This paper discusses the effect of jet impingement of water on a photovoltaic thermal (PVT) collector and compound parabolic concentrators (CPC) on electrical efficiency, thermal efficiency and power production of a PVT system. A prototype of a PVT solar water collector installed with a jet impingement and CPC has been designed, fabricated and experimentally investigated. The efficiency of the system can be improved by using jet impingement of water to decrease the temperature of the solar cells. The electrical efficiency and power output are directly correlated with the mass flow rate. The results show that electrical efficiency was improved by 7% when using CPC and jet impingement cooling in a PVT solar collector at 1:00 p.m. (solar irradiance of 1050 W/m² and an ambient temperature of 33.5 °C). It can also be seen that the power output improved by 36% when using jet impingement cooling with CPC, and 20% without CPC in the photovoltaic (PV) module at 1:30 p.m. The short-circuit current I SC of the PV module experienced an improvement of ~28% when using jet impingement cooling with CPC, and 11.7% without CPC. The output of the PV module was enhanced by 31% when using jet impingement cooling with CPC, and 16% without CPC.

Current standard rules of combined anteversion prevent prosthetic impingement but ignore osseous contact in total hip arthroplasty.

Science.gov (United States)

Weber, Markus; Woerner, Michael; Craiovan, Benjamin; Voellner, Florian; Worlicek, Michael; Springorum, Hans-Robert; Grifka, Joachim; Renkawitz, Tobias

2016-12-01

In this prospective study of 135 patients undergoing cementless total hip arthroplasty (THA) we asked whether six current definitions of combined anteversion prevent impingement and increase postoperative patient individual impingement-free range-of-motion (ROM). Implant position was measured by an independent, external institute on 3D-CT performed six weeks post-operatively. Post-operative ROM was calculated using a CT-based algorithm detecting osseous and/or prosthetic impingement by virtual hip movement. Additionally, clinical ROM was evaluated pre-operatively and one-year post-operatively by a blinded observer. Combined component position of cup and stem according to the definitions of Ranawat, Widmer, Dorr, Hisatome and Yoshimine inhibited prosthetic impingement in over 90 %, while combined osseous and prosthetic impingement still occurred in over 40 % of the cases. The recommendations by Jolles, Widmer, Dorr, Yoshimine and Hisatome enabled higher flexion (p ≤ 0.001) and internal rotation (p ≤ 0.006). Clinically, anteversion rules of Widmer and Yoshimine provided one-year post-operatively statistically but not clinically relevant higher internal rotation (p ≤0.034). Standard rules of combined anteversion detect prosthetic but fail to prevent combined osseous and prosthetic impingement in THA. Future models will have to account for the patient-individual anatomic situation to ensure impingement-free ROM.

Physical Modelling of Axisymmetric Turbulent Impinging Jets as used within the Nuclear Industry for Mobilisation of Sludges

International Nuclear Information System (INIS)

McKendrick, D.; Biggs, S.R.; Fairweather, M.; Rhodes, D.

2008-01-01

The impingement of a fluid jet onto a surface has broad applications across many industries. Within the UK nuclear industry, during the final stages of fuel reprocessing, impinging fluid jets are utilised to mobilise settled sludge material within storage tanks and ponds in preparation for transfer and ultimate immobilisation through vitrification. Despite the extensive applications of impinging jets within the nuclear and other industries, the study of two-phase, solid loaded, impinging jets is limited, and generally restricted to computational modelling. Surprisingly, very little fundamental understanding of the turbulence structure within such fluid flows through experimental investigation is found within the literature. The physical modelling of impinging jet systems could successfully serve to aid computer model validation, determine operating requirements, evaluate plant throughput requirements, optimise process operations and support design. Within this project a method is illustrated, capable of exploring the effects of process and material variables on flow phenomena of impinging jets. This is achieved via the use of non-intrusive measurement techniques Particle Image Velocimetry (PIV), Ultrasonic Doppler Velocity Profiler (UDVP) and high speed imaging. The turbulence structure for impinging jets, and their resultant radial wall jets, is presented at different jet-to-plate ratios, jet Reynolds numbers and jet outlet diameters. (authors)

Technical innovation: digital tomosynthesis of the hip following intra-articular administration of contrast

International Nuclear Information System (INIS)

Gazaille, Roland E.; Flynn, Michael J.; Page, Walter; Finley, Sonia; Holsbeeck, Marnix van

2011-01-01

To demonstrate the clinical use of digital tomosynthesis in the depiction of labral and chondral pathology in the setting of post-operative CAM-type impingement of the hip following intra-articular administration of dilute iodinated contrast. We present images from a 46 year-old African American female with suspected CAM-type femoroacetabular impingement (FAI) following percutaneous pinning of the right hip for slipped capital femoral epiphysis (SCFE). A partial tear of the labrum and clinically significant acetabular chondral abnormalities were demonstrated with the use of digital tomosynthesis with superb anatomic detail. Digital tomosynthesis can be of great clinical utility and can depict pathology in superb anatomic detail, particularly in situations in which MRI is not available as well as under circumstances in which artifact due to orthopedic hardware is of concern as shown in this case. (orig.)

Impingement and entrainment of fishes at the Savannah River Plant: an NPDES 316b demonstration

International Nuclear Information System (INIS)

McFarlane, R.W.; Frietsche, R.F.; Miracle, R.D.

1978-02-01

Environmental impacts of the Savannah River Plant's withdrawal of Savannah River water include impingement of juvenile and adult fish on trash removal screens, and entrainment of planktonic fish eggs and larval fish into the pumping system. The Savannah River Plant (SRP) has the capacity to pump 3.6 million cubic meters of water per day--25% of the minimal river discharge--for cooling and other purposes. Present removal is 7% of the actual river discharge. In the river and intake canals reside sixty-nine species of fishes. The species composition of the resident fish community of the intake canals is similar to the species composition in the river, but different in relative species abundance. The dominant sunfishes tend to reside in the canals for long periods and seldom go from canal to canal. The fish impingement rate at the plant ranks very low in comparison with electric power plants on inland waters. Thirty-five species of fishes were impinged during 1977. The average impingement rate of 7.3 fish per day extrapolates to 2,680 fish per year. No single species comprised more than 10% of the sample. The most commonly impinged species were bluespotted sunfish, warmouth, channel catfish, and yellow perch. The relative abundance of those species impinged deviates from their relative abundance in the canal fish population

Numerical study of a hybrid jet impingement/micro-channel cooling scheme

International Nuclear Information System (INIS)

Barrau, Jérôme; Omri, Mohammed; Chemisana, Daniel; Rosell, Joan; Ibañez, Manel; Tadrist, Lounes

2012-01-01

A new hybrid jet impingement/micro-channel cooling scheme is studied numerically for use in high-heat-flux thermal management of electronic and power devices. The device is developed with the objective of improving the temperature uniformity of the cooled object. A numerical model based on the k–ω SST turbulent model is developed and validated experimentally. This model is used to carry out a parametrical characterization of the heat sink. The study shows that variations in key parameters of jet impingement and micro-channel technologies allow for the cooling scheme to obtain a wide range of temperature profiles for the cooled object. - Highlights: ► A new hybrid cooling scheme is numerically studied. ► The cooling scheme combines the benefits of jet impingement and micro-channel flows. ► The numerical model is validated by comparison with experimental results. ► The temperature distribution can be adapted to the needs of the cooled system.

Estudo anatômico do terço proximal do fêmur: impacto femoroacetabular e o efeito cam Anatomic study of the proximal third of the femur: femoroacetabular impact and the cam effect

Directory of Open Access Journals (Sweden)

Pedro José Labronici

2009-04-01

Full Text Available OBJETIVO: Analisar as varia��ões anatômicas da extremidade proximal do fêmur que pudessem desenvolver o impacto femoroacetabular. MÉTODOS: Foram utilizados 199 espécimes anatômicos de fêmures esqueleticamente maduros. Os fêmures foram medidos para determinar o ângulo da anteversão do colo femoral, ângulo cervicodiafisário, esfericidade da cabeça femoral em ântero-posterior e súpero-inferior, ângulo entre a epífise e o colo femoral anterior, ângulo entre a epífise e o colo em perfil, distância em ântero-posterior a 5mm da junção cabeça e colo e distância em ântero-posterior da base do colo. RESULTADOS: Observou-se que o subgrupo com impacto apresentou diâmetro da junção a 5mm (p = 0,0001 e cam-cabeça (% (p = 0,0001 significativamente maiores e base-cam (% (p = 0,0001 significativamente menor que o subgrupo sem impacto. Identificou-se que cam-cabeça (% > 80 e base-cam (% OBJECTIVE: to analyze anatomical variations of the proximal end of femur that could cause a femoroacetabular impact. METHODS: 199 skeletically mature anatomical specimens of femurs were used. The femurs were measured in order to determine the anteversion angle of the femoral neck, neckshaft angle, sphericity of the femoral head at anteroposterior and superoinferior, angle between epiphysis and the anterior femoral neck, angle between epiphysis and the neck at lateral plane, anteroposterior distance at 5mm of the head and neck junction and anteroposterior distance of the neck base. RESULTS: we found that the impact subgroup presented a significantly larger junction diameter of 5mm (p = 0.0001 and cam-head (% (p= 0.0001, while base-cam (% (p = 0.0001 showed a significantly smaller diameter than the subgroup without impact. It was identified that cam-head (% > 80 e base-cam (% < 73 were identified as the optimal impact points. CONCLUSION: our study showed that the effect cam, caused by anatomical variations of the proximal femoral end focused the

Cryogenic Impinging Jets Subjected to High Frequency Transverse Acoustic Forcing in a High Pressure Environment

Science.gov (United States)

2016-07-27

impingement sheet – Probably due to a impingement point physically moving Distribution A: Approved for Public Release; Distribution Unlimited. PA# 16333 22...AIAA-92- 0458 30th ASM 7. N. Bremond and E. Villermaux, “Atomization by jet impact”, J. Fluid Mech 2006, vol.549, 273-306 8. W.E. Anderson, H. M. Ryan...Sheets formed by Impinging Jets in High Pressure Environments,” AIAA-2004-3526 40th ASM 11. X. Chen, D. Ma, and V. Yang, “Mechanism Study of Impact Wave

Outdoor Performance Analysis of a Photovoltaic Thermal (PVT Collector with Jet Impingement and Compound Parabolic Concentrator (CPC

Directory of Open Access Journals (Sweden)

Ahed Hameed Jaaz

2017-08-01

Full Text Available This paper discusses the effect of jet impingement of water on a photovoltaic thermal (PVT collector and compound parabolic concentrators (CPC on electrical efficiency, thermal efficiency and power production of a PVT system. A prototype of a PVT solar water collector installed with a jet impingement and CPC has been designed, fabricated and experimentally investigated. The efficiency of the system can be improved by using jet impingement of water to decrease the temperature of the solar cells. The electrical efficiency and power output are directly correlated with the mass flow rate. The results show that electrical efficiency was improved by 7% when using CPC and jet impingement cooling in a PVT solar collector at 1:00 p.m. (solar irradiance of 1050 W/m2 and an ambient temperature of 33.5 °C. It can also be seen that the power output improved by 36% when using jet impingement cooling with CPC, and 20% without CPC in the photovoltaic (PV module at 1:30 p.m. The short-circuit current ISC of the PV module experienced an improvement of ~28% when using jet impingement cooling with CPC, and 11.7% without CPC. The output of the PV module was enhanced by 31% when using jet impingement cooling with CPC, and 16% without CPC.

Muscle shortening maneuver and not topical anti-inflammatory therapy is effective in reducing the width of subacromial-subdeltoid bursa in shoulder impingement syndrome

Science.gov (United States)

Melchiorre, Daniela; Lippi, Paolo; Marchi, Alberto; Maresca, Marco; Bravi, Riccardo; Eros, Quarta; Lazzerini, Patrizia; Bagni, Maria Angela

2018-04-01

Aim of the study was to compare the efficacy of a muscle shortening maneuver (MSM) with the efficacy of a topical NSAID (flurbiprofen) in patients with subacromial impingement syndrome (SIS). The effects of these therapies were evaluated by sonographic exam (US). SIS was diagnosed by US in 78 patients with painful shoulder. Thirty patients (first group) were treated with topical flurbiprofen for 15 days. Forty-eight patients (second group) were treated with MSM, which was performed once. The shoulder was analyzed in all patients by US before and after treatment. Before treatment and 15 days after treatment, pain by Visual Analogue Scale (VAS), range of motion (ROM) and Neer's Test were evaluated. Pain was decreased by both treatments. In only 8 patients of the first group, the encroachment of acromion into the rotator cuff was no more detectable by US after the treatment; ROM increased (> 45°) only in 11 patients (36%) and the width of subacromial-subdeltoid bursa (SSB) was not significantly reduced. At variance with the results obtained in the first group, in all patients of the second group the encroachment of acromion was no more detectable by US, ROM increased (> 45°) and the width of SSB was significantly reduced after the maneuver. Both topical flurbiprofen and MSM were helpful in pain control, but better results, with decrease of width of SSB assessed by US, were obtained by MSM.

The influence of material hardness on liquid droplet impingement erosion

International Nuclear Information System (INIS)

Fujisawa, Nobuyuki; Yamagata, Takayuki; Takano, Shotaro; Saito, Kengo; Morita, Ryo; Fujiwara, Kazutoshi; Inada, Fumio

2015-01-01

Highlights: • Liquid droplet impingement erosion is studied for various metal materials. • Average power dependency on droplet velocity is found as 7. • Power dependency on Vickers hardness is found as −4.5. • An empirical formula is constructed for erosion rates of metal materials. • Predicted erosion rate is well correlated with experiment within a factor of 1.5. - Abstract: This paper describes the experimental study on the liquid droplet impingement erosion of metal materials to understand the influence of material hardness on the erosion rate. The experiment is carried out using a water spray jet apparatus with a condition of relatively thin liquid film thickness. The metal materials tested are pure aluminum, aluminum alloy, brass, mild steel, carbon steel and stainless steel. The liquid droplets considered are 30 ± 5 μm in volume average diameter of water, which is the same order of droplet diameter in the actual pipeline in nuclear/fossil power plants. In order to understand the influence of material hardness on the liquid droplet impingement erosion, the scanning electron microscope (SEM) observation on the eroded surface and the measurement of erosion rate are carried out in the terminal stage of erosion. The experimental results indicate that the erosion rates are expressed by the droplet velocity, volume flux, Vickers hardness and the liquid film thickness, which are fundamentals of the liquid droplet impingement erosion. The empirical formula shows that the power index for droplet velocity dependency is found to be 7 with a scattering from 5 to 9 depending on the materials, while the power index for Vickers hardness dependency is found as −4.5

The influence of material hardness on liquid droplet impingement erosion

Energy Technology Data Exchange (ETDEWEB)

Fujisawa, Nobuyuki, E-mail: fujisawa@eng.niigata-u.ac.jp [Visualization Research Center, Niigata University, 8050, Ikarashi 2-Nocho, Nishi-ku, Niigata 950-2181 (Japan); Yamagata, Takayuki, E-mail: yamagata@eng.niigata-u.ac.jp [Visualization Research Center, Niigata University, 8050, Ikarashi 2-Nocho, Nishi-ku, Niigata 950-2181 (Japan); Takano, Shotaro; Saito, Kengo [Graduate School of Science and Technology, Niigata University, 8050, Ikarashi 2-Nocho, Nishi-ku, Niigata 950-2181 (Japan); Morita, Ryo; Fujiwara, Kazutoshi; Inada, Fumio [Central Research Institute of Electric Power Industry, 2-11-1, Iwatokita, Komae, Tokyo 201-8511 (Japan)

2015-07-15

Highlights: • Liquid droplet impingement erosion is studied for various metal materials. • Average power dependency on droplet velocity is found as 7. • Power dependency on Vickers hardness is found as −4.5. • An empirical formula is constructed for erosion rates of metal materials. • Predicted erosion rate is well correlated with experiment within a factor of 1.5. - Abstract: This paper describes the experimental study on the liquid droplet impingement erosion of metal materials to understand the influence of material hardness on the erosion rate. The experiment is carried out using a water spray jet apparatus with a condition of relatively thin liquid film thickness. The metal materials tested are pure aluminum, aluminum alloy, brass, mild steel, carbon steel and stainless steel. The liquid droplets considered are 30 ± 5 μm in volume average diameter of water, which is the same order of droplet diameter in the actual pipeline in nuclear/fossil power plants. In order to understand the influence of material hardness on the liquid droplet impingement erosion, the scanning electron microscope (SEM) observation on the eroded surface and the measurement of erosion rate are carried out in the terminal stage of erosion. The experimental results indicate that the erosion rates are expressed by the droplet velocity, volume flux, Vickers hardness and the liquid film thickness, which are fundamentals of the liquid droplet impingement erosion. The empirical formula shows that the power index for droplet velocity dependency is found to be 7 with a scattering from 5 to 9 depending on the materials, while the power index for Vickers hardness dependency is found as −4.5.

Impingement wastage experiments with 9Cr 1Mo steel

Energy Technology Data Exchange (ETDEWEB)

Kishore, S., E-mail: skishore@igcar.gov.in [IGCAR (India); Beauchamp, François; Allou, Alexandre [CEA (France); Kumar, A. Ashok; Chandramouli, S.; Rajan, K.K. [IGCAR (India)

2016-02-15

Highlights: • Sodium heated steam generators are crucial components of fast breeder reactors. • A leak in steam generator tube will cause sodium water reaction that damages the tubes. • A collaborative study by CEA and IGCAR was conducted to quantify the extent of damage on 9Cr 1Mo tube due to a steam/water leak. • It was compared against the predictions of PROPANA code. - Abstract: Steam Generator (SG) is one of the vital components of sodium cooled fast reactor (SFR). The main safety concern with SG is a probable sodium–water reaction. In case, one of its water/steam carrying tubes leaks, water/steam gets into contact with sodium causing sodium-water reaction, which is highly exothermic and producing corrosive NaOH and hydrogen. The ejecting reaction products at high temperature, impinges upon adjacent tubes by a process called impingement wastage. It could damage one of the neighboring tubes in a short time, if the detection and protection systems are failing. IGCAR and CEA carried out a collaborative study on impingement wastage of 9Cr 1Mo steel, which is one of the candidate materials for SFR SG tubes. The studies comprise of experimental works at IGCAR and simulation works with PROPANA code at CEA. This paper brings out the data and experience gained through this cooperative work.

Active Control of Supersonic Impinging Jets Using Supersonic Microjets

National Research Council Canada - National Science Library

Alvi, Farrukh

2005-01-01

.... Supersonic impinging jets occur in many applications including in STOVL aircraft where they lead to a highly oscillatory flow with very high unsteady loads on the nearby aircraft structures and the landing surfaces...

Outcomes of cup revision for ilio-psoas impingement after total hip arthroplasty: Retrospective study of 46 patients.

Science.gov (United States)

Batailler, C; Bonin, N; M Wettstein; Nogier, A; Martres, S; Ollier, E; May, O; Lustig, S

2017-12-01

Impingement of the ilio-psoas tendon on the acetabular component is a cause of pain after total hip arthroplasty (THA). Studies of cup revision for ilio-psoas impingement (IPI) are scarce and limited in size. We therefore conducted a large multicentre retrospective study with the following objectives: to assess the effectiveness of cup replacement in resolving the impingement syndrome, to determine the frequency and nature of complications after cup revision for IPI, and to identify pre-operative factors associated with good outcomes of cup revision for IPI. Cup revision is effective in resolving the pain due to IPI in selected patients. This retrospective multicentre study included 46 patients who underwent cup revision because of IPI. Before the revision, 38 (83%) patients had prominence of the anterior cup rim (mean, 9.9±4.5mm (range, 2-22mm) by radiography and 35 (76%) had cup malposition (anteversion50°). Mean follow-up was 21months (range, 6months to 6 years) and no patient was lost to follow-up. Outcomes at last follow-up were assessed based on the Oxford Hip Score (OHS), patient satisfaction index, complications, and revisions. At last follow-up, 39 (85%) patients were satisfied with the revision procedure, a significant improvement versus baseline was noted in the OHS (mean, 43±6; range, 25-48; P<0.001), and 41 patients were free of pain during hip flexion (P<0.001 versus baseline). Complications occurred in 3 (6.5%) patients, but only one complication was severe (deep infection). Recurrent groin pain was reported by 4 (8.7%) patients at last follow-up. None of the factors studied predicted the outcome of revision surgery. Cup revision for IPI after THA is effective in relieving the groin pain in 80% of patients with anterior cup rim prominence and/or cup malposition. However, complications can occur. Tenotomy may be preferable when the diagnosis is in doubt and/or cup position is acceptable. IV, retrospective observational study. Published by Elsevier

Impinging jets controlled by fluidic input signal

Czech Academy of Sciences Publication Activity Database

Tesař, Václav; Trávníček, Zdeněk; Peszyński, K.

2016-01-01

Roč. 249, October (2016), s. 85-92 ISSN 0924-4247 R&D Projects: GA ČR GA13-23046S; GA ČR GA14-08888S Institutional support: RVO:61388998 Keywords : fluidics * jets * impinging jets * coanda effect Subject RIV: BK - Fluid Dynamics Impact factor: 2.499, year: 2016 http://www.sciencedirect.com/science/article/pii/S0924424716303880

FLOW VISUALIZATION OF RECTANGULAR SLOT AIR JET IMPINGEMENT ON FLAT SURFACES

OpenAIRE

Satheesha V *1, B. K. Muralidhra2, Abhilash N3, C. K. Umesh4

2018-01-01

Jet impingement near the mid-chord of the gas turbine blade is treated as a flat plate. Experimental and numerical investigations are carried out for a single slot air jet impinging on flat surface for two different rectangular slots of dimension (3mm x 65 mm) and (5mm x 65 mm). Experimentation is done to study the flow pattern topography on the flat target plate, with varying the flow rate from 20 LPM to 50 LPM by varying the nozzle to plate distance from 9 mm to 24 mm for slot jet of 3mm an...

Numerical analysis of droplet impingement using the moving particle semi-implicit method

International Nuclear Information System (INIS)

Xiong, Jinbiao; Koshizuka, Seiichi; Sakai, Mikio

2010-01-01

Droplet impingement onto a rigid wall is simulated in two and three dimensions using the moving particle semi-implicit method. In two-dimensional calculations, the convergence is achieved and the propagation of a shockwave in a droplet is captured. The average pressure on the contact area decreases gradually after the maximum value. The numerically obtained maximum average impact pressure agrees with the Heymann correlation. A large shear stress appears at the contact edge due to jetting. A parametric study shows that the droplet diameter has only a minor effect on the pressure load due to droplet impingement. When the impingement takes place from an impact angle of π/4 rad, the pressure load and shear stress show a dependence only on the normal velocity to the wall. A comparison between the three-dimensional and two-dimensional results shows that consideration of the three-dimensional effect can decrease the average impact pressure by about 12%. (author)

Hybrid RANS/LES of flow and heat transfer in round impinging jets

International Nuclear Information System (INIS)

Kubacki, Slawomir; Dick, Erik

2011-01-01

Fluid flow and convective heat transfer predictions are presented of round impinging jets for several combinations of nozzle-plate distances H/D = 2, 6 and 13.5 (where D is the nozzle diameter) and Reynolds numbers Re = 5000, 23,000 and 70,000 with the newest version of the k-ω model of and three hybrid RANS/LES models. In the RANS mode of the hybrid RANS/LES models, the k-ω model is recovered. Three formulations are considered to activate the LES mode. The first model is similar to the hybrid models of and . The turbulent length scale is replaced by the grid size in the destruction term of the k-equation and in the definition of the RANS eddy viscosity. As grid size, a maximum measure of the hexahedral grid cell is used. The second model has the same k-equation, but the eddy viscosity is the minimum of the k-ω eddy viscosity and the Smagorinsky eddy viscosity, following a proposal by . The Smagorinsky eddy viscosity is formed with the cube root of the cell volume. The third model has, again, the same k-equation, but has an eddy viscosity which is an intermediate between the eddy viscosities of the first and second models. This is reached by using the cube root of the cell volume in the eddy viscosity formula of the first model. The simulation results are compared with experimental data for the high Reynolds number cases Re = 23,000 and Re = 70,000 and LES data for the low-Reynolds number case Re = 5000. The Reynolds numbers are defined with the nozzle diameter and the bulk velocity at nozzle outlet. At low nozzle-plate distance (the impingement plate is in the core of the jet), turbulent kinetic energy is overpredicted by RANS in the stagnation flow region. This leads to overprediction of the heat transfer rate along the impingement plate in the impact zone. At high nozzle-plate distance (the impingement plate is in the mixed-out region of the jet), the turbulence mixing is underpredicted by RANS in the shear layer of the jet which gives a too high length of

Mapping of local argon impingement on a virtual surface: an insight for gas injection during FEBID

Energy Technology Data Exchange (ETDEWEB)

Wanzenboeck, H.D.; Hochleitner, G.; Mika, J.; Shawrav, M.M.; Gavagnin, M.; Bertagnolli, E. [Vienna University of Technology, Institute for Solid State Electronics, Vienna (Austria)

2014-12-15

During the last decades, focused electron beam induced deposition (FEBID) has become a successful approach for direct-write fabrication of nanodevices. Such a deposition technique relies on the precursor supply to the sample surface which is typically accomplished by a gas injection system using a tube-shaped injector nozzle. This precursor injection strategy implies a position-dependent concentration gradient on the surface, which affects the geometry and chemistry of the final nanodeposit. Although simulations already proposed the local distribution of nozzle-borne gas molecules impinging on the surface, this isolated step in the FEBID process has never been experimentally measured yet. This work experimentally investigates the local distribution of impinging gas molecules on the sample plane, isolating the direct impingement component from surface diffusion or precursor depletion by deposition. The experimental setup used in this work maps and quantifies the local impinging rate of argon gas over the sample plane. This setup simulates the identical conditions for a precursor molecule during FEBID. Argon gas was locally collected with a sniffer tube, which is directly connected to a residual gas analyzer for quantification. The measured distribution of impinging gas molecules showed a strong position dependence. Indeed, a 300-μm shift of the deposition area to a position further away from the impingement center spot resulted in a 50 % decrease in the precursor impinging rate on the surface area. With the same parameters, the precursor distribution was also simulated by a Monte Carlo software by Friedli and Utke and showed a good correlation between the empirical and the simulated precursor distribution. The results hereby presented underline the importance of controlling the local precursor flux conditions in order to obtain reproducible and comparable deposition results in FEBID. (orig.)

Mapping of local argon impingement on a virtual surface: an insight for gas injection during FEBID

International Nuclear Information System (INIS)

Wanzenboeck, H.D.; Hochleitner, G.; Mika, J.; Shawrav, M.M.; Gavagnin, M.; Bertagnolli, E.

2014-01-01

During the last decades, focused electron beam induced deposition (FEBID) has become a successful approach for direct-write fabrication of nanodevices. Such a deposition technique relies on the precursor supply to the sample surface which is typically accomplished by a gas injection system using a tube-shaped injector nozzle. This precursor injection strategy implies a position-dependent concentration gradient on the surface, which affects the geometry and chemistry of the final nanodeposit. Although simulations already proposed the local distribution of nozzle-borne gas molecules impinging on the surface, this isolated step in the FEBID process has never been experimentally measured yet. This work experimentally investigates the local distribution of impinging gas molecules on the sample plane, isolating the direct impingement component from surface diffusion or precursor depletion by deposition. The experimental setup used in this work maps and quantifies the local impinging rate of argon gas over the sample plane. This setup simulates the identical conditions for a precursor molecule during FEBID. Argon gas was locally collected with a sniffer tube, which is directly connected to a residual gas analyzer for quantification. The measured distribution of impinging gas molecules showed a strong position dependence. Indeed, a 300-μm shift of the deposition area to a position further away from the impingement center spot resulted in a 50 % decrease in the precursor impinging rate on the surface area. With the same parameters, the precursor distribution was also simulated by a Monte Carlo software by Friedli and Utke and showed a good correlation between the empirical and the simulated precursor distribution. The results hereby presented underline the importance of controlling the local precursor flux conditions in order to obtain reproducible and comparable deposition results in FEBID. (orig.)

Mapping of local argon impingement on a virtual surface: an insight for gas injection during FEBID

Science.gov (United States)

Wanzenboeck, H. D.; Hochleitner, G.; Mika, J.; Shawrav, M. M.; Gavagnin, M.; Bertagnolli, E.

