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Sample records for acromioclavicular joint acj

  1. Acromioclavicular joint cyst formation.

    PubMed

    Hiller, Andrew D; Miller, Joshua D; Zeller, John L

    2010-03-01

    Acromioclavicular joint (ACJ) cysts are an uncommon and unusual sequela associated with shoulder pathophysiology. The majority of literature on ACJ cysts consists of individual case reports with no definitive literature review currently available. In addition to a comprehensive literature review, four clinical cases are presented in this report. First described by Craig (1984), a total of 41 cases have been previously reported in the literature. Of these cases, five occurred with the rotator cuff musculature intact. The remaining 36 cases of ACJ cysts occurred in patients with a complete tear/avulsion of the rotator cuff. Previous attempts at compiling a complete record of all reported cases have combined several distinct conditions into a single category. This article presents two distinct etiologies for the pathogenesis of ACJ cyst formation. In the presence of an intact rotator cuff, a Type 1 cyst can form superficially and be limited to the ACJ. Following a massive or traumatic tear of the rotator cuff, mechanical instability of the humeral head can cause a deterioration of the inferior acromioclavicular capsule (cuff tear arthropathy) and an overproduction of synovial fluid. Overtime, a "geyser" of fluid can form between the glenohumeral and the ACJ, forming a Type 2 cyst. This differentiation and categorization is essential for appropriate classification and treatment.

  2. Acromioclavicular joint cyst formation.

    PubMed

    Hiller, Andrew D; Miller, Joshua D; Zeller, John L

    2010-03-01

    Acromioclavicular joint (ACJ) cysts are an uncommon and unusual sequela associated with shoulder pathophysiology. The majority of literature on ACJ cysts consists of individual case reports with no definitive literature review currently available. In addition to a comprehensive literature review, four clinical cases are presented in this report. First described by Craig (1984), a total of 41 cases have been previously reported in the literature. Of these cases, five occurred with the rotator cuff musculature intact. The remaining 36 cases of ACJ cysts occurred in patients with a complete tear/avulsion of the rotator cuff. Previous attempts at compiling a complete record of all reported cases have combined several distinct conditions into a single category. This article presents two distinct etiologies for the pathogenesis of ACJ cyst formation. In the presence of an intact rotator cuff, a Type 1 cyst can form superficially and be limited to the ACJ. Following a massive or traumatic tear of the rotator cuff, mechanical instability of the humeral head can cause a deterioration of the inferior acromioclavicular capsule (cuff tear arthropathy) and an overproduction of synovial fluid. Overtime, a "geyser" of fluid can form between the glenohumeral and the ACJ, forming a Type 2 cyst. This differentiation and categorization is essential for appropriate classification and treatment. PMID:20069645

  3. Reverse Total Shoulder Replacement with Minimal ACJ Excision Arthroplasty for Management of Massive ACJ Cyst - A Case Report

    PubMed Central

    Shaarani, Shahril R; Mullett, Hannan

    2014-01-01

    Massive acromioclavicular joint (ACJ) cysts are an extremely rare cause of shoulder impairment and with limited consensus in its management. We present the first published case report of a patient with a massive ACJ cyst treated with a reverse total shoulder replacement with minimal ACJ excision arthroplasty. PMID:25279019

  4. Acromioclavicular Joint Reconstruction.

    PubMed

    Scillia, Anthony J; Cain, E Lyle

    2015-12-01

    Our technique for acromioclavicular joint reconstruction provides a variation on coracoclavicular ligament reconstruction to also include acromioclavicular ligament reconstruction. An oblique acromial tunnel is drilled, and the medial limb of the gracilis graft, after being crossed and passed beneath the coracoid and through the clavicle, is passed through this acromial tunnel and sutured to the trapezoid graft limb after appropriate tensioning. Tenodesis screws are not placed in the bone tunnels to avoid graft fraying, and initial forces on the graft are offloaded with braided absorbable sutures passed around the clavicle. PMID:27284528

  5. Acromioclavicular joint disorders.

    PubMed

    Turnbull, J R

    1998-04-01

    The acromioclavicular joint is commonly involved in athletic injuries. Most commonly, a sprain to the joint occurs with variability in the amount of ligamentous damage and displacement that occurs. In all but the most severe dislocations, treatment consists of initial sling immobilization and early functional rehabilitation. The outcome is usually excellent with full return of function following these injuries. The rarer types (IV, V, and VI) require operative reduction and fixation. Distal clavicle fractures are related injuries, which many times disrupt the stabilizing ligaments of the acromioclavicular joint. Many can be treated nonoperatively, but there are several subtypes that should be considered for early fixation to reduce complications of pain and shoulder dysfunction. An atraumatic, overuse condition, which is becoming more prevalent and seems related to weight training, is osteolysis of the distal clavicle. There is insidious onset of shoulder pain with symptoms and signs consistent with acromioclavicular pathology. Activity modification is the best method of controlling symptoms. Failure of the conservative approach necessitates operative excision of the distal clavicle.

  6. [Injuries of the acromioclavicular joint].

    PubMed

    Meeder, P J; Dannöhl, C

    1988-07-01

    The injuries of the acromio-clavicular joint require a differentiated diagnosis and treatment. The classification of the acromio-clavicular dislocations from grade I to grade III according to Tossy is proved. The diagnosis of a complete acromio-clavicular dislocation (Tossy III) is an indication for a surgical repair. Many and different methods are reported in the literature. 178 patients with a fresh acromio-clavicular dislocation (Typ Tossy II and III) were treated at the BG-Unfallklinik Tübingen from 1970 to 1987 by suturing the ligaments, inserting pins across the joint and tension wire bending. In old cases with Tossy III dislocation of the acromio-clavicular joint an oblique osteotomy combined with the reduction of the clavicle is recommended as a method of choice. The results of these procedures and there possible intra- and postoperative complications are reported. The incision along the clavicle quite often gives scar problems. Therefore the advantages of an arched incision across the acromio-clavicular joint is pointed out. Because of there biomechanical relationship fractures in the lateral third of the clavicle are similar to dislocations of the acromio-clavicular joint. The classification of these fractures according to Jäger, Buschle and Breitner allows a differentiated management of these lesions.

  7. Management of acute acromioclavicular joint dislocations: current concepts.

    PubMed

    Tauber, Mark

    2013-07-01

    Acromioclavicular joint (ACJ) injuries represent a common injury to the shoulder girdle. In the management algorithm of acute ACJ injuries complete radiological evaluation represents the key to a successful therapy. According to the classification of Rockwood the presence of a horizontal component in addition to vertical instability has to be detected. Using axillary functional views or Alexander views dynamic horizontal ACJ instability can be diagnosed in a simple, efficient and cost-effective manner reducing the number of mis-/underdiagnosed ACJ injuries. MRI should not be the imaging modality of first choice. The treatment of ACJ dislocations must consider two aspects. In addition to the correct type of injury therapy strategies should be adapted to patient's demands and compliance. Low grade AC injuries types I and II are treated non-operatively in terms of "skilful-neglect". High-grade injuries types IV-VI should be treated operatively within a time frame of 2-3 weeks after injury. A certain debate is still ongoing regarding type III injuries. Out from the literature, non-operative treatment of type III injuries results to provide at least equal functional outcomes as compared to surgical treatment associated with less complications and earlier return to professional and sports activities. If surgical treatment is indicated, open surgical procedures using pins, PDS-slings or hook plates are still widely used concurring with recently raising minimally invasive, arthroscopic techniques using new implants designed to remain in situ. Combined coracoclavicular and acromioclavicular repair are gaining in importance to restore horizontal as well as vertical ACJ stability.

  8. Management of acromioclavicular joint injuries.

    PubMed

    Li, Xinning; Ma, Richard; Bedi, Asheesh; Dines, David M; Altchek, David W; Dines, Joshua S

    2014-01-01

    Acromioclavicular joint injuries are among the most common shoulder girdle injuries in athletes and most commonly result from a direct force to the acromion with the arm in an adducted position. Acromioclavicular joint injuries often present with associated injuries to the glenohumeral joint, including an increased incidence of superior labrum anterior posterior (SLAP) tears that may warrant further evaluation and treatment. Anteroposterior stability of the acromioclavicular joint is conferred by the capsule and acromioclavicular ligaments, of which the posterior and superior ligaments are the strongest. Superior-inferior stability is maintained by the coracoclavicular (conoid and trapezoid) ligaments. Type-I or type-II acromioclavicular joint injuries have been treated with sling immobilization, early shoulder motion, and physical therapy, with favorable outcomes. Return to activity can occur when normal shoulder motion and strength are obtained and the shoulder is asymptomatic as compared with the contralateral normal extremity. The management of type-III injuries remains controversial and is individualized. While a return to the previous level of functional activity with nonsurgical treatment has been documented in a number of case series, surgical reduction and coracoclavicular ligament reconstruction has been associated with a favorable outcome and can be considered in patients who place high functional demands on their shoulders or in athletes who participate in overhead sports. Surgical management is indicated for high-grade (≥type IV) acromioclavicular joint injuries to achieve anatomic reduction of the acromioclavicular joint, reconstruction of the coracoclavicular ligaments, and repair of the deltotrapezial fascia. Outcomes after surgical reconstruction of the coracoclavicular ligaments have been satisfactory with regard to achieving pain relief and return to functional activities, but further improvements in the biomechanical strength of these

  9. Acromioclavicular joint separations grades I-III: a review of the literature and development of best practice guidelines.

    PubMed

    Reid, Duncan; Polson, Kate; Johnson, Louise

    2012-08-01

    Acromioclavicular joint (ACJ) separation injuries are common injuries among sporting populations. ACJ separations are graded according to severity from grade I being a mild sprain to grade VI, which is severe dislocation with displacement. There is consensus in the literature that grade I-III ACJ separations are managed conservatively and grades IV-VI are managed surgically. Despite conservative care being recommended for lesser grades of injury, there is very little evidence in the literature as to what constitutes conservative care. Therefore, the purpose of this paper was, first, to review the relevant anatomy and kinematics of the ACJ and, second, to review the literature relating to current evidence of conservative management of ACJ injury. Using this data, a best practice guideline for conservative rehabilitation in grade I-III ACJ separations was developed. For the conservative management, a literature search was undertaken using the following databases in the Auckland University of Technology's electronic library resources; MEDLINE, CINAHL, SPORTDiscus™ and the Cochrane Library. The following keywords or phrases were used: 'acromioclavicular joint separations', 'injury', 'dislocations', 'rehabilitation', 'conservative care', 'physiotherapy' and 'exercise'. A total of 24 articles was identified. There were no randomized controlled trials (RCTs) that investigated conservative treatment for grade I-III ACJ sprains. Therefore, a narrative review was formulated covering the anatomy and biomechanics of the ACJ, injury mechanisms and relevant literature reviewed covering rehabilitation principles. Conservative management of grade I-III ACJ separations is still the main recommendation following this review. A best practice guideline for managing grade I-III ACJ separations is presented to help guide clinicians until well constructed RCTs are carried out to improve the conservative management of ACJ injuries.

  10. Coracoid Process Avulsion Fracture at the Coracoclavicular Ligament Attachment Site in an Osteoporotic Patient with Acromioclavicular Joint Dislocation

    PubMed Central

    Umemoto, Takahisa; Fukuda, Kimitaka; Kajino, Tomomichi

    2016-01-01

    Coracoid fractures are uncommon, mostly occur at the base or neck of the coracoid process (CP), and typically present with ipsilateral acromioclavicular joint (ACJ) dislocation. However, CP avulsion fractures at the coracoclavicular ligament (CCL) attachment with ACJ dislocation have not been previously reported. A 59-year-old woman receiving glucocorticoid treatment fell from bed and complained of pain in her shoulder. Radiographs revealed an ACJ dislocation with a distal clavicle fracture. Three-dimensional computed tomography (3D-CT) reconstruction showed a small bone fragment at the medial apex of the CP. She was treated conservatively and achieved a satisfactory outcome. CP avulsion fractures at the CCL attachment can occur in osteoporotic patients with ACJ dislocations. Three-dimensional computed tomography is useful for identifying this fracture type. CP avulsion fractures should be suspected in patients with ACJ dislocations and risk factors for osteoporosis or osteopenia. PMID:27493819

  11. Acromio-clavicular joint cyst associated with a complete rotator cuff tear - a case report.

    PubMed

    McCreesh, Karen M; Riley, Sara J; Crotty, James M

    2014-10-01

    This case report describes a patient with an acromio-clavicular joint (ACJ) cyst, associated with a complete tear of the supraspinatus tendon, and the related arthropathy. Ultrasound was a suitable imaging modality to make the diagnosis, and rule out other pathologies. Full assessment of the rotator cuff must be carried out in the presence of ACJ cysts due to their common co-existence with large cuff tears. Cyst aspiration is not a suitable treatment, due to the high likelihood of recurrence. Optimal treatment requires management of the underlying rotator cuff tear.

  12. Management of acromioclavicular joint injuries.

    PubMed

    Stucken, Charlton; Cohen, Steven B

    2015-01-01

    Although recent advances have been made in the treatment of acromioclavicular (AC) joint injuries, they are still challenging for shoulder surgeons. There is a consensus that type I and II injuries should be treated nonoperatively, whereas acute type IV, V, and VI injuries should be treated surgically. There is no algorithm for correctly diagnosing and treating type III injuries, but the current trend is toward nonoperative treatment except for those with persistent symptoms and functional limitations after a course of conservative management. If surgery is indicated, newer anatomic techniques of reconstructing the coracoclavicular (CC) and AC ligaments are recommended.

  13. Acromioclavicular joint injury in competitive golfers.

    PubMed

    Mallon, W J; Colosimo, A J

    1995-01-01

    We reviewed a series of professional and competitive low-handicap golfers with shoulder pain. All but one player (34/35) had pain in the left shoulder. A high incidence of problems (53%) related to the acromioclavicular joint was noted in these golfers with left shoulder pain. With proper treatment all but one (17/18 [94%]) of the golfers with acromioclavicular joint problems was able to return to competitive golf. By studying the mechanics of the golf swing, a possible mechanism for this high incidence of acromioclavicular joint problems is given.

  14. The acromioclavicular joint.

    PubMed

    Montellese, Phyllis; Dancy, Timothy

    2004-12-01

    Acute injuries of the AC joint have a limited differential diagnosis. A thorough examination and appropriate radiographs can identify nearly all problems while ruling out tumors as a causal factor. AC injury frequently occurs with other fractures, dislocations, or soft tissue injury around the shoulder. The single unifying diagnosis one searches for in medical conditions is frequently absent in musculoskeletal injury. For effective management of AC separations, the primary care physician need only distinguish type I, II, and III injuries from surgically treated type IV, V, and VI injuries. Types I, II, and III injuries should be treated with pain control and progressive rehabilitation as described previously. Patients who have types IV, V, and VI injuries should be referred to an orthopedic surgeon. Chronic injuries of the AC joint are also clearly diagnosed by appropriate physical examination and radiographs. Steroid injections can aid in the diagnosis and management of these conditions. Injury to one shoulder component predisposes to other shoulder injuries. A thorough examination will reveal these other associated abnormalities that may not be part of the presenting complaint. With practice in the examination of the shoulder and intra-articular injections, the primary care physician can effectively treat most common AC conditions. Only after conservative measures fail is it necessary to refer the patient for surgical management.

  15. Evaluation and management of acromioclavicular joint injuries.

    PubMed

    Dumonski, Mark; Mazzocca, Augustus D; Rios, Cliff; Romeo, Anthony A; Arciero, Robert A

    2004-10-01

    The acromioclavicular joint is stabilized by the coracoclavicular and acromioclavicular ligaments and by the trapezius and deltoid muscles. Joint dislocation commonly results from a direct blow to the acromion. Injury types I through III are generally treated nonoperatively, whereas types IV through VI are treated operatively. Nonoperative protocols should always begin with ice and immobilization. Operative techniques include acromioclavicular ligament repair, dynamic transfer of the conjoined tendon, coracoclavicular ligament reconstruction, and coracoacromial ligament transfer. The goal with any injury type should always be full return to the patient's preinjury condition.

  16. Injuries to the acromioclavicular joint.

    PubMed

    Fraser-Moodie, J A; Shortt, N L; Robinson, C M

    2008-06-01

    Injuries to the acromioclavicular joint are common but underdiagnosed. Sprains and minor subluxations are best managed conservatively, but there is debate concerning the treatment of complete dislocations and the more complex combined injuries in which other elements of the shoulder girdle are damaged. Confusion has been caused by existing systems for classification of these injuries, the plethora of available operative techniques and the lack of well-designed clinical trials comparing alternative methods of management. Recent advances in arthroscopic surgery have produced an even greater variety of surgical options for which, as yet, there are no objective data on outcome of high quality. We review the current concepts of the treatment of these injuries.

  17. Arthroscopic resection of the distal clavicle in osteoarthritis of the acromioclavicular joint

    PubMed Central

    Park, Tae-Soo; Lee, Kwang-Won

    2016-01-01

    Background: Symptomatic acromioclavicular joint (ACJ) lesions are a common cause of shoulder complaints that can be treated successfully with both conservative and surgical methods. There are several operative techniques, including both open and arthroscopic surgery, for excising the distal end of the clavicle. Here, we present a new modified arthroscopic technique for painful osteoarthritis of the ACJ and evaluate its clinical outcomes. Our hypothesis was that 4- to 7-mm resection of the distal clavicle in an en bloc fashion would have several advantages, including no bony remnants, maintenance of stability of the ACJ, and reduced prevalence of heterotopic ossification, in addition to elimination of the pathologic portion of the distal clavicle. Materials and Methods: 20 shoulders of 20 consecutive patients with painful and isolated osteoarthritis of the ACJ who were treated by arthroscopic en bloc resection of the distal clavicle were included in the study. There were 10 males and 10 females with an average age of 56 years (range 42–70 years). The mean duration of followup was 6 years and 2 months (range 4–8 years 10 months). The results were evaluated using the University of California Los Angeles (UCLA) shoulder rating score. Results: The overall UCLA score was 13.7 preoperatively, which improved to 33.4 postoperatively. All subscores were improved significantly (P < 0.001). There were no specific complications at the latest followup. Conclusion: It is critical in this procedure to resect the distal clavicle evenly from superior to inferior in an en bloc fashion without any small bony remnants and to preserve the capsule and acromioclavicular ligament superoposteriorly. This arthroscopic procedure is a reliable and reproducible technique for painful osteoarthritis of the ACJ lesions in active patients engaged in overhead throwing sports and heavy labor. PMID:27512219

  18. Evaluation and treatment of acromioclavicular joint injuries.

    PubMed

    Mazzocca, Augustus D; Arciero, Robert A; Bicos, James

    2007-02-01

    Acromioclavicular joint injuries and, more specifically, separations are commonplace both in general practice and during athletic participation. This article reviews the traditional classification as well as the clinical evaluation of patients with acute and chronic acromioclavicular joint separations. It also highlights many recent advances, principally in the anatomy and biomechanics of the acromioclavicular joint ligamentous complex. The concept of increases in superior translation as well as disturbances in horizontal translation with injuries to this joint and ligaments are discussed. This information, coupled with the unpredictable long-term results with the Weaver-Dunn procedure and its modifications, have prompted many recent biomechanical studies evaluating potential improvements in the surgical management of acute and chronic injuries. The authors present these recent works investigating cyclic loading and ultimate failure of traditional reconstructions, augmentations, use of free graft, and the more recent anatomic reconstruction of the conoid and trapezoid ligaments. The clinical results (largely retrospective), including acromioclavicular joint repair, reconstruction and augmentation with the coracoclavicular ligament, supplemental sutures, and the use of free autogenous grafts, are summarized. Finally, complications and the concept of the failed distal clavicle resection and reconstruction are addressed. The intent is to provide a current, in-depth treatise on all aspects of acromioclavicular joint complex injuries to include anatomy, biomechanics, benchmark studies on instability and reconstruction, clinical and radiographic evaluation, and to present the most recent clinical research on surgical outcomes.

  19. Acromioclavicular joint injuries: diagnosis and management.

    PubMed

    Simovitch, Ryan; Sanders, Brett; Ozbaydar, Mehmet; Lavery, Kyle; Warner, Jon J P

    2009-04-01

    Acromioclavicular joint injuries represent nearly half of all athletic shoulder injuries, often resulting from a fall onto the tip of the shoulder with the arm in adduction. Stability of this joint depends on the integrity of the acromioclavicular ligaments and capsule as well as the coracoclavicular ligaments and the trapezius and deltoid muscles. Along with clinical examination for tenderness and instability, radiographic examination is critical in the evaluation of acromioclavicular joint injuries. Nonsurgical treatment is indicated for type I and II injuries; surgery is almost always recommended for type IV, V, and VI injuries. Management of type III injuries remains controversial, with nonsurgical treatment favored in most instances and reconstruction of the acromioclavicular joint reserved for symptomatic instability. Recommended techniques for stabilization in cases of acute and late symptomatic instability include screw fixation of the coracoid process to the clavicle, coracoacromial ligament transfer, and coracoclavicular ligament reconstruction. Biomechanical studies have demonstrated that anatomic acromioclavicular joint reconstruction is the most effective treatment for persistent instability.

