The clinical diagnosis of pelvic inflammatory disease – reuse of electronic medical record data from 189 patients visiting a Swedish university hospital emergency department

BACKGROUND: The pelvic inflammatory disease (PID) diagnosis is mostly based on clinical findings. However, few studies have examined the clinical basis for the diagnostics of PID, which was the aim of this study. METHODS: A retrospective study was performed of 189 out-patients diagnosed as having PID at the obstetric and gynecological emergency department of a Swedish university hospital. Data on symptoms, signs, pelvic examination and laboratory tests were extracted from the electronic medical records in comparison with the diagnostic criteria of the PID Guideline of the US Center of Disease Control from 2002 (CDC 2002 Guidelines). RESULTS: Eight symptoms in varying combinations were associated with the PID diagnosis. Most of them are mentioned in the CDC 2002 Guidelines. Detected rates of C. Trachomatis (CT) and N. Gonorrhoeae (NG) were 5% and 0%, respectively, among the tested patients (CT = 52% and NG = 12%). The C-reactive protein was normal in the majority of tested patients. CONCLUSION: The clinical basis for the diagnostics of PID was largely in accordance with the criteria in the CDC 2002 Guidelines. The limited number of CT tests performed is somewhat disappointing, considering the fact that effective disease prevention includes widespread CT screening. Further studies in different settings are needed in order to analyze how the testing rate for CT can be improved in clinical praxis

Correlation between preoperative and postoperative knee kinematics in total knee arthroplasty using cruciate retaining designs

The authors evaluated the relationships between preoperative and postoperative kinematics in 50 osteoarthritic knees scheduled for cruciate retaining total knee arthroplasty with regards to posterior femoral roll back and external femoral rotation using a navigation system from 10° to 120° of knee flexion. Although posterior femoral roll back was maintained, external femoral rotation was significantly decreased compared to those of the preoperative knee after total knee arthroplasty. However, the amount of posterior roll back and external femoral rotation after total knee arthroplasty were found to be significantly positively related to those measured preoperatively (r = 0.62 and 0.57, respectively). These significant kinematic correlations may explain why preoperative range of knee motion influences range of motion after total knee arthroplasty