2014-12-01

During the last decades, focused electron beam induced deposition (FEBID) has become a successful approach for direct-write fabrication of nanodevices. Such a deposition technique relies on the precursor supply to the sample surface which is typically accomplished by a gas injection system using a tube-shaped injector nozzle. This precursor injection strategy implies a position-dependent concentration gradient on the surface, which affects the geometry and chemistry of the final nanodeposit. Although simulations already proposed the local distribution of nozzle-borne gas molecules impinging on the surface, this isolated step in the FEBID process has never been experimentally measured yet. This work experimentally investigates the local distribution of impinging gas molecules on the sample plane, isolating the direct impingement component from surface diffusion or precursor depletion by deposition. The experimental setup used in this work maps and quantifies the local impinging rate of argon gas over the sample plane. This setup simulates the identical conditions for a precursor molecule during FEBID. Argon gas was locally collected with a sniffer tube, which is directly connected to a residual gas analyzer for quantification. The measured distribution of impinging gas molecules showed a strong position dependence. Indeed, a 300-µm shift of the deposition area to a position further away from the impingement center spot resulted in a 50 % decrease in the precursor impinging rate on the surface area. With the same parameters, the precursor distribution was also simulated by a Monte Carlo software by Friedli and Utke and showed a good correlation between the empirical and the simulated precursor distribution. The results hereby presented underline the importance of controlling the local precursor flux conditions in order to obtain reproducible and comparable deposition results in FEBID.

Study on pipe wastage mechanism by liquid droplet impingement erosion

International Nuclear Information System (INIS)

Higashi, Yuma; Narabayashi, Tadashi; Shimazu, Yoichiro; Tsuji, Masashi; Ohmori, Shuichi; Mori, Michitsugu; Tezuka, Kenichi

2009-01-01

Evaluation of wastage speed for nuclear power plant maintains plant reliability and power up rating is important. There are two main cause of wastage flow accelerated corrosion (FAC) and mechanical erosion. This study is to develop evaluating the wastage speed by liquid droplet impingement erosion (LDIE). LDIE often occurs at downstream of corner of pipe or orifice. In this study, the liquid drop impinging tests were conducted with the test pieces mounted on a high speed rotating disk that cross thin water down jet and produced LDIE phenomena. The amount of the wastage by LDIE was evaluated by changing the rotational speed, the impingement frequency, and test piece materials. In addition, the generation mechanism of erosion was investigated by observing the surface of the test piece with a microscope. There is a method of evaluating by the mass difference before and after experiments. But this method is not correct because error becomes larger for mass measurement in the experiment, for the lost mass by LDIE is very little amount. Therefore, the method was developed to measure the volume in the erosion part. In this method, depth of LDIE was measured by the accuracy of ±0.01μm; therefore accurate measurement of the wastage can be improved. (author)

Numerical investigation of mist/air impingement cooling on ribbed blade leading-edge surface.

Science.gov (United States)

Bian, Qingfei; Wang, Jin; Chen, Yi-Tung; Wang, Qiuwang; Zeng, Min

2017-12-01

The working gas turbine blades are exposed to the environment of high temperature, especially in the leading-edge region. The mist/air two-phase impingement cooling has been adopted to enhance the heat transfer on blade surfaces and investigate the leading-edge cooling effectiveness. An Euler-Lagrange particle tracking method is used to simulate the two-phase impingement cooling on the blade leading-edge. The mesh dependency test has been carried out and the numerical method is validated based on the available experimental data of mist/air cooling with jet impingement on a concave surface. The cooling effectiveness on three target surfaces is investigated, including the smooth and the ribbed surface with convex/concave columnar ribs. The results show that the cooling effectiveness of the mist/air two-phase flow is better than that of the single-phase flow. When the ribbed surfaces are used, the heat transfer enhancement is significant, the surface cooling effectiveness becomes higher and the convex ribbed surface presents a better performance. With the enhancement of the surface heat transfer, the pressure drop in the impingement zone increases, but the incremental factor of the flow friction is smaller than that of the heat transfer enhancement. Copyright © 2017 Elsevier Ltd. All rights reserved.

Outdoor Performance Analysis of a Photovoltaic Thermal (PVT) Collector with Jet Impingement and Compound Parabolic Concentrator (CPC)

OpenAIRE

Ahed Hameed Jaaz; Husam Abdulrasool Hasan; Kamaruzzaman Sopian; Abdul Amir H. Kadhum; Tayser Sumer Gaaz; Ahmed A. Al-Amiery

2017-01-01

This paper discusses the effect of jet impingement of water on a photovoltaic thermal (PVT) collector and compound parabolic concentrators (CPC) on electrical efficiency, thermal efficiency and power production of a PVT system. A prototype of a PVT solar water collector installed with a jet impingement and CPC has been designed, fabricated and experimentally investigated. The efficiency of the system can be improved by using jet impingement of water to decrease the temperature of the solar ce...

Numerical study of heat transfer enhancement due to the use of fractal-shaped design for impingement cooling

Directory of Open Access Journals (Sweden)

Cai Lin

2017-01-01

Full Text Available This paper describes a numerical analysis of a heat transfer enhancement technique that introduces fractal-shaped design for impingement cooling. Based on the gas turbine combustion chamber cooling, a fractal-shaped nozzle is designed for the constant flow area in a single impingement cooling model. The incompressible Reynolds-averaged Navier-Stokes equations are applied to the system using CFD software. The numerical results are compared with the experiment results for array impingement cooling.

Danish Hip Arthroscopy Registry (DHAR)

DEFF Research Database (Denmark)

Lund, Bent; Mygind-Klavsen, Bjarne; Grønbech Nielsen, Torsten

2017-01-01

The Danish Hip Arthroscopy Registry (DHAR) was initiated in January 2012 as a web-based prospective registry. The purpose of this study was to evaluate and report the first registry based outcome data of a national population with radiological and clinical femoroacetabular impingement (FAI......) data from DHAR between January 2012 and November 2015 were extracted. Radiological pincer-type FAI was defined as LCE > 35° and cam FAI as alpha-angle > 55°. These data were combined with FAI surgical data such as osteochondroplasty and labral repair or resection. PROMs consisting of HAGOS, EQ-5 D...

Properties of Supersonic Impinging Jets

Science.gov (United States)

Alvi, F. S.; Iyer, K. G.; Ladd, J.

1999-11-01

A detailed study examining the behavior of axisymmetric supersonic jets impinging on a ground plane is described. Our objective is to better understand the aeroacoustics governing this complex flowfield which commonly occurs in the vicinity of STOVL aircraft. Flow issuing through a Mach 1.5 C-D and a converging sonic nozzle is examined over a wide parametric range. For some cases a large diameter circular 'lift' plate, with an annular hole through which the jet is issued, is attached at the nozzle exit to simulate a generic airframe. The impinging jet flowfield was examined using Particle Image Velocimetry (PIV), which provides the velocity field for the entire region and shadowgraph visualization techniques. Near-field acoustic, as well as, mean and unsteady pressure measurements on the ground and lift plate surfaces were also obtained. The velocity field data, together with the surface flow measurements have resulted in a much better understanding of this flow from a fundamental standpoint while also identifying critical regions of interest for practical applications. Some of these findings include the presence of a stagnation bubble with recirculating flow; a very high speed (transonic/supersonic) radial wall jet; presence of large, spatially coherent turbulent structures in the primary jet and wall jet and high unsteady loads on the ground plane and lift plates. The results of a companion CFD investigation and its comparison to the experimental data will also be presented. Very good agreement has been found between the computational and experimental results thus providing confidence in the development of computational tools for the study of such flows.

Single-phase liquid jet impingement heat transfer

International Nuclear Information System (INIS)

Webb, B.W.; Ma, C.F.

1995-01-01

Impinging liquid jets have been demonstrated to be an effective means of providing high heat/mass transfer rates in industrial transport processes. When a liquid jet strikes a surface, thin hydrodynamic and thermal boundary layers from in the region directly beneath due to the jet deceleration and the resulting increase in pressure. The flow is then forced to accelerate in a direction parallel to the target surface in what is termed the wall jet or parallel flow zone. The thickness of the hydrodynamic and thermal boundary layers in the stagnation region may be of the order of tens of micrometers. Consequently, very high heat/mass transfer coefficients exist in the stagnation zone directly under the jet. Transport coefficients characteristic of parallel flow prevail in the wall jet region. The high heat transfer coefficients make liquid jet impingement an attractive cooling option where high heat fluxes are the norm. Some industrial applications include the thermal treatment of metals, cooling of internal combustion engines, and more recently, thermal control of high-heat-dissipation electronic devices. Both circular and planar liquid jets have attracted research attention. 180 refs., 35 figs., 11 tabs

Computational Analysis of Droplet Mass and Size Effect on Mist/Air Impingement Cooling Performance

Directory of Open Access Journals (Sweden)

Zhenglei Yu

2013-01-01

Full Text Available Impingement cooling has been widely employed to cool gas turbine hot components such as combustor liners, combustor transition pieces, turbine vanes, and blades. A promising technology is proposed to enhance impingement cooling with water droplets injection. However, previous studies were conducted on blade shower head film cooling, and less attention was given to the transition piece cooling. As a continuous effort to develop a realistic mist impingement cooling scheme, this paper focuses on simulating mist impingement cooling under typical gas turbine operating conditions of high temperature and pressure in a double chamber model. Furthermore, the paper presents the effect of cooling effectiveness by changing the mass and size of the droplets. Based on the heat-mass transfer analogy, the results of these experiments prove that the mass of 3E – 3 kg/s droplets with diameters of 5–35 μm could enhance 90% cooling effectiveness and reduce 122 K of wall temperature. The results of this paper can provide guidance for corresponding experiments and serve as the qualification reference for future more complicated studies with convex surface cooling.

Targeted Ultrasound-Guided Perineural Hydrodissection of the Sciatic Nerve for the Treatment of Piriformis Syndrome.

Science.gov (United States)

Burke, Christopher J; Walter, William R; Adler, Ronald S

2018-05-01

Piriformis syndrome is a common cause of lumbar, gluteal, and thigh pain, frequently associated with sciatic nerve symptoms. Potential etiologies include muscle injury or chronic muscle stretching associated with gait disturbances. There is a common pathological end pathway involving hypertrophy, spasm, contracture, inflammation, and scarring of the piriformis muscle, leading to impingement of the sciatic nerve. Ultrasound-guided piriformis injections are frequently used in the treatment of these pain syndromes, with most of the published literature describing injection of the muscle. We describe a safe, effective ultrasound-guided injection technique for the treatment of piriformis syndrome using targeted sciatic perineural hydrodissection followed by therapeutic corticosteroid injection.

Vortex Structure Effects on Impingement, Effusion, and Cross Flow Cooling of a Double Wall Configuration

Science.gov (United States)

Ligrani, P. M.

2018-03-01

A variety of different types of vortices and vortex structures have important influences on thermal protection, heat transfer augmentation, and cooling performance of impingement cooling, effusion cooling, and cross flow cooling. Of particular interest are horseshoe vortices, which form around the upstream portions of effusion coolant concentrations just after they exit individual holes, hairpin vortices, which develop nearby and adjacent to effusion coolant trajectories, and Kelvin-Helmholtz vortices which form within the shear layers that form around each impingement cooling jet. The influences of these different vortex structures are described as they affect and alter the thermal performance of effusion cooling, impingement cooling, and cross flow cooling, as applied to a double wall configuration.

Quantifying cell adhesion through impingement of a controlled microjet

NARCIS (Netherlands)

Visser, C.W.; Gielen, Marise V.; Gielen, Marise Vera; Hao, Zhenxia; le Gac, Severine; Lohse, Detlef; Sun, Chao

2015-01-01

The impingement of a submerged, liquid jet onto a cell-covered surface allows assessing cell attachment on surfaces in a straightforward and quantitative manner and in real time, yielding valuable information on cell adhesion. However, this approach is insufficiently characterized for reliable and

Comparison of methods for detection and enumeration of airborne microorganisms collected by liquid impingement.

OpenAIRE

Terzieva, S; Donnelly, J; Ulevicius, V; Grinshpun, S A; Willeke, K; Stelma, G N; Brenner, K P

1996-01-01

Bacterial agents and cell components can be spread as bioaerosols, producing infections and asthmatic problems. This study compares four methods for the detection and enumeration of aerosolized bacteria collected in an AGI-30 impinger. Changes in the total and viable concentrations of Pseudomonas fluorescens in the collection fluid with respect to time of impingement were determined. Two direct microscopic methods (acridine orange and BacLight) and aerodynamic aerosol-size spectrometry (Aeros...

Plume Impingement to the Lunar Surface: A Challenging Problem for DSMC

Science.gov (United States)

Lumpkin, Forrest; Marichalar, Jermiah; Piplica, Anthony

2007-01-01

The President's Vision for Space Exploration calls for the return of human exploration of the Moon. The plans are ambitious and call for the creation of a lunar outpost. Lunar Landers will therefore be required to land near predeployed hardware, and the dust storm created by the Lunar Lander's plume impingement to the lunar surface presents a hazard. Knowledge of the number density, size distribution, and velocity of the grains in the dust cloud entrained into the flow is needing to develop mitigation strategies. An initial step to acquire such knowledge is simulating the associated plume impingement flow field. The following paper presents results from a loosely coupled continuum flow solver/Direct Simulation Monte Carlo (DSMC) technique for simulating the plume impingement of the Apollo Lunar module on the lunar surface. These cases were chosen for initial study to allow for comparison with available Apollo video. The relatively high engine thrust and the desire to simulate interesting cases near touchdown result in flow that is nearly entirely continuum. The DSMC region of the flow field was simulated using NASA's DSMC Analysis Code (DAC) and must begin upstream of the impingement shock for the loosely coupled technique to succeed. It was therefore impossible to achieve mean free path resolution with a reasonable number of molecules (say 100 million) as is shown. In order to mitigate accuracy and performance issues when using such large cells, advanced techniques such as collision limiting and nearest neighbor collisions were employed. The final paper will assess the benefits and shortcomings of such techniques. In addition, the effects of plume orientation, plume altitude, and lunar topography, such as craters, on the flow field, the surface pressure distribution, and the surface shear stress distribution are presented.

Open versus arthroscopic treatment of chronic rotator cuff impingement

NARCIS (Netherlands)

Schröder, J.; van Dijk, C. N.; Wielinga, A.; Kerkhoffs, G. M.; Marti, R. K.

2001-01-01

We report the results of 238 consecutive patients who underwent in total 261 acromioplasties because of chronic rotator cuff impingement. The procedure was performed either in conventional open technique (80) or arthroscopically (181). Two years (1-10) after the operation 68% of the patients treated

Effect of a novel mobilization with movement procedure on anterolateral ankle impingement - A case report.

Science.gov (United States)

Anandkumar, Sudarshan

2018-07-01

This case report describes a 50-year-old male who presented with right anterolateral ankle pain managed unsuccessfully with rest, medications, bracing, injection, physical therapy, and massage therapy. Clinical diagnosis of anterolateral ankle impingement was based on concordant symptom reproduction with palpatory tenderness and a positive lateral synovial impingement test. This case report is a potential first time description of the successful management of anterolateral ankle impingement utilizing a novel Mulligan's mobilization with movement procedure (consisting of internal rotation of the distal tibia) and taping with immediate improvements noted in pain, range of motion, and function. The patient was seen twice a week and was discharged after four treatment sessions. A follow-up after 4 months revealed that the patient was pain free and fully functional.

Numerical study of metal foam heat sinks under uniform impinging flow

International Nuclear Information System (INIS)

Andreozzi, A; Bianco, N; Iasiello, M; Naso, V

2017-01-01

The ever-increasing demand for performance improvement and miniaturization of electronics has led to a significant generation of waste heat that must be dissipated to ensure a reliable device operation. The miniaturization of the components complicates this task. In fact, reducing the heat transfer area, at the same required heat rate, it is necessary to increase the heat flux, so that the materials operate in a temperature range suitable to its proper functioning. Traditional heat sinks are no longer capable of dissipating the generated heat and innovative approaches are needed to address the emerging thermal management challenges. Recently, heat transfer in open-cell metal foams under an impinging jet has received attention due to the considerable heat transfer potential of combining two cooling technologies: impinging jet and porous medium. This paper presents a numerical study on Finned Metal Foam (FMF) and Metal Foam (MF) heat sinks under impinging air jet cooling. The analysis is carried out by means of the commercial software COMSOL Multiphysics®. The purpose is to analyze the thermal performance of the metal foam heat sink, finned or not, varying its geometric parameters. Results are presented in terms of predicted dissipated heat rate, convective heat transfer coefficient and pressure losses. (paper)

Controlled antisolvent precipitation of spironolactone nanoparticles by impingement mixing.

Science.gov (United States)

Dong, Yuancai; Ng, Wai Kiong; Shen, Shoucang; Kim, Sanggu; Tan, Reginald B H

2011-05-30

Continuous antisolvent precipitation of spironolactone nanoparticles were performed by impingement mixing in this work. In the range of Reynolds numbers (Re) 2108-6325 for the antisolvent water stream and 1771-5313 for the solvent stream, i.e. acetonic drug solution, 302-360 nm drug nanoparticles were achieved. Increasing drug concentration from 25 to 50 and 100 mg/ml led to a significant size increase from 279.0±2.6 to 302.7±4.9 and 446.0±17.3 nm, respectively. "Two-step crystallization" was first observed for spironolactone in the water/acetone system: the drug was precipitated initially as spherical cluster, which rearranged into ordered cuboidal nanocrystals finally. The nanoformulation showed faster dissolution rate in comparison with the raw drug. By combining the impingement mixing and an on-line spray drying, a fully continuous process may be developed for mass-production of dried drug nanoparticles. Copyright © 2011 Elsevier B.V. All rights reserved.

Shock and vibration protection of submerged jet impingement cooling systems: Theory and experiment

International Nuclear Information System (INIS)

Haji Hosseinloo, Ashkan; Tan, Siow Pin; Yap, Fook Fah; Toh, Kok Chuan

2014-01-01

In the recent years, advances in high power density electronics and computing systems have pushed towards more advanced thermal management technologies and higher-capacity cooling systems. Among different types of cooling systems, jet impingement technology has gained attention and been widely used in different industries for its adaptability, cooling uniformity, large heat capacity, and ease of its localization. However, these cooling systems may not function properly in dynamically harsh environment inherent in many applications such as land, sea and air transportation. In this research article, a novel double-chamber jet impingement cooling system is fabricated and its performance is studied in harsh environment. Using the authors' previous studies, isolators with optimum properties are selected to ruggedize the chassis containing the cooling chamber against shock and random vibration. Experiments are conducted on both hard-mounted and isolated chassis and the cooling performance of the system is assessed using the inlet, and impingement surface temperatures of the cooling chamber. The experimental results show the isolation system prevents any failure that otherwise would occur, and also does not compromise the thermal performance of the system. - Highlights: • A novel double-chamber jet impingement cooling system was designed and fabricated. • Comprehensive set of random vibration and shock tests are conducted. • The isolation system proved to protect the cooling system properly against mechanical failure. • Cooling system performance was not significantly affected by the input random vibration and shock

Gas turbine bucket with impingement cooled platform

Science.gov (United States)

Jones, Raphael Durand

2002-01-01

In a turbine bucket having an airfoil portion and a root portion, with a substantially planar platform at an interface between the airfoil portion and root portion, a platform cooling arrangement including at least one bore in the root portion and at least one impingement cooling tube seated in the bore, the tube extending beyond the bore with an outlet in close proximity to a targeted area on an underside of the platform.

Cost-effectiveness of exercise therapy after corticosteroid injection for moderate to severe shoulder pain due to subacromial impingement syndrome: a trial-based analysis.

Science.gov (United States)

Jowett, Sue; Crawshaw, Dickon P; Helliwell, Philip S; Hensor, Elizabeth M A; Hay, Elaine M; Conaghan, Philip G

2013-08-01

To perform a cost-effectiveness analysis of subacromial corticosteroid injection combined with exercise compared with exercise alone in patients with moderate to severe shoulder pain from subacromial impingement syndrome. A within-trial cost-effectiveness analysis with 232 patients randomized to physiotherapy-led injection combined with exercise (n = 115) or exercise alone (n = 117). The analysis was from a health care perspective with 24-week follow-up. Resource use information was collected from all patients on interventions, medication, primary and secondary care contacts, private health care use and over-the-counter purchases. The measure of outcome was quality-adjusted life years (QALYs), calculated from EQ-5D responses at baseline and three further time points. An incremental cost-effectiveness analysis was conducted. Mean per patient NHS costs (£255 vs £297) and overall health care costs (£261 vs £318) were lower in the injection plus exercise arm, but this difference was not statistically significant. Total QALYs gained were very similar in the two trial arms (0.3514 vs 0.3494 QALYs), although slightly higher in the injection plus exercise arm, indicating that injection plus exercise may be the dominant treatment option. At a willingness to pay of £20,000 per additional QALY gained, there was a 61% probability that injection plus exercise was the most cost-effective option. Injection plus exercise delivered by therapists may be a cost-effective use of resources compared with exercise alone and lead to lower health care costs and less time off work. International Standard Randomised Controlled Trial Number Register, http://www.controlled-trials.com/isrctn/, ISRCT 25817033.

Configurable double-sided modular jet impingement assemblies for electronics cooling

Science.gov (United States)

Zhou, Feng; Dede, Ercan Mehmet

2018-05-22

A modular jet impingement assembly includes an inlet tube fluidly coupled to a fluid inlet, an outlet tube fluidly coupled to a fluid outlet, and a modular manifold having a first distribution recess extending into a first side of the modular manifold, a second distribution recess extending into a second side of the modular manifold, a plurality of inlet connection tubes positioned at an inlet end of the modular manifold, and a plurality of outlet connection tubes positioned at an outlet end of the modular manifold. A first manifold insert is removably positioned within the first distribution recess, a second manifold insert is removably positioned within the second distribution recess, and a first and second heat transfer plate each removably coupled to the modular manifold. The first and second heat transfer plates each comprise an impingement surface.

Annular Impinging Jet Controlled by Radial Synthetic Jets

Czech Academy of Sciences Publication Activity Database

Trávníček, Zdeněk; Tesař, Václav; Broučková, Zuzana; Peszyński, K.

2014-01-01

Roč. 35, 16-17 (2014), s. 1450-1461 ISSN 0145-7632 R&D Projects: GA ČR GA14-08888S; GA AV ČR(CZ) IAA200760801 Institutional support: RVO:61388998 Keywords : impinging jet * hybrid synthetic jet * flow control Subject RIV: JU - Aeronautics, Aerodynamics, Aircrafts Impact factor: 0.814, year: 2014 http://dx.doi.org/10.1080/01457632.2014.889467

Breakup characteristics of power-law liquid sheets formed by two impinging jets

International Nuclear Information System (INIS)

Bai, Fuqiang; Diao, Hai; Chang, Qing; Wang, Endong; Du, Qing; Zhang, Mengzheng

2014-01-01

The breakup characteristics of the shear-thinning power-law liquid sheets formed by two impinging jets have been investigated with the shadowgraph technique. This paper focuses on the effects of spray parameters (jet velocity), physical parameters (viscosity) and geometry parameters (impinging angle and nozzle cross-sectional shape) on the breakup behaviors of liquid sheets. The breakup mode, sheet length and expansion angle of the sheet are extracted from the spray images obtained by a high speed camera. Impinging angle and Weber number play the similar roles in promoting the breakup of liquid sheets. With the increase of jet velocity, five different breakup modes are observed and the expansion angle increases consistently after the closed-rim mode while the sheet length first increases and then decreases. But there exists a concave consisting of a fierce drop and a second rising process on the sheet length curve for the fluid with smaller viscosity. Different nozzle cross-sectional shapes emphasize significant effects on the sheet length and expansion angle of liquid sheets. At a fixed Weber number, the liquid sheet with greater viscosity has a greater sheet length and a smaller expansion angle due to the damping effect of viscosity. (papers)

Fish impingement at estuarine power stations and its significance to commercial fishing

International Nuclear Information System (INIS)

Turnpenny, A.W.H.

1989-01-01

The abstraction of cooling water (CW) at power stations sited on tidal waters inevitably leads to mortalities of some fish which are drawn in with the CW supply and become impinged on the intake screens. These fish are predominantly 0- or 1-group juveniles which, owing to their small size, are unable to resist intake currents. Commercial fishermen often object to the fact that juvenile fish are killed in this way. Their concern stems from the fact that in order to protect stocks, commercial fishing is restricted to fish which are above a statutory minimum landing size, whereas the majority of fish killed by impingement are below this size. This Report considers the significance of impingement mortalities at four estuarine sites in Britain for six commercially important species. Life tables are used to establish expected survival trajectories for each species and to compute reproductive potential. Each fish killed on intake screens is then considered in terms of the fraction of the reproductive potential of a single adult at maturity, and is ascribed an 'adult equivalent' value. Total catches of mixed juveniles and adults are then presented as 'adult equivalent' values. (author)

Investigation of Characteristics of Impinging Jet for 1/5-Scale ECC injection

Energy Technology Data Exchange (ETDEWEB)

Shin, Byung Soo; Ko, Yung Joo; Bae, Hwang; Kwon, Tae Soon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2010-05-15

In ECCS of SMART reactor, safety injection pump discharges cooling water into the core to maintain the water level by filling the amount of loss of coolant under emergency situation such as SBLOCA. Once the ECCS starts to operate, the injected water will be impinged to the upper wall of core support barrel (CBS). And the water will fall along the wall forming liquid film or droplets as shown in Fig. 1(b) due to high Reynolds number. The breakup and film flow will be bypassed by high temperature and pressure steam-water mixture cross flow from RCP discharge into the atmosphere through broken injection nozzle. Then, the flow phenomena in the downcomer is very complex situation with including jet impingement, jet breakup, liquid entrainment, steam condensation, counter-current flow and etc. In this study, the hydraulic features of impinging jet were investigated through visualization for full scale test for simulation of SMART ECC jet and SWAT test of 1/5 simulated test for ECCS of SMART reactor and measurement of the film width. And the scaling method for SWAT test was discussed considering jet break up and other phenomena

Pixel signal intensity analysis of anterior cruciate ligament grafts in knees with and without intercondylar roof impingement

International Nuclear Information System (INIS)

Howell, S.M.; Berns, G.S.; Farley, T.E.; Clark, J.A.

1990-01-01

This paper determines if intercondylar roof (IR) impingement produces quantitative, regionalized, and time-dependent differences in the pixel signal intensity (PSI) of anterior cruciate ligament (ACL) grafts. Patients with hamstring autografts were placed into two groups: inpinged (n = 14) and unimpinged (n = 18). MR images were obtained at 3, 6, 9, and over 12 months after operation in the unimpinged group and at 22 months in the impinged group. The PSI was measured along the proximal, middle, and distal thirds of the graft. The PSI was greater in the impinged knees in the distal (P < .008) and middle thirds (P < .009) of the graft, but there was no difference in the proximal third. In the unimpinged group, the signal in all three zones did not change from 3 to 12 months after operation. The tibial tunnel placement was more anterior in the impinged knees (P < .001). Stability (P < .012) and knee extension (P < .003) were better in the unimpinged knees

Microjet impingement followed by scanning electron microscopy as a qualitative technique to compare cellular adhesion to various biomaterials.

Science.gov (United States)

Richards, R G; ap Gwynn, I; Bundy, K J; Rahn, B A

1995-12-01

Adhesion of cells to biomaterial surfaces is one of the major factors which mediates their biocompatibility. Quantitative or qualitative cell adhesion measurements would be useful for screening new implant materials. Microjet impingement has been evaluated by scanning electron microscopy, to determine to what extent it measures cell adhesion. The shear forces of the impingement, on the materials tested here, are seen to be greater than the cohesive strength of the cells in the impinged area, causing their rupture. The cell bodies are removed during impingement, leaving the sites of adhesion and other cellular material behind. Thus the method is shown not to provide quantification of cell adhesion forces for the metals and culture plastic tested. It is suggested that with highly adherent biomaterials, the distribution and patterns of these adhesion sites could be used for qualitative comparisons for screening of implant surfaces.

Buoyancy effects laminar slot jet impinging on a surface with constant heat flux

International Nuclear Information System (INIS)

Shokouhmand, H.; Esfahanian, V.; Masoodi, R.