  20. Acromioclavicular joint injuries: anatomy, diagnosis, and treatment.

    PubMed

    Willimon, S Clifton; Gaskill, Trevor R; Millett, Peter J

    2011-02-01

    Acromioclavicular (AC) joint injuries are common in athletic populations and account for 40% to 50% of shoulder injuries in many contact sports, including lacrosse, hockey, rugby and football. The AC joint is stabilized by static and dynamic restraints, including the coracoclavicular (CC) ligaments. Knowledge of these supporting structures is important when identifying injury and directing treatment. Management of AC injuries should be guided by severity of injury, duration of injury and symptoms, and individual patient factors. These help determine how best to guide management, and whether patients should be treated surgically or nonsurgically. Treatment options for AC injuries continue to expand, and include arthroscopic-assisted anatomic reconstruction of the CC ligaments. The purpose of this article is to review the anatomy, diagnostic methods, and treatment options for AC joint injuries. In addition, the authors' preferred reconstruction technique and outcomes are presented.

  1. Dislocation of the acromioclavicular joint. An end-result study.

    PubMed

    Taft, T N; Wilson, F C; Oglesby, J W

    1987-09-01

    The cases of 127 patients who had an acute dislocation of the acromioclavicular joint were studied. Fifty-two patients, with an average follow-up of 10.8 years, were managed operatively, and seventy-five patients, with an average follow-up of 9.5 years, were managed non-operatively. Using a rating system that included subjective, objective, and roentgenographic criteria, it did not appear that reduction of the acromioclavicular joint was necessary to obtain consistently good results. Operative management, using either coracoclavicular or acromioclavicular fixation, was associated with a higher rate of complications than non-operative treatment. The use of a sling for four weeks without reduction of the joint, followed by a graduated exercise program, led to acceptable clinical results. In patients who had persistent pain and stiffness of the acromioclavicular joint, or in whom symptomatic post-traumatic arthritis developed, resection of the distal part of the clavicle reliably produced significant improvement.

  2. A dual injury of the shoulder: acromioclavicular joint dislocation (type IV) coupled with ipsilateral mid-shaft clavicle fracture.

    PubMed

    Madi, Sandesh; Pandey, Vivek; Khanna, Vikrant; Acharya, Kiran

    2015-11-23

    A direct blow to the shoulder, as may be sustained in a road traffic accident (RTA), can result in various combinations of fracture dislocations in the shoulder joint complex. Among these, a rare variety is an acromioclavicular joint (ACJ) dislocation coupled with ipsilateral mid-shaft clavicle fracture. Diverse treatment options have been described in the literature, ranging from non-operative and operative, to hybrid management. Treatment for this complex injury is predominantly dictated by the type of dislocation and displacement of the clavicle fracture, as well as age and demand of the patient. Acute high grades of ACJ dislocation require restoration of the coracoclavicular relationship (in place of torn coracoclavicular (CC) ligament) by some form of internal fixation, thereby maintaining the ACJ reduction. An arthroscopic reinstatement of the coracoclavicular relationship using a dog bone button and fibre tape implant for this composite injury pattern has not been previously described. Furthermore, a comprehensive review of the literature associated with this injury pattern is briefly described.

  3. [Athletic capacity after surgical management of acromioclavicular joint separation].

    PubMed

    Krüger-Franke, M; Maurer, T; Rosemeyer, B

    1992-09-01

    Acromioclavicular separation is a common injury in sports. This study was done to show the activity and problems of athletes after operative treatment of this kind of injury. Between 1986 and 1989 21 athletes with acromioclavicular separation had been treated by operation. The coracoclavicular ligaments had been sutured and augmented by a PDS cord. The acromioclavicular ligaments had also been reattached and the ac-joint had been transfixed with a Kirschner-wire. The results show 18 athletes doing their sports on the same level as preoperatively. Two athletes with a frequency of sporting activity once a week could not continue their sporting activity. One athlete changed the disciplines to less shoulder stressing kind of sport. The comparison of clinical and radiological results showed no correlation, even patients with an osteoarthrosis of the ac-joint and coracoclavicular ossifications had best clinical results. We recommend therefore operative treatment for acromioclavicular separation in athletes.

  4. Acromioclavicular joint instability: anatomy, biomechanics and evaluation.

    PubMed

    Saccomanno, Maristella F; DE Ieso, Carmine; Milano, Giuseppe

    2014-01-01

    Acromioclavicular (AC) joint instability is a common source of pain and disability. The injury is most commonly a result of a direct impact to the AC joint. The AC joint is surrounded by a capsule and has an intra-articular synovium and an articular cartilage interface. An articular disc is usually present in the joint, but this varies in size and shape. The AC joint capsule is quite thin, but has considerable ligamentous support; there are four AC ligaments: superior, inferior, anterior and posterior. The coracoclavicular (CC) ligament complex consists of the conoid and trapezoid ligaments. They insert on the posteromedial and anterolateral region of the undersurface of the distal clavicle, respectively. The coracoid origin of the trapezoid covers the posterior half of the coracoid dorsum; the conoid origin is more posterior on the base of the coracoid. Several biomechanical studies showed that horizontal stability of the AC joint is mediated by the AC ligaments while vertical stability is mediated by the CC ligaments. The radiographic classification of AC joint injuries described by Rockwood includes six types: in type I injuries the AC ligaments are sprained, but the joint is intact; in type II injuries, the AC ligaments are torn, but the CC ligaments are intact; in type III injuries both the AC and the CC ligaments are torn; type IV injuries are characterized by complete dislocation with posterior displacement of the distal clavicle into or through the fascia of the trapezius; type V injuries are characterized by a greater degree of soft tissue damage; type VI injuries are inferior AC joint dislocations into a subacromial or subcoracoid position. The diagnosis of AC joint instability can be based on historical data, physical examination and imaging studies. The cross body adduction stress test has the greatest sensitivity, followed by the AC resisted extension test and the O'Brien test. Proper radiographic evaluation of the AC joint is necessary. The Zanca view

  5. Septic arthritis of the acromioclavicular joint: an uncommon location.

    PubMed

    Martínez-Morillo, Melania; Mateo Soria, Lourdes; Riveros Frutos, Anne; Tejera Segura, Beatriz; Holgado Pérez, Susana; Olivé Marqués, Alejandro

    2014-01-01

    Septic pyogenic arthritis of the acromioclavicular joint is a rare entity that occurs in immunosuppressed patients or those with discontinuity of defense barriers. There are only 15 cases described in the literature. The diagnosis is based on clinical features and the isolation of a microorganism in synovial fluid or blood cultures. The evidence of arthritis by imaging (MRI, ultrasound or scintigraphy) may be useful. Antibiotic treatment is the same as in septic arthritis in other locations. Staphylococcus aureus is the microorganism most frequently isolated. Our objective was to describe the clinical features, treatment and outcome of patients diagnosed with septic arthritis of the acromioclavicular joint at a Rheumatology Department. We developed a study with a retrospective design (1989-2012). The medical records of patients with septic arthritis were reviewed (101 patients). Those involving the acromioclavicular joint were selected (6 patients; 6%).

  6. A modified surgical technique for reconstruction of an acute acromioclavicular joint dislocation

    PubMed Central

    Marchie, Anthony; Kumar, Arun; Catre, Melanio

    2009-01-01

    We report a modified surgical technique for reconstruction of coracoclavicular and acromioclavicular ligaments after acute dislocation of acromioclavicular joint using suture anchors. We have repaired 3 consecutive type III acromioclavicular dislocations with good results. This technique is simple and safe and allows anatomical reconstruction of the ligaments in acute dislocations. PMID:20671868

  7. [Treatment of chronic acromioclavicular joint instability].

    PubMed

    Natera-Cisneros, L; Santiago-Boccolini, H; Sarasquete-Reiriz, J

    2015-01-01

    The purpose of this paper is to assess the results obtained with the arthroscopy-assisted surgical technique for the treatment of chronic acromioclavicular joint instability (CACJI), based on non-rigid coracoclavicular (CC) fixation and anatomical CC reconstruction with a tendinous allograft. Patients with CACJI who underwent surgery between 2008 and 2012 were included in the study. Clinical assessments included SF36, VAS and DASH, applied at the preoperative visit (POV) and at the last follow-up visit (LFUV). The Constant score and the General Satisfaction Score (0-10) were applied at the last follow-up visit. Occurrence of secondary subluxations was assessed. Ten patients were included; mean age was 41 years (range 33-55). Mean follow-up was 25.50 months (range 24-30). Surgical treatment was indicated in all patients after failure of conservative treatment. Questionnaires applied at the POV and the LFUV showed the following results: 1. SF36: physical, POV = 29.60 ± 3.41 and LFUV = 59.58 ± 1.98 (p = 0.000); 2. SF36 mental, POV = 46.57 ± 3.80 and LFUV = 56.62 ± 1.89 (p = 0.000); 3. VAS: POV = 5.17 ± 2.40 and LFUV: 1.67 ± 2.07 (p = 0.022); and 4. DASH: POV = 63.33 ± 23.56 and LFUV = 2.61 ± 1.79 (p = 0.000). The Constant score and the general satisfaction at the LFUV were 95.56 ± 3.28 and 9.22 ± 0.67, respectively. There were no secondary subluxations. Treatment of CACJI with a CC suspension device and arthroscopically-assisted anatomical reconstruction of CC ligaments may provide a significant quality of life improvement to patients. It is a strategy that, upon considering primary mechanical CC fixation, may minimize the chance of failure and occurrence of secondary subluxations. PMID:26999968

  8. Acromioclavicular joint problems in athletes and new methods of management.

    PubMed

    Rios, Clifford G; Mazzocca, Augustus D

    2008-10-01

    The acromioclavicular (AC) complex consists of bony and ligamentous structures that stabilize the upper extremity through the scapula to the axial skeleton. The AC joint pathology in the athlete is generally caused by 1 of 3 processes: trauma (fracture, AC joint separation, or dislocation); AC joint arthrosis (posttraumatic or idiopathic); or distal clavicle osteolysis. This article presents systematically the relevant anatomy, classification, evaluation, and treatment of these disorders. Management of AC joint problems is dictated by the severity and chronicity of the injury, and the patient's needs and expectations.

  9. Rehabilitation of acromioclavicular joint separations: operative and nonoperative considerations.

    PubMed

    Cote, Mark P; Wojcik, Karen E; Gomlinski, Gregg; Mazzocca, Augustus D

    2010-04-01

    Acromioclavicular joint (AC) separations are one of the most common injuries seen in orthopedic and sports medicine practices, accounting for 9% of all injuries to the shoulder girdle. Various operative and nonoperative treatment schemes have been described for the management of AC joint injuries. Although there is controversy about the efficacy of surgical reconstruction versus nonoperative intervention for grade III type injuries, grade I and II separations seem to respond favorably to conservative management. Conversely, grades IV, V, and VI often require surgical reconstruction. Regardless of the type of injury, rehabilitation as a part of conservative management and postoperative care plays an important role in the management of these injuries. This article presents a rehabilitation approach to treatment of acromioclavicular separations pre- and postoperatively.

  10. How to minimize complications in acromioclavicular joint and clavicle surgery.

    PubMed

    Hsu, Stephanie H; Ahmad, Christopher S; Henry, Patrick D G; McKee, Michael D; Levine, William N

    2012-01-01

    Up to 50% of all athletic shoulder injuries are acromioclavicular joint separations. The ideal treatment for type III injuries remains controversial. Current reconstruction techniques include anatomic coracoclavicular reconstructions and newly developed arthroscopic techniques. Clavicle fractures have traditionally been treated nonsurgically based largely on early reports of surgical complications, but there has been a dramatic surge in the surgical treatment of clavicle fractures over the past 5 years because of recent reports of poorer outcomes with nonsurgical management.

  11. Injuries to the acromioclavicular joint. Diagnosis and management.

    PubMed

    VanFleet, T A; Bach, B

    1994-02-01

    Injuries to the acromioclavicular (AC) joint are common in athletes. Diagnosis can often be made clinically, but radiographs are needed to classify the severity of injury. Treatment is often conservative, consisting of immobilization or symptomatic modalities. Surgery is generally performed on patients with the more severe injuries. Controversy surrounds the treatment of type III injuries. The current trend is toward nonsurgical options, consisting of either symptomatic treatment or immobilization. If surgery is necessary, coracoclavicular (CC) fixation is currently the treatment of choice.

  12. Controversies relating to the management of acromioclavicular joint dislocations.

    PubMed

    Modi, C S; Beazley, J; Zywiel, M G; Lawrence, T M; Veillette, C J H

    2013-12-01

    The aim of this review is to address controversies in the management of dislocations of the acromioclavicular joint. Current evidence suggests that operative rather than non-operative treatment of Rockwood grade III dislocations results in better cosmetic and radiological results, similar functional outcomes and longer time off work. Early surgery results in better functional and radiological outcomes with a reduced risk of infection and loss of reduction compared with delayed surgery. Surgical options include acromioclavicular fixation, coracoclavicular fixation and coracoclavicular ligament reconstruction. Although non-controlled studies report promising results for arthroscopic coracoclavicular fixation, there are no comparative studies with open techniques to draw conclusions about the best surgical approach. Non-rigid coracoclavicular fixation with tendon graft or synthetic materials, or rigid acromioclavicular fixation with a hook plate, is preferable to fixation with coracoclavicular screws owing to significant risks of loosening and breakage. The evidence, although limited, also suggests that anatomical ligament reconstruction with autograft or certain synthetic grafts may have better outcomes than non-anatomical transfer of the coracoacromial ligament. It has been suggested that this is due to better restoration horizontal and vertical stability of the joint. Despite the large number of recently published studies, there remains a lack of high-quality evidence, making it difficult to draw firm conclusions regarding these controversial issues.

  13. Acromioclavicular joint injuries in sport. Recommendations for treatment.

    PubMed

    Dias, J J; Gregg, P J

    1991-02-01

    Dislocation of the acromioclavicular joint is a common joint injury in sport, especially those in which there is the risk of falling on to the point of the shoulder. There is controversy regarding the early management of such a dislocation but recent literature strongly favours a conservative approach, because no single surgical procedure has produced results which are consistently better than those achieved following conservative management. In addition the few studies which document late results suggest that in most instances the outcome following conservative treatment is very satisfactory with good power and movement of the shoulder.

  14. [Dislocation of the acromioclavicular joint--conservative or surgical therapy?].

    PubMed

    Hack, U; Bibow, K

    1988-01-01

    Reported in this paper are therapeutic results obtained from 54 hospitalised patients who had been treated for acromioclavicular dislocation. Indications, tactical approaches to treatment, and results are described and discussed in some detail. Good results were obtained from conservative treatment of Tossy-I injuries. However, surgery in the first place is recommended, when it comes to Tossy-II and Tossy-III serverities (ligament suture and temporary arthrodesis of the AC joint), as this has proved to yield results which were superior to secondary plastic ligament repair. Poorest results were recorded from conservative treatment of patients with Tossy-III injuries.

  15. Traumatic pseudodislocation of the acromioclavicular joint in children. A fifteen year review.

    PubMed

    Black, G B; McPherson, J A; Reed, M H

    1991-01-01

    Traumatic acromioclavicular separation in the skeletally immature patient is frequently overdiagnosed and overtreated. Fifty-eight children, aged 5 to 16 years, who presented over a 15 year period with injuries to the distal clavicle, were reviewed retrospectively. The majority showed coracoclavicular widening radiographically, suggesting acromioclavicular separation. In 45 cases, a distal clavicular fracture was identified, while an acromioclavicular separation without fracture was initially diagnosed in 13. Long-term followups of these patients demonstrate excellent results with conservative management. "Pseudodislocation" involves a clavicular fracture of the lateral metaphysis or metaphyseal epiphyseal separation and not an acromioclavicular disruption. This pseudodislocation of the acromioclavicular joint in the skeletally immature patient must be differentiated from the adult counterpart to avoid unnecessary operative intervention.

  16. The evaluation and treatment of the injured acromioclavicular joint in athletes.

    PubMed

    Lemos, M J

    1998-01-01

    Injuries to the acromioclavicular joint are among the most commonly occurring problems in the athletic patient population. However, these injuries are often confused with other problems associated with the shoulder complex. This confusion was noted by Hippocrates (460-377 BC), who realized that acromioclavicular dislocation often was misdiagnosed as a glenohumeral injury. Galen (129-199 AD) experienced an acromioclavicular dislocation and could not tolerate the tight bandaging recommended at the time and thus became one of the earliest noncompliant patients. The understanding of acromioclavicular injuries and their management has evolved rapidly during the last 2 decades. This review will clarify the current concepts in the management and treatment of acromioclavicular injuries in the athlete.

  17. All-Arthroscopic Technique for Reconstruction of Acute Acromioclavicular Joint Dislocations

    PubMed Central

    Cutbush, Kenneth; Hirpara, Kieran M.

    2015-01-01

    Acromioclavicular joint dislocations are a common injury particularly among contact sports players. There has been an increasing trend toward arthroscopic management of these injuries. To date, these reconstructions have primarily addressed superoinferior instability by reconstructing the coracoclavicular ligaments. We describe an all-arthroscopic technique for reconstruction of the coracoclavicular ligaments using Arthrex ABS TightRopes (Arthrex, Naples, FL), with additional stabilization of the superior acromioclavicular joint capsule using an anchor-based suture bridge to address anteroposterior instability. PMID:26697307

  18. Clinical Effect of Acute Complete Acromioclavicular Joint Dislocation Treated with Micro-Movable and Anatomical Acromioclavicular Plate

    PubMed Central

    Liu, Qingjun; Miao, Jianyun; Lin, Bin; Guo, Zhimin

    2012-01-01

    Objectives: We evaluated the long-term clinical results of acute complete acromioclavicular dislocations treated with micro-movable and anatomical acromioclavicular plate. Methods: Open reduction and internal fixation was performed using the MAAP in 16 patients (10 males, 6 females; mean age 36 years; range16 to 63 years) with acute complete acromioclavicular joint dislocation. Radiographic evaluations were routinely conducted every 3 weeks until 3 months postoperatively. The MAAP were removed under local anesthesia after 3 months postoperatively. We evaluated the functional results by using the constant scoring system and radiological results in the last follow-up time. The mean follow up was 26 months (range 16 to 38 months). Results: The mean Constant score was 94 (range, 78 to 100). The results were excellent in 12 patients (75.0%), good in 3 patients (18.8%) and satisfactory in 1patient (6.2%). Three patients with scores of 80 to 90 had mild pain during activity, but have not affected the shoulder range of motion. One patient has both some pain and limited range of motion of shoulder joint. All patients but one have returned to their preoperative work without any limitations. Compared to the contralateral side, radiography showed anatomical reposition in the vertical plane in 14 cases, slight loss of reduction in 2 older patients. Conclusion: We recommend the MAAP fixation for surgical treatment of acute complete acromioclavicular joint dislocation as it could provide satisfactory shoulder functions and clinical results, with lower complication rate. However, it is necessary to continue to observe the clinical effects of this fixation technique. PMID:23091410

  19. Wide field of view CT and acromioclavicular joint instability: A technical innovation.

    PubMed

    Dyer, David R; Troupis, John M; Kamali Moaveni, Afshin

    2015-06-01

    A 21-year-old female with a traumatic shoulder injury is investigated and managed for symptoms relating to this injury. Pathology at the acromioclavicular joint is detected clinically; however, clinical examination and multiple imaging modalities do not reach a unified diagnosis on the grading of this acromioclavicular joint injury. When management appropriate to that suggested injury grading fail to help the patient's symptoms, further investigation methods were utilised. Wide field of view, dynamic CT (4D CT) is conducted on the patient's affected shoulder using a 320 × 0.5 mm detector multislice CT. Scans were conducted with a static table as the patient completed three movements of the affected shoulder. Capturing multiple data sets per second over a z-axis of 16 cm, measurements of the acromioclavicular joint were made, to show dynamic changes at the joint. Acromioclavicular (AC) joint translations were witnessed in three planes (a previously unrecognised pathology in the grading of acromioclavicular joint injuries). Translation in multiple planes was also not evident on careful clinical examination of this patient. AC joint width, anterior-posterior translation, superior-inferior translation and coracoclavicular width were measured with planar reconstructions while volume-rendered images and dynamic sequences aiding visual understanding of the pathology. Wide field of view dynamic CT (4D CT) is an accurate and quick modality to diagnose complex acromioclavicular joint injury. It provides dynamic information that no other modality can; 4D CT shows future benefits for clinical approach to diagnosis and management of acromioclavicular joint injury, and other musculoskeletal pathologies.

