BACKGROUND: A herniated disc in the spine is a condition during which a nucleus pulposus is displaced from intervertebral space. AIM: The study aimed to investigate and observe variation of clinical, epidemiological, and radiological aspects for patients suspected of lumbar herniation based on observed evaluation of CT and MRI imagery. METHODS: This is a cross-sectional study conducted during the periods March 2015 and November 2019. Patients were subjected to MRI and CT based on the emergency or scheduled of diagnose. All MRI scans were obtained with 1.5 tesla MRI machine and for CT had undergone examinations with one of the following equipment: Siemens with 128 slice and Phillips 64 slice. The patients were placed in supine position. RESULTS: Overall 194 symptomatic patients were recruited as a participant in this study, 118 men and 76 women with an average age of 44.9 ±10.4 years. Patients belong to the active age (35–44-years-old and 45–54-years-old) appeared to have the highest percentage of lumbar disk herniation (LDH) 30.9% and 25.8%, respectively. There were a significant association between such as epidemiological data (such as gender, BMI, age groups, and employment status) and presence of LDH, p ˂ 0.05. Acute pain was presented in 69.07% of patients and according to complaint associated with low back pain (LBP), most of them 47.4% appeared with Right Sciatica. MRI is the most diagnostic methods used in evaluation of LDH in 52% of patients, and CT was used in 48% of them. The most common changes were between L2-L3, L3-L4, and L4-L5. Furthermore, the grading findings which corresponding to lumbosacral segment were Grade I and Grade II. Grade V was less common. CONCLUSION: This study involving patients with lumbar disk herniation and associated LBP showed that a combination of clinical features and epidemiological predicted the presence or absence of a significant association. Further research is required to validate these findings in different types of LDH and LBP for other findings and conditions.

BACKGROUND: Osteoarthritis (OA) of the genu joint is a degenerative disease of the genu joint, which due to functional limitations leads to deterioration of the quality of life of these patients. In many cases, surgical therapy prosthesis of articular surfaces represents the gold standard of treatment for these patients. AIM: In this study, it is proposed to evaluate the effectiveness of hyaluronic acid (HA) injected under the direction of Echo (ultrasound) in the genu articulation accompanied by a rehabilitation program. MATERIALS AND METHODS: Fifteen patients with knee OA were studied. According to the Kellgren-Lawrence radiological classification, Grade II-III arthrosis does not qualify for surgical treatment. Patients underwent intra-articular injection with HA, under ultrasound guidance, and after 6 days continued with rehabilitative treatment aimed at combating the patient’s analgesic posture, recovery of muscle traction participating in genu joint movement, decompression maneuvers, and decompaction in monopodial load. Patients were evaluated at the beginning and after 3 months. RESULTS: In the evaluation of patients at the beginning and after 3 months, a reduction in> 60% of the pain was found, and the Western Ontario and McMaster University Osteoarthritis test in 40% of patients after the first intra-articular injection. No significant side effects were observed during infiltrative procedures. CONCLUSIONS: This study confirms the effectiveness of the combined treatment of the rehabilitation program and intra-articular therapy under the guidance of Echos, in patients suffering from knee OA, significantly reducing pain and recovery of functional capacity.

Background: Lumbar disc degenerative disease has now been proven as the most common cause of low back pain throughout the world. Approximately 5–15% of patients with low back pain suffer from lumbar disc herniation. Presenting symptoms of lumbar disc degeneration are lower back pain and sciatica which may be aggravated by walking, sitting, standing, bending, lifting etc. Aim: To evaluate based on MRI images the prevalence of LDH in patients with low back pain and its correlation between various demographic data. Methods: This Cross sectional and observational study was conducted from January 2016 to December 2017 at department of Imagery in the University Hospital Center `Mother Theresa`. During the two years’ period of this study, 342 patients of low back pain were presented to department of imagery suspected for lumbar disc herniation. Diagnostic criteria were based upon abnormal findings in MRI. All MRI scans were obtained with 1.5 tesla MRI machine. Data analysis was carried out with SPSS software for Windows version 20.0. Results: Overall 342 patients with LBP came into Imagery department, the prevalence of lumbar disc herniation resulted 31.9% (109/342). Most of patients 60.5% were presented with continuous LBP with a predominance of deterioration of pain by the walking activity 65.2%. The average age of patients with LDH resulted 51.12 years old with min 32 years and max 74 years old. The ratio M:F of LDH patients resulted 1.4, with predominance of males 59.6%. The active age 40-49 years (28.9%) old and 50-59 years (36.9%) were the most affected by LDH compared to other age groups. Based on MRI images disc herniation was most commonly present at the level of L3/L4 and L4/L5. Commonest types of disc herniation were protrusion 63.3% (69/109) followed by extrusion 21.1% (23/109). In the overall multivariate regression analysis, a significant relation between lumbar disk herniation and some of occupation was found (p˂0.05) Conclusions: Biologically, the lumbar herniation disc is a potential contributor to low back pain. The prevalence of LDH among patients with LBP resulted 31.9%, and men were more prone to suffered from disc herniation than women, due to increased mechanical stress and injury. Results reported the frequent occurrence of lumbar disc degenerative disease in active age. The lumbar discs most often affected and leads to herniation are L3-L4, and L4–L5. Research efforts should endeavor to reduce risk factors and improve the quality of life.