2004-01-01

The two-dimensional laminar air jet issuing from a nozzle of half which terminates at height above a flat plate normal to the jet is numerically on the flow and thermal structure of the region near impingement. The impinging surface is maintained at a constant heat flux condition. The full Navier-Stocks and energy equations are solved by a finite difference method to evaluate the velocity profiles and temperature distribution. The governing parameters and their ranges are: Reynolds number Re, 10-50, Grashof number Gr, 0-50, Richardson number Ri=Gr/ Re 2 , Non dimensional nozzle height H,2-3. Results of the free streamline, local friction factor and heat transfer coefficient are graphically presented. It is found that enhancement of the heat transfer rate is substantial for high Richardson number conditions. Although the laminar jet impingement for isothermal condition has been already studied, however the constant heat flux has not been studied enough. the present paper will analyze a low velocity air jet, Which can be used for cooling of a simulated electronics package

"Simultaneous measurement of flame impingement and piston surface temperatures in an optically accessible spark ignition engine"

Science.gov (United States)

Ding, Carl-Philipp; Honza, Rene; Böhm, Benjamin; Dreizler, Andreas

2017-04-01

This paper shows the results of spatially resolved temperature measurements of the piston surface of an optically accessible direct injection spark ignition engine during flame impingement. High-speed thermographic phosphor thermometry (TPT), using Gd3Ga5O12:Cr,Ce, and planar laser-induced fluorescence of the hydroxyl radical (OH-PLIF) were used to investigate the temperature increase and the time and position of flame impingement at the piston surface. Measurements were conducted at two operating cases and showed heating rates of up to 16,000 K/s. The OH-PLIF measurements were used to localize flame impingement and calculate conditioned statistics of the temperature profiles. The TPT coating was characterized and its influence on the temperature measurements evaluated.

Understanding Athletic Pubalgia: A Review.

Science.gov (United States)

Cohen, Brian; Kleinhenz, Dominic; Schiller, Jonathan; Tabaddor, Ramin

2016-10-04

Athletic Pubalgia, more commonly known as sports hernia, is defined as chronic lower abdominal and groin pain without the presence of a true hernia. It is increasingly recognized in athletes as a source of groin pain and is often associated with other pathology. A comprehensive approach to the physical exam and a strong understanding of hip and pelvic anatomy are critical in making the appropriate diagnosis. Various management options are available. We review the basic anatomy, patholophysiology, diagnostic approach and treatment of athletic pubalgia as well as discuss associated conditions such as femoroacetabular impingement. [Full article available at http://rimed.org/rimedicaljournal-2016-10.asp].

Temperature-field measurements of a premixed butane/air circular impinging-flame using reference-beam interferometry

International Nuclear Information System (INIS)

Qi, J.A.; Leung, C.W.; Wong, W.O.; Probert, S.D.

2006-01-01

Reference-beam interferometry (RBI) was applied to study the axisymmetric temperature fields of a small-scale, low Reynolds-number, low-pressure and fuel-rich premixed butane/air circular-flame jet, when it was impinging vertically upwards onto a horizontal copper plate. By maintaining a Reynolds number, Re, of 500 and an equivalence ratio, φ, of 1.8, interferograms of the impinging-flame jet were obtained for various nozzle-to-plate-distances. Temperature fields of the flame were then determined using the inverse Abel transformation from the obtained interferograms. Temperatures at several locations were measured experimentally with a T-type thermocouple: they were used as a reference to help in the determination as well as the validation. In the present study, a non-contact method has been successfully developed to measure the temperature fields of a circular impinging gas-fired flame jet

Nineth Rib Syndrome after 10th Rib Resection

OpenAIRE

Yu, Hyun Jeong; Jeong, Yu Sub; Lee, Dong Hoon; Yim, Kyoung Hoon

2016-01-01

The 12th rib syndrome is a disease that causes pain between the upper abdomen and the lower chest. It is assumed that the impinging on the nerves between the ribs causes pain in the lower chest, upper abdomen, and flank. A 74-year-old female patient visited a pain clinic complaining of pain in her back, and left chest wall at a 7 on the 0-10 Numeric Rating scale (NRS). She had a lateral fixation at T12-L2, 6 years earlier. After the operation, she had multiple osteoporotic compression fractur...

Flowfield Behavior of Supersonic Impinging Jets

Science.gov (United States)

Iyer, K. G.; Alvi, F. S.

1998-11-01

A detailed study is being conducted which examines the behavior of normally impinging, supersonic jets, issuing from axisymmetric a Mach 1.5 C-D and a sonic nozzle. Our goal is to understand the physics of this flowfield (commonly observed in STOVL aircraft) and its influence on the acoustic and aerodynamic loading on the ground plane and the airframe. The airframe is simulated by a circular disc ('lift' plate) with an annular hole from which the jet is issued. Tests are carried out for a wide range of pressure ratios and the ground plane distance is varied from 1.5 to 60 nozzle diameters. Flowfield measurements include Particle Image Velocimetry (PIV) and schlieren/shadowgraph visualization. Surface measurements on the ground and lift plates include mean and unsteady surface pressure distributions and the surface streamline visualization. Near-field acoustic measurements using a microphone are also obtained. For certain cases, the PIV measurements -- first of their kind, to our knowledge -- clearly show the presence of large-scale coherent turbulent structures which, upon jet impingement, propagate into the resulting wall jet. These structures are believed to generate very high unsteady pressure loads on the ground plane thus leading to ground erosion. They are also suspected to be the source of acoustic waves which lead to a feedback loop causing violent oscillations of the primary jet and can result in increased acoustic loading and subsequent damage to the aircraft. As a result of this detailed study over a wide parametric space, we hope to gain a much better understanding of the physical mechanisms governing this complex flow.

Flow field characteristics of impinging sweeping jets: TR-PIV measurement

Science.gov (United States)

Wen, Xin; Peng, Di; Liu, Yingzheng; Tang, Hui

2017-11-01

Influence of Reynolds number of sweeping jets on its impinging flow fields was extensively investigated in a water tank. Toward this end, a fluidic oscillator was specially designed to produce spatially sweeping jets which imping on a flat plate. Six Reynolds numbers were tested by controlling the supply flow rate of the fluidic oscillator. Impinging flow fields were captured by time-resolved Particle Image Velocimetry (TR-PIV) measurement. Reference signals were extracted from the flow fields for phase reconstruction. The oscillating flow fields with super-harmonic frequency at different regions were discussed in term of the phase-averaged velocity, vorticity and turbulent velocity. Dynamic mode decomposition (DMD) was used to capture the most-energetic flow patterns with distinct frequencies. By projecting the phase-averaged flow fields onto a reduced basis of DMD modes, the phase correlation between the distinct flow patterns were analyzed under different Reynolds numbers.

Flow Characteristics of Rectangular Underexpanded Impinging Jets

Institute of Scientific and Technical Information of China (English)

Minoru YAGA; Yoshio KINJO; Masumi TAMASHIRO; Kenyu OYAKAWA

2006-01-01

In this paper, the flow fields of underexpanded impinging jet issued from rectangular nozzles of aspect ratio 1,3 and 5 are numerically and experimentally studied. Two dimensional temperature and pressure distributions are measured by using infrared camera and the combination of a pressure scanning device and a stepping motor, respectively. The variation of the stagnation pressure on the impinging plate reveals that a hystcretic phenomenon exists during the increasing and decreasing of the pressure ratio for the aspect ratio of 3.0 and 5.0. It is also found that the nozzle of aspect ratio 1.0 caused the largest total pressure loss pc/p0 = 0.27 at the pressure ratio of p0/pb, = 6.5, where pc is the stagnation center pressure on the wall, p0 the upstream stagnation pressure, pb the ambient pressure. The other two nozzles showed that the pressure loss pc / p0=0.52 and 0.55 were achieved by the nozzles of the aspect ratio 3,0 and 5.0, respectively. The comparison between the calculations and experiments is fairly good, showing the three dimensional streamlines and structures of the shock waves in the jets. However, the hysteresis of the pressure variations observed in the experiments between the pressure ratio of 3.5 and 4.5 cannot be confirmed in the calculations.

Multiple hereditary exostoses and ischiofemoral impingement: a case-control study

International Nuclear Information System (INIS)

Yoong, Philip; Mansour, Ramy; Teh, James L.

2014-01-01

To assess whether there is a significant difference in the ischiofemoral space in patients with multiple hereditary exostoses affecting the proximal femora compared to normal patients. Ischiofemoral impingement is an increasingly recognized cause of hip and buttock pain. This causes narrowing of the ischiofemoral space resulting in an abnormal quadratus femoris muscle. We performed a retrospective search for individuals with MHE with proximal femoral involvement on pelvic MRI over a 7-year period (2006-2013). Suitable patients were age- and sex-matched with a control group. The minimum ischiofemoral space (MIFS) was recorded in each hip, as was the presence of edema and atrophy of quadratus femoris and concomitant hip osteoarthrosis. MRI features suggestive of ischiofemoral impingement were defined as MIFS less than 10 mm or an abnormal quadratus femoris muscle. Twenty-one hips in 11 individuals with MHE were included in the study. A total of 42 hips were analyzed. The mean age was 37 years (range, 13-72 years) and 55 % were male. There was a significant difference (p < 0.05) in the MIHS in individuals with MHE (mean, 10.7 mm, range, 0-21 mm) compared to a control group (mean, 18.1 mm, range, 10.5-26.5 mm). MRI features suggestive of ischiofemoral impingement were seen in 13/21 (62 %) hips in the MHE group and 0/21 (0 %) in the control group. The reduced ischiofemoral space and associated quadratus femoris abnormalities in patients with MHE involving the proximal femora may account for hip/buttock symptoms in the absence of significant degenerative change. (orig.)

Multiple hereditary exostoses and ischiofemoral impingement: a case-control study

Energy Technology Data Exchange (ETDEWEB)

Yoong, Philip; Mansour, Ramy; Teh, James L. [Nuffield Orthopaedic Centre, Department of Radiology, Oxford (United Kingdom)

2014-09-15

To assess whether there is a significant difference in the ischiofemoral space in patients with multiple hereditary exostoses affecting the proximal femora compared to normal patients. Ischiofemoral impingement is an increasingly recognized cause of hip and buttock pain. This causes narrowing of the ischiofemoral space resulting in an abnormal quadratus femoris muscle. We performed a retrospective search for individuals with MHE with proximal femoral involvement on pelvic MRI over a 7-year period (2006-2013). Suitable patients were age- and sex-matched with a control group. The minimum ischiofemoral space (MIFS) was recorded in each hip, as was the presence of edema and atrophy of quadratus femoris and concomitant hip osteoarthrosis. MRI features suggestive of ischiofemoral impingement were defined as MIFS less than 10 mm or an abnormal quadratus femoris muscle. Twenty-one hips in 11 individuals with MHE were included in the study. A total of 42 hips were analyzed. The mean age was 37 years (range, 13-72 years) and 55 % were male. There was a significant difference (p < 0.05) in the MIHS in individuals with MHE (mean, 10.7 mm, range, 0-21 mm) compared to a control group (mean, 18.1 mm, range, 10.5-26.5 mm). MRI features suggestive of ischiofemoral impingement were seen in 13/21 (62 %) hips in the MHE group and 0/21 (0 %) in the control group. The reduced ischiofemoral space and associated quadratus femoris abnormalities in patients with MHE involving the proximal femora may account for hip/buttock symptoms in the absence of significant degenerative change. (orig.)

Development of Augmented Spark Impinging Igniter System for Methane Engines

Science.gov (United States)

Marshall, William M.; Osborne, Robin J.; Greene, Sandra E.

2017-01-01

The Lunar Cargo Transportation and Landing by Soft Touchdown (Lunar CATALYST) program is establishing multiple no-funds-exchanged Space Act Agreement (SAA) partnerships with U.S. private sector entities. The purpose of this program is to encourage the development of robotic lunar landers that can be integrated with U.S. commercial launch capabilities to deliver payloads to the lunar surface. NASA can share technology and expertise under the SAA for the benefit of the CATALYST partners. MSFC seeking to vacuum test Augmented Spark Impinging (ASI) igniter with methane and new exciter units to support CATALYST partners and NASA programs. ASI has previously been used/tested successfully at sea-level, with both O2/CH4 and O2/H2 propellants. Conventional ignition exciter systems historically experienced corona discharge issues in vacuum. Often utilized purging or atmospheric sealing on high voltage lead to remedy. Compact systems developed since PCAD could eliminate the high-voltage lead and directly couple the exciter to the spark igniter. MSFC developed Augmented Spark Impinging (ASI) igniter. Successfully used in several sea-level test programs. Plasma-assisted design. Portion of ox flow is used to generate hot plasma. Impinging flows downstream of plasma. Additional fuel flow down torch tube sleeve for cooling near stoichiometric torch flame. Testing done at NASA GRC Altitude Combustion Stand (ACS) facility 2000-lbf class facility with altitude simulation up to around 100,000 ft. (0.2 psia [10 Torr]) via nitrogen driven ejectors. Propellant conditioning systems can provide temperature control of LOX/CH4 up to test article.

Two or more impingement and/or instability deformities are often present in patients with hip pain.

Science.gov (United States)

Tibor, Lisa M; Liebert, Gunnar; Sutter, Reto; Impellizzeri, Franco M; Leunig, Michael

2013-12-01

Damage to the hip can occur due to impingement or instability caused by anatomic factors such as femoral and acetabular version, neck-shaft angle, alpha angle, and lateral center-edge angle (CEA). The associations between these anatomic factors and how often they occur in a painful hip are unclear but if unaddressed might explain failed hip preservation surgery. We determined (1) the influence of sex on the expression of impingement-related or instability-related factors, (2) the associations among these factors, and (3) how often both impingement and/or instability factors occur in the same hip. We retrospectively reviewed a cohort of 170 hips (145 patients) undergoing MR arthrography of the hip for any reason. We excluded 58 hips with high-grade dysplasia, Perthes' sequelae, previous surgery, or incomplete radiographic information, leaving 112 hips (96 patients). We measured femoral version and alpha angles on MR arthrograms. Acetabular anteversion, lateral CEA, and neck-shaft angle were measured on pelvic radiographs. We observed a correlation between sex and alpha angle. Weak or no correlations were observed between the other five parameters. In 66% of hips, two or more (of five) impingement parameters, and in 51% of hips, two or more (of five) instability parameters were found. Patients with hip pain frequently have several anatomic factors potentially contributing to chondrolabral damage. To address pathologic hip loading due to impingement and/or instability, all of the anatomic influences should be known. As we found no associations between anatomic factors, we recommend an individualized assessment of each painful hip.

Results of Treatment of Posterior Ankle Impingement Syndrome and Flexor Hallucis Longus Tendinopathy in Dancers: A Systematic Review.

Science.gov (United States)

Rietveld, A B M Boni; Hagemans, F M T; Haitjema, S; Vissers, T; Nelissen, R G H H

2018-03-15

Dancing on pointe and relevé requires extreme plantar flexion of the talo-crural joint. Hence, these positions may lead to posterior ankle impingement syndrome (PAIS). PAIS often coincides with flexor hallucis longus tendinopathy (FHL tendinopathy, or "dancers' tendinitis"). Both injuries can appear in isolation as well. The goal of this review is to evaluate the results and the available levels of evidence of conservative and operative treatment (both open and endoscopic) of PAIS and FHL tendinopathy in dancers. It also offers an insight into the history of dance medical publications on this subject. In October 2016, a systematic search of PubMed, Embase, Cochrane, CINAHL, Web of Science, and (in French) ScienceDirect databases was undertaken. Five hundred and seventy-six publications were found, of which a total of 27 reported the results of operative treatment in 376 ankles (344 open, 32 endoscopic) in 324 dancers. The outcome was good to excellent in most cases (89%). The mean period of return to dance for all surgeries combined (PAIS and FHL tendinopathy, open and endo) was 11 weeks (range: 4 to 36 weeks), and for isolated FHL tendinopathy 16 weeks (range: 8 to 36 weeks). Only six publications reported the results of conservative treatment in 33 ankles (13 PAIS, 20 FHL tendinopathy) of 28 dancers, which does not allow for any evidence-based recommendations. Most studies failed to include dance-specific baseline characteristics, like dance style and level of participation. We concluded that only retrospective studies with levels of evidence four and five show that operative treatment for PAIS and FHL tendinopathy is successful with few complications. Since isolated PAIS, PAIS combined with FHL tendinopathy, and isolated FHL injuries appear to be different pathological entities, more research taking into account demography, dance type, and level of participation is needed to find out in which cases early operative management should be considered or avoided. The

Surgery for subacromial impingement syndrome in relation to occupational exposures, lifestyle factors and diabetes mellitus: a nationwide nested case-control study.

Science.gov (United States)

Dalbøge, Annett; Frost, Poul; Andersen, Johan Hviid; Svendsen, Susanne Wulff

2017-10-01

To estimate the risk of surgery for subacromial impingement syndrome (SIS) in relation to occupational exposures, lifestyle factors and diabetes mellitus. We conducted a case-control study nested in a register-based cohort study of the Danish working population. For each of 3000 first-time cases of surgery for SIS, two age-matched and sex-matched controls were drawn. Cases and controls received a questionnaire on job history and other factors. Job histories were combined with a psychosocial job exposure matrix (JEM) and the updated Shoulder JEM, which provided exposure intensities on measurement scales. Ten-year cumulative exposures to upper arm elevation >90°, repetitive shoulder movements, forceful shoulder exertions and hand-arm vibrations (HAVs) were estimated. We used conditional logistic regression. There were 5396 persons (60%) who answered the questionnaire. For occupational mechanical exposures, the adjusted OR (OR adj ) ranged from 1.9 (95% CI 1.5 to 2.5 for HAVs) to 2.5 (95% CI 1.9 to 3.5 for force) among men and 1.7 (95% CI 1.2 to 2.5 for HAVs) to 2.0 (95% CI 1.3 to 2.9 for force) among women. No statistically significant associations were found for occupational psychosocial factors. Body mass index (BMI) and pack-years of smoking showed OR adj up to 2.0. Diabetes mellitus showed OR adj of 1.5 (95% CI 1.1 to 2.2) for men and 2.2 (95% CI 1.4 to 3.4) for women. Our findings add to the evidence of an increased risk of surgery for SIS in relation to occupational cumulative mechanical exposures, even when an increased risk in relation to BMI, smoking and diabetes mellitus is taken into account. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Impingement studies at the 100-N reactor water intake

International Nuclear Information System (INIS)

Page, T.L.; Neitzel, D.A.; Gray, R.H.

1977-09-01

Fish impingement and traveling screen passage were studied at the 100-N reactor water intake structure, Columbia River mile 380, from late April to August 1977. Species and numbers of fish affected were determined and compared to those at the adjacent Hanford Generating Project (HGP). Fish protection procedures previously developed for HGP were evaluated for application at 100-N

Impact of entrainment and impingement on fish populations in the Hudson River Estuary. Volume II. Impingement impact analyses, evaluations of alternative screening devices, and critiques of utility testimony relating to density-dependent growth, the age-composition of the striped bass spawning stock, and the LMS real-time life cycle model

International Nuclear Information System (INIS)

Barnthouse, L.W.; Van Winkle, W.; Golumbek, J.; Cada, G.F.; Goodyear, C.P.; Christensen, S.W.; Cannon, J.B.; Lee, D.W.

1982-04-01

This volume includes a series of four exhibits relating to impacts of impingement on fish populations, together with a collection of critical evaluations of testimony prepared for the utilities by their consultants. The first exhibit is a quantitative evaluation of four sources of bias (collection efficiency, reimpingement, impingement on inoperative screens, and impingement survival) affecting estimates of the number of fish killed at Hudson River power plants. The two following exhibits contain, respectively, a detailed assessment of the impact of impingement on the Hudson River white perch population and estimates of conditional impingement mortality rates for seven Hudson River fish populations. The fourth exhibit is an evaluation of the engineering feasibility and potential biological effectiveness of several types of modified intake structures proposed as alternatives to cooling towers for reducing impingement impacts. The remainder of Volume II consists of critical evaluations of the utilities' empirical evidence for the existence of density-dependent growth in young-of-the-year striped bass and white perch, of their estimate of the age-composition of the striped bass spawning stock in the Hudson River, and of their use of the Lawler, Matusky, and Skelly (LMS) Real-Time Life Cycle Model to estimate the impact of entrainment and impingement on the Hudson River striped bass population

Subacute posteromedial impingement of the ankle in athletes: MR imaging evaluation and ultrasound guided therapy

International Nuclear Information System (INIS)

Messiou, Christina; Robinson, Philip; O'Connor, Philip J.; Grainger, Andrew

2006-01-01

To describe the use of MR imaging and efficacy of ultrasound-guided steroid injection in the diagnosis and management of athletes with clinical posteromedial impingement of the ankle. A retrospective analysis of imaging findings on MR was undertaken in nine elite athletes with clinical posteromedial ankle impingement. MR studies from six professional athletes with posterolateral pain were also reviewed as an imaging control group. The two reviewing radiologists were blinded to the clinical details and the proportion of control and study subjects. The nine study athletes also underwent diagnostic ultrasound and ultrasound-guided injection of steroid and anaesthetic into the posteromedial capsular abnormality. Follow-up was by telephone interview. Posteromedial capsular thickening was seen only in athletes with posteromedial impingement (7/9). Posteromedial synovitis was present in all athletes with posteromedial impingement; however, posterior and posterolateral synovitis was also seen in these athletes. Mild posteromedial synovitis was present in two control athletes. Ultrasound identified abnormal posteromedial soft tissue thickening deep to tibialis posterior between the medial malleolus and talus in all nine athletes. After injection all athletes returned to their previous level of sport, with eight of the nine not experiencing any residual or recurrent symptoms. If MR imaging excludes significant coexistent abnormality, ultrasound can localise posteromedial soft tissue abnormality and guide injection therapy, allowing return to athletic activity without surgical intervention. (orig.)

An analytical wall-function for recirculating and impinging turbulent heat transfer

International Nuclear Information System (INIS)

Suga, K.; Ishibashi, Y.; Kuwata, Y.

2013-01-01

Highlights: ► Improvement of the analytical wall-function is proposed. ► Strain parameter dependency is introduced to the prescribed eddy viscosity profile of the analytical wall-function. ► The model performance is evaluated in turbulent pipe, channel, back-step, abrupt expansion pipe and plane impinging flows. ► Generally improved heat transfer is obtained in all the test cases with the standard k-e model. -- Abstract: The performance of the analytical wall-function (AWF) of Craft et al. [Craft, T.J., Gerasimov, A.V., Iacovides, H., Launder, B.E., 2002, Progress in the generalisation of wall-function treatments. Int. J. Heat Fluid Flow 23, 148–160.] is improved for predicting turbulent heat transfer in recirculating and impinging flows. Since constant parameters of the eddy viscosity formula were used to derive the AWF, the prediction accuracy of the original AWF tends to deteriorate in complex flows where those parameters need changing according to the local turbulence. To overcome such shortcomings, the present study introduces a functional behaviour on the strain parameter into the coefficient of the eddy viscosity of the AWF. The presently modified version of the AWF is validated in turbulent heat transfer of pipe flows, channel flows, back-step flows, pipe flows with abrupt expansion and plane impinging slot jets. The results confirm that the present modification successfully improves the performance of the original AWF for all the flows and heat transfer tested

Global mode decomposition of supersonic impinging jet noise

Science.gov (United States)

Hildebrand, Nathaniel; Nichols, Joseph W.

2015-11-01

We apply global stability analysis to an ideally expanded, Mach 1.5, turbulent jet that impinges on a flat surface. The analysis extracts axisymmetric and helical instability modes, involving coherent vortices, shocks, and acoustic feedback, which we use to help explain and predict the effectiveness of microjet control. High-fidelity large eddy simulations (LES) were performed at nozzle-to-wall distances of 4 and 4.5 throat diameters with and without sixteen microjets positioned uniformly around the nozzle lip. These flow configurations conform exactly to experiments performed at Florida State University. Stability analysis about LES mean fields predicted the least stable global mode with a frequency that matched the impingement tone observed in experiments at a nozzle-to-wall distance of 4 throat diameters. The Reynolds-averaged Navier-Stokes (RANS) equations were solved at five nozzle-to-wall distances to create base flows that were used to investigate the influence of this parameter. A comparison of the eigenvalue spectra computed from the stability analysis about LES and RANS base flows resulted in good agreement. We also investigate the effect of the boundary layer state as it emerges from the nozzle using a multi-block global mode solver. Computational resources were provided by the Argonne Leadership Computing Facility.

Hip arthroscopy in patients with recurrent pain following Bernese periacetabular osteotomy for acetabular dysplasia: operative findings and clinical outcomes

Science.gov (United States)

Cvetanovich, Gregory L.; Heyworth, Benton E.; Murray, Kerri; Yen, Yi-Meng; Kocher, Mininder S.; Millis, Michael B.

2015-01-01

To report the operative findings and outcomes of hip arthroscopy for recurrent pain following periacetabular osteotomy (PAO) for acetabular dysplasia. A departmental database was used to identify patients who underwent hip arthroscopy following PAO between 2000 and 2009. Demographic data, arthroscopic findings, functional outcome scores and patient satisfaction were analysed. Of 556 PAO patients, 17 hips in 16 patients (3.1%) underwent post-PAO hip arthroscopy. Mean age at PAO was 23.8 years, and mean age at arthroscopy was 27.0 years. Common hip arthroscopy findings included labral tears (13 hips, 81.3%), significant (≥grade 2) chondral changes (12 hips, 75%), cam impingement (7 hips, 43.8%) and pincer impingement (6 hips, 37.5%). At mean follow-up 2.8 years after arthroscopy, additional procedures had been performed in six hips (37.5%), including total hip arthroplasty in one hip. Post-PAO arthroscopy questionnaire revealed 85.7% of patients with improved hip pain, 57.1% improved hip stiffness and 57.1% improved hip function. There was no significant difference in functional outcome measures. Common post-PAO hip arthroscopy findings include labral tears, chondral changes and femoroacetabular impingement. Many patients reported subjective hip improvement from post-PAO arthroscopy, but hip outcome scores were unchanged and one-third of patients had further surgery. PMID:27011852

Rotation Effect on Jet Impingement Heat Transfer in Smooth Rectangular Channels with Film Coolant Extraction

Directory of Open Access Journals (Sweden)

James A. Parsons

2001-01-01

Full Text Available The effect of channel rotation on jet impingement cooling by arrays of circular jets in twin channels was studied. Impinging jet flows were in the direction of rotation in one channel and opposite to the direction of rotation in the other channel. The jets impinged normally on the smooth, heated target wall in each channel. The spent air exited the channels through extraction holes in each target wall, which eliminates cross flow on other jets. Jet rotation numbers and jet Reynolds numbers varied from 0.0 to 0.0028 and 5000 to 10,000, respectively. For the target walls with jet flow in the direction of rotation (or opposite to the direction of rotation, as rotation number increases heat transfer decreases up to 25% (or 15% as compared to corresponding results for non-rotating conditions. This is due to the changes in flow distribution and rotation induced Coriolis and centrifugal forces.

Exploration of Impinging Water Spray Heat Transfer at System Pressures Near the Triple Point

Science.gov (United States)

Golliher, Eric L.; Yao, Shi-Chune

2013-01-01

The heat transfer of a water spray impinging upon a surface in a very low pressure environment is of interest to cooling of space vehicles during launch and re-entry, and to industrial processes where flash evaporation occurs. At very low pressure, the process occurs near the triple point of water, and there exists a transient multiphase transport problem of ice, water and water vapor. At the impingement location, there are three heat transfer mechanisms: evaporation, freezing and sublimation. A preliminary heat transfer model was developed to explore the interaction of these mechanisms at the surface and within the spray.