  20. Horizontal and Vertical Stabilization of Acute Unstable Acromioclavicular Joint Injuries Arthroscopy-Assisted

    PubMed Central

    Cisneros, Luis Natera; Sarasquete Reiriz, Juan; Besalduch, Marina; Petrica, Alexandru; Escolà, Ana; Rodriguez, Joaquim; Fallone, Jan Carlo

    2015-01-01

    We describe the technical aspects of an arthroscopy-assisted procedure indicated for the management of acute unstable acromioclavicular joint injuries, consisting of a synthetic augmentation of both the coracoclavicular and acromioclavicular ligaments, that anatomically reproduces the coracoclavicular biomechanics and offers fixation that keeps the torn ends of the ligaments facing one another, thus allowing healing of the native structures without the need for a second surgical procedure for metal hardware removal. PMID:26870653

  1. Management of type 3 acromioclavicular joint dislocations--current controversies.

    PubMed

    Kim, Suezie; Blank, Alan; Strauss, Eric

    2014-01-01

    AC (acromioclavicular) joint dislocations are a common injury seen by physicians. Symptoms range from minor discomfort with activity to complete disability of the extremity. Although most orthopaedic surgeons agree on how to treat either mild (type 1-2) or severe (type 4-6) injuries, there is no consensus for treatment of type 3 injuries. This article reviews the relevant literature pertaining to the anatomy of the injury, evaluation of the patient, pertinent imaging as well as the controversial management of type 3 AC joint dislocations. With improvement in surgical techniques over the past 30 years, there have been many published studies evaluating both operative and non-operative care. Surgery has shown dramatic improvement in patient-rated outcomes; however, it is not always without complications. These risks in some patients may not be worth the potential surgical benefits. In type 3 AC joint injuries each patient and pathology must be carefully analyzed to ensure that the correct treatment option is chosen.

  2. Unilateral duplication of the acromioclavicular joint: case report and literature review.

    PubMed

    Viard, Brice; Karp, Jean-Sébastien; Tremlet, Julien; Asali, Zahed; Trouilloud, Pierre; Trost, Olivier

    2013-12-01

    Clavicle duplication is a rare anatomical variation of the scapular belt: only seven cases have been reported in the literature to date, and only one took note of the existence of a duplication of the acromioclavicular joint. Two hypotheses have been proposed to interpret this variation: genetic factors, or trauma occurred in the growth period. Clavicle duplication should not be mistaken for a quite frequent coracoclavicular joint widely described. The authors report the case of a left acromioclavicular joint duplication in a 51-year-old male patient presenting with left shoulder pain. This case was the first of literature providing 3D CT-scan images.

  3. Acromioclavicular joint reconstruction using the LockDown synthetic implant: a study with cadavers.

    PubMed

    Taranu, R; Rushton, P R P; Serrano-Pedraza, I; Holder, L; Wallace, W A; Candal-Couto, J J

    2015-12-01

    Dislocation of the acromioclavicular joint is a relatively common injury and a number of surgical interventions have been described for its treatment. Recently, a synthetic ligament device has become available and been successfully used, however, like other non-native solutions, a compromise must be reached when choosing non-anatomical locations for their placement. This cadaveric study aimed to assess the effect of different clavicular anchorage points for the Lockdown device on the reduction of acromioclavicular joint dislocations, and suggest an optimal location. We also assessed whether further stability is provided using a coracoacromial ligament transfer (a modified Neviaser technique). The acromioclavicular joint was exposed on seven fresh-frozen cadaveric shoulders. The joint was reconstructed using the Lockdown implant using four different clavicular anchorage points and reduction was measured. The coracoacromial ligament was then transferred to the lateral end of the clavicle, and the joint re-assessed. If the Lockdown ligament was secured at the level of the conoid tubercle, the acromioclavicular joint could be reduced anatomically in all cases. If placed medial or 2 cm lateral, the joint was irreducible. If the Lockdown was placed 1 cm lateral to the conoid tubercle, the joint could be reduced with difficulty in four cases. Correct placement of the Lockdown device is crucial to allow anatomical joint reduction. Even when the Lockdown was placed over the conoid tubercle, anterior clavicle displacement remained but this could be controlled using a coracoacromial ligament transfer.

  4. Anatomy of the pectoralis minor tendon and its use in acromioclavicular joint reconstruction.

    PubMed

    Moinfar, Amir R; Murthi, Anand M

    2007-01-01

    Many procedures described for operative management of acromioclavicular joint separations entail transfer of the coracoacromial ligament. We sought to describe the anatomy and morphology of the pectoralis minor tendon better, to assess its anatomic potential as a substitute for sacrificing the coracoacromial ligament, and to compare the ultimate tensile strength of the pectoralis minor with that of the coracoacromial ligament and detached coracoclavicular ligament. The morphology of the pectoralis minor tendon was carefully delineated and compared with that of the coracoacromial ligament, and 10 paired fresh-frozen cadaveric shoulders were tested to failure by applying a single uniaxial tensile load. Anatomic study of the pectoralis minor tendon confirmed its adequacy as a source of local autograft tissue in acromioclavicular joint reconstruction. We hypothesize that, in cases of acromioclavicular joint separation necessitating operative intervention, the use of the pectoralis minor tendon as a potential source of autograft tissue is anatomically feasible and it is slightly stronger than the coracoacromial ligament.

  5. Surgical outcome following arthroscopic fixation of acromioclavicular joint disruption with the tightrope device.

    PubMed

    Thiel, Eric; Mutnal, Amar; Gilot, Gregory J

    2011-07-07

    The objective of this study was to evaluate the preliminary radiographic and clinical results of grade IV and V acromioclavicular joint disruption repair using the arthroscopic Arthrex acromioclavicular TightRope (Naples, Florida) fixation technique. Numerous procedures have been described for surgical management of acromioclavicular joint disruption. The TightRope device involves an arthroscopic technique that allows nonrigid anatomic fixation of the acromioclavicular joint. A cohort of 10 men and 2 women with a mean age of 43 years (range, 25-61 years) underwent the acromioclavicular joint TightRope procedure between April 2007 and October 2009. Eleven patients had either Rockwood grade IV or V disruptions and 1 sustained a distal third clavicle fracture with acromioclavicular joint disruption. Data was collected from a chart review. Patients were evaluated clinically, radiographically, by the simple shoulder test, and by overall satisfaction. There were 2 failures of reduction and 1 loss of reduction at final radiographic follow-up. The rate of fixation failure was 16.6%. All patients had >110° of total elevation. The majority of patients obtained satisfactory functional results according to the Simple Shoulder Test averaging 11 of 12 questions answered positively (range, 7-12; standard deviation, 1.50) and 11 of 12 patients were satisfied with the procedure. At final phone interview at approximately 2 years postoperatively, 6 patients were lost to follow-up. The remaining patients were all satisfied with the procedure and no patients reported subjective loss of reduction or deterioration of function. Simple Shoulder Test average was maintained with 11 of 12 positively answered questions (range, 7-12; standard deviation, 2.0) This case series revealed a high rate of fixation failure with the TightRope system. Still, most patients were satisfied with the procedure and achieved high functional shoulder results.

  6. Surgical treatment of a concurrent type 5 acromioclavicular joint dislocation and a failed anterior glenohumeral joint stabilization.

    PubMed

    Rashid, Abbas; Lawrence, Christopher; Tytherleigh-Strong, Graham

    2016-10-01

    Traumatic glenohumeral joint dislocation and acromioclavicular joint subluxations tend to occur in young active males. Use of the coracoid process either as a transfer in recurrent instability or in suspensory reconstructions of the coracoclavicular ligaments have gained popularity. However this requires careful consideration in the event of concomitant injuries if they both require surgery. PMID:27660658

  7. Surgical treatment of a concurrent type 5 acromioclavicular joint dislocation and a failed anterior glenohumeral joint stabilization.

    PubMed

    Rashid, Abbas; Lawrence, Christopher; Tytherleigh-Strong, Graham

    2016-10-01

    Traumatic glenohumeral joint dislocation and acromioclavicular joint subluxations tend to occur in young active males. Use of the coracoid process either as a transfer in recurrent instability or in suspensory reconstructions of the coracoclavicular ligaments have gained popularity. However this requires careful consideration in the event of concomitant injuries if they both require surgery.

  8. Inter- and intraobserver reliability of the radiographic diagnosis and treatment of acromioclavicular joint separations.

    PubMed

    Kraeutler, Matthew J; Williams, Gerald R; Cohen, Steven B; Ciccotti, Michael G; Tucker, Bradford S; Dines, Joshua S; Altchek, David W; Dodson, Christopher C

    2012-10-01

    The management of acromioclavicular joint separations, in particular Rockwood types III and V, remains controversial. The purpose of this study was to investigate the observer reliability of shoulder surgeons when presented with the same cases of acromioclavicular joint separations. The authors retrospectively identified 28 patients who were diagnosed with a type III, IV, or V acromioclavicular joint separation. A PowerPoint presentation was compiled that contained an anteroposterior and axial radiograph from each patient prior to treatment. Radiographs were sent to surgeons, who diagnosed each injury according to the Rockwood classification and stated whether they recommended operative or nonoperative treatment for each patient.Inter- and intraobserver reliability were calculated from the surgeons' reviews. Repeat diagnoses were returned by 8 surgeons. A single-measure intraclass correlation coefficient (ICC) was used to determine interobserver reliability for the surgeons' Rockwood classifications (ICC=0.602) and their decision to operate (ICC=0.469). Intraobserver reliability also was calculated for Rockwood classifications (ρ=0.694) and decision to operate (κ=0.366). Two (25%) of 8 surgeons stated that they would have used open and arthroscopic techniques for repairing the dislocations, whereas the remaining (75%) surgeons would have performed open techniques. Individual surgeons were consistent in their grading of acromioclavicular joint dislocations, but less observer agreement existed among the surgeons. Poor agreement among surgeons for the decision to operate indicates that this decision is heavily influenced by clinical factors and the radiographic classification.

  9. [Use of a periosteal flap in the surgical management of rupture of the acromioclavicular joint capsule and ligament. Preliminary report].

    PubMed

    Sánta, S; Varga, Z; Tasnády, Z

    1989-01-01

    Authors use in the treatment of acromioclavicular joint dislocations to increase the safety of the ligament sutures a periosteal flap, gained from the clavicle. The use of the periosteal flap to increase the strength of the acromioclavicular ligament sutures is described. In case of fixing the joint with a tension band the suspension of the cerclage on a screw for an easier removal is suggested.

  10. Double-button Fixation System for Management of Acute Acromioclavicular Joint Dislocation

    PubMed Central

    Torkaman, Ali; Bagherifard, Abolfazl; Mokhatri, Tahmineh; Haghighi, Mohammad Hossein Shabanpour; Monshizadeh, Siamak; Taraz, Hamid; Hasanvand, Amin

    2016-01-01

    Background: Surgical treatments for acromioclavicular (AC) joint dislocation present with some complications. The present study was designed to evaluate the double-button fixation system in the management of acute acromioclavicular joint dislocation. Methods: This cross sectional study, done between February 2011 to June 2014, consisted of 28 patients who underwent surgical management by the double-button fixation system for acute AC joint dislocation. Age, sex, injury mechanism, dominant hand, side with injury, length of follow up, time before surgery, shoulder and hand (DASH), constant and visual analogue scale (VAS) scores, and all complications of the cases during the follow up were recorded. Results: The mean age of patients was 33.23±6.7 years. Twenty four patients (85.71%) were male and four (14.28%) were female. The significant differences were observed between pre-operation VAS, constant shoulder scores and post-operation measurements. There were not any significant differences between right and left coracoclavicular, but two cases of heterotrophic ossifications were recorded. The mean follow-up time was 16.17±4.38 months. Conclusion: According to the results, the double-button fixation system for management of acute acromioclavicular joint dislocation has suitable results and minimal damage to the soft tissues surrounding the coracoclavicular ligaments. PMID:26894217

  11. Clinical and radiologic outcomes of surgical and conservative treatment of type III acromioclavicular joint injury.

    PubMed

    Calvo, Emilio; López-Franco, Mariano; Arribas, Ignacio M

    2006-01-01

    The management of acute acromioclavicular joint dislocations is controversial. The purpose of this study was to compare the incidence of posttraumatic anatomic alterations after surgical or conservative treatment of type III injuries and to analyze their effect on the outcome. Forty-three patients were evaluated retrospectively, clinically and radiographically, at a 12-month minimum follow-up. Thirty-two were treated surgically, using the Phemister technique, and 11 had conservative treatment. A comparison of the overall clinical results in both groups showed no statistically significant differences. The acromioclavicular joint was anatomically reduced in only half of the surgical patients. Those shoulders treated surgically showed a significantly higher incidence of osteoarthritis and coracoclavicular ligament ossification. Differences in clavicular deformity or osteolysis were not significant. None of these abnormalities had any influence on the clinical result. Because operative and conservative treatments achieve equally good clinical results and surgery carries a higher risk of osteoarthritis, we recommend managing this injury conservatively.

  12. [Late results of surgical treatment of Tossy III acromioclavicular joint separation with the Balser plate].

    PubMed

    Graupe, F; Dauer, U; Eyssel, M

    1995-08-01

    Various surgical procedures have been recommended for the treatment of complete acromioclavicular joint separations. The results have been similar in case reports by various authors. From 1984 to 1992, 35 patients were operated on for acromioclavicular joint separations (Tossy III) in the Department of Surgery, Marien-Hospital, Düsseldorf, using Balser's hook plate. The postoperative morbidity rate was 14.3%. Follow-up examinations were performed on 30 patients (85.7%) with average follow-up of 4.1 years, using a rating system that include subjective, objective, and roentgenographic criteria. Fifty percent of patients had no complaints, but residual dislocation was found in 36.7% of cases. While 26 patients (86.7%) were satisfied with the results of the operation, 30% demonstrated a fair result according to the scoring system. The complaints and clinical findings showed no correlation with the X-ray results, e.g. calcification or arthrosis, redislocations.

  13. Chronic acromioclavicular joint dislocations treated by the GraftRope device

    PubMed Central

    Nordin, Jonas S; Aagaard, Knut E; Lunsjö, Karl

    2015-01-01

    Background and purpose Surgical treatment of chronic acromioclavicular joint dislocations is challenging, and no single procedure can be considered to be the gold standard. In 2010, the GraftRope method (Arthrex Inc., Naples, FL) was introduced in a case series of 10 patients, showing good clinical results and no complications. We wanted to evaluate the GraftRope method in a prospective consecutive series. Patients and methods 8 patients with chronic Rockwood type III–V acromioclavicular joint dislocations were treated surgically using the GraftRope method. The patients were clinically evaluated and a CT scan was performed to assess the integrity of the repair. Results and interpretation In 4 of the 8 patients, loss of reduction was seen within the first 6 weeks postoperatively. A coracoid fracture was the reason in 3 cases and graft failure was the reason in 1 case. In 3 of the 4 patients with intact repairs, the results were excellent with no subjective shoulder disability 12 months postoperatively. It was our intention to include 30 patients in this prospective treatment series, but due to the high rate of complications the study was discontinued prematurely. Based on our results and other recent reports, we cannot recommend the GraftRope method as a treatment option for chronic acromioclavicular joint dislocations. PMID:25323800

  14. Surgical treatment of an aseptic fistulized acromioclavicular joint cyst: a case report and review of the literature.

    PubMed

    Murena, Luigi; D'angelo, Fabio; Falvo, Daniele A; Vulcano, Ettore

    2009-01-01

    An acromioclavicular joint cyst is an uncommonly reported condition, which seems to result from a massive rotator cuff tear and degenerative osteoarthritis of the acromioclavicular joint. We present the case of an 81-year-old man affected by an acromioclavicular joint cyst, associated to a massive rotator cuff tear, proximal migration of the humeral head and osteoarthritis of the gleno-humeral joint. The mass was 7 x 2.5 cm in size and the overlying skin presented a fistula that drained clear synovial-like fluid. Plain X-ray examination of the left shoulder showed proximal migration of the humeral head migration and osteoarthritis of the gleno-humeral joint, and further MRI evaluation confirmed the clinical diagnosis of a complete rotator cuff tear and observed a large subcutaneous cyst in communication with the degenerative acromioclavicular joint. The patient underwent surgical excision of the cyst and lateral resection of the clavicle to prevent disease recurrence. To the best of our knowledge, this is the first reported case of an acromioclavicular joint cyst complicated by an aseptic fistula resulting from multiple aspirations. PMID:19918423

  15. Acromioclavicular Joint Dislocation with Ipsilateral Mid Third Clavicle, Mid Shaft Humerus and Coracoid Process Fracture – A Case Report

    PubMed Central

    Sharma, Naveen; Mandloi, Avinash; Agrawal, Ashish; Singh, Shailendra

    2016-01-01

    Introduction: The clavicle, humerus and acromioclavicular (AC) joint separately are very commonly involved in traumatic injuries around the shoulder. Acromioclavicular joint dislocation with distal clavicle fracture is a well recognized entity in clinical practice. AC joint dislocation with mid shaft clavicle fracture is uncommon and only few cases have been reported in literature. However, to the best of our knowledge, this is the first case report to describe an acromioclavicular dislocation with ipsilateral mid shaft clavicle, mid shaft humerus and coracoid process fracture. Fractures of the humerus and clavicle along with the acromioclavicular joint dislocation were fixed at the same setting. Case Report: A 65-year-old male met with a high velocity road traffic accident. Plain radiographs showed displaced mid third clavicle fracture with acromioclavicular joint dislocation with mid shaft humerus fracture. Surgical fixation was planned for humerus with interlocking nail, clavicle with locking plate and acromioclavicular joint with reconstruction of coracoclavicular ligaments. Intraoperatively, coracoid process was found to have a comminuted fracture. The operative plan had to be changed on table as coracoclavicular fixation was not possible. So acromioclavicular joint fixation was done using tension band wiring and the coracoclavicular ligament was repaired using a 2-0 ethibond. The comminuted coracoid fracture was managed conservatively. K wires were removed at 6 weeks. Early mobilization was started. Conclusion: In acromioclavicular joint injuries, clavicle must be evaluated for any injury. Although it is more commonly associated with distal clavicle fractures, it can be associated with middle third clavicle fractures. As plain radiographs, AP view are most of the times insufficient for viewing integrity of coracoid process, either special views like Stryker notch or CT scan may help in diagnosing such concealed injuries. When associated with fractures of the

  16. Evaluation and management of adult shoulder pain: a focus on rotator cuff disorders, acromioclavicular joint arthritis, and glenohumeral arthritis.

    PubMed

    Armstrong, April

    2014-07-01

    Shoulder pain is a common reason for a patient to see their primary care physician. This article focuses on the evaluation and management of 3 common shoulder disorders; rotator cuff disorders, acromioclavicular joint arthritis, and glenohumeral joint arthritis. The typical history and physical examination findings for each of these entities are highlighted, in addition to treatment options.

  17. Triple endobuttton technique for the treatment of acute complete acromioclavicular joint dislocations: preliminary results.

    PubMed

    Wei, Hai-Feng; Chen, Yun-Feng; Zeng, Bing-Fang; Zhang, Chang-Qing; Chai, Yi-Min; Wang, Hai-Ming; Lu, Ye

    2011-04-01

    Numerous procedures have been described for the operative management of acromioclavicular (AC) joint injuries. Some of these techniques, including hardware fixation and non-anatomical reconstructions, are associated with serious complications and high failure rates. Recently, AC joint reconstruction techniques have focused on anatomical restoration of the coracoclavicular ligaments to achieve optimal clinical outcomes. We used a triple endobutton technique to separately reconstruct the trapezoid and the coronoid portions of the coracoclavicular ligament. We evaluated the preliminary clinical and radiological results of this technique in patients with acute complete dislocation of the AC joint. All patients achieved a significant improvement in the pain and function of shoulder at a mean follow-up interval of 12 months (range, 8-14 months). Excellent reduction of the AC joint was maintained. The triple endobutton technique may be safe and effective for the treatment of acute complete AC joint dislocations.

  18. Type IV acromioclavicular joint dislocation associated with a mid-shaft clavicle malunion

    PubMed Central

    Mohammed, Khalid D.; Stachiw, Danielle; Malone, Alex A.

    2016-01-01

    This reports presents the case of a combined clavicle fracture malunion and chronic Type IV acromioclavicular (AC) joint dislocation. The patient was seen acutely in the emergency department following a mountain bike accident at which time the clavicle fracture was identified and managed conservatively however the AC dislocation was not diagnosed. The patient presented 25 months following the injury with persistent pain and disability and was treated with clavicle osteotomy and AC stabilization. We document the clinical details, surgical treatment and outcome. PMID:26980988

  19. Acute septic arthritis of the acromioclavicular joint caused by Haemophilus parainfluenzae: a rare causative origin.

    PubMed

    Hong, Myong-Joo; Kim, Yeon-Dong; Ham, Hyang-Do

    2015-04-01

    Septic arthritis of the acromioclavicular (AC) joint is a rare entity with symptoms that include erythema, swelling, and tenderness over the AC joint, fever, and limitation of shoulder motion with pain. In previous reports, Staphylococcus and Streptococcus species have been mentioned as common causative organisms. Haemophilus parainfluenzae is a normal inhabitant of the oral cavity, respiratory tract, gastrointestinal tract, and urogenital tract. However, it sometimes causes opportunistic infections leading to septic arthritis and osteomyelitis. AC joint infection associated with H.parainfluenzae is very rare, and only one case has been reported in the literature. Moreover, septic arthritis in immunocompetent patients is also very rare. Here, we report the case of a healthy patient with H. parainfluenzae-related septic arthritis of the AC joint.

  20. Surgical treatment of acute acromioclavicular joint injuries using a modified Weaver-Dunn procedure and clavicular hook plate.