Numerical Predictions of Enhanced Impingement Jet Cooling with Ribs and Pins in Co-Flow and Cross-Flow Configurations

Directory of Open Access Journals (Sweden)

A. M. El-Jummah

2017-02-01

Full Text Available Numerical calculations relevant to gas turbine internal wall heat transfer cooling were conducted using conjugate heat transfer (CHT computational Fluid Dynamics (CFD commercial codes. The CHT CFD predictions were carried out for impingement heat transfer with different types of obstacle walls (fins on the target surfaces. A 10 × 10 row of impingement air jet holes (or hole density n of 4306 m-2 was used, which gives ten rows of holes in the cross-flow direction and only one heat transfer enhancement obstacle per impingement jet was investigated. Previously, four different shaped obstacles were investigated experimentally and were used to validate the present predictions. The obstacle walls, which were equally spaced on the centreline between each impingement jet are of the co-flow and cross-flow configurations. The impingement jet pitch X to diameter D, X/D and gap Z to diameter, Z/D ratios were kept constant at 4.66 and 3.06 for X, Z and D of 15.24, 10.00 and 3.27 mm, respectively. The obstacles investigated were ribs and rectangular pin-fins shapes, using two obstacles height H to diameter, H/D ratio of 1.38 and 2.45. Computations were carried out for three different mass flux G of 1.08, 1.48 and 1.94 kg/sm2. Relative pressure loss ∆P/P and surface average heat transfer coefficient (HTC h predictions for the range of G, showed good agreement with the experimental results. The prediction also reveals that obstacles not only increases the turbulent flows, but also takes away most of the cooling heat transfer that produces the regions with highest thermal gradients. It also reduces the impingement gap downstream cross-flow.

Development of iodine based impinger solutions for the efficient capture of Hg{sup 0} using direct injection nebulization-inductively coupled plasma mass spectrometry analysis

Energy Technology Data Exchange (ETDEWEB)

Hedrick, E.; Lee, T.G.; Biswas, P.; Zhuang, Y. [US Environmental Protection Agency, Cincinnati, OH (USA). National Exposure Research Laboratory

2001-09-15

Inductively coupled plasma mass spectrometry (ICP/MS) with direct injection nebulization (DIN) was used to evaluate novel impinger solution compositions capable of capturing elemental mercury (Hg{sup 0}) in EPA Method 5 type sampling. An iodine based impinger solution proved to be very efficient for Hg{sup 0} capture and was amenable to direct analysis by DIN-ICP/MS. Hg{sup 0} capture efficiency using aqueous iodine (I{sub 3}{sup -}) was comparable to Hg{sup 0} capture using acidified potassium permanganate impinger solutions which were analyzed by cold vapor atomic absorption spectrometry (CVAAS) with greater than 98% capture of Hg{sup 0} in the oxidizing impinger. Using DIN-ICP/MS, it was demonstrated for the first time that iodine can be generated just prior to impinger sampling for efficiently oxidizing Hg{sup 0} and retailing it in solution as HgI{sub 4}{sup 2-}. Due to the increased interest in Hg speciation from combustion sources and the potential for using DIN-ICP/MS for multiple metals analyses, an impinger sampling train for gaseous Hg speciation and multiple metals analyses using DIN-ICP/MS analyses is presented. The unique feature of such a sampling train is that each impinger solution in the series is amenable to direct analysis by DIN-ICP/MS. A bituminous coal was combusted in a bench scale coal system, and gaseous Hg species (oxidized and elemental) were determined using the proposed impinger train. The DIN-ICP/Ms instrumental detection limit was 0.003 ppb, and MDLs ranged from 0.007 to 0.116 {mu}g/L (ppb) in a variety of impinger solutions used for Hg capture. 33 refs., 5 figs., 7 tabs.

The importance of bony impingement in restricting flexion after total knee arthroplasty: computer simulation model with clinical correlation.

Science.gov (United States)

Mizu-Uchi, Hideki; Colwell, Clifford W; Fukagawa, Shingo; Matsuda, Shuichi; Iwamoto, Yukihide; D'Lima, Darryl D

2012-10-01

We constructed patient-specific models from computed tomography data after total knee arthroplasty to predict knee flexion based on implant-bone impingement. The maximum flexion before impingement between the femur and the tibial insert was computed using a musculoskeletal modeling program (KneeSIM; LifeModeler, Inc, San Clemente, California) during a weight-bearing deep knee bend. Postoperative flexion was measured in a clinical cohort of 21 knees (low-flex group: 6 knees with 125° of flexion at 2 years). Average predicted flexion angles were within 2° of clinical measurements for the high-flex group. In the low-flex group, 4 cases had impingement involving the bone cut at the posterior condyle, and the average predicted knee flexion was 102° compared with 93° measured clinically. These results indicate that the level of the distal femoral resection should be carefully planned and that exposed bone proximal to the tips of the posterior condyles of the femoral component should be removed if there is risk of impingement. Copyright © 2012 Elsevier Inc. All rights reserved.

Flow characteristics and heat transfer performances of a semi-confined impinging array of jets: effect of nozzle geometry

Energy Technology Data Exchange (ETDEWEB)

Dano, B.P.E.; Liburdy, J.A. [Oregon State Univ., Corvallis, OR (United States). Dept. of Mechanical Engineering; Kanokjaruvijit, Koonlaya [Imperial College, London (United Kingdom). Dept. of Mechanical Engineering

2005-02-01

The flow and heat transfer characteristics of confined jet array impingement with crossflow is investigated. Discrete impingement pressure measurements are used to obtain the jet orifice discharge flow coefficient. Digital particle image velocimetry (DPIV) and flow visualization are used to determine the flow characteristics. Two thermal boundary conditions at the impinging surface are presented: an isothermal surface, and a uniform heat flux, where thermocouple and thermochromic liquid crystal methods were used, respectively, to determine the local heat transfer coefficient. Two nozzle geometries are studied, circular and cusped ellipse. Based on the interaction with the jet impingement at the surface, the crossflow is shown to influence the heat transfer results. The two thermal boundary conditions differ in overall heat transfer correlation with the jet Reynolds number. Detailed velocity data show that the flow development from the cusped ellipse nozzle affects the wall region flow more than the circular nozzle, as influenced by the crossflow interactions. The overall heat transfer for the uniform heat flux boundary condition is found to increase for the cusped ellipse orifice. (Author)

Novel two-phase jet impingement heat sink for active cooling of electronic devices

International Nuclear Information System (INIS)

Oliveira, Pablo A. de; Barbosa, Jader R.

2017-01-01

Highlights: • Novel jet-based heat sink integrates the evaporator and the expansion device. • The system was tested with a small-scale oil-free R-134a compressor. • The thermodynamic performance of the cooling system was evaluated experimentally. • The single-jet maximum cooling capacity was 160 W, with a COP of 2.3 and a η 2nd of 8%. • Maximum heat transfer coefficient of 15 kW m −2 K −1 and surface temperature of 30 °C. - Abstract: This work presents a compact vapor compression cooling system equipped with a small-scale oil-free R-134a compressor and a jet-impingement-based heat sink that integrates the evaporator and the expansion device into a single unit. At the present stage of the development, a single orifice was used to generate the high-speed two-phase impinging jet on the heated surface. The effects of the compressor piston stroke, applied thermal load and orifice diameter on the system performance were quantified. The thermodynamic performance of the system was evaluated in terms of the temperature of the heated surface, impinging jet heat transfer coefficient, several system thermal resistances, coefficient of performance, second-law efficiency and second-law ratio. The coefficient of performance of the new refrigeration system increased with the cooling capacity, justifying its application in the removal of large thermal loads. The maximum system cooling capacity with a single jet was approximately 160 W, which was achieved with an orifice diameter of 500 μm and operation at a full compressor piston stroke. This condition corresponded to a COP of 2.3, a second-law efficiency of 8.0%, a jet impingement heat transfer coefficient above 15 kW m −2 K −1 and a heater surface temperature of approximately 30 °C.

Atmospheric H2O2 measurement: comparison of cold trap method with impinger bubbling method

Science.gov (United States)

Sakugawa, H.; Kaplan, I. R.

1987-01-01

Collection of atmospheric H2O2 was performed by a cold trap method using dry ice-acetone as the refrigerant. The air was drawn by a pump into a glass gas trap immersed in the dry ice-acetone slush in a dewar flask at a flow rate of 2.5 l min-1 for approximately 2 h. Collection efficiency was > 99% and negligible interferences by O3, SO2 or organic matter with the collected H2O2 in the trap were observed. This method was compared with the air impinger bubbling method which has been previously described (Kok et al., 1978a, b, Envir. Sci. Technol. 12, 1072-1080). The measured total peroxide (H2O2 + organic peroxide) values in a series of aim samples collected by the impinger bubbling method (0.06-3.7 ppb) were always higher than those obtained by the cold trap method (0.02-1.2 ppb). Laboratory experiments suggest that the difference in values between the two methods probably results from the aqueous phase generation of H2O2 and organic peroxide in the impinger solution by a reaction of atmospheric O3 with olefinic and aromatic compounds. If these O3-organic compound reactions which occur in the impinger also occur in aqueous droplets in the atmosphere, the process could be very important for aqueous phase generation of H2O2 in clouds and rainwater.

Arthroscopic treatment of impingement of the ankle reduces pain and enhances function

DEFF Research Database (Denmark)

Rasmussen, S; Hjorth Jensen, C

2002-01-01

A consecutive series of 105 patients with a median age of 35 (16-62) years who were operated on with arthroscopic resection for impingement of the ankle using standardized technique without distraction is presented. All patients complained of painful dorsiflexion and had failed to respond to cons...... synovectomy and intravenous antibiotics. In one patient persistent symptoms were recorded. Ankle arthroscopy yielded good results in the treatment of anterior impingement of the ankle as it effectively reduced pain and enhanced function....... of pain. Gait was improved in 30/41 patients and 22 resumed sporting activities. The results were graded excellent in 67, good in 25, fair in six and poor in seven patients. There were four deep infections and one synovial fistula in this series. The deep infections all responded well to arthroscopic...

Reasons for and functional results of repeated hip arthroscopy: A continuous prospective study of 17 revisions out of 295 primary hip arthroscopies at mean 28months' follow-up.

Science.gov (United States)

Tissot, C; Merlini, L; Mercier, M; Bonin, N

2017-09-01

The rate of iterative arthroscopy has been increasing over the last decade as the technique has grown. The results of and reasons for these revision procedures, however, are not exactly known. We therefore conducted a prospective study to shed light on: 1) functional results and patient satisfaction following repeated arthroscopy, and 2) the relevant indications. Functional scores and patient satisfaction increase following repeated arthroscopy. MATERIALS AND METHOD: A single-center continuous prospective study without control group included patients undergoing repeated hip arthroscopy between September 2010 and September 2014, with a mean 28months' follow-up (median, 23.3months; range, 12-62months). Preoperative and follow-up functional assessment used the modified Harris hip, WOMAC and Christensen (NHAS) questionnaires, and a satisfaction scale. On etiological analysis, repeated arthroscopy was indicated if a cause of recurrent or persistent pain accessible to arthroscopic treatment was identified. Seventeen patients were included out of 295 primary arthroscopies (5.7%): 9 male, 8 female; median age, 29.6years (range, 16-48years). Indications for primary arthroscopy comprised 13 cases of femoroacetabular impingement, 3 labrum lesions with instability, 1 chondromatosis and 1 case of osteoarthritis. Eleven of the 17 primary lesions showed persistence, including 9 of the 13 cases of femoroacetabular impingement. There were 3 failures in 17 repeated arthroscopies. All functional scores improved, with a gain of 7 points (P<0.06) on modified Harris hip score, 25 points (P<0.0006) on WOMAC score, and 27 points (P<0.001) on NHAS score. Ten of the 17 patients were satisfied or very satisfied with the repeated arthroscopy (59%). Although less good than on primary arthroscopy, functional results on repeated hip arthroscopy were satisfactory in the short term. The main reason for repeated arthroscopy was persistence of initial abnormality due to insufficient treatment

Revision Hip Arthroscopy: A Systematic Review of Diagnoses, Operative Findings, and Outcomes.

Science.gov (United States)

Cvetanovich, Gregory L; Harris, Joshua D; Erickson, Brandon J; Bach, Bernard R; Bush-Joseph, Charles A; Nho, Shane J

2015-07-01

To determine indications for, operative findings of, and outcomes of revision hip arthroscopy. A systematic review was registered with PROSPERO and performed based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Therapeutic clinical outcome studies reporting the indications for, operative findings of, and outcomes of revision hip arthroscopy were eligible for inclusion. All study-, patient-, and hip-specific data were extracted and analyzed. The Modified Coleman Methodology Score was used to assess study quality. Five studies were included (348 revision hip arthroscopies; 333 patients; mean age, 31.4 ± 4.2 years; 60% female patients). All 5 studies were either Level III or IV evidence. The surgeon performing revision hip arthroscopy was the same as the primary hip surgeon in only 25% of cases. The mean time between primary and revision hip arthroscopy was 27.8 ± 7.0 months (range, 2 to 193 months). Residual femoroacetabular impingement was the most common indication for and operative finding of revision hip arthroscopy (81% of cases). The most commonly reported revision procedures were femoral osteochondroplasty (24%) and acetabuloplasty (18%). The modified Harris Hip Score was used in all 5 analyzed studies, with significant (P arthroscopy, subsequent reported operations were hip arthroplasty in 11 patients and re-revision hip arthroscopy in 8 patients (5% total reoperation rate). Revision hip arthroscopy is most commonly performed for residual femoroacetabular impingement, with statistically significant and clinically relevant improvements shown in multiple patient-reported clinical outcome scores at short-term follow-up. The reoperation rate after revision hip arthroscopy is 5% within 2 years, including further arthroscopy or conversion to hip arthroplasty. Level IV, systematic review of Level III and IV studies. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Outcomes of Hip Arthroscopy in Competitive Athletes.

Science.gov (United States)

Perets, Itay; Hartigan, David E; Chaharbakhshi, Edwin O; Ashberg, Lyall; Ortiz-Declet, Victor; Domb, Benjamin G

2017-08-01

To evaluate the minimum 2-year postoperative clinical outcomes and the rate of return to sports in athletes who underwent capsular plication for the treatment of ligamentous laxity and/or borderline dysplasia during hip arthroscopy for the treatment of femoroacetabular impingement and labral pathology. Since 2008, data were prospectively collected on patients who underwent hip arthroscopy for the treatment of femoroacetabular impingement and/or labral tears. Inclusion criteria were as follows: athlete at the high school, collegiate, or professional levels preoperatively, underwent capsular plication, and preoperatively recorded patient-reported outcome scores including modified Harris hip score (mHHS), nonarthritic athletic hip score (NAHS), hip outcome score-sports-specific subscale (HOS-SSS), and visual analog scale (VAS). Exclusion criteria were as follows: 1, and previous hip conditions. Sports activity and competitive levels were collected at a minimum of 2 years postoperatively. Fifty-one hips (49 patients) met the inclusion criteria, and 41 hips (39 patients) had minimum 2-year follow-up (80.4% follow-up). Mean mHHS increased from 67.1 preoperatively to 83.5 (P arthroscopies allowed the patients to return to sports at follow-up. Thirty-four (82.9%) hip arthroscopies allowed the patients to maintain their competitive physical abilities at follow-up. Patient-reported outcomes and VAS in athletes significantly improved at a minimum of 2 years after capsular plication as a part of hip arthroscopy addressing varying pathologies. In addition, most patients returned to sports at similar or higher competitive levels. These results suggest that capsular plication is a favorable treatment option in athletes with ligamentous laxity and/or borderline dysplasia. Level IV, therapeutic case series. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Effect of wall impingement on ambient gas entrainment, fuel evaporation and mixture formation of diesel spray

Energy Technology Data Exchange (ETDEWEB)

Nishida, Keiya [Department of Mechanical Physics Engineering, University of Hiroshima (Japan); Matsumoto, Yuhei; Zhang, Wu [Mazda Motor Corp. (Japan); Gao, Jian [University of Wisconsin (United States); Moon, Seoksu [Argonne National Laboratory (United States)

2010-07-01

In the energy sector, with the implementation of stringent regulations on combustion emissions and the depletion of conventional fuels, there is a pressing need to improve the performance of engines. The purpose of this paper is to determine the impact of wall impingement on several characteristics of diesel spray. Experiments were carried out with both a small and a large amount of diesel spray injected and ambient gas entrainment, fuel evaporation and mixture formation were evaluated using an LAS optical system. Results showed that wall impingement has the same effects for small or large amounts of diesel spray injected; these are: a larger volume spray after the impingement and a smaller volume after it, the suppression of ambient gas entrainment and fuel evaporation, and the shift of the PDF peak of the vapor equivalent ratio. This study provided useful information but further work is needed to address the remaining issues.

Effect of guide wall on jet impingement cooling in blade leading edge channel

International Nuclear Information System (INIS)

Zhao, Qing-Yang; Chung, Heeyoon; Choi, Seok Min; Cho, Hyung Hee

2016-01-01

The characteristics of fluid flow and heat transfer, which are affected by the guide wall in a jet impinged leading edge channel, have been investigated numerically using three-dimensional Reynolds-averaged Navier-Stokes analysis via the shear stress transport turbulence model and gamma theta transitional turbulence model. A constant wall heat flux condition has been applied to the leading edge surface. The jet-to-surface distance is constant, which is three times that of the jet diameter. The arrangement of the guide wall near the jet hole is set as a variable. Results presented in this study include the Nusselt number contour, velocity vector, streamline with velocity, and local Nusselt number distribution along the central line on the leading edge surface. The average Nusselt number and average pressure loss between jet nozzle and channel exit are calculated to assess the thermal performance. The application of the guide wall is aimed at improving heat transfer uniformity on the leading edge surface. Results indicated that the streamwise guide wall ensures the vertical jet impingement flow intensity and prevents the flow after impingement to reflux into jet flow. Thus, a combined rectangular guide wall benefits the average heat transfer, thermal performance and heat transfer distribution uniformity

Spray-Wall Impingement of Diesel-CNG Dual Fuel Jet using Schlieren Imaging Technique

Directory of Open Access Journals (Sweden)

Ismael Mhadi Abaker

2014-07-01

Full Text Available Natural gas is a low cost fuel with high availability in nature. However, it cannot be used by itself in conventional diesel engines due to its low flame speed and high ignition temperature. The addition of a secondary fuel to enhance the mixture formation and combustion process facilitate its wider use as an alternative fuel. An experimental study was performed to investigate the diesel-CNG dual fuel jet-wall impingement. A constant volume optical chamber was designed to facilitate maximum optical access for the study of the jet-wall impingement at different injection pressures, temperatures and injector-wall distances. The bottom plate of the test rig was made of aluminum (piston material and it was heated up to 500 K at ambient pressure. An injector driver was used to control the single-hole nozzle diesel injector combined with a natural gas injector. The injection timing of both injectors was synchronized with a camera trigger. The jet-wall impingement of diesel and diesel-CNG dual fuel jets was recorded with a high speed camera using Schlieren imaging technique and associated image processing software. The measurements of the jet radial penetration were higher in diesel-CNG dual fuel while the jet height travel along were higher in the case of diesel single fuel.

Effectiveness of Standardized Physical Therapy Exercises for Patients With Difficulty Returning to Usual Activities After Decompression Surgery for Subacromial Impingement Syndrome: Randomized Controlled Trial.

Science.gov (United States)

Christiansen, David Høyrup; Frost, Poul; Falla, Deborah; Haahr, Jens Peder; Frich, Lars Henrik; Andrea, Linda Christie; Svendsen, Susanne Wulff

2016-06-01

Little is known about the effectiveness of exercise programs after decompression surgery for subacromial impingement syndrome. For patients with difficulty returning to usual activities, special efforts may be needed to improve shoulder function. The purpose of this study was to evaluate the effectiveness at 3 and 12 months of a standardized physical therapy exercise intervention compared with usual care in patients with difficulty returning to usual activities after subacromial decompression surgery. A multicenter randomized controlled trial was conducted. The study was conducted in 6 public departments of orthopedic surgery, 2 departments of occupational medicine, and 2 physical therapy training centers in Central Denmark Region. One hundred twenty-six patients reporting difficulty returning to usual activities at the postoperative clinical follow-up 8 to 12 weeks after subacromial decompression surgery participated. A standardized exercise program consisting of physical therapist-supervised individual training sessions and home training was used. The primary outcome measure was the Oxford Shoulder Score. Secondary outcome measures were the Constant Score and the Fear-Avoidance Beliefs Questionnaire. At 3 and 12 months, follow-up data were obtained for 92% and 83% of the patients, respectively. Intention-to-treat analyses suggested a between-group difference on the Oxford Shoulder Score favoring the exercise group at 3 months, with an adjusted mean difference of 2.0 (95% confidence interval=-0.5, 4.6), and at 12 months, with an adjusted mean difference of 5.8 (95% confidence interval=2.8, 8.9). Significantly larger improvements for the exercise group were observed for most secondary and supplementary outcome measures. The nature of the exercise intervention did not allow blinding of patients and care providers. The standardized physical therapy exercise intervention resulted in statistically significant and clinically relevant improvement in shoulder pain and

Influence of microscale surface modification on impinging flow heat transfer performance

NARCIS (Netherlands)

Taha, T.J.; Lefferts, Leonardus; van der Meer, Theodorus H.

2016-01-01

An experimental approach has been used to investigate the influence of a thin layer of carbon nanotubes (CNTs) on the convective heat transfer performance under impinging flow conditions. A successful synthesis of CNT layers was achieved using a thermal catalytic vapor deposition process (TCVD) on

Study of Plume Impingement Effects in the Lunar Lander Environment

Science.gov (United States)

Marichalar, Jeremiah; Prisbell, A.; Lumpkin, F.; LeBeau, G.

2010-01-01

Plume impingement effects from the descent and ascent engine firings of the Lunar Lander were analyzed in support of the Lunar Architecture Team under the Constellation Program. The descent stage analysis was performed to obtain shear and pressure forces on the lunar surface as well as velocity and density profiles in the flow field in an effort to understand lunar soil erosion and ejected soil impact damage which was analyzed as part of a separate study. A CFD/DSMC decoupled methodology was used with the Bird continuum breakdown parameter to distinguish the continuum flow from the rarefied flow. The ascent stage analysis was performed to ascertain the forces and moments acting on the Lunar Lander Ascent Module due to the firing of the main engine on take-off. The Reacting and Multiphase Program (RAMP) method of characteristics (MOC) code was used to model the continuum region of the nozzle plume, and the Direct Simulation Monte Carlo (DSMC) Analysis Code (DAC) was used to model the impingement results in the rarefied region. The ascent module (AM) was analyzed for various pitch and yaw rotations and for various heights in relation to the descent module (DM). For the ascent stage analysis, the plume inflow boundary was located near the nozzle exit plane in a region where the flow number density was large enough to make the DSMC solution computationally expensive. Therefore, a scaling coefficient was used to make the DSMC solution more computationally manageable. An analysis of the effectiveness of this scaling technique was performed by investigating various scaling parameters for a single height and rotation of the AM. Because the inflow boundary was near the nozzle exit plane, another analysis was performed investigating three different inflow contours to determine the effects of the flow expansion around the nozzle lip on the final plume impingement results.

Computational parametric study of an impinging jet in a cross-flow configuration for electronics cooling applications

International Nuclear Information System (INIS)

Larraona, Gorka S.; Rivas, Alejandro; Antón, Raúl; Ramos, Juan Carlos; Pastor, Ignacio; Moshfegh, Bahram

2013-01-01

A parametric study based on design of experiments (DoE) techniques was carried out by computational simulation in order to evaluate the effect that design parameters have on heat transfer and pressure loss of an impinging jet in a cross-flow configuration. The main effects of each parameter and the interactions between parameters were analyzed in detail through the Response Surface Methodology (RSM). Additionally, the potential of the impinging jet in a cross-flow configuration was assessed by calculating the optimal values of the parameters and comparing the cooling efficiency of the resulting configuration with the efficiency of the conventional cross-flow configuration. It was found that the degree to which the average heat transfer coefficient is enhanced as the result of adding an impinging jet depends on the height of the cooled component. Specifically, it was found that the higher the component, the more significant the enhancement. -- Highlights: ► Five design parameters of an impinging jet in a cross-flow (IJCF) have been considered. ► Channel and jet velocities are found to be the most influential parameters. ► Significant interactions exist between some of the parameters. ► Larger cooling efficiency is achieved with the IJCF compared to the cross-flow solely. ► The enhancement obtained with the IJCF depends on the height of the component

Hip arthroscopy

Directory of Open Access Journals (Sweden)

Henrique Antônio Berwanger de Amorim Cabrita

2015-06-01

Full Text Available Hip arthroscopy is a safe method for treating a variety of pathological conditions that were unknown until a decade ago. Femoroacetabular impingement is the commonest of these pathological conditions and the one with the best results when treated early on. The instruments and surgical technique for hip arthroscopy continue to evolve. New indications for hip arthroscopy has been studied as the ligamentum teres injuries, capsular repair in instabilities, dissection of the sciatic nerve and repair of gluteal muscles tears (injuries to the hip rotator cuff, although still with debatable reproducibility. The complication rate is low, and ever-better results with fewer complications should be expected with the progression of the learning curve.

Visualization and mass transfer with a bistable two-slot impinging jet

Czech Academy of Sciences Publication Activity Database

Trávníček, Zdeněk; Maršík, František

2003-01-01

Roč. 6, č. 4 (2003), s. 337-441 ISSN 1343-8875 R&D Projects: GA AV ČR IAA2076203 Institutional research plan: CEZ:AV0Z2076919 Keywords : visualization * mass transfer * impinging jet Subject RIV: BK - Fluid Dynamics Impact factor: 0.279, year: 2002

The scapular dyskinesis test

DEFF Research Database (Denmark)

Christiansen, David Høyrup; Møller, Anders Damgaard; Vestergaard, Jesper Medom

2017-01-01

tests with which to identify scapular dyskinesis. PURPOSE OF THE STUDY: To evaluate intrarater and interrater reliability and predictive value of the Scapular Dyskinesis Test (SDT) in patients with subacromial impingement syndrome. METHODS: Forty-five patients with subacromial impingement syndrome were...

Numerical study of an impinging jet to a turbulent channel flow in a T-Junction configuration

Science.gov (United States)

Georgiou, Michail; Papalexandris, Miltiadis

2016-11-01

In this talk we report on Large Eddy Simulations of an impinging planar jet to a turbulent channel flow in a T-Junction configuration. Due to its capacity for mixing and heat transfer enhancement, this type of flow is encountered in various industrial applications. In particular, our work is related to the emergency cooling systems of pressurized water reactors. As is well known, this type of flow is dominated by a large separation bubble downstream the jet impingement location. Secondary regions of flow separation are predicted both upstream and downstream the impinging jet. We describe how these separation regions interact with the shear layer that is formed by the injection of the jet to the crossflow, and how they affect the mixing process. In our talk we further examine the influence of the jet's velocity to characteristic quantities of the jet, such as penetration length and expansion angle, as well as to the first and second-order statistics of the flow.

Detection of airborne Legionella while showering using liquid impingement and fluorescent in situ hybridization (FISH).

Science.gov (United States)

Deloge-Abarkan, Magali; Ha, Thi-Lan; Robine, Enric; Zmirou-Navier, Denis; Mathieu, Laurence

2007-01-01

Aerosols of water contaminated with Legionella bacteria constitute the only mode of exposure for humans. However, the prevention strategy against this pathogenic bacteria risk is managed through the survey of water contamination. No relationship linked the Legionella bacteria water concentration and their airborne abundance. Therefore, new approaches in the field of the metrological aspects of Legionella bioaerosols are required. This study was aimed at testing the main principles for bioaerosol collection (solid impaction, liquid impingement and filtration) and the in situ hybridization (FISH) method, both in laboratory and field assays, with the intention of applying such methodologies for airborne Legionella bacteria detection while showering. An aerosolization chamber was developed to generate controlled and reproducible L. pneumophila aerosols. This tool allowed the identification of the liquid impingement method as the most appropriate one for collecting airborne Legionella bacteria. The culturable fraction of airborne L. pneumophila recovered with the liquid impingement principle was 4 and 700 times higher compared to the impaction and filtration techniques, respectively. Moreover, the concentrations of airborne L. pneumophila in the impinger fluid were on average 7.0 x 10(5) FISH-cells m(-3) air with the fluorescent in situ hybridization (FISH) method versus 9.0 x 10(4) CFU m(-3) air with the culture method. These results, recorded under well-controlled conditions, were confirmed during the field experiments performed on aerosols generated by hot water showers in health institutions. This new approach may provide a more accurate characterization of aerobiocontamination by Legionella bacteria.