    PubMed

    Liu, Hsin-Hua; Chou, Yi-Jiun; Chen, Chi-Hui; Chia, Wei-Tso; Wong, Chi-Yin

    2010-08-11

    Various surgical procedures have been described for the treatment of complete acromioclavicular joint dislocation, but no consensus exists on the optimal therapy. The aim of each type of procedure is to stabilize the clavicle by substitution of the ruptured coracoclavicular ligaments. Treatment modalities have changed with increasing understanding of the nature of the problem and the biomechanics of the joint. This article presents a method consisting of a modified Weaver-Dunn procedure and a clavicular hook plate for the operative management of acute acromioclavicular joint injuries.We performed a retrospective study of 46 patients who had undergone a modified Weaver-Dunn procedure with a clavicular hook plate for acute acromioclavicular joint injuries between July 2002 and December 2006. Average follow-up was 36.6 months (range, 24-46 months). There was 1 skin-deep infection, 1 dislocation of the hook, and 2 redislocations of the acromioclavicular joint. Thirteen patients had some calcification between the clavicle and the coracoid process, which did not cause loss of motion or other symptoms. All but 1 patient returned to work, and all but 1 returned to their preoperative activity level. The mean Constant score was 88.2 points. The mean Disabilities of the Arm, Shoulder, and Hand (DASH) score was 12.2 points.Treatment of acute acromioclavicular joint injuries using a modified Weaver-Dunn procedure and a clavicular hook plate showed good short-term clinical results with a low complication rate. Further investigation and long-term results are needed to confirm these preliminary findings.

  1. The MRI geyser sign: acromioclavicular joint cysts in the setting of a chronic rotator cuff tear.

    PubMed

    Cooper, H John; Milillo, Ralph; Klein, Devon A; DiFelice, Gregory S

    2011-06-01

    We present the case of a 71-year-old man with a large acromioclavicular (AC) joint cyst successfully managed with surgical excision. AC joint cysts are soft tissue masses generally signifying underlying rotator cuff pathology. Traditionally, these cysts were identified with shoulder arthrography as a "geyser" of fluid escaping through the AC joint. Magnetic resonance imaging (MRI) is today's preferred imaging modality; we describe the MRI equivalent of the "geyser sign," signifying synovial fluid escaping through the cuff defect, across the subacromial bursa, and decompressing superiorly through a degenerated AC joint. Surgical management is preferred for symptomatic cysts. Based on a review of limited retrospective case series, recommendations for management of these lesions are as follows. Repair of the rotator cuff is preferable whenever possible. In the case of an irreparable defect, good results can be achieved through excisional AC joint arthroplasty and resection of the cyst base. Aspiration of these cysts should not be attempted, due to the high recurrence rate and potential for a draining sinus. Hemiarthroplasty also may be effective in indirectly decompressing these cysts; but given the invasive nature of this procedure, it should be reserved for patients who are also symptomatic from cuff arthropathy.

  2. The MRI geyser sign: acromioclavicular joint cysts in the setting of a chronic rotator cuff tear.

    PubMed

    Cooper, H John; Milillo, Ralph; Klein, Devon A; DiFelice, Gregory S

    2011-06-01

    We present the case of a 71-year-old man with a large acromioclavicular (AC) joint cyst successfully managed with surgical excision. AC joint cysts are soft tissue masses generally signifying underlying rotator cuff pathology. Traditionally, these cysts were identified with shoulder arthrography as a "geyser" of fluid escaping through the AC joint. Magnetic resonance imaging (MRI) is today's preferred imaging modality; we describe the MRI equivalent of the "geyser sign," signifying synovial fluid escaping through the cuff defect, across the subacromial bursa, and decompressing superiorly through a degenerated AC joint. Surgical management is preferred for symptomatic cysts. Based on a review of limited retrospective case series, recommendations for management of these lesions are as follows. Repair of the rotator cuff is preferable whenever possible. In the case of an irreparable defect, good results can be achieved through excisional AC joint arthroplasty and resection of the cyst base. Aspiration of these cysts should not be attempted, due to the high recurrence rate and potential for a draining sinus. Hemiarthroplasty also may be effective in indirectly decompressing these cysts; but given the invasive nature of this procedure, it should be reserved for patients who are also symptomatic from cuff arthropathy. PMID:21869946

  3. Segmental clavicle fracture and acromio-clavicular joint disruption: an unusual case report.

    PubMed

    Marjoram, Tom P; Chakrabarti, Anil

    2015-07-01

    Clavicle fractures are common, accounting for 2.6% of all adult fractures. We describe a most unusual segmental fracture pattern of the clavicle with concurrent disruption of acromioclavicular (AC) joint. We were unable to find any publications or reports describing this fracture pattern. During surgery for a medial one-third shaft of clavicle fracture and AC joint dislocation, the medial clavicle was exposed, leading to the discovery (on table) of a previously unidentified additional undisplaced fracture of the medial clavicle cleaving the bone into three distinct fragments. An anatomical plate was successfully applied, fixing both fractures. The AC joint was then reduced with a hook plate. At 8 months, after removal of the hook plate, the patient has an excellent outcome with an Oxford Shoulder Score of 45/48 and a full range of movement without instability of the AC joint. We describe the operative management of this rare fracture pattern. This also highlights that segmental fractures of the clavicle are easily missed. It was successfully treated with a medial anatomic plate and lateral hook plate. We were unable to find any publications or reports describing the fracture pattern in this case. PMID:27582977

  4. [Results of treatment after different surgical procedures for management of acromioclavicular joint dislocation].

    PubMed

    Göhring, U; Matusewicz, A; Friedl, W; Ruf, W

    1993-07-01

    Sixty-four patients underwent surgery for acromioclavicular (AC) disruption, Tossy type III, at the Department of Surgery, University of Heidelberg, between January 1983 and May 1990. Surgery consisted of a suture of the AC and coracoclavicular ligaments. Fixation of the joint was achieved with three different techniques: tension band wire with two Kirschner wires, special hook-plate (Wolter), double tension band fixation using polydioxanon (PDS) cordula. The early postoperative complication rate was higher following tension band wires (42.9%) and hook plate (58.3%) than after tension band PDS cordula (16.7%). The patients were re-examined after an average of 35.3 months. An instability of the AC joint was found in 31.8% of patients with tension band wire, 50.0% of patients with Wolter plate, and 23.8% of patients with tension band PDS cordula. The comparison of these results with those after conservative treatment, as reported in the literature, emphasizes the need for limiting surgery to young adults and athletes. The long term results of AC joint fixation are better using PDS cordula than tension band wire or hook plate. PDS cordula has the additional advantages, that dislocation and fracture of metal implants do not occur, and metal removal is avoided. Therefore, tension PDS cordula is associated with a marked reduction of the overall hospitalization period. Further improvements of results of AC joint fixation can be expected using the described technique of double tension band PDS cordula.

  5. Modified Weaver-Dunn Procedure Versus The Use of Semitendinosus Autogenous Tendon Graft for Acromioclavicular Joint Reconstruction

    PubMed Central

    Hegazy, Galal; Safwat, Hesham; Seddik, Mahmoud; Al-shal, Ehab A.; Al-Sebai, Ibrahim; Negm, Mohame

    2016-01-01

    Background: The optimal operative method for acromioclavicular joint reconstruction remains controversial. The modified Weaver-Dunn method is one of the most popular methods. Anatomic reconstruction of coracoclavicular ligaments with autogenous tendon grafts, widely used in treating chronic acromioclavicular joint instability, reportedly diminishes pain, eliminates sequelae, and improves function as well as strength. Objective: To compare clinical and radiologic outcomes between a modified Weaver-Dunn procedure and an anatomic coracoclavicular ligaments reconstruction technique using autogenous semitendinosus tendon graft. Methods: Twenty patients (mean age, 39 years) with painful, chronic Rockwood type III acromioclavicular joint dislocations were subjected to surgical reconstruction. In ten patients, a modified Weaver-Dunn procedure was performed, in the other ten patients; autogenous semitendinosus tendon graft was used. The mean time between injury and the index procedure was 18 month (range from 9 – 28). Clinical evaluation was performed using the Oxford Shoulder Score and Nottingham Clavicle Score after a mean follow-up time of 27.8 months. Preoperative and postoperative radiographs were compared. Results: In the Weaver-Dunn group the Oxford Shoulder Score improved from 25±4 to 40±2 points. While the Nottingham Clavicle Score increased from 48±7 to 84±11. In semitendinosus tendon graft group, the Oxford Shoulder Score improved from 25±3 points to 50±2 points and the Nottingham Clavicle Score from 48±8 points to 95±8, respectively. Conclusion: Acromioclavicular joint reconstruction using the semitendinosus tendon graft achieved better Oxford Shoulder Score and Nottingham Clavicle Score compared to the modified Weaver-Dunn procedure. PMID:27347245

  6. Acromioclavicular joint injuries and reconstructions: a review of expected imaging findings and potential complications.

    PubMed

    Kim, Andrew C; Matcuk, George; Patel, Dakshesh; Itamura, John; Forrester, Deborah; White, Eric; Gottsegen, Christopher J

    2012-10-01

    Shoulder injuries, including acromioclavicular (AC) joint separations, remain a common reason for presentation to the emergency room. Although the diagnosis can be made apparent through proper history and physical examination by the emergency medicine physician, ascertaining the degree of injury can be difficult on the basis of clinical evaluation alone. While there is consensus in the literature that low-grade AC joint injuries can be treated with conservative management, high-grade injuries will generally require surgical intervention. Furthermore, the treatment of grade 3 injuries remains controversial, making it incumbent upon the radiologist to become comfortable with distinguishing this diagnosis from lower or higher grade injuries. Imaging of AC joint injuries after clinical evaluation is generally initiated in the emergency room setting with plain film radiography; however, on occasion, an alternative modality may be presented to the emergency room radiologist for interpretation. As such, it remains important to be familiar with the appearance of AC joint separations on a variety of modalities. Another possible patient presentation in both the emergent and nonemergent setting includes new onset of pain or instability in the postsurgical shoulder. In this scenario, the onus is often placed on the radiologist to determine whether the pain or instability represents the sequelae of reinjury versus a complication of surgery. The purpose of this review is to present an anatomically based discussion of imaging findings associated with AC joint separations as seen on multiple modalities, as well as to describe and elucidate a variety of potential complications which may present to the emergency room radiologist.

  7. Clinics in diagnostic imaging (151). Acromioclavicular joint geyser sign with chronic full-thickness supraspinatus tendon (SST) tear.

    PubMed

    Khor, Andrew Yu Keat; Wong, Steven Bak Siew

    2014-02-01

    An 82-year-old man presented with neck pain, right upper limb radiculopathy and right shoulder pain. Physical examination revealed a soft lump over the right shoulder joint, as well as reduced range of shoulder movements. On magnetic resonance imaging, the soft lump was shown to be a cystic mass over the acromioclavicular joint and was related to a full-thickness supraspinatus tendon tear. This is the classic geyser sign. The pathophysiology and clinical features of the geyser sign, and its imaging features with various imaging modalities, are discussed.

  8. Clinics in diagnostic imaging (151). Acromioclavicular joint geyser sign with chronic full-thickness supraspinatus tendon (SST) tear.

    PubMed

    Khor, Andrew Yu Keat; Wong, Steven Bak Siew

    2014-02-01

    An 82-year-old man presented with neck pain, right upper limb radiculopathy and right shoulder pain. Physical examination revealed a soft lump over the right shoulder joint, as well as reduced range of shoulder movements. On magnetic resonance imaging, the soft lump was shown to be a cystic mass over the acromioclavicular joint and was related to a full-thickness supraspinatus tendon tear. This is the classic geyser sign. The pathophysiology and clinical features of the geyser sign, and its imaging features with various imaging modalities, are discussed. PMID:24570312

  9. Clinics in diagnostic imaging (151). Acromioclavicular joint geyser sign with chronic full-thickness supraspinatus tendon (SST) tear.

    PubMed Central

    Khor, Andrew Yu Keat; Wong, Steven Bak Siew

    2014-01-01

    An 82-year-old man presented with neck pain, right upper limb radiculopathy and right shoulder pain. Physical examination revealed a soft lump over the right shoulder joint, as well as reduced range of shoulder movements. On magnetic resonance imaging, the soft lump was shown to be a cystic mass over the acromioclavicular joint and was related to a full-thickness supraspinatus tendon tear. This is the classic geyser sign. The pathophysiology and clinical features of the geyser sign, and its imaging features with various imaging modalities, are discussed. PMID:24570312

  10. Treatment of Rockwood type III acromioclavicular joint dislocation using autogenous semitendinosus tendon graft and endobutton technique

    PubMed Central

    Ye, Gang; Peng, Chao-An; Sun, Hua-Bin; Xiao, Jing; Zhu, Kang

    2016-01-01

    Background The aim of this study was to evaluate the therapeutic effect of autogenous semitendinosus graft and endobutton technique, and compare with hook plate in treatment of Rockwood type III acromioclavicular (AC) joint dislocation. Methods From April 2012 to April 2013, we treated 46 patients with Rockwood type III AC joint dislocation. Patients were randomly divided into two groups: Group A was treated using a hook plate and Group B with autogenous semitendinosus graft and endobutton technique. All participants were followed up for 12 months. Radiographic examinations were performed every 2 months postoperatively, and clinical evaluation was performed using the Constant–Murley score at the last follow-up. Results Results indicated that patients in Group B showed higher mean scores (90.3±5.4) than Group A (80.4±11.5) in terms of Constant–Murley score (P=0.001). Group B patients scored higher in terms of pain (P=0.002), activities (P=0.02), range of motion (P<0.001), and strength (P=0.004). In Group A, moderate pain was reported by 2 (8.7%) and mild pain by 8 (34.8%) patients. Mild pain was reported by 1 (4.3%) patient in Group B. All patients in Group B maintained complete reduction, while 2 (8.7%) patients in Group A experienced partial reduction loss. Two patients (8.7%) encountered acromial osteolysis on latest radiographs, with moderate shoulder pain and limited range of motion. Conclusion Autogenous semitendinosus graft and endobutton technique showed better results compared with the hook plate method and exhibited advantages of fewer complications such as permanent pain and acromial osteolysis. PMID:26811685

  11. [Management of acromioclavicular joint dislocation with the Wolter hook-plate. One year follow-up of 35 cases].

    PubMed

    Habernek, H; Schmid, L; Walch, G

    1993-02-01

    Wolter's hook-plate provides active abduction and forward-flexion of up to 90 degrees two days postoperatively. Prebending of the plate and a precise drill hole for the hook in the acromion prevents later impingement of the hook on the humeral head or subluxation in the acromioclavicular joint, respectively. According to the shoulder evaluation form of C.R. Constant, 33 of 35 patients operated on between 1987 and 1991 at the trauma departments in Schwaz/Tirol and Bad Ischl showed excellent results one year postoperatively.

  12. Comparison of Results between Hook Plate Fixation and Ligament Reconstruction for Acute Unstable Acromioclavicular Joint Dislocation

    PubMed Central

    Yoon, Jong Pil; Lee, Byoung-Joo; Nam, Sang Jin; Chung, Seok Won; Jeong, Won-Ju; Min, Woo-Kie

    2015-01-01

    Background In the present study, we aimed to compare clinical and radiographic outcomes between hook plate fixation and coracoclavicular (CC) ligament reconstruction for the treatment of acute unstable acromioclavicular (AC) joint dislocation. Methods Forty-two patients who underwent surgery for an unstable acute dislocation of the AC joint were included. We divided them into two groups according to the treatment modality: internal fixation with a hook plate (group I, 24 cases) or CC ligament reconstruction (group II, 18 cases). We evaluated the clinical outcomes using a visual analog scale (VAS) for pain and Constant-Murley score, and assessed the radiographic outcomes based on the reduction and loss of CC distance on preoperative, postoperative, and final follow-up plain radiographs. Results The mean VAS scores at the final follow-up were 1.6 ± 1.5 and 1.3 ± 1.3 in groups I and II, respectively, which were not significantly different. The mean Constant-Murley scores were 90.2 ± 9.9 and 89.2 ± 3.5 in groups I and II, respectively, which were also not significantly different. The AC joints were well reduced in both groups, whereas CC distance improved from a mean of 215.7% ± 50.9% preoperatively to 106.1% ± 10.2% at the final follow-up in group I, and from 239.9% ± 59.2% preoperatively to 133.6% ± 36.7% at the final follow-up in group II. The improvement in group I was significantly superior to that in group II (p < 0.001). Furthermore, subluxation was not observed in any case in group I, but was noted in six cases (33%) in group II. Erosions of the acromion undersurface were observed in 9 cases in group I. Conclusions In cases of acute unstable AC joint dislocation, hook plate fixation and CC ligament reconstruction yield comparable satisfactory clinical outcomes. However, radiographic outcomes based on the maintenance of reduction indicate that hook plate fixation is a better treatment option. PMID:25729525

  13. Arthroscopic-Assisted Acromioclavicular Joint Reconstruction Using the TightRope Device With Allograft Augmentation: Surgical Technique

    PubMed Central

    Frank, Rachel M.; Trenhaile, Scott W.

    2015-01-01

    Surgical management of acromioclavicular (AC) joint separations remains challenging, especially in the revision setting. Most commonly, Rockwood type I and II injuries are managed nonoperatively whereas type IV, V, and VI injuries are managed with surgery. Type III separations are more controversial, with evidence supporting both nonoperative and operative treatment options. Multiple different arthroscopic techniques have been described; however, there is no current gold standard. AC joint reconstruction with the TightRope device (Arthrex, Naples, FL) with the patient in the lateral decubitus position is a method of restoring joint stability that allows for a minimally invasive, low-profile fixation construct using a single drill hole through the clavicle. Allograft augmentation of this fixation construct helps to eliminate the stress risers potentially created by this device while increasing overall repair construct stability. The purpose of this article is to describe the surgical technique for arthroscopic AC joint reconstruction using a TightRope device with allograft augmentation. PMID:26759765

  14. ARTHROSCOPIC TREATMENT OF ACROMIOCLAVICULAR JOINT DISLOCATION BY TIGHT ROPE TECHNIQUE (ARTHREX®)

    PubMed Central

    GÓmez Vieira, Luis Alfredo; Visco, Adalberto; Daneu Fernandes, Luis Filipe; GÓmez Cordero, Nicolas Gerardo

    2015-01-01

    Presenting the arthroscopic treatment by Tight Rope - Arthrex® system for acute acromioclavicular dislocation and to evaluate results obtained with this procedure. Methods: Between August 2006 and May 2007, 10 shoulders of 10 patients with acute acromioclavicular dislocation were submitted to arthroscopic repair using the Tight Rope - Arthrex® system. Minimum follow-up was 12 months, with a mean of 15 months. Age ranged from 26 to 42, mean 34 years. All patients were male. Radiology evaluation was made by trauma series x-ray. The patients were assisted in the first month weekly and after three months after the procedure. Clinical evaluation was based on the University of California at Los Angeles (UCLA) criteria. Results: All patients were satisfied after the arthroscopic procedure and the mean UCLA score was 32,5. Conclusion: The arthroscopic treatment by Tight Rope – Arthrex® system for acute acromioclavicular dislocation showed to be an efficient technique. PMID:26998453

  15. Comparison of 3-Dimensional Shoulder Complex Kinematics in Individuals With and Without Shoulder Pain, Part 1: Sternoclavicular, Acromioclavicular, and Scapulothoracic Joints

    PubMed Central

    LAWRENCE, REBEKAH L.; BRAMAN, JONATHAN P.; LAPRADE, ROBERT F.; LUDEWIG, PAULA M.

    2015-01-01

    STUDY DESIGN Cross-sectional. OBJECTIVES To compare sternoclavicular, acromioclavicular, and scapulothoracic joint motion between symptomatic and asymptomatic individuals during shoulder motion performed in 3 planes of humerothoracic elevation. BACKGROUND Differences in scapulothoracic kinematics are associated with shoulder pain. Several studies have measured these differences using surface sensors, but the results of this technique may be affected by skin-motion artifact. Furthermore, previous studies have not included the simultaneous measurement of sternoclavicular and acromioclavicular joint motion. METHODS Transcortical bone pins were inserted into the clavicle, scapula, and humerus of 12 asymptomatic and 10 symptomatic individuals for direct, bone-fixed tracking using electromagnetic sensors. Angular positions for the sternoclavicular, acromioclavicular, and scapulothoracic joints were measured during shoulder flexion, abduction, and scapular plane abduction. RESULTS Differences between groups were found for sternoclavicular and scapulothoracic joint positions. Symptomatic individuals consistently demonstrated less sternoclavicular posterior rotation, regardless of angle, phase, or plane of shoulder motion. Symptomatic individuals also demonstrated less scapulothoracic upward rotation at 30° and 60° of humerothoracic elevation during shoulder abduction and scapular plane abduction. CONCLUSION The results of this study show that differences in shoulder complex kinematics exist between symptomatic and asymptomatic individuals. However, the magnitude of these differences was small, and the resulting clinical implications are not yet fully understood. The biomechanical coupling of the sternoclavicular and acromioclavicular joints requires further research to better understand scapulothoracic movement deviations and to improve manual therapy and exercise-based physical therapy interventions. PMID:25103135

  16. ISAKOS upper extremity committee consensus statement on the need for diversification of the Rockwood classification for acromioclavicular joint injuries.

    PubMed

    Beitzel, Knut; Mazzocca, Augustus D; Bak, Klaus; Itoi, Eiji; Kibler, William B; Mirzayan, Raffy; Imhoff, Andreas B; Calvo, Emilio; Arce, Guillermo; Shea, Kevin

    2014-02-01

    Optimal treatment for the unstable acromioclavicular (AC) joint remains a highly debated topic in the field of orthopaedic medicine. In particular, no consensus exists regarding treatment of grade III injuries, which are classified according to the Rockwood classification by disruption of both the coracoclavicular and AC ligaments. The ISAKOS Upper Extremity Committee has provided a more specific classification of shoulder pathologies to enhance the knowledge on and clinical approach to these injuries. We suggest the addition of grade IIIA and grade IIIB injuries to a modified Rockwood classification. Grade IIIA injuries would be defined by a stable AC joint without overriding of the clavicle on the cross-body adduction view and without significant scapular dysfunction. The unstable grade IIIB injury would be further defined by therapy-resistant scapular dysfunction and an overriding clavicle on the cross-body adduction view.

  17. Clinical therapeutic effects of AO/ASIF clavicle hook plate on distal clavicle fractures and acromioclavicular joint dislocations

    PubMed Central

    Dou, Qingjun; Ren, Xiaofeng

    2014-01-01

    Objective: The aim of this study was to evaluate the security and effectiveness of AO/ASIF clavicle hook plate in the treatment of distal clavicle fractures and acromioclavicular joint dislocations. Methods: One hundred patients with distal clavicle fractures and acromioclavicular joint dislocations who were admitted in our hospital from January 2012 to January 2013 were selected as the study subjects. They were then randomly divided into a control group and an observation group (n=50). The observation group was treated with AO/ASIF clavicle hook plates, and the control group was treated with Kirschner-wire tension bands. The outcomes were recorded and compared. Results: The JOA scores of the two groups were similar before surgery (P>0.05). The two groups both had obviously increased JOA scores in the postoperative 6th and 12th weeks, and the score in the postoperative 12th week was higher. There were statistically significant intra-group differences (P<0.05). The postoperative 6th-week and 12th-week JOA scores of the observation group were (83.2±1.8) and (97.4±1.5) respectively, and those of the control group were (71.6±2.2) and (82.3±2.6) respectively, with statistically significant inter-group differences (P<0.05). Significantly more patients in the observation group (100%) were evaluated as excellent or good outcomes after fixation than those in the control group (60%). After removal of the surgical apparatus, the recurrence rates of bone fracture and joint dislocation in the observation group were significantly lower than those of the control group (P<0.05). Conclusion: AO/ASIF clavicle hook plate functioned more effectively than Kirschner-wire tension band in clinical treatment of distal clavicle fractures and acromioclavicular joint dislocations. The former protocol enjoyed small incisions, firm fixation and early shoulder mobility. Therefore, it is a safe and effective surgical method that is worthy of being widely applied in clinical practice. PMID

  18. Arthroscopically Assisted Reconstruction of Acute Acromioclavicular Joint Dislocations: Anatomic AC Ligament Reconstruction With Protective Internal Bracing-The "AC-RecoBridge" Technique.

    PubMed

    Izadpanah, Kaywan; Jaeger, Martin; Ogon, Peter; Südkamp, Norbert P; Maier, Dirk

    2015-04-01

    An arthroscopically assisted technique for the treatment of acute acromioclavicular joint dislocations is presented. This pathology-based procedure aims to achieve anatomic healing of both the acromioclavicular ligament complex (ACLC) and the coracoclavicular ligaments. First, the acromioclavicular joint is reduced anatomically under macroscopic and radiologic control and temporarily transfixed with a K-wire. A single-channel technique using 2 suture tapes provides secure coracoclavicular stabilization. The key step of the procedure consists of the anatomic repair of the ACLC ("AC-Reco"). Basically, we have observed 4 patterns of injury: clavicular-sided, acromial-sided, oblique, and midportion tears. Direct and/or transosseous ACLC repair is performed accordingly. Then, an X-configured acromioclavicular suture tape cerclage ("AC-Bridge") is applied under arthroscopic assistance to limit horizontal clavicular translation to a physiological extent. The AC-Bridge follows the principle of internal bracing and protects healing of the ACLC repair. The AC-Bridge is tightened on top of the repair, creating an additional suture-bridge effect and promoting anatomic ACLC healing. We refer to this combined technique of anatomic ACLC repair and protective internal bracing as the "AC-RecoBridge." A detailed stepwise description of the surgical technique, including indications, technical pearls and pitfalls, and potential complications, is given.

  19. Arthroscopically Assisted Reconstruction of Acute Acromioclavicular Joint Dislocations: Anatomic AC Ligament Reconstruction With Protective Internal Bracing—The “AC-RecoBridge” Technique

    PubMed Central

    Izadpanah, Kaywan; Jaeger, Martin; Ogon, Peter; Südkamp, Norbert P.; Maier, Dirk

    2015-01-01

    An arthroscopically assisted technique for the treatment of acute acromioclavicular joint dislocations is presented. This pathology-based procedure aims to achieve anatomic healing of both the acromioclavicular ligament complex (ACLC) and the coracoclavicular ligaments. First, the acromioclavicular joint is reduced anatomically under macroscopic and radiologic control and temporarily transfixed with a K-wire. A single-channel technique using 2 suture tapes provides secure coracoclavicular stabilization. The key step of the procedure consists of the anatomic repair of the ACLC (“AC-Reco”). Basically, we have observed 4 patterns of injury: clavicular-sided, acromial-sided, oblique, and midportion tears. Direct and/or transosseous ACLC repair is performed accordingly. Then, an X-configured acromioclavicular suture tape cerclage (“AC-Bridge”) is applied under arthroscopic assistance to limit horizontal clavicular translation to a physiological extent. The AC-Bridge follows the principle of internal bracing and protects healing of the ACLC repair. The AC-Bridge is tightened on top of the repair, creating an additional suture-bridge effect and promoting anatomic ACLC healing. We refer to this combined technique of anatomic ACLC repair and protective internal bracing as the “AC-RecoBridge.” A detailed stepwise description of the surgical technique, including indications, technical pearls and pitfalls, and potential complications, is given. PMID:26052493

  20. Arthroscopically Assisted Reconstruction of Acute Acromioclavicular Joint Dislocations: Anatomic AC Ligament Reconstruction With Protective Internal Bracing-The "AC-RecoBridge" Technique.

    PubMed

    Izadpanah, Kaywan; Jaeger, Martin; Ogon, Peter; Südkamp, Norbert P; Maier, Dirk

    2015-04-01

    An arthroscopically assisted technique for the treatment of acute acromioclavicular joint dislocations is presented. This pathology-based procedure aims to achieve anatomic healing of both the acromioclavicular ligament complex (ACLC) and the coracoclavicular ligaments. First, the acromioclavicular joint is reduced anatomically under macroscopic and radiologic control and temporarily transfixed with a K-wire. A single-channel technique using 2 suture tapes provides secure coracoclavicular stabilization. The key step of the procedure consists of the anatomic repair of the ACLC ("AC-Reco"). Basically, we have observed 4 patterns of injury: clavicular-sided, acromial-sided, oblique, and midportion tears. Direct and/or transosseous ACLC repair is performed accordingly. Then, an X-configured acromioclavicular suture tape cerclage ("AC-Bridge") is applied under arthroscopic assistance to limit horizontal clavicular translation to a physiological extent. The AC-Bridge follows the principle of internal bracing and protects healing of the ACLC repair. The AC-Bridge is tightened on top of the repair, creating an additional suture-bridge effect and promoting anatomic ACLC healing. We refer to this combined technique of anatomic ACLC repair and protective internal bracing as the "AC-RecoBridge." A detailed stepwise description of the surgical technique, including indications, technical pearls and pitfalls, and potential complications, is given. PMID:26052493

  1. [Surgical management of complete acromioclavicular joint dislocation (Tossy III) with PDS cord cerclage].

    PubMed

    Gollwitzer, M

    1993-12-01

    29 patients out of 33 with complete acromioclavicular dislocation treated with sewing of ligaments and stabilized with a PDS-cord cerclage could be examined. The criteria of examination were subjective complaints while lifting weight, limited range of motion in the injured shoulder and radiological results after stress with 8 kp. The examination didn't show any relationship between the 3 parameters. 4 patients with poor function had partly no, partly little complaints and if any only little AC-dislocation. On the other hand 4 patients out of 6 with remaining AC-subluxation had no complaints and in no case there was a reduced range of motion greater than 10 degrees. Three patients got postoperative infection of soft tissue or bone, probably caused by incompatibility with PDS-cord, which led to a fair or poor outcome. Instead of this there can be obtained excellent and good results in 75-85% of the cases with this simple method without inserting stabilizing metals trans- or extraarticular.

  2. Complications of the treatment of the acromioclavicular and sternoclavicular joint injuries, including instability.

    PubMed

    Lemos, Mark J; Tolo, Eric T

    2003-04-01

    Treatment of AC joint injuries and SC joint injuries continues to evolve. The risk of complications of both the operative and nonoperative management of these injuries can be minimized by the treating physician if the physician thoroughly evaluates and understands the problem. Making an accurate diagnosis of the underlying pathology and then selecting the appropriate treatment for this will minimize the risk of an associated complication. Paying attention to detail and using the appropriate technique before any operative intervention is chosen will decrease the risk of failure and complication. Close follow-up and early detection of complications will lead to less severe sequelae. AC joint injuries are more common and operative management is accepted for specific indications. Most Orthopaedic Surgeons are comfortable treating these. SC joint injuries are less common and nonoperative treatment is the mainstay. As our approach to these complex problems evolves, we must keep a wary eye towards avoiding and minimizing the complications of the new techniques.

  3. Comparison of single and two-tunnel techniques during open treatment of acromioclavicular joint disruption

    PubMed Central

    2014-01-01

    Background Coracoclavicular (CC) ligament reconstruction with semitendinosus tendon (ST) grafts has become more popular and has achieved relatively good results; however optimal reconstruction technique, single-tunnel or two-tunnel, still remains controversial. This paper is to compare the clinical and radiographic data of allogenous ST grafting with single- or two-tunnel reconstruction techniques of the AC joint. Methods The outcomes of 21 consecutive patients who underwent anatomical reduction and ST grafting for AC joint separation were reviewed retrospectively. Patients were divided into two groups: single-tunnel group (11) and two-tunnel group (10). All patients were evaluated clinically and radiographically using a modified UCLA rating scale. Results The majority of separations (18 of 21) were Rockwood type V, with one each in type III, IV and VI categories. The overall mean follow-up time was 16 months, and at the time of the latest follow-up, the overall mean UCLA rating score was 14.1 (range 8–20). The percentage of good-to-excellent outcomes was significantly higher for patients with the two-tunnel technique than for those with the one-tunnel technique (70% vs. 18%, respectively, p = 0.03). Within the single-tunnel group, there was no statistically significant difference in percentage of good-to-excellent outcomes between patients with vs. without tightrope augmentation (17% vs 20%, p > 0.99). Similarly, within the two-tunnel group, there was no significant difference in the percentage of good-to-excellent outcomes between the graft only and augment groups (67% vs. 75%, p > 0.99). Conclusion Anatomical reduction of the AC joint and reconstruction CC ligaments are crucial for optimal joint stability and function. Two-tunnel CC reconstruction with an allogenous ST graft provides superior significantly better radiographic and clinical results compared to the single-tunnel reconstruction technique. PMID:25127715

  4. The prevalence of chondrocalcinosis (CC) of the acromioclavicular (AC) joint on chest radiographs and correlation with calcium pyrophosphate dihydrate (CPPD) crystal deposition disease

    PubMed Central

    Carrera, Guillermo; Baynes, Keith; Mautz, Alan; DuBois, Melissa; Cerniglia, Ross; Ryan, Lawrence M.

    2016-01-01

    Digital imaging combined with picture archiving and communication system (PACS) access allows detailed image retrieval and magnification. Calcium pyrophosphate dihydrate (CPPD) crystals preferentially deposit in fibrocartilages, the cartilage of the acromioclavicular (AC) joint being one such structure. We sought to determine if examination of the AC joints on magnified PACS imaging of chest films would be useful in identifying chondrocalcinosis (CC). Retrospective radiographic readings and chart reviews involving 1,920 patients aged 50 or more who had routine outpatient chest radiographs over a 4-month period were performed. Knee radiographs were available for comparison in 489 patients. Medical records were reviewed to abstract demographics, chest film reports, and diagnoses. AC joint CC was identified in 1.1 % (21/1,920) of consecutive chest films. Patients with AC joint CC were 75 years of age versus 65.4 in those without CC (p<0.0002). Four hundred eighty-nine patients had knee films. Six of these patients had AC joint CC, and of these, five also had knee CC (83 %). Of the 483 without AC joint CC, 62 (12 %) had knee CC (p=0.002). Patients with AC joint CC were more likely to have a recorded history of CPPD crystal deposition disease than those without AC joint CC (14 versus 1 %, p=0.0017). The prevalence of AC joint CC increases with age and is associated with knee CC. A finding of AC joint CC should heighten suspicion of pseudogout or secondary osteoarthritis in appropriate clinical settings and, in a young patient, should alert the clinician to the possibility of an associated metabolic condition. PMID:23609408

  5. The prevalence of chondrocalcinosis (CC) of the acromioclavicular (AC) joint on chest radiographs and correlation with calcium pyrophosphate dihydrate (CPPD) crystal deposition disease.

    PubMed

    Parperis, Konstantinos; Carrera, Guillermo; Baynes, Keith; Mautz, Alan; Dubois, Melissa; Cerniglia, Ross; Ryan, Lawrence M

    2013-09-01

    Digital imaging combined with picture archiving and communication system (PACS) access allows detailed image retrieval and magnification. Calcium pyrophosphate dihydrate (CPPD) crystals preferentially deposit in fibrocartilages, the cartilage of the acromioclavicular (AC) joint being one such structure. We sought to determine if examination of the AC joints on magnified PACS imaging of chest films would be useful in identifying chondrocalcinosis (CC). Retrospective radiographic readings and chart reviews involving 1,920 patients aged 50 or more who had routine outpatient chest radiographs over a 4-month period were performed. Knee radiographs were available for comparison in 489 patients. Medical records were reviewed to abstract demographics, chest film reports, and diagnoses. AC joint CC was identified in 1.1 % (21/1,920) of consecutive chest films. Patients with AC joint CC were 75 years of age versus 65.4 in those without CC (p < 0.0002). Four hundred eighty-nine patients had knee films. Six of these patients had AC joint CC, and of these, five also had knee CC (83 %). Of the 483 without AC joint CC, 62 (12 %) had knee CC (p = 0.002). Patients with AC joint CC were more likely to have a recorded history of CPPD crystal deposition disease than those without AC joint CC (14 versus 1 %, p = 0.0017). The prevalence of AC joint CC increases with age and is associated with knee CC. A finding of AC joint CC should heighten suspicion of pseudogout or secondary osteoarthritis in appropriate clinical settings and, in a young patient, should alert the clinician to the possibility of an associated metabolic condition.

  6. Treatment of Chronic Acromioclavicular Joint Dislocation in a Paraplegic Patient with the Weaver-Dunn Procedure and a Hook-Plate

    PubMed Central

    Godry, Holger; Citak, Mustafa; Königshausen, Matthias; Schildhauer, Thomas A.; Seybold, Dominik

    2016-01-01

    In case of patients with spinal cord injury and concomitant acromioclavicular (AC) joint-dislocation the treatment is challenging, as in this special patient group the function of the shoulder joint is critical because patients depend on the upper limb for mobilization and wheelchair-locomotion. Therefore the goal of this study was to examine, if the treatment of chronic AC-joint dislocation using the Weaver-Dunn procedure augmented with a hook-plate in patients with a spinal cord injury makes early postoperative wheelchair mobilization and the wheelchair transfer with full weight-bearing possible. In this case the Weaver-Dunn procedure with an additive hook-plate was performed in a 34-year-old male patient with a complete paraplegia and a posttraumatic chronic AC-joint dislocation. The patient was allowed to perform his wheelchair transfers with full weight bearing on the first post-operative day. The removal of the hook-plate was performed four months after implantation. At the time of follow-up the patient could use his operated shoulder with full range of motion without restrictions in his activities of daily living or his wheel-chair transfers. PMID:27433301

  7. Treatment of Chronic Acromioclavicular Joint Dislocation in a Paraplegic Patient with the Weaver-Dunn Procedure and a Hook-Plate.

    PubMed

    Godry, Holger; Citak, Mustafa; Königshausen, Matthias; Schildhauer, Thomas A; Seybold, Dominik

    2016-06-27

    In case of patients with spinal cord injury and concomitant acromioclavicular (AC) joint-dislocation the treatment is challenging, as in this special patient group the function of the shoulder joint is critical because patients depend on the upper limb for mobilization and wheelchair-locomotion. Therefore the goal of this study was to examine, if the treatment of chronic AC-joint dislocation using the Weaver-Dunn procedure augmented with a hook-plate in patients with a spinal cord injury makes early postoperative wheelchair mobilization and the wheelchair transfer with full weight-bearing possible. In this case the Weaver-Dunn procedure with an additive hook-plate was performed in a 34-year-old male patient with a complete paraplegia and a posttraumatic chronic AC-joint dislocation. The patient was allowed to perform his wheelchair transfers with full weight bearing on the first post-operative day. The removal of the hook-plate was performed four months after implantation. At the time of follow-up the patient could use his operated shoulder with full range of motion without restrictions in his activities of daily living or his wheel-chair transfers. PMID:27433301

  8. [Surgical management of complete Tossy III acromioclavicular joint dislocation with the Bosworth screw or the Wolter plate. A critical evaluation].

    PubMed

    Broos, P; Stoffelen, D; Van de Sijpe, K; Fourneau, I

    1997-08-01

    The long-term results with an average of 4.3 years of 87 patients with an AC-dislocation grade III according to Tossy, treated operatively with a Bosworth screw or a Wolter plate are described and submitted to critical evaluation. Of the patients 16% had implant failures. Redislocation was seen in 25% of the patients, calcifications in 39% and arthritis in 41%. The end-result was good or excellent in 60% of the patients and fair or bad in 40%. The only factor, influencing the end result was the redislocation rate (p < 0.05). These moderate results surprised and disappointed us. They made us conclude that the grade III acromioclavicular dislocation is no absolute indication for surgical treatment, as is often suggested in literature. No significant differences could be revealed between both surgical techniques.

  9. Acromioclavicular joint reconstruction using a tendon graft: a biomechanical study comparing a novel “sutured throughout” tendon graft to a standard tendon graft

    PubMed Central

    Naziri, Qais; Williams, Nadine; Hayes, Westley; Kapadia, Bhaveen H.; Chatterjee, Dipal; Urban, William P.

    2016-01-01

    Background: With a recurrence rate of over 30%, techniques that offer stronger acromioclavicular (AC) joint reconstruction through increased graft strength may provide longevity. The purpose of our study was to determine the biomechanical strength of a novel tendon graft sutured throughout compared to a native tendon graft in Grade 3 anatomical AC joint reconstruction. Methods: For this in vitro experiment, nine paired (n = 18) embalmed cadaveric AC joints of three males and six females (age 86 years, range 51–94 years) were harvested. Anatomic repair with fresh bovine Achilles tendon grafts without bone block was simulated. Specimens were divided into two groups; with group 1 using grafts with ultra-high molecular-weight polyethylene (UHMWPE) suture ran throughout the entire length. In group 2, reconstruction with only native allografts was performed. The distal scapula and humerus were casted in epoxy compound and mounted on the mechanical testing machine. Tensile tests were performed using a mechanical testing machine at the rate of 50 mm/min. Maximum load and displacement to failure were collected. Results: The average load to failure was significantly higher for group 1 compared to group 2, with mean values of 437.5 N ± 160.7 N and 94.4 N ± 43.6 N, (p = 0.001). The average displacement to failure was not significantly different, with 29.7 mm ± 10.6 mm in group 1 and 25 mm ± 9.1 mm in group 2 (p = 0.25). Conclusion: We conclude that a UHMWPE suture reinforced graft can provide a 3.6 times stronger AC joint reconstruction compared to a native graft. PMID:27163106

  10. Clinical and radiological results after coracoclavicular ligament reconstruction for type III acromioclavicular joint dislocation using three different techniques. A retrospective study

    PubMed Central

    VASCELLARI, ALBERTO; SCHIAVETTI, STEFANO; BATTISTELLA, GIUSEPPE; REBUZZI, ENRICO; COLETTI, NICOLÒ

    2015-01-01

    Purpose the purpose of this retrospective study was to present the outcomes of three different techniques for the treatment of type III acromioclavicular joint dislocations: arthroscopic TightRope (TR), arthroscopic GraftRope (GR), and open reconstruction of the coracoclavicular (CC) ligament using the Ligament Augmentation and Reconstruction System (LARS). Methods eighteen patients underwent clinical and radiological evaluations after a mean follow-up time of 43 months. The following clinical outcome measures were considered: the Disability of the Arm, Shoulder and Hand outcome measure (DASH), the Nottingham Clavicle Score (NCS), and the Constant score (CS). On X-rays, the CC distance was measured. Results the median DASH score at follow-up was 12.5 in the TR group, 5 in the GR group, and 4.2 in the LARS group. The median NCS value was 88 in the TR group, 88 in the GR group, and 91 in the LARS group. The median CS was 100 in the TR group, 95 in the GR group, and 94.5 in the LARS group. The mean CC distance was 10.3 mm in the TR group, 13.8 in the GR group, and 16.6 in the LARS group. Conclusions all three techniques proved to be reliable in providing good clinical outcomes, although none of the studied techniques demonstrated reliability in maintaining anatomical reduction after surgery. Level of evidence Level III, retrospective comparative study. PMID:26605251

  11. Posteroinferior acromioclavicular dislocation with supraspinatus tear. A case report.

    PubMed

    Yanagisawa, K; Hamada, K; Gotoh, M; Miyazaki, S; Fukuda, H

    1998-08-01

    A 20-year-old man was treated for posteroinferior acromioclavicular dislocation. The diagnosis was based on standard radiographs and intraoperative findings. The distal end of the clavicle had impaled the supraspinatus muscle. Open reduction was performed 2 weeks after injury, followed by wire fixation of the acromioclavicular joint and repair of the torn superior acromioclavicular ligament and coracoclavicular ligaments. Two years after the procedure, standard radiographs revealed normal anatomic alignment of the acromioclavicular joint, with pain free range of motion. Active elevation in the scapular plane was 180 degrees, active external rotation was 80 degrees in the anatomic position, and passive internal rotation was to the T5 vertebra. The patient returned to playing baseball and tennis and was satisfied with the postoperative result.