Characteristics of compressed natural gas jet and jet-wall impingement using the Schlieren imaging technique

International Nuclear Information System (INIS)

Ismael, M A; Heikal, M R; Baharom, M B

2013-01-01

An experimental study was performed to investigate the compressed natural gas jet characteristics and jet-wall impingement using the Schlieren imaging technique and image processing. An injector driver was used to drive the natural gas injector and synchronized with camera triggering. A constant-volume optical chamber was designed to facilitate maximum optical access for the study of the jet macroscopic characteristics and jet-wall impingement at different injection pressures and injectors-wall distances. Measurement of the jet tip penetration and cone angle at different conditions are presented in this paper together with temporal presentation of the jet radial travel along the wall.

A 12-week rehabilitation program improves body composition, pain sensation, and internal/external torques of baseball pitchers with shoulder impingement symptom.

Science.gov (United States)

Cha, Jun-Youl; Kim, Jae-Hak; Hong, Ju; Choi, Young-Tae; Kim, Min-Ho; Cho, Ji-Hyun; Ko, Il-Gyu; Jee, Yong-Seok

2014-02-01

The aim of this study was to investigate the effects of a 12-week rehabilitation program on body composition, shoulder pain, and isokinetic internal/external torques of pitchers with impingement syndrome. A total of 30 pitchers were divided into 2 groups: experimental group (EG, n = 16) and control group (CG, n= 14). The rehabilitation program consisted of physical therapy, warm-up, work-out, and cool-down. As results, body weight and fat mass of EG were decreased whereas muscle mass of EG was significantly increased after the experiment. The pain degrees in resting, normal daily activity, and strenuous activity on the numeric pain rating scale were significantly decreased in the EG. The internal and external peak torques (PTs) of uninvolved and involved sides of EG were increased in EG after 12 weeks. Such results provide a deficit ratio of both sides in EG close to normal values. The ratios of internal/external PTs in EG were also close to the reference values. The internal and external total works of both sides in EG were similar to the values of PT. The fatigue indices of internal and external rotators of both sides in EG were decreased. As a conclusion, a 12-week rehabilitation program reduced the shoulder pain, improved the body composition and enhanced the isokinetic shoulder internal/external rotators in EG with impingement symptoms. Also the study suggested that the rehabilitation program evened out the ratio between internal and external rotators and lowered the fatigue level after the experiment.

Sports Injuries about the Hip: What the Radiologist Should Know.

Science.gov (United States)

Hegazi, Tarek M; Belair, Jeffrey A; McCarthy, Eoghan J; Roedl, Johannes B; Morrison, William B

2016-10-01

Injuries of the hip and surrounding structures represent a complex and commonly encountered scenario in athletes, with improper diagnosis serving as a cause of delayed return to play or progression to a more serious injury. As such, radiologists play an essential role in guiding management of athletic injuries. Familiarity with hip anatomy and the advantages and limitations of various imaging modalities is of paramount importance for accurate and timely diagnosis. Magnetic resonance (MR) imaging is often the modality of choice for evaluating many of the injuries discussed, although preliminary evaluation with conventional radiography and use of other imaging modalities such as ultrasonography (US), computed tomography, and bone scintigraphy may be supplementary or preferred in certain situations. Stress fractures, thigh splints, and posterior hip dislocations are important structural injuries to consider in the athlete, initially imaged with radiographs and often best diagnosed with MR imaging. Apophyseal injuries are particularly important to consider in young athletes and may be acute or related to chronic repetitive microtrauma. Femoroacetabular impingement has been implicated in development of labral tears and cartilage abnormalities. Tear of the ligamentum teres is now recognized as a potential cause of hip pain and instability, best evaluated with MR arthrography. Greater trochanteric pain syndrome encompasses a group of conditions leading to lateral hip pain, with US playing an increasingly important role for both evaluation and image-guided treatment. Muscle injuries and athletic pubalgia are common in athletes. Lastly, snapping hip syndrome and Morel-Lavallée lesions are two less common but nonetheless important considerations. © RSNA, 2016.

Current UK practices in the management of subacromial impingement.

Science.gov (United States)

Bryceland, James K; Drury, Colin; Tait, Gavin R

2015-07-01

Controversy presently exists surrounding the management of patients with subacromial impingement. This study aims to highlight current UK practices in the management of these patients. BESS members were invited to complete a questionnaire and responses were received from 157 consultant shoulder surgeons. Physiotherapy is an integral part of management for 93% of surgeons with a minimum period of 12 weeks being most popular prior to consideration of arthroscopic subacromial decompression. Subacromial steroid injection is used by 95% and 86% repeat this if the patient has failed to respond to a previous injection by the general practioner. From initial presentation, 77% felt there should be at least 3 months of conservative management before proceeding to surgery. Good but transient response to subacromial injection was considered the best predictor of good surgical outcome by 77%. The coracoacromial ligament is fully released by 78%, although there was greater variation in how aggressive surgeons were with acromioplasty. Most (59%) do not include the nontender acromioclavicular joint to any extent in routine acromioplasty. Hospital physiotherapy protocols are used by 63% for postoperative rehabilitation. Variation exists in the management regimes offered to patients with subacromial impingement, but most employ a minimum period of 12 weeks of conservative management incorporating physiotherapy and at least 2 subacromial steriod injections.

Combined Anterolateral, Anterior, and Anteromedial Ankle Impingement in an Adolescent Soccer Player-A Case Report and Review of the Literature.

Science.gov (United States)

Cosma, Dan I; Vasilescu, Dana E; Corbu, Andrei; Todor, Adrian; Valeanu, Madalina; Ulici, Alexandru

2018-01-24

A unique case of combined anterolateral, anterior, and anteromedial ankle impingement in an adolescent soccer player is presented in this article. To the best of our knowledge, this is the only report of circumferential, massive, anterior ankle impingement in children described in the literature. The importance of proper diagnosis and treatment of such a lesion is illustrated in this case report. We also emphasize that clinical examination combined with 3D computed tomography scan reconstruction is an excellent and cost-effective imaging modality that can help with the diagnosis of anterior ankle impingement. Finally, open surgical treatment showed excellent results in an elite athlete.

Excitational metamorphosis of surface flowfield under an impinging annular jet

Czech Academy of Sciences Publication Activity Database

Tesař, Václav; Trávníček, Zdeněk

2008-01-01

Roč. 144, č. 2 (2008), s. 312-316 ISSN 1385-8947 R&D Projects: GA ČR GA101/07/1499; GA AV ČR IAA200760705 Institutional research plan: CEZ:AV0Z20760514 Keywords : jets * impinging jets * flow topology * annular jets * stagnation points Subject RIV: BK - Fluid Dynamics Impact factor: 2.813, year: 2008 http://www.sciencedirect.com/

[Efficacies of arthroscopic debridement and olecranon fossa plasty in the treatment of osteoarthritis and posterior elbow impingement].

Science.gov (United States)

Liu, Yu-jie; Wang, Jun-liang; Li, Hai-feng; Qi, Wei; Wang, Ning

2012-07-17

To evaluate the efficacies of arthroscopic debridement and removal of osteophyma for olecroanon and olecranon fossa plasty for posterior impingement of elbow joint. Between 1999 and 2008, a total of 21 cases were diagnosed with osteoarthritis and posterior elbow impingement. There were 15 males and 6 females. And there were 16 right and 15 left cases. They included volleyball players (n = 7), tennis players (n = 7), golf enthusiasts (n = 4) and fencers (n = 3). The average duration of onset-operation was 3.5 years (range: 2.5 - 8). Arthroscopic exploration revealed synovial hyperplasia hypertrophy, cartilage degeneration and olecranon fossa hyperplasia with deformed olecranon fossa. Debridement and plasty were performed. Loose bodies were removed from elbow joint in 6 patients. Partial resection of posterior olecranon tip was performed and osteophytes or fibrous tissue removed in this area. Dynamic observation showed no posterior elbow impingement. Postoperative follow-up was conducted in 19 cases and 2 cases became lost to follow-up. The average follow-up period was 25.3 months (range: 18 - 42). All patients were evaluated preoperatively and postoperatively with the Hospital for Special Surgery Elbow Assessment Scale. The outcomes were excellent (n = 12), good (n = 7) and fair (n = 2). Postoperative patients elbow swelling and pain relieve, sports and life function returns to normal, elbow flexion and rotating mobility obviously improved. With the elbow radiological films to measure the range of motion, the average range of motion was 90.5° preoperatively and improved to 130° postoperatively. There was significant improvement in all cases. Posterior elbow impingement is caused by hyperextension trauma and elbow overuse during specific sporting activities. Arthroscopic debridement and olecroanon or olecranon fossa plasty demonstrates excellent results for posterior impingement of elbow joint.

Turbulent flow and heat transfer from a slot jet impinging on a moving plate

International Nuclear Information System (INIS)

Chattopadhyay, Himadri; Saha, Sujoy K.

2003-01-01

The flow field due to an impinging jet over a moving surface at a moderately high Reynolds number, emanating from a rectangular slot nozzle has been computed using the large eddy simulation technique. A dynamic subgrid-scale stress model has been used for the small scales of turbulence. The velocity of the impinging surface perpendicular to the jet velocity has been varied up to two times the jet velocity at the nozzle exit. Turbulence quantities such as kinetic energy, production rate of turbulent kinetic energy and the Reynolds stresses are calculated for different surface velocities. It has been observed that, while the turbulent kinetic energy increases with increasing velocity of the impinging surface, production rate of turbulence initially increases with increasing surface velocity and then comes down. By analyzing the components of turbulent production it was found that P 33 is the dominant term up to the surface velocity of one unit and when the surface velocity is two times the jet velocity at the nozzle exit, the major contribution to turbulence production comes from P 13 and partly from P 11 . Heat transfer from the plate initially increases with non-dimensional surface velocity up to 1.2 and then comes down

Síndrome do impacto posterior do tornozelo: um diagnóstico que deve ser lembrado pelo reumatologista. Relato de dois casos Posterior ankle impingement syndrome: a diagnosis rheumatologists should not forget. Two case reports

Directory of Open Access Journals (Sweden)

Adriano Chiereghin

2011-06-01

Full Text Available O tornozelo é sítio frequente de sintomas dolorosos em atletas e não atletas. A dor localizada na região posterior pode ser o resultado final de diversas patologias, sendo um desafio diagnóstico para o reumatologista. A síndrome do impacto (pinçamento posterior do tornozelo, também denominada síndrome os trigonum e síndrome compressiva tibiotalar posterior, é um distúrbio clínico caracterizado por dor aguda ou crônica na região posterior do tornozelo, desencadeada pela flexão plantar forçada, que promove microtrauma crônico repetitivo. A patologia do processo os trigonum-talar é a causa mais comum dessa síndrome, mas existem outras causas, como tenossinovite do flexor longo do hálux, osteocondrite de tornozelo, doença da articulação subtalar e fratura. O diagnóstico baseia-se na história clínica e exame físico, e complementado por achados na radiografia simples (RX, ultrassom (US, cintilografia, tomografia computadorizada (TC e ressonância magnética (RM. Destacamos o RX por seu baixo custo e boa sensibilidade, o US pela possibilidade de guiar infiltrações terapêuticas e a RM pela possibilidade de avaliar partes moles adjacentes.The ankle is a common site of painful symptoms in athletes and nonathletes. Posterior ankle pain can be the end result of several pathologies, and a diagnostic challenge for rheumatologists. The posterior ankle impingement syndrome, also known as os trigonum syndrome and posterior tibiotalar compression syndrome, is a clinical disorder characterized by acute or chronic posterior ankle pain triggered by forced plantar flexion, which causes chronic repetitive microtrauma. Pathology of the os trigonum-talar process is the most common cause of this syndrome, but there are other causes, such as tenosynovitis of the flexor hallucis longus, ankle osteochondritis, subtalar joint disease, and fracture. Diagnosis is based on clinical history and physical examination, and complemented by findings on

Decompression syndrome (Caisson disease) in an Indian diver.

Science.gov (United States)

Phatak, Uday A; David, Eric J; Kulkarni, Pravin M

2010-07-01

Acute decompression syndrome (Caisson's disease) is an acute neurological emergency in divers. It is caused due to release of nitrogen gas bubbles that impinge the blood vessels of the spinal cord and brain and result in severe neurodeficit. There are very few case reports in Indian literature. There are multiple factors in the pathogenesis of Acute decompression syndrome (Caisson's disease) such as health problems in divers (respiratory problems or congenital heart diseases like atrial septal defect, patent ductus arteriosus etc), speed of ascent from the depth and habits like smoking that render divers susceptible for such neurological emergency. Usually, immediate diagnosis of such a condition with MRI is not possible in hospitals in the Coastal border. Even though, MRI is performed, it has very low specificity and sensitivity. Facilities like hyperbaric oxygen treatment are virtually non-existent in these hospitals. Therefore, proper education of the divers and appropriate preventive measures in professional or recreational divers is recommended.

Decompression syndrome (Caisson disease in an Indian diver

Directory of Open Access Journals (Sweden)

Phatak Uday

2010-01-01

Full Text Available Acute decompression syndrome (Caisson′s disease is an acute neurological emergency in divers. It is caused due to release of nitrogen gas bubbles that impinge the blood vessels of the spinal cord and brain and result in severe neurodeficit. There are very few case reports in Indian literature. There are multiple factors in the pathogenesis of Acute decompression syndrome (Caisson′s disease such as health problems in divers (respiratory problems or congenital heart diseases like atrial septal defect, patent ductus arteriosus etc, speed of ascent from the depth and habits like smoking that render divers susceptible for such neurological emergency. Usually, immediate diagnosis of such a condition with MRI is not possible in hospitals in the Coastal border. Even though, MRI is performed, it has very low specificity and sensitivity. Facilities like hyperbaric oxygen treatment are virtually non-existent in these hospitals. Therefore, proper education of the divers and appropriate preventive measures in professional or recreational divers is recommended.

Numerical study of a confined slot impinging jet with nanofluids

Directory of Open Access Journals (Sweden)

Manca Oronzio

2011-01-01

Full Text Available Abstract Background Heat transfer enhancement technology concerns with the aim of developing more efficient systems to satisfy the increasing demands of many applications in the fields of automotive, aerospace, electronic and process industry. A solution for obtaining efficient cooling systems is represented by the use of confined or unconfined impinging jets. Moreover, the possibility of increasing the thermal performances of the working fluids can be taken into account, and the introduction of nanoparticles in a base fluid can be considered. Results In this article, a numerical investigation on confined impinging slot jet working with a mixture of water and Al2O3 nanoparticles is described. The flow is turbulent and a constant temperature is applied on the impinging. A single-phase model approach has been adopted. Different geometric ratios, particle volume concentrations and Reynolds number have been considered to study the behavior of the system in terms of average and local Nusselt number, convective heat transfer coefficient and required pumping power profiles, temperature fields and stream function contours. Conclusions The dimensionless stream function contours show that the intensity and size of the vortex structures depend on the confining effects, given by H/W ratio, Reynolds number and particle concentrations. Furthermore, for increasing concentrations, nanofluids realize increasing fluid bulk temperature, as a result of the elevated thermal conductivity of mixtures. The local Nusselt number profiles show the highest values at the stagnation point, and the lowest at the end of the heated plate. The average Nusselt number increases for increasing particle concentrations and Reynolds numbers; moreover, the highest values are observed for H/W = 10, and a maximum increase of 18% is detected at a concentration equal to 6%. The required pumping power as well as Reynolds number increases and particle concentrations grow, which is almost 4

Scapular Notching on Kinematic Simulated Range of Motion After Reverse Shoulder Arthroplasty Is Not the Result of Impingement in Adduction

Science.gov (United States)

Lädermann, Alexandre; Gueorguiev, Boyko; Charbonnier, Caecilia; Stimec, Bojan V.; Fasel, Jean H.D.; Zderic, Ivan; Hagen, Jennifer; Walch, Gilles

2015-01-01

Abstract Impingement after reverse shoulder arthroplasty (RSA) is believed to occur from repetitive contact in adduction between the humeral component and the inferior scapular pillar. The primary purpose of this biomechanical study was to confirm the presence of different types of impingement and to examine which daily-life movements are responsible for them. A secondary aim was to provide recommendations on the type of components that would best minimize notching and loss of range of motion (ROM). The study included 12 fresh frozen shoulder specimens; each had a computed tomography (CT) image of the entire scapula and humerus in order to acquire topological information of the bones before RSA implantation. Cyclic tests were run postimplantation with 3 shoulders in each modalities. To quantify bone loss due to impingement, 3-dimensional anatomical models of the scapula were reconstructed from the CT scans and compared to their intact states. We found 8 bony impingements in 7 specimens: 2 at the lateral acromion, 1 at the inferior acromion, 4 scapular notching, and 1 with the glenoid resulting to wear at the 3:00 to 6:00 clock-face position. Impingements occurred in all kinds of tested motions, except for the internal/external rotation at 90° of abduction. The 3 specimens tested in abduction/adduction presented bone loss on the acromion side only. Scapular notching was noted in flexion/extension and in internal/external rotation at 0° of abduction. The humeral polyethylene liner was worn in 2 specimens—1 at the 6:00 to 8:00 clock-face position during internal/external rotation at 0° of abduction and 1 at the 4:00 clock-face position during flexion/extension. The present study revealed that 2 types of impingement interactions coexist and correspond to a frank abutment or lead to a scapular notching (friction-type impingement). Scapular notching seems to be caused by more movements or combination of movements than previously considered, and in particular by

Flow induced on a salt waterbody due to the impingement of a freshwater drop

Science.gov (United States)

Benouaguef, Islam; Amah, Edison; Musunuri, Naga; Blackmore, Denis; Fischer, Ian; Singh, Pushpendra

2017-11-01

The particle image velocimetry (PIV) and planar laser-induced fluorescence (PLIF) techniques are used to study the flow induced on the surface of a salt waterbody when a drop impinges on the surface. The measurements show that the impingement of a fresh water drop causes a strong axisymmetric solutocapillary flow about the vertical line passing through the center of impact. The fluid directly below the center of impact rises upward, and near the surface it moves away from the center of impact. The flow, which develops within a fraction of second after the impact, persists for several seconds and the volume of water circulated is two orders of magnitude larger than the volume circulated when a freshwater drop falls on a freshwater body.

Current UK practices in the management of subacromial impingement

Science.gov (United States)

Drury, Colin; Tait, Gavin R

2015-01-01

Background Controversy presently exists surrounding the management of patients with subacromial impingement. This study aims to highlight current UK practices in the management of these patients. Methods BESS members were invited to complete a questionnaire and responses were received from 157 consultant shoulder surgeons. Results Physiotherapy is an integral part of management for 93% of surgeons with a minimum period of 12 weeks being most popular prior to consideration of arthroscopic subacromial decompression. Subacromial steroid injection is used by 95% and 86% repeat this if the patient has failed to respond to a previous injection by the general practioner. From initial presentation, 77% felt there should be at least 3 months of conservative management before proceeding to surgery. Good but transient response to subacromial injection was considered the best predictor of good surgical outcome by 77%. The coracoacromial ligament is fully released by 78%, although there was greater variation in how aggressive surgeons were with acromioplasty. Most (59%) do not include the nontender acromioclavicular joint to any extent in routine acromioplasty. Hospital physiotherapy protocols are used by 63% for postoperative rehabilitation. Conclusions Variation exists in the management regimes offered to patients with subacromial impingement, but most employ a minimum period of 12 weeks of conservative management incorporating physiotherapy and at least 2 subacromial steriod injections. PMID:27582972

Numerical simulation of heat transfer and fluid flow of an impinging round jet of plasma into confined walls

International Nuclear Information System (INIS)

Ezato, Koichiro; Shimizu, Akihiko; Kunugi, Tomoaki.

1995-01-01

Numerical simulations are presented on the flow and heat transfer characteristics of an impinging round jet of argon plasma with atmospheric pressure. The target slab with finite thickness upon which plasma jet impinges is assumed to be as SiC which is a candidate material for plasma facing material of fusion reactor. The plasma jet is treated by use of a magnetohydrodynamics model that takes its two-temperature non-equilibrium state into account. The rear side of the target slab is assumed to be cooled by a gas-solid suspension impinging round jet. The result shows that the plasma is in non-equilibrium state in which the electron temperature is higher than the heavy particle in the outer region of plasma jet core and that the heat flux to the target slab is over 8 MW/m 2 in the region of the plasma jet core contacts. (author)

Heat/mass transfer on effusion plate with circular pin fins for impingement/effusion cooling system with initial crossflow

International Nuclear Information System (INIS)

Hong, Sung Kook; Rhee, Dong Ho; Cho, Hyung Hee

2005-01-01

Impingement/effusion cooling technique is used for combustor liner or turbine parts cooling in gas turbine engine. In the impingement/effusion cooling system, the crossflow generated in the cooling channel induces an adverse effect on the cooling performance, which consequently affects the durability of the cooling system. In the present study, to reduce the adverse effect of the crossflow and improve the cooling performance, circular pin fins are installed in impingement/effusion cooling system and the heat transfer characteristics are investigated. The pin fins are installed between two perforated plates and the crossflow passes between these two plates. A blowing ratio is changed from 0.5 to 1.5 for the fixed jet Reynolds number of 10,000 and five circular pin fin arrangements are considered in this study. The local heat/mass transfer coefficients on the effusion plate are measured using a naphthalene sublimation method. The results show that local distributions of heat/mass transfer coefficient are changed due to the installation of pin fins. Due to the generation of vortex and wake by the pin fin, locally low heat/mass transfer regions are reduced. Moreover, the pin fin prevents the wall jet from being swept away, resulting in the increase of heat/mass transfer. When the pin fin is installed in front of the impinging jet, the blockage effect on the crossflow enhances the heat/mass transfer. However, the pin fin installed just behind the impinging jet blocks up the wall jet, decreasing the heat/mass transfer. As the blowing ratio increases, the pin fins lead to the higher Sh value compared to the case without pin fins, inducing 16%∼22% enhancement of overall Sh value at high blowing ratio of M=1.5

The sagittal stem alignment and the stem version clearly influence the impingement-free range of motion in total hip arthroplasty: a computer model-based analysis.

Science.gov (United States)

Müller, Michael; Duda, Georg; Perka, Carsten; Tohtz, Stephan

2016-03-01

The component alignment in total hip arthroplasty influences the impingement-free range of motion (ROM). While substantiated data is available for the cup positioning, little is known about the stem alignment. Especially stem rotation and the sagittal alignment influence the position of the cone in relation to the edge of the socket and thus the impingement-free functioning. Hence, the question arises as to what influence do these parameters have on the impingement-free ROM? With the help of a computer model the influence of the sagittal stem alignment and rotation on the impingement-free ROM were investigated. The computer model was based on the CT dataset of a patient with a non-cemented THA. In the model the stem version was set at 10°/0°/-10° and the sagittal alignment at 5°/0°/-5°, which resulted in nine alternative stem positions. For each position, the maximum impingement-free ROM was investigated. Both stem version and sagittal stem alignment have a relevant influence on the impingement-free ROM. In particular, flexion and extension as well as internal and external rotation capability present evident differences. In the position intervals of 10° sagittal stem alignment and 20° stem version a difference was found of about 80° in the flexion and 50° in the extension capability. Likewise, differences were evidenced of up to 72° in the internal and up to 36° in the external rotation. The sagittal stem alignment and the stem torsion have a relevant influence on the impingement-free ROM. To clarify the causes of an impingement or accompanying problems, both parameters should be examined and, if possible, a combined assessment of these factors should be made.

Characteristics of steam jet impingement on annulus

International Nuclear Information System (INIS)

Yoon, Sang H.; Kim, Won J.; Suh, Kune Y.; Song, Chul H.

2004-01-01

The steam jet impingement occurs when the steam through the cold leg from the steam generator strikes the inner reactor barrel during the reflood phase of a loss-of-coolant accident (LOCA), which is a characteristic behavior for the APR1400 (Advanced Power Reactor 1400 MWe). In the cold leg break LOCA, the steam and water flows in the downcomer are truly multidimensional. The azimuthal velocity distribution of the steam flow has an important bearing on the thermal hydraulic phenomena such as the emergency coolant water direct bypass, sweepout, steam condensation, and so forth. The investigation of jet flow is required to determine the steam path and momentum reduction rate after the impingement. For the observation of the steam behavior near the break, the computational fluid dynamic (CFD) analysis has been carried out using CFX5.6. The flow visualization and analysis demonstrate the velocity profiles of the steam flow in the annulus region for the same boundary conditions. Pursuant to the CFD results, the micro-Pitot tubes were positioned at varying angles, and corrected for their sensitivity. The experiments were carried out to directly measure the pressure differential and to visualize the flow utilizing a smoke injection method. Results from this study are slated to be applied to MARS, which is a thermal hydraulic system code for the best-estimate analysis. The current one- or two-dimensional analysis in MARS was known to distort the local flow behavior. To enhance prediction capability of MARS, it is necessary to inspect the steam path in the break flow and mechanically simulate the momentum variation. The present experimental and analytical results can locally be applied to developing the engineering models of specific and essential phenomena. (author)

The recognition and evaluation of patterns of compensatory injury in patients with mechanical hip pain.

Science.gov (United States)

Hammoud, Sommer; Bedi, Asheesh; Voos, James E; Mauro, Craig S; Kelly, Bryan T

2014-03-01

In active individuals with femoroacetabular impingement (FAI), the resultant reduction in functional range of motion leads to high impaction loads at terminal ranges. These increased forces result in compensatory effects on bony and soft tissue structures within the hip joint and hemipelvis. An algorithm is useful in evaluating athletes with pre-arthritic, mechanical hip pain and associated compensatory disorders. A literature search was performed by a review of PubMed articles published from 1976 to 2013. Level 4. Increased stresses across the bony hemipelvis result when athletes with FAI attempt to achieve supraphysiologic, terminal ranges of motion (ROM) through the hip joint required for athletic competition. This can manifest as pain within the pubic joint (osteitis pubis), sacroiliac joint, and lumbosacral spine. Subclinical posterior hip instability may result when attempts to increase hip flexion and internal rotation are not compensated for by increased motion through the hemipelvis. Prominence of the anterior inferior iliac spine (AIIS) at the level of the acetabular rim can result in impingement of the anterior hip joint capsule or iliocapsularis muscle origin against the femoral head-neck junction, resulting in a distinct form of mechanical hip impingement (AIIS subspine impingement). Iliopsoas impingement (IPI) has also been described as an etiology for anterior hip pain. IPI results in a typical 3-o'clock labral tear as well as an inflamed capsule in close proximity to the overlying iliopsoas tendon. Injury in athletic pubalgia occurs during high-energy twisting activities in which abnormal hip ROM and resultant pelvic motion lead to shearing across the pubic symphysis. Failure to recognize and address concomitant compensatory injury patterns associated with intra-articular hip pathology can result in significant disability and persistent symptoms in athletes with pre-arthritic, mechanical hip pain. B.

Scapula kinematics of pull-up techniques: Avoiding impingement risk with training changes.

Science.gov (United States)

Prinold, Joe A I; Bull, Anthony M J

2016-08-01

Overhead athletic activities and scapula dyskinesia are linked with shoulder pathology; pull-ups are a common training method for some overhead sports. Different pull-up techniques exist: anecdotally some are easier to perform, and others linked to greater incidences of pathology. This study aims to quantify scapular kinematics and external forces for three pull-up techniques, thus discussing potential injury implications. An observational study was performed with eleven participants (age=26.8±2.4 years) who regularly perform pull-ups. The upward motions of three pull-up techniques were analysed: palms facing anterior, palms facing posterior and wide-grip. A skin-fixed scapula tracking technique with attached retro-reflective markers was used. High intra-participant repeatability was observed: mean coefficients of multiple correlations of 0.87-1.00 in humerothoracic rotations and 0.77-0.90 for scapulothoracic rotations. Standard deviations of hand force was low: kinematics were observed between the pull-up techniques. The reverse technique has extreme glenohumeral internal-external rotation and large deviation from the scapula plane. The wide technique has a reduced range of pro/retraction in the same HT plane of elevation and 90° of arm abduction with 45° external rotation was observed. All these factors suggest increased sub-acromial impingement risk. The scapula tracking technique showed high repeatability. High arm elevation during pull-ups reduces sub-acromial space and increases pressure, increasing the risk of impingement injury. Wide and reverse pull-ups demonstrate kinematics patterns linked with increased impingement risk. Weight-assisted front pull-ups require further investigation and could be recommended for weaker participants. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

THE DEVELOPMENT OF IODINE BASED IMPINGER SOLUTIONS FOR THE EFFICIENT CAPTURE OF HG USING DIRECT INJECTION NEBULIZATION - INDUCTIVELY COUPLED PLASMA MASS SPECTROMETRY ANALYSIS

Science.gov (United States)

Inductively coupled plasma mass spectrometry (ICP/MS) with direct injection nebulization (DIN) was used to evaluate novel impinger solution compositions capable of capturing elemental mercury (Hgo) in EPA Method 5 type sampling. An iodine based impinger solutoin proved to be ver...