  12. Current concepts in the diagnosis and management of acromioclavicular dislocations.

    PubMed

    Post, M

    1985-11-01

    Not all complete dislocations of the acromioclavicular joint should be treated by one method alone. A classification of acromioclavicular dislocation is presented and is based upon the pathology of the injury. Grade I sprain results from a mild force that causes tearing of only a few fibers of the acromioclavicular joint. Grade II sprains are caused by a moderate force with a rupture of the capsule and acromioclavicular ligament. Grade III sprains result from a severe force that ruptures both the acromioclavicular and coracoclavicular ligaments and causes a dislocation of the joint. Grade IV dislocation may be associated with an avulsion fracture of the coracoclavicular ligament from the inferior lateral clavicle, severe tearing or other injury to the soft-tissue envelope about the lateral clavicle, or a buttonhole injury of the lateral clavicle. Grade V dislocation refers to a posterior displacement of the lateral clavicle from any cause, while Grade VI relates to an inferior lateral clavicle displacement. Grades I, II, and most Grade III injuries can be treated conservatively. The indications for open treatment of Grade III injuries are reviewed. It is recommended that Grade IV and most Grade V and VI dislocations be managed with open methods.

  13. Instability of the sternoclavicular joint: current concepts in classification, treatment and outcomes.

    PubMed

    Sewell, M D; Al-Hadithy, N; Le Leu, A; Lambert, S M

    2013-06-01

    The sternoclavicular joint (SCJ) is a pivotal articulation in the linked system of the upper limb girdle, providing load-bearing in compression while resisting displacement in tension or distraction at the manubrium sterni. The SCJ and acromioclavicular joint (ACJ) both have a small surface area of contact protected by an intra-articular fibrocartilaginous disc and are supported by strong extrinsic and intrinsic capsular ligaments. The function of load-sharing in the upper limb by bulky periscapular and thoracobrachial muscles is extremely important to the longevity of both joints. Ligamentous and capsular laxity changes with age, exposing both joints to greater strain, which may explain the rising incidence of arthritis in both with age. The incidence of arthritis in the SCJ is less than that in the ACJ, suggesting that the extrinsic ligaments of the SCJ provide greater stability than the coracoclavicular ligaments of the ACJ. Instability of the SCJ is rare and can be difficult to distinguish from medial clavicular physeal or metaphyseal fracture-separation: cross-sectional imaging is often required. The distinction is important because the treatment options and outcomes of treatment are dissimilar, whereas the treatment and outcomes of ACJ separation and fracture of the lateral clavicle can be similar. Proper recognition and treatment of traumatic instability is vital as these injuries may be life-threatening. Instability of the SCJ does not always require surgical intervention. An accurate diagnosis is required before surgery can be considered, and we recommend the use of the Stanmore instability triangle. Most poor outcomes result from a failure to recognise the underlying pathology. There is a natural reluctance for orthopaedic surgeons to operate in this area owing to unfamiliarity with, and the close proximity of, the related vascular structures, but the interposed sternohyoid and sternothyroid muscles are rarely injured and provide a clear boundary to the

  14. Acute acromioclavicular dislocation: a cheaper, easier and all-arthroscopic system. Is it effective in nowadays economical crisis?

    PubMed

    Sastre, Sergi; Dada, Michelle; Santos, Simon; Lozano, Lluis; Alemany, Xavier; Peidro, Lluis

    2015-03-01

    The objective of this manuscript is to show an effective, easier and cheaper way to reduce acute acromioclavicular (AC) dislocation type III and V (Rockwood classification). Numerous procedures have been described for surgical management of acromioclavicular joint disruption. Newest devices involve an arthroscopic technique that allows nonrigid anatomic fixation of the acromioclavicular joint. Arthroscopically assisted treatment of acute AC joint dislocation is advantageous because it provides good clinical results and few complications. It also allows reviewing glenohumeral associated lesions. This surgical technique requires no specific implants to achieve a correct AC reduction. Actually, economical advantages are very important factors to decide the use of determinate surgical techniques.

  15. Acromioclavicular septic arthritis and sternoclavicular septic arthritis with contiguous pyomyositis.

    PubMed

    Corey, Sally A; Agger, William A; Saterbak, Andrew T

    2015-03-01

    Acromioclavicular (AC) and sternoclavicular (SC) septic arthritis with contiguous pyomyositis are rare, especially in immunocompetent individuals. We report a case of septic AC joint with pyomyositis of the deltoid and supraspinatus muscles and a separate case with septic SC joint with pyomysitis of the sternocleidomastoid muscle. Both patients had similar presentations of infections with Staphylococcus aureus and were successfully treated with surgical incision and drainage followed by prolonged antibiotic therapy.

  16. Treatment of the acute traumatic acromioclavicular separation.

    PubMed

    Bishop, Julie Y; Kaeding, Christopher

    2006-12-01

    Injuries to the acromioclavicular joint occur commonly in athletes, especially those involved in contact sports. The majority of these injuries are type I and II acromioclavicular joint separations and are treated nonoperatively with rehabilitation. A rapid and full return to play is expected. Acute types IV, V, and VI are less common and operative intervention is recommended. The type III injury is more controversial and current trends are towards initial nonoperative management. Operative treatment is sought only when the athlete remains symptomatic with painful instability. However, some do support early intervention in the overhead athlete. The goal of operative intervention is to create a stiff and strong repair/reconstruction of the coracoclavicular ligaments while providing stability in all planes. This will allow early and more aggressive rehabilitation. Surgical treatment includes reconstruction of the coracoclavicular ligaments with an augmented coracoacromial ligament transfer and more recently tendon graft reconstructions. Biomechanical research supports an anatomic reconstruction of the ligaments to confer the most function and stability.

  17. Practical management of grade III acromioclavicular separations.

    PubMed

    Trainer, Gabriel; Arciero, Robert A; Mazzocca, Augustus D

    2008-03-01

    Acromioclavicular joint (AC) injuries are common in the young athletic population. There is general agreement that grade I and grade II separations are best managed nonoperatively, whereas grades IV to VI warrant surgical stabilization. In contrast, considerable controversy exists surrounding the best method of treatment for grade III AC separations. The trend in recent literature is toward the initial nonoperative management of these injuries. However, consideration of other factors such as type of sport, timing of injury relative to athletic season, or the throwing demands in an injured dominant arm may play a role in the decision to treat grade III injuries operatively or nonoperatively. We offer a protocol algorithm for treating grade III AC separations for managing this controversial injury.

  18. Manipulation of an Innate Escape Response in Drosophila: Photoexcitation of acj6 Neurons Induces the Escape Response

    PubMed Central

    Manoli, Devanand S.; Zhang, Feng; Deisseroth, Karl; Baker, Bruce S.; Scott, Matthew P.

    2009-01-01

    Background The genetic analysis of behavior in Drosophila melanogaster has linked genes controlling neuronal connectivity and physiology to specific neuronal circuits underlying a variety of innate behaviors. We investigated the circuitry underlying the adult startle response, using photoexcitation of neurons that produce the abnormal chemosensory jump 6 (acj6) transcription factor. This transcription factor has previously been shown to play a role in neuronal pathfinding and neurotransmitter modality, but the role of acj6 neurons in the adult startle response was largely unknown. Principal Findings We show that the activity of these neurons is necessary for a wild-type startle response and that excitation is sufficient to generate a synthetic escape response. Further, we show that this synthetic response is still sensitive to the dose of acj6 suggesting that that acj6 mutation alters neuronal activity as well as connectivity and neurotransmitter production. Results/Significance These results extend the understanding of the role of acj6 and of the adult startle response in general. They also demonstrate the usefulness of activity-dependent characterization of neuronal circuits underlying innate behaviors in Drosophila, and the utility of integrating genetic analysis into modern circuit analysis techniques. PMID:19340304

  19. EXTRA-ARTICULAR FRACTURE OF THE MEDIAL END OF THE CLAVICLE ASSOCIATED WITH TYPE IV ACROMIOCLAVICULAR DISLOCATION: CAAE REPORT

    PubMed Central

    Correa, Mário Chaves; Gonçalves, Lucas Braga Jacques; Vilela, Jose Carlos Souza; Leonel, Igor Lima; Costa, Lincoln Paiva; de Andrade, Ronaldo Percopi

    2015-01-01

    Fractures of the clavicle and acromioclavicular dislocations are very common injuries when they occur separately. The combination of an acromioclavicular dislocation and a fracture of the lateral third of the clavicle is not rare. However, there are very few reported cases of acromioclavicular dislocations associated with fractures of the middle third of the clavicle; those associated with fractures of the medial third are even rarer. We report the case of an adult male who suffered an acromioclavicular dislocation (type IV) associated with a displaced extra-articular fracture of the medial end of the clavicle (Almann group 3) in a cycling accident. The patient was treated during the acute phase with open reduction and internal fixation of the two lesions. At the clinical evaluation 12 months after the surgery, the patient was asymptomatic, with full active and passive mobility, and normal strength and endurance of the shoulder girdle. Radiographs and a three-dimensional CT scan showed persistent posterosuperior subluxation of the acromioclavicular joint and anatomical consolidation of the clavicular fracture. PMID:27027060

  20. Editorial Commentary: Are Larger Screws the Answer When Anatomic Reconstruction of an Acromioclavicular Separation Fails?

    PubMed

    Denard, Patrick J

    2016-08-01

    Although fixation methods have improved, failure after fixation of an acromioclavicular joint separation is not uncommon. This biomechanical study shows that in the setting of graft slippage through previously well-placed clavicular tunnels, a revision anatomic reconstruction is feasible with larger tenodesis screws. Although the risk of clavicular fracture increases with larger tunnels, anatomic revision with larger screws is an option in select cases. PMID:27495861

  1. Acromial stress fractures: correlation with acromioclavicular osteoarthritis and acromiohumeral distance.

    PubMed

    Dubrow, Samuel; Streit, Jonathan J; Muh, Stephanie; Shishani, Yousef; Gobezie, Reuben

    2014-12-01

    Fractures around the acromion are a known complication of reverse total shoulder arthroplasty. The literature provides limited data on the risk factors associated with this complication as well as the ultimate outcomes after nonoperative treatment. The goal of this study was to report clinical outcomes in patients with acromial fractures after nonoperatively treated reverse total shoulder arthroplasty. The authors performed a retrospective review of 125 patients undergoing reverse total shoulder arthroplasty that included several acromial stress fractures in the postoperative period. They prospectively compared radiographic data, including acromiohumeral distance, the presence of acromioclavicular joint arthritis, clinical measures of motion, visual analog scale (VAS) pain score, American Shoulder and Elbow Surgeons (ASES) score, and Single Assessment Numeric Evaluation (SANE) score, in 2 groups based on the presence or absence of fracture in the postoperative period. Fourteen patients (11.2%) had an acromial fracture after reverse total shoulder arthroplasty at an average of 5.1 months postoperatively. Patients who had fractures had worse postoperative forward elevation before fracture (116.6 vs 143.5; P=.02) and greater pain relief after reverse shoulder replacement, before fracture (P=.04). No significant difference was found between groups when the degree of arm lengthening was compared (27.6 vs 26.2 mm), and no difference was found in the prevalence of degenerative acromioclavicular joint changes identified preoperatively (66.4% vs 77.3%). After conservative management, most patients who had an acromial fracture returned to a functional level that was comparable to that achieved before fracture.

  2. Acromial stress fractures: correlation with acromioclavicular osteoarthritis and acromiohumeral distance.

    PubMed

    Dubrow, Samuel; Streit, Jonathan J; Muh, Stephanie; Shishani, Yousef; Gobezie, Reuben

    2014-12-01

    Fractures around the acromion are a known complication of reverse total shoulder arthroplasty. The literature provides limited data on the risk factors associated with this complication as well as the ultimate outcomes after nonoperative treatment. The goal of this study was to report clinical outcomes in patients with acromial fractures after nonoperatively treated reverse total shoulder arthroplasty. The authors performed a retrospective review of 125 patients undergoing reverse total shoulder arthroplasty that included several acromial stress fractures in the postoperative period. They prospectively compared radiographic data, including acromiohumeral distance, the presence of acromioclavicular joint arthritis, clinical measures of motion, visual analog scale (VAS) pain score, American Shoulder and Elbow Surgeons (ASES) score, and Single Assessment Numeric Evaluation (SANE) score, in 2 groups based on the presence or absence of fracture in the postoperative period. Fourteen patients (11.2%) had an acromial fracture after reverse total shoulder arthroplasty at an average of 5.1 months postoperatively. Patients who had fractures had worse postoperative forward elevation before fracture (116.6 vs 143.5; P=.02) and greater pain relief after reverse shoulder replacement, before fracture (P=.04). No significant difference was found between groups when the degree of arm lengthening was compared (27.6 vs 26.2 mm), and no difference was found in the prevalence of degenerative acromioclavicular joint changes identified preoperatively (66.4% vs 77.3%). After conservative management, most patients who had an acromial fracture returned to a functional level that was comparable to that achieved before fracture. PMID:25437081

  3. Complications following arthroscopic fixation of acromioclavicular separations: a systematic review of the literature

    PubMed Central

    Woodmass, Jarret M; Esposito, John G; Ono, Yohei; Nelson, Atiba A; Boorman, Richard S; Thornton, Gail M; Lo, Ian KY

    2015-01-01

    Purpose Over the past decade, a number of arthroscopic or arthroscopically assisted reconstruction techniques have emerged for the management of acromioclavicular (AC) separations. These techniques provide the advantage of superior visualization of the base of the coracoid, less soft tissue dissection, and smaller incisions. While these techniques have been reported to provide excellent functional results with minimal complications, discrepancies exist within the literature. This systematic review aims to assess the rate of complications following these procedures. Methods Two independent reviewers completed a search of Medline, Embase, PubMed, and the Cochrane Library entries up to December 2013. The terms “Acromioclavicular Joint (MeSH)” OR “acromioclavicular* (text)” OR “coracoclavicular* (text)” AND “Arthroscopy (MeSH)” OR “Arthroscop* (text)” were used. Pooled estimates and 95% confidence intervals were calculated assuming a random-effects model. Statistical heterogeneity was quantified using the I2 statistic. Level of evidence IV Results A total of 972 abstracts met the search criteria. After removal of duplicates and assessment of inclusion/exclusion criteria, 12 articles were selected for data extraction. The rate of superficial infection was 3.8% and residual shoulder/AC pain or hardware irritation occurred at a rate of 26.7%. The rate of coracoid/clavicle fracture was 5.3% and occurred most commonly with techniques utilizing bony tunnels. Loss of AC joint reduction occurred in 26.8% of patients. Conclusion Arthroscopic AC reconstruction techniques carry a distinct complication profile. The TightRope/Endobutton techniques, when performed acutely, provide good radiographic outcomes at the expense of hardware irritation. In contrast, graft reconstructions in patients with chronic AC separations demonstrated a high risk for loss of reduction. Fractures of the coracoid/clavicle remain a significant complication occurring predominately with

  4. The use of a hook-plate in the management of acromioclavicular injuries. Report of ten cases.

    PubMed

    Faraj, A A; Ketzer, B

    2001-12-01

    A hook-plate is a clavicular small fragment AO plate with a hook engaging below the acromion. It is primarily used to secure the ligament repair in the treatment of displaced acromioclavicular joint dislocations. We have used the hook-plate in conjunction with a Weaver-Dunn procedure to secure the repair in seven patients. In another three we used this plate to reduce and stabilize distal clavicular fractures. Satisfactory results were obtained in all patients; the deformity disappeared, full pain-free shoulder movement was regained with no motor weakness, with a mean follow-up of 11 months (6-25 months). Our patients returned early to work and sports activities (mean period of three months). The three clavicular fractures healed. One patient developed a superficial would infection, which responded to antibiotics and would dressing. None of our patients required removal of the implant. The hook-plate appears to be a useful device for acromioclavicular trauma.

  5. Long-term results of the surgical treatment of type III acromioclavicular dislocations: an update of a previous report.

    PubMed

    Lizaur, A; Sanz-Reig, J; Gonzalez-Parreño, S

    2011-08-01

    The purpose of this study was to review the long-term outcomes of a previously reported prospective series of 46 type III acromioclavicular dislocations. These were treated surgically with temporary fixation of the acromioclavicular joint with wires, repair of the acromioclavicular ligaments, and overlapped suture of the deltoid and trapezius muscles. Of the 46 patients, one had died, four could not be traced, and three declined to return for follow-up, leaving 38 patients in the study. There were 36 men and two women, with a mean age at follow-up of 57.3 years (41 to 71). The mean follow-up was 24.2 years (21 to 26). Patients were evaluated using the Imatani and University of California, Los Angeles (UCLA) scoring systems. Their subjective status was assessed using the Disabilities of the Arm, Shoulder and Hand and Simple Shoulder Test questionnaires, and a visual analogue scale for patient satisfaction. The examination included radiographs of the shoulder. At a follow-up of 21 years, the results were satisfactory in 35 (92.1%) patients and unsatisfactory in three (7.9%). In total, 35 patients (92.1%) reported no pain, one slight pain, and two moderate pain. All except two patients had a full range of shoulder movement compared with the opposite side. Unsatisfactory results were the result of early redisplacement in two patients, and osteoarthritis without redisplacement in one. According to the Imatani and UCLA scores, there was no difference between the operated shoulder and the opposite shoulder (p > 0.05). Given the same situation, 35 (92.1%) patients would opt for the same surgical treatment again. Operative treatment of type III acromioclavicular joint injuries produces satisfactory long-term results.

  6. Help Desk Answers: Surgery vs conservative management for AC joint repair: How do the 2 compare?

    PubMed

    Matchin, Bruce; Yee, Bruce; Mott, Timothy

    2016-04-01

    When not considering the grade of acromioclavicular (AC) joint dislocation, both conservative and surgical management lead to positive outcomes, although surgically managed patients require more time out of work. PMID:27262254

  7. Treatment of grade III acromioclavicular separations. Operative versus nonoperative management.

    PubMed

    Press, J; Zuckerman, J D; Gallagher, M; Cuomo, F

    1997-01-01

    Twenty-six patients with Grade III acromioclavicular joint separations were evaluated to determine the outcomes of nonoperative and operative management. Evaluation consisted of a detailed functional questionnaire, physical examination, and comprehensive isokinetic strength assessment. The patients were divided into two groups: operative (n = 16) and nonoperative (n = 10). Operative management consisted of coracoclavicular stabilization with heavy suture material and with nine of the sixteen patients treatment also consisted of coracoacromial ligament transfer and lateral clavicle resection. Nonoperative management consisted of short-term immobilization with early range of motion and rehabilitation. The two groups were similar in all characteristics except mean age: 30.7 years for the operative group and 49.6 years for the nonoperative group. Follow-up evaluation was performed an average of 32.9 months after either injury (nonoperative group) or surgery. Our results indicated that nonoperative management was superior to operative management with respect to time to return to work (0.8 months vs. 2.6 months), time to return to athletics (3.5 months vs. 6.4 months) and time of immobilization (2.7 weeks vs. 6.2 weeks). However, operative management was superior to nonoperative management in the following parameters: time to attain completely pain-free status, the patient's subjective impression of pain, range of motion, functional limitations, cosmesis, and long-term satisfaction. There were no significant differences between the two groups with respect to shoulder range of motion, manual muscle testing, or neurovascular findings. Isokinetic strength testing of the involved shoulder, expressed as a percentage of the uninvolved shoulder, showed no significant differences in peak torque, total work, or total power between the operative and nonoperative groups. However, comparison of the involved to the uninvolved extremity within each group did reveal a trend toward

  8. Limb-threatening ischemia secondary to a congenital acromioclavicular remnant.

    PubMed

    Enlow, Jonathan M; McGregor, Walter E

    2009-07-01

    Upper extremity vascular compromise from thoracic outlet syndrome is rare and is usually the result of a "cervical rib," anterior scalene muscle abnormality, or clavicular trauma. We report a case of acute axillary artery thrombosis secondary to a congenital acromioclavicular remnant in a 40-year-old woman.