[Cartilage regeneration surgery on the hip : What is feasible?

Science.gov (United States)

Landgraeber, Stefan; Jäger, Marcus; Fickert, Stefan

2017-11-01

Localized cartilage defects at the hip are mainly caused by pre-arthritic deformities, particularly by cam-type femoroacetabular impingement (FAI). Timely elimination of symptomatic deformities can prevent further progression such as cartilage defects. As the defects mostly occur in the anterolateral part of the acetabulum, they can be easily treated either by open surgery or by arthroscopy. To date the most effective methods of treatment are bone marrow stimulation, with or without a covering of biomaterials, and autologous chondrocyte transplantation. In selected cases, readaptation of the damaged cartilage can be attempted by biological procedures. In the present article, the findings reported in current studies on these procedures are summarized and discussed in detail. An outlook is given regarding possible future treatment concepts.

Nineth Rib Syndrome after 10(th) Rib Resection.

Science.gov (United States)

Yu, Hyun Jeong; Jeong, Yu Sub; Lee, Dong Hoon; Yim, Kyoung Hoon

2016-07-01

The 12(th) rib syndrome is a disease that causes pain between the upper abdomen and the lower chest. It is assumed that the impinging on the nerves between the ribs causes pain in the lower chest, upper abdomen, and flank. A 74-year-old female patient visited a pain clinic complaining of pain in her back, and left chest wall at a 7 on the 0-10 Numeric Rating scale (NRS). She had a lateral fixation at T12-L2, 6 years earlier. After the operation, she had multiple osteoporotic compression fractures. When the spine was bent, the patient complained about a sharp pain in the left mid-axillary line and radiating pain toward the abdomen. On physical examination, the 10(th) rib was not felt, and an image of the rib-cage confirmed that the left 10(th) rib was severed. When applying pressure from the legs to the 9(th) rib of the patient, pain was reproduced. Therefore, the patient was diagnosed with 9(th) rib syndrome, and ultrasound-guided 9(th) and 10(th) intercostal nerve blocks were performed around the tips of the severed 10(th) rib. In addition, local anesthetics with triamcinolone were administered into the muscles beneath the 9(th) rib at the point of the greatest tenderness. The patient's pain was reduced to NRS 2 point. In this case, it is suspected that the patient had a partial resection of the left 10(th) rib in the past, and subsequent compression fractures at T8 and T9 led to the deformation of the rib cage, causing the tip of the remaining 10(th) rib to impinge on the 9(th) intercostal nerves, causing pain.

Impinging jet study of the deposition of colloidal particles on synthetic polymer (Zeonor)

DEFF Research Database (Denmark)

Vlček, Jakub; Lapčík, Lubomír; Cech, Jiri

2014-01-01

In this study, an impinging jet deposition experiments were performed on synthetic polymer (Zeonor) original and by micro-embossing modified substrates with exactly defined topology as confirmed by AFM and SEM. Deposition experiments were performed at ambient temperature and at selected flow regi...

Study on the characteristics of the impingement erosion-corrosion for Cu-Ni Alloy sprayed coating(I)

International Nuclear Information System (INIS)

Lee, Sang Yeol; Lim, Uh Joh; Yun, Byoung Du

1998-01-01

Impingement erosion-corrosion test and electrochemical corrosion test in tap water(5000Ω-cm) and seawater(25Ω-cm). Thermal spraying coated Cu-Ni alloy on the carbon steel was carried out. The impingement erosion-corrosion behavior and electrochemical corrosion characteristics of the substrate(SS41) and Cu-Ni thermal spray coating were investigated. The erosion-corrosion control efficiency of Cu-Ni coating to substrate was also estimated quantitatively. Main results obtained are as follows : 1) Under the flow velocity of 13m/s, impingement erosion-corrosion of Cu-Ni coating is under the control of electrochemical corrosion factor rather than that of mechanical erosion. 2) The corrosion potential of Cu-Ni coating becomes more noble than that of substrate, and the current density of Cu-Ni coating under the corrosion potential is drained lowly than that of substrate. 3) The erosion-corrosion control efficiency of Cu-Ni coating to substrate is excellent in the tap water of high specific resistance solution, but it becomes dull in the seawater of low specific resistance. 4) The corrosion control efficiency of Cu-Ni coating to substrate in the seawater appears to be higher than that in the tap water

Survival of fishes after impingement on traveling screens at Hudson River power plants

International Nuclear Information System (INIS)

Muessig, P.H.; Hutchison, J.B.; King, L.R.; Ligotino, R.J.; Daley, M.

1988-01-01

The survival of Hudson River fishes, juveniles and adults, after they had been impinged on continuously rotated traveling screens at the Bowline Point and Danskammer Point power plants was examined. Survival of principal species was similar at the two plants, and estimates of survival improved as monitoring stress was reduced. Adjusted for survival of control fish, survival over 84-108 h after fish were recovered from the screens was highest for Atlantic tomcod, striped bass, and white perch (50-90%) and lowest for bay anchovy, alewife, and blueback herring; other species showed intermediate survival. Survival of striped bass and white perch was positively correlated with water temperature in winter and with conductivity in spring and fall. Continual rotation of the screens, which shortens the average time that fish are impinged, increased survival over that associated with intermittent rotation. 24 refs., 9 figs., 4 tabs

Heat flux characteristics of spray wall impingement with ethanol, butanol, iso-octane, gasoline and E10 fuels

International Nuclear Information System (INIS)

Serras-Pereira, J.; Aleiferis, P.G.; Walmsley, H.L.; Davies, T.J.; Cracknell, R.F.

2013-01-01

Highlights: • Heat flux sensors used to characterise the locations of fuel spray wall impingement. • Droplet evaporation modelling used to study the effect of fuel properties. • Behaviour of ethanol and butanol distinctively different to hydrocarbons. -- Abstract: Future fuel stocks for spark-ignition engines are expected to include a significant portion of bio-derived components with quite different chemical and physical properties to those of liquid hydrocarbons. State-of-the-art high-pressure multi-hole injectors for latest design direct-injection spark-ignition engines offer some great benefits in terms of fuel atomisation, as well as flexibility in in-cylinder fuel targeting by selection of the exact number and angle of the nozzle’s holes. However, in order to maximise such benefits for future spark-ignition engines and minimise any deteriorating effects with regards to exhaust emissions, it is important to avoid liquid fuel impingement onto the cylinder walls and take into consideration various types of biofuels. This paper presents results from the use of heat flux sensors to characterise the locations and levels of liquid fuel impingement onto the engine’s liner walls when injected from a centrally located multi-hole injector with an asymmetric pattern of spray plumes. Ethanol, butanol, iso-octane, gasoline and a blend of 10% ethanol with 90% gasoline (E10) were tested and compared. The tests were performed in the cylinder of a direct-injection spark-ignition engine at static conditions (i.e. quiescent chamber at 1.0 bar) and motoring conditions (at full load with inlet plenum pressure of 1.0 bar) with different engine temperatures in order to decouple competing effects. The collected data were analysed to extract time-resolved signals, as well as mean and standard deviation levels of peak heat flux. The results were interpreted with reference to in-cylinder spray formation characteristics, as well as fuel evaporation rates obtained by modelling

Numerical study of the spray impingement onto a solid wall

OpenAIRE

Rodrigues, Christian Michel Gomes

2011-01-01

The modelling of turbulent multiphase flows has been gathering high interest in the last decades in the scientific community due to its relevance in several applications, such as in industrial and environmental processes or for chemical and biomedical purposes. In fact, regarding the industrial applications, the impingement of liquid fuel sprays onto engine surfaces has become a subject of interest due to its influence on the mixture preparation prior to combustion and, consequently, engine p...

Evaluation of a barrier net used to mitigate fish impingement at a Hudson River power plant intake

International Nuclear Information System (INIS)

Hutchison, J.B.; Matousek, J.A.

1988-01-01

A multifilament nylon net of 0.95-cm bar mesh was deployed as a physical barrier to fish in front of the Bowline Point power plant cooling water intake on the Hudson River from 1976 to 1985. The barrier net was deployed during the historical peak impingement months of October-May. The primary species impinged on the intake screens during this period were young-of-year and yearling white perch, striped bass, rainbow smelt, alewife, blue-back herring, and American shad, generally ranging from 5 to 10 cm in total length. When the barrier net was deployed, median impingement of all fish was 91% lower than during comparable periods before the net was installed. A mark-recapture population estimate indicated that 230,000 yearling striped bass and white perch were in the embayment outside the net in April 1982; over a 9-d study period, only 1.6% of this estimated population was impinged. Concurrent survival probability studies of fish marked and released at locations inside and outside the barrier net showed that fish released inside had 72% lower survival (P

Spatially-resolved, three-dimensional spray characterization of impinging jets by digital in-line holography

Science.gov (United States)

Gao, Jian; Rodrigues, Neil; Sojka, Paul; Chen, Jun

2014-11-01

The impinging jet injector is a preferred method for the atomization of liquid rocket propellants. The majority of experimental studies in literature are not spatially-resolved due to the limitations of widely available point-wise and two-dimensional (2D) diagnostic techniques such as phase Doppler anemometry (PDA), which requires significant experimental repetitions to give spatially-resolved measurements. In the present study, digital in-line holography (DIH) is used to provide spatially-resolved, three-dimensional (3D) characteristics of impinging jet sprays. A double-exposure DIH setup is configured to measure droplet 3D, three-component velocity as well as the size distribution. The particle information is extracted by the hybrid method, which is recently proposed as a particle detection method. To enlarge the detection volume, two parallel, collimated laser beams are used to simultaneously probe the spray at two locations, and two identical cameras are used to record the corresponding holograms. Such a setup has a detection volume of approximately 20 cm by 3.6 cm by 4.8 cm. Sprays of both Newtonian and non-Newtonian liquids corresponding to regimes at relatively lower jet Reynolds and Weber numbers are investigated. Measurements from DIH are further verified by comparison with experimental data obtained from shadowgraph and PDA. It is revealed that DIH is particularly suitable to provide spatially-resolved, 3D measurements of impinging jet sprays that are not particularly dense.

Large Eddy Simulation of a cooling impinging jet to a turbulent crossflow

Science.gov (United States)

Georgiou, Michail; Papalexandris, Miltiadis

2015-11-01

In this talk we report on Large Eddy Simulations of a cooling impinging jet to a turbulent channel flow. The impinging jet enters the turbulent stream in an oblique direction. This type of flow is relevant to the so-called ``Pressurized Thermal Shock'' phenomenon that can occur in pressurized water reactors. First we elaborate on issues related to the set-up of the simulations of the flow of interest such as, imposition of turbulent inflows, choice of subgrid-scale model and others. Also, the issue of the commutator error due to the anisotropy of the spatial cut-off filter induced by non-uniform grids is being discussed. In the second part of the talk we present results of our simulations. In particular, we focus on the high-shear and recirculation zones that are developed and on the characteristics of the temperature field. The budget for the mean kinetic energy of the resolved-scale turbulent velocity fluctuations is also discussed and analyzed. Financial support has been provided by Bel V, a subsidiary of the Federal Agency for Nuclear Control of Belgium.

Performance analysis of solar air heater with jet impingement on corrugated absorber plate

Directory of Open Access Journals (Sweden)

Alsanossi M. Aboghrara

2017-09-01

Full Text Available This paper deals with the experimental investigation outlet temperature and efficiency, of Solar Air heater (SAH. The experimental test set up designed and fabricated to study the effect of jet impingement on the corrugated absorber plate, through circular jets in a duct flow of solar air heater, and compared with conventional solar air heater on flat plat absorber. Under effect of mass flow rate (ṁ of air and solar radiation on outlet air temperature, and efficiency, are analyzed. Results show the flow jet impingement on corrugated plat absorber is a strong function of heat transfer enhancement. The present investigation concludes that the mass flow rate of air substantially influences the heat transfer on solar air heaters. And the thermal efficiency of proposed design duct is observed almost 14% more as compare to the smooth duct. At solar radiation 500–1000 (W/M2, 308 K ambient temperature and 0.01–0.03 (Kg/S mass flow rate

Is there any value to arthroscopic debridement of ankle osteoarthritis and impingement?

Science.gov (United States)

Phisitkul, Phinit; Tennant, Joshua N; Amendola, Annunziato

2013-09-01

This article summarizes the current literature regarding the use of arthroscopy for the various types of ankle osteoarthritis with impingement symptoms. Discussion includes the role of diagnostic arthroscopy and adjunctive use of arthroscopy with other modalities. The section on the authors' preferred technique describes our current operative and perioperative strategies in detail. Published by Elsevier Inc.

Visualization and modeling of the hydrodynamics of an impinging microjet.

Science.gov (United States)

Bitziou, Eleni; Rudd, Nicola C; Edwards, Martin A; Unwin, Patrick R

2006-03-01

The use of fluorescence confocal laser scanning microscopy (CLSM) for flow visualization is described, with a focus on elucidating the pattern of flow in the microjet electrode (MJE). The MJE employs a nozzle, formed from a fine glass capillary, with an inner diameter of approximately 100 microm, to direct solution at an electrode surface, using high velocity but at moderate volume flow rates. For CLSM visualization, the jetted solution contains a fluorescent probe, fluorescein at high pH, which flows into a solution buffered at low pH, where the fluorescence is extinguished, thereby highlighting the flow field of the impinging microjet. The morphology of the microjet and the hydrodynamic boundary layer are shown to be highly sensitive to the volume flow rate, with a collimated jet and thin boundary layer formed at the faster flow rates (approximately 1 cm(3) min(-1)). In contrast, at lower flow rates and for relatively large substrates, an unusual recirculation zone is observed experimentally for the first time. This effect can be eliminated by employing small substrates. The experimental observations have been quantified through numerical solution of the Navier-Stokes equations of continuity and momentum balance. The new insights provided by CLSM imaging demonstrate that flow in the MJE, and impinging jets in general, are more complex than predicted by classical models but are well-defined and quantifiable.

Experimental and numerical investigations of the impingement of an oblique liquid jet onto a superhydrophobic surface: energy transformation

Energy Technology Data Exchange (ETDEWEB)

Kibar, Ali, E-mail: alikibar@kocaeli.edu.tr [Department of Mechanical and Material Technologies, Kocaeli University, 41285, Arslanbey Campus, Kocaeli (Turkey)

2016-02-15

This study presents the theory of impinging an oblique liquid jet onto a vertical superhydrophobic surface based on both experimental and numerical results. A Brassica oleracea leaf with a 160° apparent contact angle was used for the superhydrophobic surface. Distilled water was sent onto the vertical superhydrophobic surface in the range of 1750–3050 Reynolds number, with an inclination angle of 20°−40°, using a circular glass tube with a 1.75 mm inner diameter. The impinging liquid jet spread onto the surface governed by the inertia of the liquid and then reflected off the superhydrophobic surface due to the surface energy of the spreading liquid. Two different energy approaches, which have time-scale and per-unit length, were performed to determine transformation of the energy. The kinetic energy of the impinging liquid jet was transformed into the surface energy with an increasing interfacial surface area between the liquid and air during spreading. Afterwards, this surface energy of the spreading liquid was transformed into the reflection kinetic energy. (paper)

Survey of fish impingement at power plants in the United States. Volume II. Inland waters

International Nuclear Information System (INIS)

Freeman, R.F. III; Sharma, R.K.

1977-03-01

Impingement of fish at cooling-water intakes of 33 power plants located on inland waters other than the Great Lakes has been surveyed and data are presented. Descriptions of site, plant, and intake design and operation are provided. Reports in this volume summarize impingement data for individual plants in tabular and histogram formats. Information was available from differing sources such as the utilities themselves, public documents, regulatory agencies, and others. Thus, the extent of detail in the reports varies greatly from plant to plant. Histogram preparation involved an extrapolation procedure that has inadequacies. The reader is cautioned in the use of information presented in this volume to determine intake-design acceptability or intensity of impacts on ecosystems. No conclusions are presented herein; data comparisons are made in Volume IV

Impinging Water Droplets on Inclined Glass Surfaces

Energy Technology Data Exchange (ETDEWEB)

Armijo, Kenneth Miguel [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Lance, Blake [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Ho, Clifford K. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2017-09-01

Multiphase computational models and tests of falling water droplets on inclined glass surfaces were developed to investigate the physics of impingement and potential of these droplets to self-clean glass surfaces for photovoltaic modules and heliostats. A multiphase volume-of-fluid model was developed in ANSYS Fluent to simulate the impinging droplets. The simulations considered different droplet sizes (1 mm and 3 mm), tilt angles (0°, 10°, and 45°), droplet velocities (1 m/s and 3 m/s), and wetting characteristics (wetting=47° contact angle and non-wetting = 93° contact angle). Results showed that the spread factor (maximum droplet diameter during impact divided by the initial droplet diameter) decreased with increasing inclination angle due to the reduced normal force on the surface. The hydrophilic surface yielded greater spread factors than the hydrophobic surface in all cases. With regard to impact forces, the greater surface tilt angles yielded lower normal forces, but higher shear forces. Experiments showed that the experimentally observed spread factor (maximum droplet diameter during impact divided by the initial droplet diameter) was significantly larger than the simulated spread factor. Observed spread factors were on the order of 5 - 6 for droplet velocities of ~3 m/s, whereas the simulated spread factors were on the order of 2. Droplets were observed to be mobile following impact only for the cases with 45° tilt angle, which matched the simulations. An interesting phenomenon that was observed was that shortly after being released from the nozzle, the water droplet oscillated (like a trampoline) due to the "snapback" caused by the surface tension of the water droplet being released from the nozzle. This oscillation impacted the velocity immediately after the release. Future work should evaluate the impact of parameters such as tilt angle and surface wettability on the impact of particle/soiling uptake and removal to investigate ways that

A new classification for 'Pistol Grip Deformity'. Correlation between the severity of the deformity and the grade of osteoarthritis of the hip

International Nuclear Information System (INIS)

Ipach, Ingmar; Mittag, F.; Sachsenmaier, S.; Kluba, T.; Heinrich, P.

2011-01-01

Purpose: Two types of femoroacetabular impingement (FAI) are described as reasons for the early development of osteoarthritis of the hip. Cam impingement develops from contact between an abnormal head-neck junction and the acetabular rim. Pincer impingement is characterized by local or general overcoverage of the femoral head by the acetabular rim. Both forms might cause early osteoarthritis of the hip. A decreased head/neck offset has been recognized on AP pelvic views and labeled as 'pistol grip deformity'. The aim of the study was to develop a classification for this deformity with regard to the stage of osteoarthritis of the hip. Materials and Methods: 76 pelvic and axial views were analyzed for alpha angle and head ratio. 22 of them had a normal shape in the head-neck region and no osteoarthritis signs, 27 had a 'pistol grip deformity' and osteoarthritis I and 27 had a 'pistol grip deformity' and osteoarthritis II -IV . The CART method was used to develop a classification. Results: There was a statistically significant correlation between alpha angle and head ratio. A statistically significant difference in alpha angle and head ratio was seen between the three groups. Using the CART method, we developed a three-step classification system for the 'pistol grip deformity' with very high accuracy. This deformity was aggravated by increasing age. Conclusion: Using this model it is possible to differentiate between normal shapes of the head-neck junction and different severities of the pistol grip deformity. (orig.)

Survey of fish impingement at power plants in the United States. Volume I. The Great Lakes

International Nuclear Information System (INIS)

Sharma, R.K.; Freeman, R.F. III.

1977-03-01

Impingement of fish at cooling-water intakes of 20 power plants located on the Great Lakes has been surveyed and data are presented. Descriptions of site, plant, and intake design and operation are provided. Reports in this volume summarize impingement data for individual plants in tabular and histogram formats. Information was available from differing sources such as the utilities themselves, public documents, regulatory agencies, and others. Thus, the extent of detail in the reports varies greatly from plant to plant. Histogram preparation involved an extrapolation procedure that has inadequacies. The reader is cautioned in the use of information presented in this volume to determine intake-design acceptability or intensity of impacts on ecosystems. No conclusions are presented herein; data comparisons are made in Volume IV

Evaluation of liquid droplet impingement erosion by micro-scale fracture analysis

International Nuclear Information System (INIS)

Kitajima, Yasumi; Hagiwara, Tsuyoshi; Jimbo, Masakazu; Endo, Tetsuo

2008-01-01

Several estimation methods based on round-robin experiments and/or actual plant experiences have been used to estimate erosion by liquid drop impingement (LDI). However, in recent years, due to developments on computer technology, it is possible to utilize large scale computational analyses. This study proposes a method for the evaluation of LDI erosion by means of computational fracture analysis using results (diameters, velocity, or speed of drops) of fluid dynamics analysis. (author)

Cochlear vertebral entrapment syndrome: a case report

Energy Technology Data Exchange (ETDEWEB)

Liu Chinghsiung; Lin Shinnkuang E-mail: sk1943@adm.cgmh.org.tw; Chang Yeujhy

2001-11-01

The authors describe a patient with isolated involvement of vestibulocochlear nerve by a huge vascular loop from vertebral dolichoectasia. No other neurological deficit was found except for unilateral hearing loss. Abnormal brainstem auditory evoked potential study indicated a retrocochlear lesion. The brain computed tomography (CT) and magnetic resonance imaging (MRI) studies demonstrated an abnormally enhanced vascular lesion impinged on the left porus acusticus with a displacement of the brainstem to the right. There was no infarction in the brainstem. A cerebral angiography demonstrated a megadolichoectatic horizontal loop at the intracranial portion of the left vertebral artery. There was no thrombus or atherosclerosis in the vertebrobasilar system. A mechanical compression by a vascular loop is the only possible pathogenesis for hearing loss. The authors diagnose this condition as cochlear vertebral entrapment syndrome.

Biological evaluation of devices used for reducing entrainment and impingement losses at thermal power plants

International Nuclear Information System (INIS)

Cada, G.F.; Szluha, A.T.

1978-01-01

A preliminary survey of fish protection devices either in use or proposed for water intake structures was conducted for the purpose of assessing their potential for reducing impingement and entrainment. All the designs examined can be divided into two basic categories: behavioral screening systems and physical screening systems. The behavioral screening devices rely upon the ability of fish to sense artificial stimuli and respond by swimming away from hazardous areas. These systems are of little or no value in protecting planktonic fish eggs, larvae, and disoriented, heat-shocked, or lethargic adult fishes. Many of the physical screening devices, on the other hand, require the impingement of organisms against a screen before they can be removed from the intake system, thus subjecting survival. Some of the designs incorporate both behavioral and physical sceening concepts. Six devices were selected for further consideration based on their potential or demonstrated effectiveness in reducing impingement and entrainment losses at a variety of intake situations. The structures evaluated were modified vertical traveling screens, louvers, angled vertical traveling screens, horizontal traveling screens, center-flow screens, and wedge-wire screens. Since some of these intake structures represent new concepts, few laboratory or in situ biological studies have been carried out. For others, actual reductions in fish losses have been demonstrated. The design features and status of biological testing is discussed for each device, and an evaluation of their fish protection potential is presented

Treatment Algorithm for Patients with Non-arthritic Hip Pain, Suspect for an Intraarticular Pathology

DEFF Research Database (Denmark)

Jørgensen, Rasmus Wejnold; Dippmann, Christian; Dahl, L

2016-01-01

BACKGROUND: The amount of patients referred with longstanding, non-arthritic hip pain is increasing, as are the treatment options. Left untreated hip dysplasia, acetabular retroversion and femoroacetabular impingement (FAI) may lead to osteoarthritis (OA). Finding the right treatment option...... associated with acetabular retroversion described in the literature were the crossover sign, the posterior wall sign and the ischial spine sign, while Wiberg's lateral center-edge angle (CE-angle) together with Leqeusne's acetabular index indicate hip dysplasia. A Tönnis index >2 indicates osteoarthritis...... for the right patient can be challenging in patients with non-arthritic hip pain. PURPOSE: The purpose of this study was to categorize the radiographic findings seen in patients with longstanding hip pain, suspect for an intraarticular pathology, and provide a treatment algorithm allocating a specific treatment...

Secondary Subacromial Impingement after Valgus Closing-Wedge Osteotomy for Proximal Humerus Varus

Directory of Open Access Journals (Sweden)

Hirotaka Sano

2015-01-01

Full Text Available A 31-year-old construction worker had been suffering from both the motion pain and the restriction of elevation in his right shoulder due to severe varus deformity of humeral neck, which occurred after proximal humeral fracture. The angle for shoulder flexion and abduction was restricted to 50 and 80 degrees, respectively. Valgus closing-wedge osteotomy followed by the internal fixation using a locking plate was carried out at 12 months after injury. Postoperatively, the head-shaft angle of the humerus improved from 65 to 138 degrees. Active flexion and abduction angles improved from 80 to 135 degrees and from 50 to 135 degrees, respectively. However, the patient complained from a sharp pain with a clicking sound during shoulder abduction even after removal of the locking plate. Since subacromial steroid injection temporarily relieved his shoulder pain, we assumed that the secondary subacromial impingement was provoked after osteotomy. Thus, arthroscopic subacromial decompression was carried out at 27 months after the initial operation, which finally relieved his symptoms. In the valgus closing-wedge osteotomy, surgeons should pay attention to the condition of subacromial space to avoid causing the secondary subacromial impingement.

Impingement heat/mass transfer to hybrid synthetic jets and other reversible pulsating jets

Czech Academy of Sciences Publication Activity Database

Trávníček, Zdeněk; Vít, T.

2015-01-01

Roč. 85, June (2015), s. 473-487 ISSN 0017-9310 R&D Projects: GA ČR GA14-08888S Institutional support: RVO:61388998 Keywords : impinging jet * reversible pulsating jet * synthetic jet Subject RIV: JU - Aeronautics, Aerodynamics, Aircrafts Impact factor: 2.857, year: 2015 http://www.sciencedirect.com/science/article/pii/S001793101500143X

Modeling of soft impingement effect during solid-state partitioning phase transformations in binary alloys

NARCIS (Netherlands)

Chen, H.; Van der Zwaag, S.

2010-01-01

The soft impingement effect at the later stage of partitioning phase transformations has been modeled both for the diffusion-controlled growth model and for the mixed-mode model. Instead of the linear and exponential approximations for the concentration gradient in front of the interface used in the

Large and Small Droplet Impingement Data on Airfoils and Two Simulated Ice Shapes

Science.gov (United States)

Papadakis, Michael; Wong, See-Cheuk; Rachman, Arief; Hung, Kuohsing E.; Vu, Giao T.; Bidwell, Colin S.

2007-01-01

Water droplet impingement data were obtained at the NASA Glenn Icing Research Tunnel (IRT) for four wings and one wing with two simulated ice shapes. The wings tested include three 36-in. chord wings (MS(1)-317, GLC-305, and a NACA 652-415) and a 57-in. chord Twin Otter horizontal tail section. The simulated ice shapes were 22.5- and 45-min glaze ice shapes for the Twin Otter horizontal tail section generated using the LEWICE 2.2 ice accretion program. The impingement experiments were performed with spray clouds having median volumetric diameters of 11, 21, 79, 137, and 168 mm. Comparisons to the experimental data were generated which showed good agreement for the clean wings and ice shapes at lower drop sizes. For larger drop sizes LEWICE 2.2 over predicted the collection efficiencies due to droplet splashing effects which were not modeled in the program. Also for the more complex glaze ice shapes interpolation errors resulted in the over prediction of collection efficiencies in cove and shadow regions of ice shapes.

Ultrasound in Total Hip Replacement: Value of Anterior Acetabular Cup Visibility and Contact With the Iliopsoas Tendon.

Science.gov (United States)

Guillin, Raphaël; Bertaud, Valérie; Garetier, Marc; Fantino, Olivier; Polard, Jean-Louis; Lambotte, Jean-Christophe

2018-06-01

To assess visibility of the acetabular cup in total hip replacement and to determine the value of direct and indirect signs of iliopsoas impingement syndrome with ultrasound. Ultrasound examinations were performed by a single operator in 17 patients with iliopsoas impingement syndrome and 48 control patients. Cup visibility, contact between the cup and psoas tendon, and the presence of indirect signs of iliopsoas impingement syndrome were investigated in all patients. When the acetabular cup was visible, its size and position in relation to the psoas tendon were recorded. Anterior cup visibility (P = .03), contact with the psoas tendon (P cup shift of 3 mm or greater yielded respective sensitivities of 82% and 59% and specificities of 81% and 100%. When iliopsoas impingement syndrome is clinically suspected, the presence of iliopsoas bursitis or a posteroanterior cup shift of greater than 3 mm under the psoas tendon serve to confirm the diagnosis. In the absence of these conditions, a therapeutic test may be necessary because of the incomplete, albeit high, specificity of other signs. © 2017 by the American Institute of Ultrasound in Medicine.

Mobilization with movement and kinesiotaping compared with a supervised exercise program for painful shoulder: results of a clinical trial.

Science.gov (United States)

Djordjevic, Olivera C; Vukicevic, Danijela; Katunac, Ljiljana; Jovic, Stevan

2012-07-01

The purpose of this study was to compare the efficacy of Mobilization with Movement (MWM) and kinesiotaping (KT) techniques with a supervised exercise program in participants with patients with shoulder pain. Twenty subjects with shoulder pain were included if subjects were diagnosed by the referring physician with either rotator cuff lesion with impingement syndrome or impingement shoulder syndrome. Participants were randomly assigned to 1 of 2 groups after clinical and radiologic assessment: group 1 was treated with MWM and KT techniques, whereas group 2 was treated with a supervised exercise program. The main outcome measures were active pain-free shoulder abduction and flexion tested on days 0, 5, and 10. Improvement in active pain-free shoulder range of motion was significantly higher in the group treated with MWM and KT. Repeated-measures analysis of variance indicated significant effects of treatment, time, and treatment×time interaction. This study suggests that MWM and KT may be an effective and useful treatment in range of motion augmentation of subjects with rotator cuff lesion and impingement syndrome or impingement shoulder syndrome. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

Analysis of reactor material experiments investigating oxide fuel crust stability and heat transfer in jet impingement flow

International Nuclear Information System (INIS)

Sienicki, J.J.; Spencer, B.W.

1985-01-01

An analysis is presented of the crust stability and heat transfer behavior in the CSTI-1, CSTI-3, and CWTI-11 reactor material experiments in which a jet of molten oxide fuel at approx. 160 0 K above its freezing temperature was impinged normally upon stainless steel plates initially at 300 and 385 K. The major issue is the existence of nonexistence of a stable solidified layer of fuel, or crust, interstitial to the flowing hot fuel and the steel substrate, tending to insulate the steel from the hot molten fuel. A computer model was developed to predict the heatup of thermocouples imbedded immediately beneath the surface of the plate for both of the cases in which a stable crust is assumed to be either present or absent during the impingement phase. Comparison of the model calculations with the measured thermocouple temperatures indicates that a protective crust was present over nearly all of the plate surface area throughout the impingement process precluding major melting of the plate steel. However, the experiments also show evidence for very localized and isolated steel melting as revealed by localized and isolated pitting of the steel surface and the response of thermocouples located within the pitted region

Experimental investigation of impingement cooling with turbulators or surface enlarging elements

Energy Technology Data Exchange (ETDEWEB)

Persson, Johan

2000-02-01

For the materials in modern gas turbines to sustain, a considerable amount of cooling is required. In cases where large amounts of heat need to be removed, impingement cooling with its high heat transfer coefficients may be the only alternative. In this work the possibilities of enhancing impingement cooling by introducing surface enlarging - turbulence enhancing elements are examined experimentally. A configuration consisting of a staggered array of 45 impingement jets distributed over 10 rows is used for the purpose. A thermo camera is used to measure the temperature distribution on the target plate, giving an opportunity to separately evaluate the Nusselt number enhancement for different areas. Experiments are conducted for five different area enlarging geometries: triangle, wing, cylinder, dashed rib, and angel, all made from aluminium. Comparison between each area enlarged surface and a flat plate is made, with results presented as Nusselt number enhancement factors. The effect of pumping power required is also investigated in order to maximize the cooling efficiency. Parameters varied are Reynolds number and jet to plate distance. Overall Nusselt number enhancement factors show values of 1 to 1.3, the trend being decreasing with increased jet to plane distance and Reynolds number. When taking into account pumping power the enhancement factors drop to 0.4 to 1.2. The best results are achieved with the rib geometry and when not using a too large value of enlarger height over jet to plate distance (h/z). Row wise evaluation of Nusselt number enhancement shows an increased enhancement with row number and thereby crossflow ratio (Gc/Gj). Typical increases in enhancement of 1 to 1.5 with Gc/Gj from 0 to 0.8 are found. The thermo camera pictures reveal that the enhancement is found in three different areas, on the enlarger base area, the area just downstream the enlarger and in diagonal streaks with increased turbulence caused by the enlargers. Tests using an

Role of the confinement of a root canal on jet impingement during endodontic irrigation

NARCIS (Netherlands)

Verhaagen, B.; Boutsioukis, C.; Heijnen, G. L.; van der Sluis, L. W. M.; Versluis, M.

2012-01-01

During a root canal treatment the root canal is irrigated with an antimicrobial fluid, commonly performed with a needle and a syringe. Irrigation of a root canal with two different types of needles can be modeled as an impinging axisymmetric or non-axisymmetric jet. These jets are investigated

Shoulder MR arthrography of the posterior labrocapsular complex in overhead throwers with pathologic internal impingement and internal rotation deficit

International Nuclear Information System (INIS)

Tuite, Michael J.; Petersen, Brian D.; Wise, Steven M.; Fine, Jason P.; Kaplan, Lee D.; Orwin, John F.

2007-01-01

To determine if overhead-throwing athletes with internal impingement pain and internal rotation deficit have thickening of the posterior inferior labrocapsular complex on MR arthrogram images. This study was approved and a waiver of consent granted by our institutional review board. Twenty-six overhead-throwing athletes with internal impingement pain and internal rotation deficit, and 26 controls who had undergone MR arthrograms, were retrospectively examined. The MR studies were combined and read in a blind fashion. On an axial image through the posteroinferior glenoid rim, the readers measured the labral length, capsule-labrum length, and the posterior recess angle. A t-test was used to determine statistical significance. The mean labral length was 4.9 mm [standard deviation (SD) 1.4 mm] for the controls, and 6.4 mm (SD 1.6 mm) for the athletes (P = 0.001). The mean capsule-labrum length was 5.4 mm (SD 2.1 mm) for the controls, and 8.8 mm (SD 2.9 mm) for the athletes (P < 0.001). The mean posterior recess angle measured 65 (SD 27 ) for the controls and 94 (SD 38 ) for the athletes (P = 0.002). Overhead-throwing athletes with internal impingement pain and internal rotation deficit tend to have a thicker labrum and a shallower capsular recess in the posterior inferior shoulder joint than do non-overhead-throwing athletes. In many, the posteroinferior capsule is also thickened. These MR findings should alert the radiologist to closely inspect the posterior cuff and posterosuperior labrum for the tears associated with internal impingement. (orig.)

Shoulder MR arthrography of the posterior labrocapsular complex in overhead throwers with pathologic internal impingement and internal rotation deficit

Energy Technology Data Exchange (ETDEWEB)

Tuite, Michael J; Petersen, Brian D; Wise, Steven M [University of Wisconsin Hospital and Clinics, Department of Radiology, Madison, WI (United States); Fine, Jason P [University of Wisconsin Hospital and Clinics, Department of Biostatistics, Madison, WI (United States); Kaplan, Lee D; Orwin, John F [University of Wisconsin Hospital and Clinics, Department of Orthopedic Surgery, Madison, WI (United States)

2007-06-15

To determine if overhead-throwing athletes with internal impingement pain and internal rotation deficit have thickening of the posterior inferior labrocapsular complex on MR arthrogram images. This study was approved and a waiver of consent granted by our institutional review board. Twenty-six overhead-throwing athletes with internal impingement pain and internal rotation deficit, and 26 controls who had undergone MR arthrograms, were retrospectively examined. The MR studies were combined and read in a blind fashion. On an axial image through the posteroinferior glenoid rim, the readers measured the labral length, capsule-labrum length, and the posterior recess angle. A t-test was used to determine statistical significance. The mean labral length was 4.9 mm [standard deviation (SD) 1.4 mm] for the controls, and 6.4 mm (SD 1.6 mm) for the athletes (P = 0.001). The mean capsule-labrum length was 5.4 mm (SD 2.1 mm) for the controls, and 8.8 mm (SD 2.9 mm) for the athletes (P < 0.001). The mean posterior recess angle measured 65 (SD 27 ) for the controls and 94 (SD 38 ) for the athletes (P = 0.002). Overhead-throwing athletes with internal impingement pain and internal rotation deficit tend to have a thicker labrum and a shallower capsular recess in the posterior inferior shoulder joint than do non-overhead-throwing athletes. In many, the posteroinferior capsule is also thickened. These MR findings should alert the radiologist to closely inspect the posterior cuff and posterosuperior labrum for the tears associated with internal impingement. (orig.)

The Superior Labrum, Anterior-to-Posterior ’SLAP’ Lesion

Science.gov (United States)

2006-10-01

motion and equal sensation bilaterally. Testing was negative for impingement, rotator cuff disease, biceps tendon pathology, acromioclavicular ...impingement syndrome, acromioclavicular joint pain, bicipital tendonitis or symptomatic shoulder instability. The original description of SLAP

Survey of fish impingement at power plants in the United States. Volume III. Estuaries and coastal waters

International Nuclear Information System (INIS)

Stupka, R.C.; Sharma, R.K.

1977-03-01

Impingement of fish at cooling-water intakes of 32 power plants, located on estuaries and coastal waters has been surveyed and data are presented. Descriptions of site, plant, and intake design and operation are provided. Reports in this volume summarize impingement data for individual plants in tabular and histogram formats. Information was available from differing sources such as the utilities themselves, public documents, regulatory agencies, and others. Thus, the extent of detail in the reports varies greatly from plant to plant. Histogram preparation involved an extrapolation procedure that has inadequacies. The reader is cautioned in the use of information presented in this volume to determine intake-design acceptability or intensity of impacts on ecosystems. No conclusions are presented herein; data comparisons are made in Volume IV

Survey of fish impingement at power plants in the United States. Volume III. Estuaries and coastal waters

Energy Technology Data Exchange (ETDEWEB)

Stupka, Richard C.; Sharma, Rajendra K.

1977-03-01

Impingement of fish at cooling-water intakes of 32 power plants, located on estuaries and coastal waters has been surveyed and data are presented. Descriptions of site, plant, and intake design and operation are provided. Reports in this volume summarize impingement data for individual plants in tabular and histogram formats. Information was available from differing sources such as the utilities themselves, public documents, regulatory agencies, and others. Thus, the extent of detail in the reports varies greatly from plant to plant. Histogram preparation involved an extrapolation procedure that has inadequacies. The reader is cautioned in the use of information presented in this volume to determine intake-design acceptability or intensity of impacts on ecosystems. No conclusions are presented herein; data comparisons are made in Volume IV.

Experimental investigation on the performance of an impinging jet solar air heater

Directory of Open Access Journals (Sweden)

T. Rajaseenivasan

2017-03-01

Full Text Available Investigation on an impinging jet solar air heater is performed and reported in this work. The air is supplied through an impinging jet pipe which contains the nozzles to distribute the air in the solar air heater. The air is released from the jet strikes the absorber plate which increases the heat transfer rate by creating turbulent flow in the collector. This study is focused on the parameters that affect the heat transfer characteristics and compared with conventional solar air heater. The system is examined by varying the angle of attack (0°, 10°, 20°, 30°, 60° and 90° and the nozzle diameter (3 mm, 5 mm and 7 mm in the air mass flow rate range of 0.012–0.016 kg/s. The study revealed that the highest performance is achieved with the 30° angle of attack, and the lowest performance is recorded with the 0°. The reduction in jet diameter increases the pressure loss in the collector. The better system performance is observed with the 5 mm diameter hole. The maximum thermal enhancement factor of 2.19 and efficiency of 55.8% are reached with the flow rate of 0.016 kg/s.

Magnetic resonance imaging of the shoulder

International Nuclear Information System (INIS)

Ziemianski, A.; Romanowski, L.

1994-01-01

The technique of the own method of shoulder examination was presented. Anatomy and the most common diseases of the shoulder are discussed. The diseases of the shoulder diagnosed on the basis of the MR are: rotator cuff disease, impingement syndrome and instability. MR findings occurred in these entities were demonstrated. The most common MR finding of the rotator cuff disease was higher signal intensity within the supraspinatus tendon, while in shoulder instability was labral abnormality. Impingement syndrome is the previous syndrome of the full MR imaging of the rotator cuff disease. (author)

Comparison study of exhaust plume impingement effects of small mono- and bipropellant thrusters using parallelized DSMC method.

Directory of Open Access Journals (Sweden)

Kyun Ho Lee

Full Text Available A space propulsion system is important for the normal mission operations of a spacecraft by adjusting its attitude and maneuver. Generally, a mono- and a bipropellant thruster have been mainly used for low thrust liquid rocket engines. But as the plume gas expelled from these small thrusters diffuses freely in a vacuum space along all directions, unwanted effects due to the plume collision onto the spacecraft surfaces can dramatically cause a deterioration of the function and performance of a spacecraft. Thus, aim of the present study is to investigate and compare the major differences of the plume gas impingement effects quantitatively between the small mono- and bipropellant thrusters using the computational fluid dynamics (CFD. For an efficiency of the numerical calculations, the whole calculation domain is divided into two different flow regimes depending on the flow characteristics, and then Navier-Stokes equations and parallelized Direct Simulation Monte Carlo (DSMC method are adopted for each flow regime. From the present analysis, thermal and mass influences of the plume gas impingements on the spacecraft were analyzed for the mono- and the bipropellant thrusters. As a result, it is concluded that a careful understanding on the plume impingement effects depending on the chemical characteristics of different propellants are necessary for the efficient design of the spacecraft.

Modeling and computation of heat exchanges in the configuration of an impinging jet on a hot plate

International Nuclear Information System (INIS)

Seiler, N.; Mimouni, S.; Simonin, O.; Gardin, P.; Seiler, J.M.

2003-01-01

The knowledge of the metal temperature history is essential, especially when strip leave the rolling mill, to get adequate final mechanical properties of steel. Some experiments have yet been carried out on the heat transfer associated with the impingement of a planar (1*9 mm 2 ) subcooled (5-16 K) water jet on a heated plate. Complete boiling curves were then obtained at different locations from the stagnation point and it was observed a phenomenon of 'shoulder of flux' in the transition boiling region near the impingement point. The aim of this work is to compute the heat flux transferred between a very hot plate and a subcooled liquid under a planar impinging jet to obtain the transient temperature distribution in the plate. To achieve this goal, a physical modelling of the phenomenon of 'shoulder of flux' has been carried out. This modelling is based on the assumption that the apparition of periodic bubble oscillations at the wall surface is due to the hydrodynamic fragmentation by the jet. The relation derived from this modelling is validated against experimental results from the literature obtained for a wide range of jet velocity, subcooling and jet diameter. This model is implemented in the new multiphase flow solver developed by EDF 'SATURNE polyphasique'. Numerical results are then compared to experimental heat fluxes obtained on previous experiments. (authors)

Flow transport and mixing induced by horizontal jets impinging on a vertical wall of the multi-compartment PANDA facility

International Nuclear Information System (INIS)

Paladino, Domenico; Zboray, Robert; Andreani, Michele; Dreier, Joerg

2010-01-01

In the frame of the OECD/NEA SETH project an experimental campaign has been carried out in the PANDA facility to investigate gas transport and mixing induced by a plume or a jet in the large-scale multi-compartment PANDA facility. The paper summarizes the results of the horizontal jet test series consisting of eight tests. Horizontal jets impinging on a vertical wall of one of the cylindrical PANDA containment vessels have been generated by changing various parameters, such as: type of injected fluid (steam or a mixture of steam and helium), fluid injection velocity, elevation (with respect to the containment vessel) of the injection exit, initial fluid composition in the vessels, and location of the vent line. The initial jet Froude number has been varied between 17 and 36 and in one of the test condensation occurred. The paper shows the effect of these parameters variation on the test evolution with respect to jet impingement location in the vertical curved wall and variation of impingement location as a function of buoyancy variation. Fluid mixing and stratification, characteristics of gas transport between the compartment and the effect of condensation on the overall phenomena evolution are analyzed in the paper.

A study on post impingement effects of urea-water solution spray on the heated wall of automotive SCR systems

Science.gov (United States)

Shahariar, G. M. H.; Wardana, M. K. A.; Lim, O. T.

2018-04-01

The post impingement effects of urea-water solution spray on the heated wall of automotive SCR systems was numerically investigated in a constant volume chamber using STAR CCM+ CFD code. The turbulence flow was modelled by realizable k-ε two-layer model together with standard wall function and all y+ treatment was applied along with two-layer approach. The Eulerian-Lagrangian approach was used for the modelling of multi phase flow. Urea water solution (UWS) was injected onto the heated wall for the wall temperature of 338, 413, 473, 503 & 573 K. Spray development after impinging on the heated wall was visualized and measured. Droplet size distribution and droplet evaporation rates were also measured, which are vital parameters for the system performance but still not well researched. Specially developed user defined functions (UDF) are implemented to simulate the desired conditions and parameters. The investigation reveals that wall temperature has a great impact on spray development after impingement, droplet size distribution and evaporation. Increasing the wall temperature leads to longer spray front projection length, smaller droplet size and faster droplet evaporation which are preconditions for urea crystallization reduction. The numerical model and parameters are validated comparing with experimental data.

Bilateral iliopsoas muscle contracture and spinous process impingement in a German Shepherd dog.

Science.gov (United States)

Ragetly, Guillaume R; Griffon, Dominique J; Johnson, Ann L; Blevins, William E; Valli, Victor E

2009-12-01

To report diagnosis and treatment of bilateral iliopsoas muscle contracture in a dog with spinous process impingement. Case report. German Shepherd dog. A dog with chronic progressive lameness, flexion contracture of the coxofemoral joints, severe pain, and decreased femoral reflexes had severe spondylosis bridging the vertebral bodies from L1 to L4 and enlarged dorsal spinous processes from T8 to L6 with impingement and bony proliferation. Ultrasonographic and magnetic resonance imaging (MRI) findings were consistent with fibrosis, mineralization, and atrophy of the iliopsoas muscles bilaterally which was treated by staged tenectomy of the insertions of the iliopsoas muscles. Because of severe perivascular fibrosis, the femoral vessels required ligation. Bilateral iliopsoas muscle tenectomy improved gait and provided pain relief. Histologic findings were consistent with fibrotic myopathy. Slow progression of severe clinical signs observed bilaterally in this dog differs from previous reports of iliopsoas myopathy. Findings were similar to the fibrotic myopathy of the gracilis or semitendinosus muscles described in dogs. Iliopsoas muscle abnormalities should be considered in dogs with limited hip extension and pain. MRI is useful for diagnosing muscle fibrosis. Iliopsoas tenectomy may improve clinical function in dogs with fibrotic myopathy.

Erosion onset of a cohesionless granular medium by an immersed impinging round jet

Science.gov (United States)

Brunier-Coulin, Florian; Cuéllar, Pablo; Philippe, Pierre

2017-03-01

Among different devices developed quite recently to quantify the resistance to erosion of natural soil within the broader context of dyke safety, the most commonly used is probably the jet erosion test in which a scouring crater is induced by impingement of an immersed water jet. A comprehensive experimental investigation on the jet erosion in the specific situation of a cohesionless granular material is presented here. The tests were performed by combining special optical techniques allowing for an accurate measurement of the scouring onset and evolution inside an artificially translucent granular sample. The impinging jet hydrodynamics are also analyzed, empirically validating the use of a self-similar theoretical framework for the laminar round jet. The critical conditions at the onset of erosion appear to be best described by a dimensionless Shields number based on the inertial drag force created by the fluid flow on the eroded particles rather than on the pressure gradients around them. To conclude, a tentative empirical model for the maximal flow velocity initiating erosion at the bottom of the scoured crater is put forward and discussed in the light of some preliminary results.

Mucosal deformation from an impinging transonic gas jet and the ballistic impact of microparticles

International Nuclear Information System (INIS)

Hardy, M P; Kendall, M A F

2005-01-01

By means of a transonic gas jet, gene guns ballistically deliver microparticle formulations of drugs and vaccines to the outer layers of the skin or mucosal tissue to induce unique physiological responses for the treatment of a range of conditions. Reported high-speed imaging experiments show that the mucosa deforms significantly while subjected to an impinging gas jet from a biolistic device. In this paper, the effect of this tissue surface deformation on microparticle impact conditions is simulated with computational fluid dynamics (CFD) calculations. The microparticles are idealized as spheres of diameters 26.1, 39 and 99 μm and a density of 1050 kg m -3 . Deforming surface calculations of particle impact conditions are compared directly with an immobile surface case. The relative velocity and obliquity of the deforming surface decrease the normal component of particle impact velocity by up to 30% at the outer edge of the impinging gas jet. This is qualitatively consistent with reported particle penetration profiles in the tissue. It is recommended that these effects be considered in biolistic studies requiring quantified particle impact conditions

Experimental studies on transient water-steam impinging jet

International Nuclear Information System (INIS)

Kitade, Kozo; Nakatogawa, Tetsundo; Nishikawa, Hideo; Kawanishi, Kohei; Tsuruto, Chuichi.

1980-01-01

Blowdown experiments were carried out in order to clarify pipe reaction forces and jet forces at hypothetical pipe break accident in PWR. The experiments were carried out at the initial pressure of about 70 and 150 kg/cm 2 .G with subcooling temperature of 13 -- 41 0 C. The reaction force has a maximum value just after the rupture in such a manner to attain abruptly to a peak and gradually decreases after that time in proportion to the inner pressure of the pipe. A plane board was used as a target, on which two-phase flow jet impinged vertically. A distribution of pressure on the target is most wide just after break. On the other hand, the pressure has a maximum value after a short period of time from the rupture. (author)

An Investigation of Fuel Mixing and Reaction in a CH4/Syngas/Air Premixed Impinging Flame with Varied H2/CO Proportion

Directory of Open Access Journals (Sweden)

Chih-Pin Chiu

2017-07-01

Full Text Available For industrial applications, we propose a concept of clean and efficient combustion through burning syngas on an impinging burner. We performed experimental measurements of particle image velocimetry, OH radical (OH* chemiluminescence, flame temperature, and CO emission to examine the fuel mixing and reaction of premixed impinging flames of CH4/syngas/air with H2/CO in varied proportions. The velocity distribution of the combustion flow field showed that a deceleration area in the main flow formed through the mutual impingement of two jet flows, which enhanced the mixing of fuel and air because of an increased momentum transfer. The deceleration area expanded with an increased CO proportion, which indicated that the mixing of fuel and air also increased with the increased CO proportion. Our examination of the OH* chemiluminescence demonstrated that its intensity increased with increased CO proportion, which showed that the reaction between fuel and air accordingly increased. CO provided in the syngas hence participated readily in the reaction of the CH4/syngas/air premixed impinging flames when the syngas contained CO in a large proportion. Although the volume flow rate of the provided CO quadrupled, the CO emission increased by only 12% to 15%. The results of this work are useful to improve the feasibility of fuel-injection systems using syngas as an alternative fuel.

The activity pattern of shoulder muscles in subjects with and without subacromial impingement

DEFF Research Database (Denmark)

Diederichsen, Louise Pyndt; Nørregaard, Jesper; Dyhre-Poulsen, Poul

2009-01-01

Altered shoulder muscle activity is frequently believed to be a pathogenetic factor of subacromial impingement (SI) and therapeutic interventions have been directed towards restoring normal motor patterns. Still, there is a lack of scientific evidence regarding the changes in muscle activity in p...... that the different motor patterns might be a pathogenetic factor of SI, perhaps due to inappropriate neuromuscular strategies affecting both shoulders....

Numerical Investigation of Jet Impingement Heat Transfer on a Flat plate

Directory of Open Access Journals (Sweden)

Asem Nabadavis

2016-12-01

Full Text Available The numerical investigation emphasizes on studying the heat transfer characteristics when a high velocity air jet impinges upon a flat plate having constant heat flux. Numerical analysis has been conducted by solving conservation equations of momentum, mass and energy with two equations based k- ε turbulence model to determine the wall temperature and Nu of the plate considering the flow to be incompressible. It was found from the investigation that the heat transfer rate increases with the increase of Reynolds number of the jet (Rej. It was also found that there is an optimum value for jet distance to nozzle diameter ratio (H/d for maximum heat transfer when all the other parameters were kept fixed. Similar results as above were found when two jets of air were used instead of one jet keeping the mass flow rate constant. For a two jets case it was also found that heat transfer rate over the surface increases when the jets are inclined outward compared to vertical and inward jets and also there exists an optimum angle of jet for maximum heat transfer. Further investigation was carried out for different jetto-jet separation distance for a twin jet impingement model where it was noted that heat transfer is more distributed in case of larger values of L and the rate of heat transfer increases as the separation between the jet increases till a certain point after which the rate of heat transfer decreases.

Correlation of clinical and magnetic resonance imaging findings in hips of elite female ballet dancers.

Science.gov (United States)

Duthon, Victoria B; Charbonnier, Caecilia; Kolo, Frank C; Magnenat-Thalmann, Nadia; Becker, Christophe D; Bouvet, Cindy; Coppens, Elia; Hoffmeyer, Pierre; Menetrey, Jacques

2013-03-01

To understand why professional female ballet dancers often complain of inguinal pain and experience early hip osteoarthritis (OA). Goals were to examine clinical and advanced imaging findings in the hips of dancers compared with those in a matched cohort of nondancers and to assess the femoral head translation in the forward split position using magnetic resonance imaging (MRI). Twenty professional female ballet dancers and 14 active healthy female individuals matched for age (control group) completed a questionnaire on hip pain and underwent hip examination with impingement tests and measurement of passive hip range of motion (ROM). All had a pelvic 1.5 T MRI in the back-lying position to assess femoroacetabular morphologic features and lesions. For the dancers, additional MR images were acquired in the split position to evaluate femoroacetabular congruency. Twelve of 20 dancers complained of groin pain only while dancing; controls were asymptomatic. Dancers' passive hip ROM was normal. No differences in α neck angle, acetabular depth, acetabular version, and femoral neck anteversion were found between dancers and controls. MRI of dancers while performing splits showed a mean femoral head subluxation of 2.05 mm. MRI of dancers' hips showed labral tears, cartilage thinning, and herniation pits, located in superior and posterosuperior positions. Lesions were the same for symptomatic and asymptomatic dancers. Controls had proportionally the same number of labral lesions but in an anterosuperior position. They also had 2 to 3 times fewer cartilage lesions and pits than did dancers. The results of our study are consistent with our hypothesis that repetitive extreme movements can cause femoral head subluxations and femoroacetabular abutments in female ballet dancers with normal hip morphologic features, which could result in early OA. Pathologic changes seen on MRI were symptomatic in less than two thirds of the dancers. Level IV, therapeutic case series. Copyright �

Danish Hip Arthroscopy Registry (DHAR)

DEFF Research Database (Denmark)

Lund, Bent; Mygind-Klavsen, Bjarne; Grønbech Nielsen, Torsten

2017-01-01

The Danish Hip Arthroscopy Registry (DHAR) was initiated in January 2012 as a web-based prospective registry. The purpose of this study was to evaluate and report the first registry based outcome data of a national population with radiological and clinical femoroacetabular impingement (FAI......) undergoing hip arthroscopic treatment. Our primary hypothesis was that patients undergoing hip arthroscopy would improve significantly in pain, quality of life and sports related outcome measurements in Patient Related Outcome Measures (PROM). Peri-operative data and Patient Reported Outcome Measures (PROM......-5 D demonstrated improvement after 1 and 2 years from 0.66 pre-op to 0.78 at 2 years. HSAS improved significantly from 2.5 to 3.3. Pain score data demonstrated improvement in NRS-rest 39 to 17 and NRS Walk 49 to 22 at follow-up. We conclude that patients with FAI undergoing hip arthroscopy...