  9. Design of a knee joint mechanism that adapts to individual physiology.

    PubMed

    Jiun-Yih Kuan; Pasch, Kenneth A; Herr, Hugh M

    2014-01-01

    This paper describes the design of a new knee joint mechanism, called the Adaptive Coupling Joint (ACJ). The new mechanism has an adaptive trajectory of the center of rotations (COR) that automatically matches those of the attached biological joint. The detailed design is presented as well as characterization results of the ACJ. Conventional exoskeleton and assistive devices usually consider limb joints as a one to three degrees of freedom (DOFs) joint synthesized by multiple one-DOF hinge joints in a single plane. However, the biological joints are complex and usually rotate with respect to a changing COR. As a result, the mismatch between limb joint motion and mechanical interface motion can lead to forces that cause undesired ligament and muscle length changes and internal mechanical changes. These undesired changes contribute to discomfort, as well as to the slippage and sluggish interaction between humans and devices. It is shown that the ACJ can transmit planetary torques from either active or passive devices to the limbs without altering the normal biological joint motion. PMID:25570389

  10. Design of a knee joint mechanism that adapts to individual physiology.

    PubMed

    Jiun-Yih Kuan; Pasch, Kenneth A; Herr, Hugh M

    2014-01-01

    This paper describes the design of a new knee joint mechanism, called the Adaptive Coupling Joint (ACJ). The new mechanism has an adaptive trajectory of the center of rotations (COR) that automatically matches those of the attached biological joint. The detailed design is presented as well as characterization results of the ACJ. Conventional exoskeleton and assistive devices usually consider limb joints as a one to three degrees of freedom (DOFs) joint synthesized by multiple one-DOF hinge joints in a single plane. However, the biological joints are complex and usually rotate with respect to a changing COR. As a result, the mismatch between limb joint motion and mechanical interface motion can lead to forces that cause undesired ligament and muscle length changes and internal mechanical changes. These undesired changes contribute to discomfort, as well as to the slippage and sluggish interaction between humans and devices. It is shown that the ACJ can transmit planetary torques from either active or passive devices to the limbs without altering the normal biological joint motion.

  11. All Things Clavicle: From Acromioclavicular to Sternoclavicular and All Points in Between.

    PubMed

    Groh, Gordon I; Mighell, Mark A; Basamania, Carl J; Kibler, W Ben

    2016-01-01

    The clavicle is the most frequently injured bone in the human body. In most cases, fractures that occur in the midshaft of the clavicle can be managed nonsurgically. An increasing number of studies suggest that displaced midshaft clavicle fractures have improved outcomes after surgical management, and equivalent outcomes can be achieved with both plating and intramedullary techniques. Distal clavicle fractures are managed according to the disruption of the coracoclavicular ligaments. Fractures with disruption of the ligaments usually will require fixation, whereas fractures with intact ligaments may be treated with closed management. Multiple techniques of reconstruction appear to yield similar outcomes; however, hook-plating techniques result in the highest complication rates. The evaluation process for acromioclavicular joint injuries is moving from a static two-dimensional evaluation to a three-dimensional evaluation that involves an assessment for scapular dyskinesis. Surgical reconstruction is indicated for patients who exhibit scapular dyskinesis. Anterior sternoclavicular injuries can typically be managed nonsurgically, whereas posterior sternoclavicular dislocations always require urgent surgical management. Newer techniques of ligament reconstruction for sternoclavicular injuries yield improved biomechanical stability.

  12. Conservative management of a type III acromioclavicular separation: a case report and 10-year follow-up

    PubMed Central

    Robb, Andrew J.; Howitt, Scott

    2011-01-01

    Objective The purpose of this study is to present a 10-year prospective case of a right incomplete type III acromioclavicular (AC) separation in a 26-year-old patient. Clinical Features A 26-year-old male patient fell directly on his right shoulder with the arm in an outstretched and overhead position. Pain and swelling were immediate and were associated with a “step deformity.” The patient had limited right shoulder range of motion (ROM), strength, and function. Radiographic findings confirmed a type III AC separation on the right. At 1-year follow-up, the patient did not report any deficits in ROM or function, but did note a prominent distal clavicle on the right. At 3-, 5-, 7-, and 10-year follow-up, the patient did not report changes from 1 year. The radiographic findings at the 10-year follow-up indicated mild degenerative joint disease in both AC joints and mild elevation of the distal clavicle on the right. Intervention and Outcome The patient received chiropractic care to control for pain, swelling, and loss of ROM. The patient received acupuncture, joint mobilizations, palliative adhesive taping of the AC joint, Active Release Technique, and progressive resisted exercises. Radiographic study was done at the time of the injury and at 10 years to observe for any osseous changes in the AC joint. Conclusion The patient yielded excellent results from conservative chiropractic management that was reflected in a prompt return to work 19 days after the injury. Follow-up at 1, 3, 5, 7, and 10 years exhibited absence of residual deficits in ROM and function. The “step deformity” was still present after the injury on the right. PMID:22654684

  13. Acromioclavicular Dislocation Associated with Coracoid Process Fracture: Report of Two Cases and Review of the Literature

    PubMed Central

    Kose, Ozkan; Canbora, Kerem; Guler, Ferhat; Kilicaslan, Omer Faruk; May, Hasan

    2015-01-01

    Acromioclavicular dislocation associated with coracoid process fracture is a rare injury. Herein we reported two further cases with such combination of injuries and reviewed all previously published cases in current literature. In this review, we discussed the demographic characteristics, mechanism of injury, diagnosis, and treatment options extensively. PMID:26491588

  14. POSTEROSUPERIOR SURGICAL ACCESS ROUTE FOR TREATMENT OF ACROMIOCLAVICULAR DISLOCATIONS: RESULTS FROM 84 SURGICAL CASES

    PubMed Central

    Dal Molin, Danilo Canesin; Ribeiro, Fabiano Rebouças; Filho, Rômulo Brasil; Filardi, Cantídio Salvador; Tenor, Antonio Carlos; Stipp, Willian Nandi; Petros, Rodrigo Souto Borges

    2015-01-01

    Objective: To evaluate the results from surgical treatment of 84 cases of acute acromioclavicular dislocation, using a posterosuperior access route. Methods: Eighty-four cases of acute acromioclavicular dislocation (grade III in the Allman-Tossy classification) operated between November 2002 and May 2010 were evaluated. The patients’ mean age was 34 years. The diagnoses were made using clinical and radiographic evaluations. The patients were operated by the same surgical team, within three weeks of the date of the trauma, using a posterosuperior approach to the shoulder to access the top of the base of the coracoid process for placement of two anchors, which were used in reducing the dislocation. The minimum follow-up was 12 months. The postoperative clinical-radiographic evaluation was done using the modified Karlsson criteria and the University of California at Los Angeles (UCLA) score. Results: 92.8% of the 84 patients treated presented good or excellent results, and 7.2% presented fair or poor results, using the UCLA assessment score. According to the modified Karlsson criteria, 76.2% were assessed as grade A, 17.9% as grade B and 5.9% as grade C. Conclusion: The posterosuperior access route to the shoulder is a new option for accessing the coracoid process and treating acromioclavicular dislocation, with clinical and radiographic results equivalent to those in the literature. PMID:27047866

  15. Evaluation and treatment of sternoclavicular, clavicular, and acromioclavicular injuries.

    PubMed

    Balcik, Brenden J; Monseau, Aaron J; Krantz, William

    2013-12-01

    Injuries to the clavicle and associated structures may involve fractures of the clavicle or injuries to the surrounding joints, usually from a blow to the shoulder. They present with variable signs and symptoms, requiring a thorough history and physical examination. Diagnosis typically involves plain radiographs but more advanced imaging may be required, especially in the case of sternoclavicular joint dislocations. Often, nonoperative management is indicated but, occasionally, surgical intervention is required. Due to the high incidence of clavicle injuries, it is paramount that the primary care physician be able to recognize, diagnose, and manage these injuries.

  16. Biomechanical Model for Evaluation of Pediatric Upper Extremity Joint Dynamics during Wheelchair Mobility

    PubMed Central

    Schnorenberg, Alyssa J.; Slavens, Brooke A.; Wang, Mei; Vogel, Lawrence; Smith, Peter; Harris, Gerald F.

    2014-01-01

    Pediatric manual wheelchair users (MWU) require high joint demands on their upper extremity (UE) during wheelchair mobility, leading them to be at risk of developing pain and pathology. Studies have examined UE biomechanics during wheelchair mobility in the adult population; however, current methods for evaluating UE joint dynamics of pediatric MWU are limited. An inverse dynamics model is proposed to characterize three-dimensional UE joint kinematics and kinetics during pediatric wheelchair mobility using a SmartWheel instrumented handrim system. The bilateral model comprises thorax, clavicle, scapula, upper arm, forearm, and hand segments and includes the sternoclavicular, acromioclavicular, glenohumeral, elbow and wrist joints. A single 17 year-old male with a C7 spinal cord injury (SCI) was evaluated while propelling his wheelchair across a 15-meter walkway. The subject exhibited wrist extension angles up to 60°, large elbow ranges of motion and peak glenohumeral joint forces up to 10% body weight. Statistically significant asymmetry of the wrist, elbow, glenohumeral and acromioclavicular joints was detected by the model. As demonstrated, the custom bilateral UE pediatric model may provide considerable quantitative insight into UE joint dynamics to improve wheelchair prescription, training, rehabilitation and long-term care of children with orthopaedic disabilities. Further research is warranted to evaluate pediatric wheelchair mobility in a larger population of children with SCI to investigate correlations to pain, function and transitional changes to adulthood. PMID:24309622

  17. Biomechanical model for evaluation of pediatric upper extremity joint dynamics during wheelchair mobility.

    PubMed

    Schnorenberg, Alyssa J; Slavens, Brooke A; Wang, Mei; Vogel, Lawrence C; Smith, Peter A; Harris, Gerald F

    2014-01-01

    Pediatric manual wheelchair users (MWU) require high joint demands on their upper extremity (UE) during wheelchair mobility, leading them to be at risk of developing pain and pathology. Studies have examined UE biomechanics during wheelchair mobility in the adult population; however, current methods for evaluating UE joint dynamics of pediatric MWU are limited. An inverse dynamics model is proposed to characterize three-dimensional UE joint kinematics and kinetics during pediatric wheelchair mobility using a SmartWheel instrumented handrim system. The bilateral model comprises thorax, clavicle, scapula, upper arm, forearm, and hand segments and includes the sternoclavicular, acromioclavicular, glenohumeral, elbow and wrist joints. A single 17 year-old male with a C7 spinal cord injury (SCI) was evaluated while propelling his wheelchair across a 15-meter walkway. The subject exhibited wrist extension angles up to 60°, large elbow ranges of motion and peak glenohumeral joint forces up to 10% body weight. Statistically significant asymmetry of the wrist, elbow, glenohumeral and acromioclavicular joints was detected by the model. As demonstrated, the custom bilateral UE pediatric model may provide considerable quantitative insight into UE joint dynamics to improve wheelchair prescription, training, rehabilitation and long-term care of children with orthopedic disabilities. Further research is warranted to evaluate pediatric wheelchair mobility in a larger population of children with SCI to investigate correlations to pain, function and transitional changes to adulthood.

  18. Treatment of grade III acromioclavicular separations in professional throwing athletes: results of a survey.

    PubMed

    McFarland, E G; Blivin, S J; Doehring, C B; Curl, L A; Silberstein, C

    1997-11-01

    Forty-two team orthopedists representing all 28 major league baseball teams were surveyed to ascertain their definitive treatment for a hypothetical starting rotation pitcher who had sustained a grade III acromioclavicular (AC) separation to his throwing arm 1 week before the season. Twenty-nine (69%) of the physicians would treat the injury nonoperatively, while 13 (31%) would operate immediately. Twenty-five (60%) of the orthopedists had actually treated a pitcher or position baseball player with a grade III AC separation in the throwing arm, the 25 treating a total of 32 patients. Twenty (63%) of these injuries were treated nonoperatively, and 12 (37%) were treated operatively. The physicians reported that 16 (80%) of the patients treated nonoperatively regained normal function and achieved complete relief of pain, while 18 (90%) had normal range of motion after treatment; of those treated operatively, 11 (92%) regained normal function, achieved complete relief of pain, and had normal range of motion after surgery.

  19. Surgical Treatment for Unstable Distal Clavicle Fracture with Micromovable and Anatomical Acromioclavicular Plate

    PubMed Central

    Liu, Qingjun; Miao, Jianyun; Lin, Bin; Lian, Kejian

    2012-01-01

    Between 2006 and 2009, 18 patients of distal clavicle fracture were treated with micro-movable and anatomical acromioclavicular plate (MAAP) in our department. According to the Neer's classification, all cases were unstable with type IIA (12 cases) and type IIB (6 cases). Functional outcome was evaluated using the Karlsson's criteria. The mean follow-up was 18 months (range, 12-36months). No postoperative plate screws complication was observed. Osseous union could be achieved at a mean time of 12 weeks after operation in 18 patients (range, 8 -16 weeks). According to Karlsson's criteria, radiographic appearances and postoperative shoulder functional recovery revealed a good and excellent rate in these cases. We conclude that surgical treatment using MAAP seems to be a good option for unstable type II fractures of the distal clavicle. This technique allows for reliable fixation with early functional exercises and functional recovery. PMID:22701337

  20. Surgical treatment for unstable distal clavicle fracture with micromovable and anatomical acromioclavicular plate.

    PubMed

    Liu, Qingjun; Miao, Jianyun; Lin, Bin; Lian, Kejian

    2012-01-01

    Between 2006 and 2009, 18 patients of distal clavicle fracture were treated with micro-movable and anatomical acromioclavicular plate (MAAP) in our department. According to the Neer's classification, all cases were unstable with type IIA (12 cases) and type IIB (6 cases). Functional outcome was evaluated using the Karlsson's criteria. The mean follow-up was 18 months (range, 12-36months). No postoperative plate screws complication was observed. Osseous union could be achieved at a mean time of 12 weeks after operation in 18 patients (range, 8 -16 weeks). According to Karlsson's criteria, radiographic appearances and postoperative shoulder functional recovery revealed a good and excellent rate in these cases. We conclude that surgical treatment using MAAP seems to be a good option for unstable type II fractures of the distal clavicle. This technique allows for reliable fixation with early functional exercises and functional recovery.

  1. Coracoclavicular joint, an osteological study with clinical implications: a case report

    PubMed Central

    Stavrakas, Marios-Efstathios; Stoltidou, Alexandra

    2009-01-01

    Introduction The presence of an anomalous coracoclavicular joint was studied in a human male skeleton aged 73 years old from the Osteology Collection of our Department. Case presentation We describe the exact morphology of this variation that is occasionally reported as an anatomical or radiological curiosity in the literature (0.55-21%). Conclusion Although coracoclavicular diarthrosis is of no significance other than academic, it is important to recognize this variation and the clinical symptoms that may occur, as it is a cause of shoulder pain and arthritis in this or the adjacent sternoclavicular and acromioclavicular joint. Consequently, it is vital to apply the appropriate treatment. PMID:19918399

  2. Joint swelling

    MedlinePlus

    Swelling of a joint ... Joint swelling may occur along with joint pain . The swelling may cause the joint to appear larger or abnormally shaped. Joint swelling can cause pain or stiffness. After an ...

  3. Coracoclavicular joint: osteologic study of 1020 human clavicles

    PubMed Central

    Gumina, S; Salvatore, M; De Santis, P; Orsina, L; Postacchini, F

    2002-01-01

    We examined 1020 dry clavicles from cadavers of Italian origin to determine the prevalence of the coracoclavicular joint (ccj), a diarthrotic synovial joint occasionally present between the conoid tubercle of the clavicle and the superior surface of the horizontal part of the coracoid process. Five hundred and nine clavicles from individuals of different ages were submitted to X-ray examination. Using radiography, we measured the entire length and the index of sinuosity of the anterior lateral curve, on which the distance between the conoid tubercle and the coracoid process depends. We also used radiography to record the differences in prevalence of arthritis in two neighbouring joints, the acromioclavicular and sternoclavicular joints. Of the 1020 clavicles, eight (0.8%) displayed the articular facet of the ccj. No statistical correlation was found between clavicular length and the index of sinuosity of the anterior lateral curve. The prevalence of arthritis in clavicles with ccj was higher than that revealed in clavicles without ccj. The prevalence of ccj in the studied clavicles is lower than that observed in Asian cohorts. Furthermore, ccj is not conditioned by either length or sinuosity of the anterior lateral curve of the clavicle. Finally, the assumption that ccj is a predisposing factor for degenerative changes of neighbouring joints is statistically justified. PMID:12489763

  4. Joint Disorders

    MedlinePlus

    A joint is where two or more bones come together, like the knee, hip, elbow, or shoulder. Joints can be damaged by many types of injuries or diseases, including Arthritis - inflammation of a joint. It causes pain, stiffness, and swelling. Over time, ...

  5. Ceramic joints

    DOEpatents

    Miller, Bradley J.; Patten, Jr., Donald O.

    1991-01-01

    Butt joints between materials having different coefficients of thermal expansion are prepared having a reduced probability of failure of stress facture. This is accomplished by narrowing/tapering the material having the lower coefficient of thermal expansion in a direction away from the joint interface and not joining the narrow-tapered surface to the material having the higher coefficient of thermal expansion.

  6. Temporomandibular Joint, Closed

    MedlinePlus

    ... Oral Health > The Temporomandibular Joint, Closed The Temporomandibular Joint, Closed Main Content Title: The Temporomandibular Joint, Closed Description: The temporomandibular joint connects the lower ...

  7. Compliant joint

    NASA Technical Reports Server (NTRS)

    Eklund, Wayne D. (Inventor); Kerley, James J. (Inventor)

    1990-01-01

    A compliant joint is provided for prosthetic and robotic devices which permits rotation in three different planes. The joint provides for the controlled use of cable under motion. Perpendicular outer mounting frames are joined by swaged cables that interlock at a center block. Ball bearings allow for the free rotation of the second mounting frame relative to the first mounting frame within a predetermined angular rotation that is controlled by two stop devices. The cables allow for compliance at the stops and the cables allow for compliance in six degrees of freedom enabling the duplication or simulation of the rotational movement and flexibility of a natural hip or knee joint, as well as the simulation of a joint designed for a specific robotic component for predetermined design parameters.

  8. Joint Commission

    MedlinePlus

    ... Sunday 1:00 CST, November 6, 2016 Workplace Violence Prevention Resources The Joint Commission has launched “Workplace Violence Prevention Resources,” an online resource center dedicated to ...

  9. Joint Problems

    MedlinePlus

    ... ankles and toes. Other types of arthritis include gout or pseudogout. Sometimes, there is a mechanical problem ... for more information on osteoarthritis, rheumatoid arthritis and gout. How Common are Joint Problems? Osteoarthritis, which affects ...

  10. Joint assembly

    NASA Technical Reports Server (NTRS)

    Wilson, Andrew (Inventor); Punnoose, Andrew (Inventor); Strausser, Katherine (Inventor); Parikh, Neil (Inventor)

    2010-01-01

    A joint assembly is provided which includes a drive assembly and a swivel mechanism. The drive assembly features a motor operatively associated with a plurality of drive shafts for driving auxiliary elements, and a plurality of swivel shafts for pivoting the drive assembly. The swivel mechanism engages the swivel shafts and has a fixable element that may be attached to a foundation. The swivel mechanism is adapted to cooperate with the swivel shafts to pivot the drive assembly with at least two degrees of freedom relative to the foundation. The joint assembly allows for all components to remain encased in a tight, compact, and sealed package, making it ideal for space, exploratory, and commercial applications.