Computational radiology for orthopaedic interventions

CERN Document Server

Li, Shuo

2016-01-01

This book provides a cohesive overview of the current technological advances in computational radiology, and their applications in orthopaedic interventions. Contributed by the leading researchers in the field, this volume covers not only basic computational radiology techniques such as statistical shape modeling, CT/MRI segmentation, augmented reality and micro-CT image processing, but also the applications of these techniques to various orthopaedic interventional tasks. Details about following important state-of-the-art development are featured: 3D preoperative planning and patient-specific instrumentation for surgical treatment of long-bone deformities, computer assisted diagnosis and planning of periacetabular osteotomy and femoroacetabular impingement, 2D-3D reconstruction-based planning of total hip arthroplasty, image fusion for  computer-assisted bone tumor surgery, intra-operative three-dimensional imaging in fracture treatment, augmented reality based orthopaedic interventions and education, medica...

Influence of plasma-generated negative oxygen ion impingement on magnetron sputtered amorphous SiO2 thin films during growth at low temperatures

International Nuclear Information System (INIS)

Macias-Montero, M.; Garcia-Garcia, F. J.; Alvarez, R.; Gil-Rostra, J.; Gonzalez, J. C.; Gonzalez-Elipe, A. R.; Palmero, A.; Cotrino, J.

2012-01-01

Growth of amorphous SiO 2 thin films deposited by reactive magnetron sputtering at low temperatures has been studied under different oxygen partial pressure conditions. Film microstructures varied from coalescent vertical column-like to homogeneous compact microstructures, possessing all similar refractive indexes. A discussion on the process responsible for the different microstructures is carried out focusing on the influence of (i) the surface shadowing mechanism, (ii) the positive ion impingement on the film, and (iii) the negative ion impingement. We conclude that only the trend followed by the latter and, in particular, the impingement of O - ions with kinetic energies between 20 and 200 eV, agrees with the resulting microstructural changes. Overall, it is also demonstrated that there are two main microstructuring regimes in the growth of amorphous SiO 2 thin films by magnetron sputtering at low temperatures, controlled by the amount of O 2 in the deposition reactor, which stem from the competition between surface shadowing and ion-induced adatom surface mobility.

Magnetic resonance imaging of ulnocarpal abutment syndrome

International Nuclear Information System (INIS)

Imaeda, Toshihiko; Nakamura, Ryogo; Shionoya, Kaori; Kato, Hitoshi; Makino, Naoki

1996-01-01

Ulnocarpal abutment syndrome (UAS) is the impingement between lunate and ulnar head. Twenty-two wrists of 19 patients were diagnosed as UAS arthroscopically after having undergone MRI examination. Ten wrists had MRI both before and after ulnar recession arthroplasty. Spin-echo pulse sequences were taken. T1-weighted and T2-weighted images were obtained. On T1-weighted images, the focal signal intensity of the ulnar part of the lunate was decreased in 18 wrists. On T2-weighted images, the focal signal intensity of the ulnar aspect of the lunate were from high to low in 18 wrists. There was focal and abnormal signal intensity of the triquetrum found in 10 wrists and was abnormal signal intensity of the ulnar head in two wrists. After the operation, on the T1-weighted image signal intensity of the lunate shifted from low through slightly low to iso. On the T2-weighted images it shifted from low to high or iso. Focal low signal intensity of the lunate on T1-weighted images is diagnostic of ulnocarpal abutment syndrome. The intensity of the signal from the lunate on T2-weighted images may indicate the severity of the disease. (author)

Experimental and numerical investigation of flow field and heat transfer from electronic components in a rectangular channel with an impinging jet

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Calisir Tamer

2015-01-01

Full Text Available Thermal control of electronic components is a continuously emerging problem as power loads keep increasing. The present study is mainly focused on experimental and numerical investigation of impinging jet cooling of 18 (3 × 6 array flash mounted electronic components under a constant heat flux condition inside a rectangular channel in which air, following impingement, is forced to exit in a single direction along the channel formed by the jet orifice plate and impingement plate. Copper blocks represent heat dissipating electronic components. Inlet flow velocities to the channel were measured by using a Laser Doppler Anemometer (LDA system. Flow field observations were performed using a Particle Image Velocimetry (PIV and thermocouples were used for temperature measurements. Experiments and simulations were conducted for Re = 4000 – 8000 at fixed value of H = 10 × Dh. Flow field results were presented and heat transfer results were interpreted using the flow measurement observations. Numerical results were validated with experimental data and it was observed that the results are in agreement with the experiments.

Mechanism of jet-flutter: self-induced oscillation of an upward plane jet impinging on a free surface

International Nuclear Information System (INIS)

Madarame, Haruki; Iida, Masao

1998-01-01

An upward plane jet impinging on the free surface of a shallow rectangular tank oscillates without any external periodic force. The movement of the impinging point leaves additional fluid mass on the surface behind the point, which does not balance the momentum supplied by the jet. The imbalance generates propagating waves, and a surface level gap appears there. The level gap is flattened not by the waves but by the vertical motion of water columns. The imbalance causes lateral displacement of jet, which in turn causes the imbalance, forming a positive feedback loop. The above model explains well why the frequency corresponds to that of water column oscillation in a partitioned tank with the same water depth, and the oscillation region has a wide range above a certain velocity limit determined by the water depth. (author)

An experimental study on impingement wastage of Mod 9Cr 1Mo steel due to sodium water reaction

Energy Technology Data Exchange (ETDEWEB)

Kishore, S., E-mail: skishore@igcar.gov.in [Fast Reactor Technology Group, Indira Gandhi Centre for Atomic Research, Kalpakkam (India); Ashok Kumar, A.; Chandramouli, S.; Nashine, B.K.; Rajan, K.K.; Kalyanasundaram, P.; Chetal, S.C. [Fast Reactor Technology Group, Indira Gandhi Centre for Atomic Research, Kalpakkam (India)

2012-02-15

Highlights: Black-Right-Pointing-Pointer Sodium heated steam generators are crucial components of fast breeder reactors. Black-Right-Pointing-Pointer A leak in steam generator tube will cause sodium water reaction that damages the tubes. Black-Right-Pointing-Pointer Experimental study was conducted to quantify the extent of damage on Mod 9Cr 1Mo tube due to a water leak. - Abstract: Sodium heated steam generator (SG) is a crucial component in the heat transport system of a fast breeder reactor (FBR). In case, one of its water/steam carrying tubes becomes defective, water/steam leaks into sodium, flowing in the shell side, causing sodium-water reaction, which is highly exothermic and producing corrosive NaOH. The reaction jet originating from a leaking tube may impinge on its adjacent tube, resulting in damage of the tube. Impingement wastage refers to this kind of damage, occurring to a tube of sodium heated SG, owing to a small water/steam leak from a neighboring tube. Extensive research works have been conducted all over the world to study various aspects of this phenomenon. Experimental studies were carried out in Indira Gandhi Centre for Atomic Research (IGCAR) to understand the effect of impingement wastage on Mod 9Cr 1Mo, which is the tube material of prototype fast breeder reactor (PFBR) SG. This paper brings out the data and experience gained through the experiments.

Multiple flow patterns and heat transfer in confined jet impingement

International Nuclear Information System (INIS)

Li Xianchang; Gaddis, J. Leo; Wang Ting

2005-01-01

The flow field of a 2-D laminar confined impinging slot jet is investigated. Numerical results indicate that there exist two different solutions in some range of geometric and flow parameters. The two steady flow patterns are obtained under identical boundary conditions but only with different initial flow fields. Two different exit boundary conditions are investigated with two commercial software packages to eliminate artificial or computational effects. The different flow patterns are observed to significantly affect the heat transfer. A flow visualization experiment is carried out to verify the computational results and both flow patterns are observed. The bifurcation mechanism is interpreted and discussed

Impingement and entrainment: an updated annotated bibliography. Final report

International Nuclear Information System (INIS)

Yost, F.E.; Uziel, M.S.

1981-05-01

Presented as an annotated bibliography are 1343 references dealing with entrainment and impingement effects on aquatic organisms passing through the cooling systems of thermal power plants. The references were obtained from open literature and from environmental reports and impact statements prepared by or for the electric utility industry. Two earlier bibliographies contain literature from 1950 through 1976. This update contains additional literature acquired since 1976. Topics covered are site-specific field studies at facilities located on lakes, reservoirs, rivers, or estuaries. The studies include special engineering studies, laboratory studies, studies of biological effects, reviews and methodologies, and studies of the mitigation of effects. References are arranged alphabetically by author, and indexes are provided to personal and corporate authors, and to facility, waterbody, and taxonomic names

Denervation syndromes of the shoulder girdle: MR imaging with electrophysiologic correlation

International Nuclear Information System (INIS)

Bredella, M.A.; Wischer, T.K.; Stork, A.; Genant, H.K.; Tirman, P.F.J.; Fritz, R.C.

1999-01-01

Objective. To investigate the use of MR imaging in the characterization of denervated muscle of the shoulder correlated with electrophysiologic studies.Design and patients. We studied with MR imaging five patients who presented with shoulder weakness and pain and who underwent electrophysiologic studies. On MR imaging the distribution of muscle edema and fatty infiltration was recorded, as was the presence of masses impinging on a regional nerve.Results. Acute/subacute denervation was best seen on T2-weighted fast spin-echo images with fat saturation, showing increased SI related to neurogenic edema. Chronic denervation was best seen on T1-weighted spin-echo images, demonstrating loss of muscle bulk and diffuse areas of increased signal intensity within the muscle. Three patients showed MR imaging and electrophysiologic findings of Parsonage Turner syndrome. One patient demonstrated an arteriovenous malformation within the spinoglenoid notch, impinging on the suprascapular nerve with associated atrophy of the infraspinatus muscle. The fifth patient demonstrated fatty atrophy of the teres minor muscle caused by compression by a cyst of the axillary nerve and electrophysiologic findings of an incomplete axillary nerve block.Conclusion. MR imaging is useful in detecting and characterizing denervation atrophy and neurogenic edema in shoulder muscles. MR imaging can provide additional information to electrophysiologic studies by estimating the age (acute/chronic) and identifying morphologic causes for shoulder pain and atrophy. (orig.)

Aerodynamic and mass transfer characteristicsof an annular bistable impinging jet with a fluidic flip-flop control

Czech Academy of Sciences Publication Activity Database

Trávníček, Zdeněk; Peszynsky, K.; Hošek, Jan; Wawrzyniak, S.

2003-01-01

Roč. 46, č. 7 (2003), s. 1265-1278 ISSN 0017-9310 R&D Projects: GA AV ČR IBS2076301 Institutional research plan: CEZ:AV0Z2076919 Keywords : impinging jet * visualization * mass transfer Subject RIV: BK - Fluid Dynamics Impact factor: 1.293, year: 2003

Experimental study of curvature effects on jet impingement heat transfer on concave surfaces

Directory of Open Access Journals (Sweden)

Ying Zhou

2017-04-01

Full Text Available Experimental study of the local and average heat transfer characteristics of a single round jet impinging on the concave surfaces was conducted in this work to gain in-depth knowledge of the curvature effects. The experiments were conducted by employing a piccolo tube with one single jet hole over a wide range of parameters: jet Reynolds number from 27000 to 130000, relative nozzle to surface distance from 3.3 to 30, and relative surface curvature from 0.005 to 0.030. Experimental results indicate that the surface curvature has opposite effects on heat transfer characteristics. On one hand, an increase of relative nozzle to surface distance (increasing jet diameter in fact enhances the average heat transfer around the surface for the same curved surface. On the other hand, the average Nusselt number decreases as relative nozzle to surface distance increases for a fixed jet diameter. Finally, experimental data-based correlations of the average Nusselt number over the curved surface were obtained with consideration of surface curvature effect. This work contributes to a better understanding of the curvature effects on heat transfer of a round jet impingement on concave surfaces, which is of high importance to the design of the aircraft anti-icing system.

CFD analysis of the impingement cooling effect of the coolant jet caused by the T56 1st stage disc metering hole

CSIR Research Space (South Africa)

Snedden, Glen C

2003-09-01

Full Text Available conditions applied is given in Figure 2. Figures 3 to 7 give an overview of the final mesh and some idea of the block structured approach and refinement in the main area of interest, that is, the impingement zone and metering holes at the lower part... OF THE IMPINGEMENT COOLING EFFECT OF THE COOLANT JET CAUSED BY THE T56 1ST STAGE DISC METERING HOLE ISABE-2003-1065 Glen C. Snedden CSIR, Defencetek, P O Box 395 Pretoria, 0001, South Africa Tony Lambert Rolls-Royce Indianapolis, Indiana, USA Abstract...

Novel method for the measurement of liquid film thickness during fuel spray impingement on surfaces.

Science.gov (United States)

Henkel, S; Beyrau, F; Hardalupas, Y; Taylor, A M K P

2016-02-08

This paper describes the development and application of a novel optical technique for the measurement of liquid film thickness formed on surfaces during the impingement of automotive fuel sprays. The technique makes use of the change of the light scattering characteristics of a metal surface with known roughness, when liquid is deposited. Important advantages of the technique over previously established methods are the ability to measure the time-dependent spatial distribution of the liquid film without a need to add a fluorescent tracer to the liquid, while the measurement principle is not influenced by changes of the pressure and temperature of the liquid or the surrounding gas phase. Also, there is no need for non-fluorescing surrogate fuels. However, an in situ calibration of the dependence of signal intensity on liquid film thickness is required. The developed method can be applied to measure the time-dependent and two-dimensional distribution of the liquid fuel film thickness on the piston or the liner of gasoline direct injection (GDI) engines. The applicability of this technique was evaluated with impinging sprays of several linear alkanes and alcohols with different thermo-physical properties. The surface temperature of the impingement plate was controlled to simulate the range of piston surface temperatures inside a GDI engine. Two sets of liquid film thickness measurements were obtained. During the first set, the surface temperature of the plate was kept constant, while the spray of different fuels interacted with the surface. In the second set, the plate temperature was adjusted to match the boiling temperature of each fuel. In this way, the influence of the surface temperature on the liquid film created by the spray of different fuels and their evaporation characteristics could be demonstrated.

The anti-corrosion behavior under multi-factor impingement of Hastelloy C22 coating prepared by multilayer laser cladding

Science.gov (United States)

Chen, Lin; Bai, Shu-Lin

2018-04-01

Hastelloy C22 coating was prepared on substrate of Q235 steel by high power multilayer laser cladding. The microstructure, hardness and anti-corrosion properties of coating were investigated. The corrosion tests in 3.5% NaCl solution were carried out with variation of impingement angle and velocity, and vibration frequency of sample. The microstructure of coating changes from equiaxed grain at the top surface to dendrites oriented at an angle of 60° to the substrate inside the coating. The corrosion rate of coating increases with the increase of impingement angle and velocity, and vibrant frequency of sample. Corrosion mechanisms relate to repassivation and depassivation of coating according to electrochemical measurements. Above results show that multilayer laser cladding can endow Hastelloy C22 coating with fine microstructures, high hardness and good anti-corrosion performances.

Estimation of energy saving thanks to a reduced-model-based approach: Example of bread baking by jet impingement

International Nuclear Information System (INIS)

Alamir, M.; Witrant, E.; Della Valle, G.; Rouaud, O.; Josset, Ch.; Boillereaux, L.

2013-01-01

In this paper, a reduced order mechanistic model is proposed for the evolution of temperature and humidity during French bread baking. The model parameters are identified using experimental data. The resulting model is then used to estimate the potential energy saving that can be obtained using jet impingement technology when used to increase the heat transfer efficiency. Results show up to 16% potential energy saving under certain assumptions. - Highlights: ► We developed a mechanistic model of heat and mass transfer in bread including different and multiple energy sources. ► An optimal control system permits to track references trajectories with a minimization of energy consuming. ► The methodology is evaluated with jet impingement technique. ► Results show a significant energy saving of about 17% of energy with reasonable actuator variations

Ultrasound guided versus landmark guided corticosteroid injection in patients with rotator cuff syndrome: Randomised controlled trial.

Science.gov (United States)

Bhayana, Himanshu; Mishra, Puneet; Tandon, Anupama; Pankaj, Amite; Pandey, Rohit; Malhotra, Raskesh

2018-03-01

Impingement syndrome is the most common differential in a patient presenting to an orthopaedic OPD with shoulder pain. Impingement syndrome is often managed with subacromial corticosteroid injection, which can be instilled using either landmark guided (LMG) approach or with the assistance of ultrasound (US). This study was envisaged to enquire whether ultrasound assistance improves the accuracy, efficacy or safety profile of the injection. 60 patients of rotator cuff syndrome underwent diagnostic ultrasound. They were randomly assigned to receive subacromial injection of 2 ml (40 mg/ml) methylprenisolone and 2 ml of 1% lignocaine combination either by US assistance (n = 30) or using LMG assistance (n = 30). The patients were evaluated before injection and on follow up visits at day 5, week 3, week 6 and 3rd month by a single assessor. The assessor was blinded of the treatment group to which patient belonged. Clinical assessment included demographic and clinical data, accuracy of injection, VAS (0-100) for pain, Constant score with goniometer evaluation of range of motion, patient's self assessment proforma and post injection side effects if any. Initial demographic, clinical and US findings in the groups exhibited no significant differences. The accuracy of US guided injections (100%) was more when compared from LMG injection (93.3%). Both VAS and Constant score showed significant improvement following steroid injection up to 3 months of follow up. However the differences in the two groups were not significant suggesting comparable efficacy of the two approaches. (Mean VAS score decrease: 27.23 for US and 25.16 for LMG, p guided injections have a higher accuracy of drug placement in the subacromial bursa, there is no difference in terms of clinical outcomes or safety profile of either of the method. Hence US guided injections seems to be unjustified, when compared to equally efficacious and cost effective LMG steroid injection.

Active control of supersonic impingement tones using steady and pulsed microjets

Energy Technology Data Exchange (ETDEWEB)

Choi, J.J.; Anaswamy, A.M. [Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge (United States); Lou, H. [Department of Mechanical Engineering, FAMU - FSU, College of Engineering, Tallahassee, FL (United States); Alvi, F.S.

2006-12-15

In recent years, it has been demonstrated that direct microjet injection into the shear layer of the main jet disrupts the feedback loop inherent in high speed impinging jet flows, thereby significantly reducing the adverse effects. The amount of noise reduced by microjet actuation is known to be dependent on nozzle operating conditions. In this paper, two active control strategies using microjets are suggested to maintain a uniform, reliable, and optimal reduction of these tones over the entire range of operating conditions. In the first method, a quasi-closed loop control strategy is proposed using steady microjet injection and the proper orthogonal decomposition (POD) algorithm. The most energetic spatial mode of the unsteady pressure along the nozzle diameter is captured using the POD, which in turn is used to determine the distribution of microjet intensity along the nozzle exit. Preliminary experimental results from a STOVL supersonic jet facility at Mach 1.5 show that the quasi-closed loop control strategy, in some cases, provides an additional 8-10 dB reduction compared to axisymmetric injection at the desired operating conditions. The second method consists of a pulsed microjet injection, motivated by the need to further improve the noise suppression. It was observed that the pulsed microjet was able to bring about the same noise reduction as steady injection using approximately 40% of the corresponding mass flow rate of the steady microjet case. Moreover, as the duty cycle increased, the performance of pulsed injection was further enhanced and was observed to completely eliminate the impinging tones at all operating conditions. (orig.)

Beauty parlor stroke syndrome due to a bone fragment from an osteophyte of the atlas: case report.

Science.gov (United States)

Kameda, Takuya; Otani, Koji; Tamura, Takamitsu; Konno, Shinichi

2018-04-01

Beauty parlor stroke syndrome (BPSS) is a rare condition characterized by mechanical impingement of a vertebral artery (VA) during neck rotation and/or hyperextension followed by vertebrobasilar insufficiency. However, there have been no reports of BPSS in which the cause of mechanical impingement was identified and no cases for which surgical treatment was reported. The authors report the case of a 56-year-old Japanese man who presented with presyncope that occurred during cervical extension. Given the possibility of vertebrobasilar insufficiency, digital subtraction angiography and CT angiography were performed. These studies revealed that the right VA was hypoplastic and the left VA was dominant. Moreover, in the position of cervical extension, the dominant left VA showed constriction caused by a bone fragment of an osteophyte of the atlas. Removal of the bone fragment was performed. Postoperative left vertebral angiography showed improvement of blood flow in the extended position, and the presyncope completely disappeared. The pathomechanism of this case was a bone fragment compressing the left VA in the C-1 groove during neck extension. In BPSS patients with recurrent transient symptoms, the possibility of this mechanism of VA constriction by a free bone fragment should be considered.

Outcome of pinning in patients with slipped capital femoral epiphysis: risk factors associated with avascular necrosis, chondrolysis, and femoral impingement.

Science.gov (United States)

Ulici, Alexandru; Carp, Madalina; Tevanov, Iulia; Nahoi, Catalin Alexandru; Sterian, Alin Gabriel; Cosma, Dan

2018-06-01

Objective This study aimed to assess the principal risk factors that could lead to the most common long-term complications of slipped capital femoral epiphysis, such as avascular necrosis, chondrolysis, and hip impingement. Methods We conducted a single-centre, retrospective study and evaluated patients (70 patients, 81 hips) who were treated for slipped capital femoral epiphysis from 2010 to 2015 and who underwent pinning. We measured the severity of displacement radiologically using the Southwick angle. Postoperative radiographs were evaluated for the most frequent long-term complications of avascular necrosis (AVN), chondrolysis, and femoral acetabular impingement (FAI). Results We found seven cases of AVN, 14 cases of chondrolysis, and 31 hips had an α angle of 60°. Sex, ambulation, and symptoms did not affect development of these complications. Patients with a normal weight were almost two times more likely to develop FAI. Patients with moderate and severe slips had a similar percentage of AVN. In severe slips, 85.7% of patients had an α angle higher than 60°. Conclusions This study shows that severe slips have a higher risk of developing AVN and hip impingement. Every patient who suffers from SCFE (even the mildest forms) should be regularly checked for FAI.

Extreme hip motion in professional ballet dancers: dynamic and morphological evaluation based on magnetic resonance imaging.

Science.gov (United States)

Kolo, Frank C; Charbonnier, Caecilia; Pfirrmann, Christian W A; Duc, Sylvain R; Lubbeke, Anne; Duthon, Victoria B; Magnenat-Thalmann, Nadia; Hoffmeyer, Pierre; Menetrey, Jacques; Becker, Christoph D

2013-05-01

To determine the prevalence of femoroacetabular impingement (FAI) of the cam or pincer type based on magnetic resonance imaging (MRI) in a group of adult female professional ballet dancers, and to quantify, in vivo, the range of motion (ROM) and congruence of the hip joint in the splits position. Institutional review board approval and informed consent from each volunteer were obtained. Thirty symptomatic or asymptomatic adult female professional ballet dancers (59 hips) and 14 asymptomatic non-dancer adult women (28 hips, control group) were included in the present study. All subjects underwent MRI in the supine position, while, for the dancers, additional images were acquired in the splits position. Labral abnormalities, cartilage lesions, and osseous abnormalities of the acetabular rim were assessed at six positions around the acetabulum. A morphological analysis, consisting of the measurement of the α angle, acetabular depth, and acetabular version, was performed. For the dancers, ROM and congruency of the hip joint in the splits position were measured. Acetabular cartilage lesions greater than 5 mm were significantly more frequent in dancer's hips than in control hips (28.8 vs 7.1%, p = 0.026), and were mostly present at the superior position in dancers. Distribution of labral lesions between the dancers and the control group showed substantially more pronounced labral lesions at the superior, posterosuperior, and anterosuperior positions in dancers (54 lesions in 28 dancer's hips vs 10 lesions in 8 control hips). Herniation pits were found significantly more often (p = 0.002) in dancer's hips (n = 31, 52.5%), 25 of them being located in a superior position. A cam-type morphology was found for one dancer and a retroverted hip was noted for one control. Femoroacetabular subluxations were observed in the splits position (mean: 2.05 mm). The prevalence of typical FAI of the cam or pincer type was low in this selected population of professional ballet

Range of impingement-free abduction and adduction deficit after reverse shoulder arthroplasty. Hierarchy of surgical and implant-design-related factors.

Science.gov (United States)

Gutiérrez, Sergio; Comiskey, Charles A; Luo, Zong-Ping; Pupello, Derek R; Frankle, Mark A

2008-12-01

Evaluations of functional outcomes of reverse shoulder arthroplasty have revealed variable improvements in the range of motion and high rates of scapular notching. The purpose of this study was to systematically examine the impact of surgical factors (location of the glenosphere on the glenoid and tilt angle of the glenosphere on the glenoid) and implant-related factors (implant size, center-of-rotation offset, and humeral neck-shaft angle) on impingement-free abduction motion. A computer model was developed to virtually simulate abduction/adduction motion and its dependence on five surgical and implant-related factors. Three conditions were tested for each factor, resulting in a total of 243 simulated combinations. The overall motion was determined from 0 degrees of abduction until maximum abduction, which would be limited by impingement of the humerosocket on the scapula. In those combinations in which 0 degrees of abduction could not be achieved, the adduction deficit was recorded. The largest average increase in the range of impingement-free abduction motion resulted from a more lateral center-of-rotation offset: the average increase was 31.9 degrees with a change in the center-of-rotation offset from 0 to 10 mm, and this change resulted in an increase in abduction motion in eighty of the eighty-one combinations. The position of the glenosphere on the glenoid was associated with the second largest average increase in abduction motion (28.1 degrees when the glenosphere position was changed from superior to inferior, with the change resulting in an increase in seventy-one of the eighty-one combinations). These factors were followed by glenosphere tilt, humeral neck-shaft angle, and prosthetic size in terms of their effects on abduction motion. The largest effect in terms of avoiding an adduction deficit was provided by a humeral neck-shaft angle of 130 degrees (the deficit was avoided in forty-nine of the eighty-one combinations in which this angle was used

Comparison of pre-operative dGEMRIC imaging with intra-operative findings in femoroacetabular impingement: preliminary findings

International Nuclear Information System (INIS)

Bittersohl, Bernd; Apprich, Sebastian; Siebenrock, Klaus A.; Mamisch, Tallal Charles; Hosalkar, Harish S.; Werlen, Stefan A.

2011-01-01

To study standard MRI and dGEMRIC in patients with symptomatic FAI undergoing surgical intervention and compare them with intra-operative findings to see if they were corroborative. Sixteen patients with symptomatic FAI that warranted surgical intervention were prospectively studied. All patients underwent plain radiographic series for FAI assessment followed by standard MRI and dGEMRIC. Subsequently, patients were surgically treated with safe dislocation and the joint was evaluated for any macroscopic signs of damaged cartilage. Data were statistically analyzed. A total of 224 zones in 16 patients were evaluated. One hundred and sixteen zones were intra-operatively rated as normal with mean T1 values of 510.1 ms ± 141.2 ms. Eighty zones had evidence of damage with mean T1 values of 453.1 ms ± 113.6 ms. The difference in these T1 values was significant (p = 0.003). Correlation between standard MRI and intra-operative findings was moderate (r = 0.535, p < 0.001). Intra-operative findings revealed more damage than standard MRI. On standard MRI, 68.6% zones were graded normal while 31.4% had evidence of damage. On intra-operative visualization, 56.4% zones were graded normal and 43.6% had evidence of damage. Correlation between dGEMRIC and intra-operative findings turned out to be weak (r = 0.114, p < 0.126). On T1 assessment 31.4% of zones were graded as normal and 68.6% as damaged. dGEMRIC was significantly different between normal and affected cartilage based on intra-operative assessment. The correlation for morphological findings was limited, underestimating defects. By combining morphological with biochemical assessment dGEMRIC may play some role in the future to prognosticate outcomes and facilitate surgical planning and intervention. (orig.)

Software documentation and user's manual for fish-impingement sampling design and estimation method computer programs

International Nuclear Information System (INIS)

Murarka, I.P.; Bodeau, D.J.

1977-11-01

This report contains a description of three computer programs that implement the theory of sampling designs and the methods for estimating fish-impingement at the cooling-water intakes of nuclear power plants as described in companion report ANL/ES-60. Complete FORTRAN listings of these programs, named SAMPLE, ESTIMA, and SIZECO, are given and augmented with examples of how they are used