  11. A prospective study of shoulder pain in primary care: Prevalence of imaged pathology and response to guided diagnostic blocks

    PubMed Central

    2011-01-01

    Background The prevalence of imaged pathology in primary care has received little attention and the relevance of identified pathology to symptoms remains unclear. This paper reports the prevalence of imaged pathology and the association between pathology and response to diagnostic blocks into the subacromial bursa (SAB), acromioclavicular joint (ACJ) and glenohumeral joint (GHJ). Methods Consecutive patients with shoulder pain recruited from primary care underwent standardised x-ray, diagnostic ultrasound scan and diagnostic injections of local anaesthetic into the SAB and ACJ. Subjects who reported less than 80% reduction in pain following either of these injections were referred for a magnetic resonance arthrogram (MRA) and GHJ diagnostic block. Differences in proportions of positive and negative imaging findings in the anaesthetic response groups were assessed using Fishers test and odds ratios were calculated a for positive anaesthetic response (PAR) to diagnostic blocks. Results In the 208 subjects recruited, the rotator cuff and SAB displayed the highest prevalence of pathology on both ultrasound (50% and 31% respectively) and MRA (65% and 76% respectively). The prevalence of PAR following SAB injection was 34% and ACJ injection 14%. Of the 59% reporting a negative anaesthetic response (NAR) for both of these injections, 16% demonstrated a PAR to GHJ injection. A full thickness tear of supraspinatus on ultrasound was associated with PAR to SAB injection (OR 5.02; p < 0.05). Ultrasound evidence of a biceps tendon sheath effusion (OR 8.0; p < 0.01) and an intact rotator cuff (OR 1.3; p < 0.05) were associated with PAR to GHJ injection. No imaging findings were strongly associated with PAR to ACJ injection (p ≤ 0.05). Conclusions Rotator cuff and SAB pathology were the most common findings on ultrasound and MRA. Evidence of a full thickness supraspinatus tear was associated with symptoms arising from the subacromial region, and a biceps tendon sheath effusion

  12. Joint x-ray

    MedlinePlus

    X-ray - joint; Arthrography; Arthrogram ... x-ray technologist will help you position the joint to be x-rayed on the table. Once in place, pictures are taken. The joint may be moved into other positions for more ...

  13. Joint Instability and Osteoarthritis

    PubMed Central

    Blalock, Darryl; Miller, Andrew; Tilley, Michael; Wang, Jinxi

    2015-01-01

    Joint instability creates a clinical and economic burden in the health care system. Injuries and disorders that directly damage the joint structure or lead to joint instability are highly associated with osteoarthritis (OA). Thus, understanding the physiology of joint stability and the mechanisms of joint instability-induced OA is of clinical significance. The first section of this review discusses the structure and function of major joint tissues, including periarticular muscles, which play a significant role in joint stability. Because the knee, ankle, and shoulder joints demonstrate a high incidence of ligament injury and joint instability, the second section summarizes the mechanisms of ligament injury-associated joint instability of these joints. The final section highlights the recent advances in the understanding of the mechanical and biological mechanisms of joint instability-induced OA. These advances may lead to new opportunities for clinical intervention in the prevention and early treatment of OA. PMID:25741184

  14. Spacesuit mobility knee joints

    NASA Technical Reports Server (NTRS)

    Vykukal, H. C. (Inventor)

    1979-01-01

    Pressure suit mobility joints are for use in interconnecting adjacent segments of an hermetically sealed spacesuit in which low torques, low leakage and a high degree of reliability are required. Each of the joints is a special purpose joint characterized by substantially constant volume and low torque characteristics and includes linkages which restrain the joint from longitudinal distension and includes a flexible, substantially impermeable diaphragm of tubular configuration spanning the distance between pivotally supported annuli. The diaphragms of selected joints include rolling convolutions for balancing the joints, while various joints include wedge-shaped sections which enhance the range of motion for the joints.

  15. Spacesuit mobility joints

    NASA Technical Reports Server (NTRS)

    Vykukal, H. C. (Inventor)

    1978-01-01

    Joints for use in interconnecting adjacent segments of an hermetically sealed spacesuit which have low torques, low leakage and a high degree of reliability are described. Each of the joints is a special purpose joint characterized by substantially constant volume and low torque characteristics. Linkages which restrain the joint from longitudinal distension and a flexible, substantially impermeable diaphragm of tubular configuration spanning the distance between pivotally supported annuli are featured. The diaphragms of selected joints include rolling convolutions for balancing the joints, while various joints include wedge-shaped sections which enhance the range of motion for the joints.

  16. Unusual lesions mimicking impingement syndrome in the shoulder joint - Think medially.

    PubMed

    Singh, Rohit; Malhotra, Akshay; Cribb, Gillian; Cool, Paul; Hay, Stuart

    2016-09-01

    Impingement syndrome is usually caused by irritation of the rotator cuff within the sub acromial space and this includes the coraco-acromial arch (Acromion and Coraco-acromial ligament), the acromio-clavicular joint and occasionally the coracoid. Iatrogenic causes such as sutures, pins, plates or wires left from previous surgery can cause similar symptoms. We present a series of four cases mimicking "classical" impingement symptoms/signs in which the causal pathology was identified outside the sub-acromial space. Magnetic Resonance Imaging (MRI) showed lesions that were present in the supra-spinatus fossa but were causing pressure effects on the sub-acromial space, namely - a ganglion cyst in one case, lipomata in two other cases, and a glomus tumour. A ganglion cyst and glomus tumour mimicking impingement syndrome is a rare reported case to our knowledge. These are unusual causes that should be considered when investigating classical impingement syndrome and particularly those who may have failed to respond to decompression surgery. They highlight the potential value of looking beyond the sub-acromial space for causal lesions and in these cases, at a time when limited ultrasound investigation has become increasingly popular; MRI has clearly played an important and was essential in planning surgery as these lesions would not have been identified on USS. Even though the symptoms were classical. PMID:27594993

  17. Butt Joint Tool Commissioning

    SciTech Connect

    Martovetsky, N N

    2007-12-06

    ITER Central Solenoid uses butt joints for connecting the pancakes in the CS module. The principles of the butt joining of the CICC were developed by the JAPT during CSMC project. The difference between the CSMC butt joint and the CS butt joint is that the CS butt joint is an in-line joint, while the CSMC is a double joint through a hairpin jumper. The CS butt joint has to carry the hoop load. The straight length of the joint is only 320 mm, and the vacuum chamber around the joint has to have a split in the clamp shell. These requirements are challenging. Fig.1 presents a CSMC joint, and Fig.2 shows a CS butt joint. The butt joint procedure was verified and demonstrated. The tool is capable of achieving all specified parameters. The vacuum in the end was a little higher than the target, which is not critical and readily correctable. We consider, tentatively that the procedure is established. Unexpectedly, we discover significant temperature nonuniformity in the joint cross section, which is not formally a violation of the specs, but is a point of concern. All testing parameters are recorded for QA purposes. We plan to modify the butt joining tool to improve its convenience of operation and provide all features necessary for production of butt joints by qualified personnel.

  18. Pressure suit joint analyzer

    NASA Technical Reports Server (NTRS)

    Vykukal, H. C.; Webbon, B. W. (Inventor)

    1982-01-01

    A measurement system for simultaneously measuring torque and angular flexure in a pressure suit joint is described. One end of a joint under test is held rigid. A torque transducer is pivotably supported on the other movable end of a joint. A potentiometer is attached to the transducer by an arm. The wiper shaft of the potentiometer is gripped by a reference arm that rotates the wiper shaft the same angle as the flexure of joint. A signal is generated by the potentiometer which is representative of the joint flexure. A compensation circuit converts the output of the transducer to a signal representative of joint torque.

  19. Culture - joint fluid

    MedlinePlus

    Joint fluid culture ... fungi, or viruses grow. This is called a culture. If these germs are detected, other tests may ... is no special preparation needed for the lab culture. How to prepare for the removal of joint ...

  20. Temporomandibular Joint Dysfunction

    MedlinePlus

    The temporomandibular joint (TMJ) connects your jaw to the side of your head. When it works well, it enables you to ... For people with TMJ dysfunction, problems with the joint and muscles around it may cause Pain that ...

  1. Large displacement spherical joint

    DOEpatents

    Bieg, Lothar F.; Benavides, Gilbert L.

    2002-01-01

    A new class of spherical joints has a very large accessible full cone angle, a property which is beneficial for a wide range of applications. Despite the large cone angles, these joints move freely without singularities.

  2. Hip joint replacement

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/002975.htm Hip joint replacement To use the sharing features on this page, please enable JavaScript. Hip joint replacement is surgery to replace all or part ...

  3. [Total temporomandibular joint prostheses].

    PubMed

    Zwetyenga, N; Amroun, S; Wajszczak, B-L; Moris, V

    2016-09-01

    The temporomandibular joint (TMJ) is probably the most complex human joint. As in all joints, its prosthetic replacement may be indicated in selected cases. Significant advances have been made in the design of TMJ prostheses during the last three decades and the indications have been clarified. The aim of our work was to make an update on the current total TMJ total joint replacement. Indications, contraindications, prosthetic components, advantages, disadvantages, reasons for failure or reoperation, virtual planning and surgical protocol have been exposed.

  4. Joint Enrollment Report, 2014

    ERIC Educational Resources Information Center

    Iowa Department of Education, 2014

    2014-01-01

    The Iowa Department of Education collects information on joint enrollment in Iowa's 15 community colleges. Jointly enrolled students are high school students enrolled in community college credit coursework. Most jointly enrolled students enroll through Senior Year Plus (SYP) programs such as Postsecondary Enrollment Options (PSEO) and concurrent…

  5. Arch & Chord Joint Detail; Crossbracing Center Joint Detail; Chord, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Arch & Chord Joint Detail; Crossbracing Center Joint Detail; Chord, Panel Post, Tie & Diagonal Brace Joint Detail; Chord, Panel Post, Tie & Crossbracing Joint Detail - Dunlapsville Covered Bridge, Spanning East Fork Whitewater River, Dunlapsville, Union County, IN

  6. Joint custody: preliminary impressions.

    PubMed

    Awad, G A

    1983-02-01

    Joint custody is currently a popular and debatable issue. It is felt that some of the controversy is due to the lack of agreement on a definition. Following some examples of the differences in personal and judicial definitions of joint custody, a classification of custody is offered. Four types of custody arrangements are described: Absolute Sole Custody, Sole Custody, Non-Alternating Joint Custody (disputed and undisputed) and Alternating Joint Custody (disputed and undisputed). A critical review of the literature follows. Finally, clinical impressions about the two types of joint custody are discussed. PMID:6839267

  7. Temporomandibular joint osteoarthrosis and temporomandibular joint hypermobility.

    PubMed

    Dijkstra, P U; de Bont, L G; de Leeuw, R; Stegenga, B; Boering, G

    1993-10-01

    For studying the relationship between condylar hypermobility of the temporomandibular joint (TMJ) and osteoarthrosis (OA), 13 patients with bilateral condylar hypermobility were evaluated clinically and radiographically, 30 years after non-surgical treatment. The evaluation included range of motion, joint and muscle tenderness to palpation, joint sounds and masticatory function. Radiographs of the TMJs were evaluated for the absence or presence of degenerative changes. The hypermobile group (HG) was compared with a control group (CG) (n = 13). The CG was evaluated in the same way as the HG. Statistics included t-tests (to compare ranges of motion in the HG over time and to compare ranges of motion in HG and CG), non-parametric tests (to compare tenderness of muscles and joints, joint sounds, masticatory function and radiographic changes over time in the HG). The tests were also used to compare the same variables between the HG and CG group. The groups' only difference was the presence of radiographic signs of OA. In the HG the number of joints with radiographic degenerative changes increased significantly over time and was significantly higher than the CG. Clinically and functionally, the HG and CG did not differ. Therefore, it is concluded that TMJ hypermobility is a subsidiary factor in the development of TMJ OA. PMID:8118897

  8. [Total temporomandibular joint prostheses].

    PubMed

    Zwetyenga, N; Amroun, S; Wajszczak, B-L; Moris, V

    2016-09-01

    The temporomandibular joint (TMJ) is probably the most complex human joint. As in all joints, its prosthetic replacement may be indicated in selected cases. Significant advances have been made in the design of TMJ prostheses during the last three decades and the indications have been clarified. The aim of our work was to make an update on the current total TMJ total joint replacement. Indications, contraindications, prosthetic components, advantages, disadvantages, reasons for failure or reoperation, virtual planning and surgical protocol have been exposed. PMID:27554487

  9. Mechanics of Sheeting Joints

    NASA Astrophysics Data System (ADS)

    Martel, S. J.

    2015-12-01

    Physical breakdown of rock across a broad scale spectrum involves fracturing. In many areas large fractures develop near the topographic surface, with sheeting joints being among the most impressive. Sheeting joints share many geometric, textural, and kinematic features with other joints (opening-mode fractures) but differ in that they are (a) discernibly curved, (b) open near the topographic surface, and (c) form subparallel to the topographic surface. Where sheeting joints are geologically young, the surface-parallel compressive stresses are typically several MPa or greater. Sheeting joints are best developed beneath domes, ridges, and saddles; they also are reported, albeit rarely, beneath valleys or bowls. A mechanism that accounts for all these associations has been sought for more than a century: neither erosion of overburden nor high lateral compressive stresses alone suffices. Sheeting joints are not accounted for by Mohr-Coulomb shear failure criteria. Principles of linear elastic fracture mechanics, together with the mechanical effect of a curved topographic surface, do provide a basis for understanding sheeting joint growth and the pattern sheeting joints form. Compressive stresses parallel to a singly or doubly convex topographic surface induce a tensile stress perpendicular to the surface at shallow depths; in some cases this alone could overcome the weight of overburden to open sheeting joints. If regional horizontal compressive stresses, augmented by thermal stresses, are an order of magnitude or so greater than a characteristic vertical stress that scales with topographic amplitude, then topographic stress perturbations can cause sheeting joints to open near the top of a ridge. This topographic effect can be augmented by pressure within sheeting joints arising from water, ice, or salt. Water pressure could be particularly important in helping drive sheeting joints downslope beneath valleys. Once sheeting joints have formed, the rock sheets between

  10. Surgical management of acromioclavicular dislocations.

    PubMed

    Cook, Jay B; Tokish, John M

    2014-10-01

    AC injuries are common in the military population. Many AC injuries can be treated conservatively with good success. Due to requirements of a military population, however, conservative management may fail at a higher rate than in civilian populations. Surgical management is indicated for high-grade injuries and those that are refractory to nonoperative treatment, as well as in those patients at high risk for failure of conservative management. Many techniques exist and there is no single superior technique. The anatomic reconstruction is evolving into a more consistent procedure with good biomechanical support. However, complication rates and failures are higher than ideal; thus, the surgeon must approach this injury with meticulous attention to detail and technique.

  11. Compound solder joints

    NASA Technical Reports Server (NTRS)

    Batista, R. I.; Simonson, R. B.

    1976-01-01

    Joining technique prevents contamination, may be used to join dissimilar metal tubes, minimizes fluid and gas entrapment, expedites repairs, and can yield joints having leakage rates less than 0.000001 standard cubic cm He/min. Components of joint are solder sleeve, two solder rings, Teflon sleeve, and tubing to be joined.

  12. Truss Slip Joint

    NASA Technical Reports Server (NTRS)

    Thomas, Frank

    1993-01-01

    Truss slip joint has few parts, strong, and assembled and disassembled easily. Designed to carry axial loads as large as 100,000 lb and to accommodate slight initial axial-displacement and angular misalignments. Joint assembled or disassembled by astronaut in space suit or, on Earth, by technician in heavy protective clothing; simple enough to be operable by robot. Modified to accommodate welding.

  13. Wedge Joints for Trusses

    NASA Technical Reports Server (NTRS)

    Wood, Kenneth E.

    1987-01-01

    Structure assembled rapidly with simple hand tools. Proposed locking wedge joints enable rapid assembly of lightweight beams, towers, scaffolds, and other truss-type structures. Lightweight structure assembled from tubular struts joined at nodes by wedge pins fitting into mating slots. Joint assembled rapidly by seating wedge pin in V-shaped slots and deforming end of strut until primary pawl engages it.

  14. Strategies for joint appointments.

    PubMed

    Royle, J; Crooks, D L

    1985-01-01

    The structure and policies governing joint appointments discussed above, are developed primarily through cooperation and collaboration between nursing service and education institutions. The joint appointee participates in the process of negotiation of salary, benefits and role responsibilities and exploration of the implications of the appointment for personal career development. Implementation and maintenance of the appointment requires the collaborative efforts of the joint appointee with both contracting agencies. Factors influencing the functioning of joint appointees have been identified and strategies to facilitate functioning presented. The joint appointee must be independent in thought and action yet adaptable to work within the boundaries of two social systems with differing values and expectations. Nursing management, peers and students can provide the support needed to overcome the frustrations and to achieve the rewards inherent in successful implementation of an exciting and innovative role. PMID:3852805

  15. [Approach to joint effusion].

    PubMed

    Henniger, M; Rehart, S

    2016-09-01

    The fundamental components of the differential diagnostics of joint effusions are the patient history and clinical examination. In the case of unclear findings, arthrosonography can provide information for the distinction between intra-articular and extra-articular pathologies. In atraumatic joint effusions inflammatory parameters in blood are determined in order to differentiate between systemic inflammatory and local inflammatory joint effusions. In the case of normal values further diagnostics are carried out using imaging. With elevated inflammatory parameters the main differential diagnoses are gouty arthritis, autoimmune joint processes and septic arthritis. When in doubt, a joint aspiration and synovial fluid analysis should be performed to rule out septic arthritis or if necessary confirmation of gouty arthritis. PMID:27562127

  16. MISR JOINT_AS Data

    Atmospheric Science Data Center

    2014-07-21

    Joint Aerosol Product (JOINT_AS) The MISR Level 3 Products are global or regional ... field campaigns at daily and monthly time scales. The Joint Aerosol product provides a monthly global statistical summary of MISR ...

  17. Pressure vessel flex joint

    NASA Technical Reports Server (NTRS)

    Kahn, Jon B. (Inventor)

    1992-01-01

    An airtight, flexible joint is disclosed for the interfacing of two pressure vessels such as between the Space Station docking tunnel and the Space Shuttle Orbiter bulkhead adapter. The joint provides for flexibility while still retaining a structural link between the two vessels required due to the loading created by the internal/external pressure differential. The joint design provides for limiting the axial load carried across the joint to a specific value, a function returned in the Orbiter/Station tunnel interface. The flex joint comprises a floating structural segment which is permanently attached to one of the pressure vessels through the use of an inflatable seal. The geometric configuration of the joint causes the tension between the vessels created by the internal gas pressure to compress the inflatable seal. The inflation pressure of the seal is kept at a value above the internal/external pressure differential of the vessels in order to maintain a controlled distance between the floating segment and pressure vessel. The inflatable seal consists of either a hollow torus-shaped flexible bladder or two rolling convoluted diaphragm seals which may be reinforced by a system of straps or fabric anchored to the hard structures. The joint acts as a flexible link to allow both angular motion and lateral displacement while it still contains the internal pressure and holds the axial tension between the vessels.

  18. Compliant Joints For Robots

    NASA Technical Reports Server (NTRS)

    Kerley, James J., Jr.

    1990-01-01

    Compliant joints devised to accommodate misalignments of tools and/or workpieces with respect to robotic manipulators. Has characteristics and appearance of both universal-joint and cable-spring-type flexible shaft coupling. Compliance derived from elastic properties of short pieces of cable. Compliance of joint determined by lengths, distances between, relative orientations, thickness of strands, number of strands, material, amount of pretwist, and number of short pieces of cable. Worm-drive mechanism used to adjust lengths to vary compliance as needed during operation.

  19. Total ankle joint replacement.

    PubMed

    2016-02-01

    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications.

  20. Knee joint replacement

    MedlinePlus

    ... is used to attach this part. Repair your muscles and tendons around the new joint and close the surgical cut. The surgery takes about 2 hours. Most artificial knees have both metal and plastic parts. Some ...

  1. Wrist joint assembly

    NASA Technical Reports Server (NTRS)

    Kersten, L.; Johnson, J. D. (Inventor)

    1978-01-01

    A wrist joint assembly is provided for use with a mechanical manipulator arm for finely positioning an end-effector carried by the wrist joint on the terminal end of the manipulator arm. The wrist joint assembly is pivotable about a first axis to produce a yaw motion, a second axis is to produce a pitch motion, and a third axis to produce a roll motion. The wrist joint assembly includes a disk segment affixed to the terminal end of the manipulator arm and a first housing member, a second housing member, and a third housing member. The third housing member and the mechanical end-effector are moved in the yaw, pitch, and roll motion. Drive means are provided for rotating each of the housings about their respective axis which includes a cluster of miniature motors having spur gears carried on the output drive shaft which mesh with a center drive gear affixed on the housing to be rotated.

  2. Improved orthopedic arm joint

    NASA Technical Reports Server (NTRS)

    Dane, D. H.

    1971-01-01

    Joint permits smooth and easy movement of disabled arm and is smaller, lighter and less expensive than previous models. Device is interchangeable and may be used on either arm at the shoulder or at the elbow.

  3. Joint fluid Gram stain

    MedlinePlus

    Gram stain of joint fluid ... result means no bacteria are present on the Gram stain. Normal value ranges may vary slightly among ... Abnormal results mean bacteria were seen on the Gram stain. This may be a sign of a ...

  4. Scaling in Columnar Joints

    NASA Astrophysics Data System (ADS)

    Morris, Stephen

    2007-03-01

    Columnar jointing is a fracture pattern common in igneous rocks in which cracks self-organize into a roughly hexagonal arrangement, leaving behind an ordered colonnade. We report observations of columnar jointing in a laboratory analog system, desiccated corn starch slurries. Using measurements of moisture density, evaporation rates, and fracture advance rates, we suggest an advective-diffusive system is responsible for the rough scaling behavior of columnar joints. This theory explains the order of magnitude difference in scales between jointing in lavas and in starches. We investigated the scaling of average columnar cross-sectional areas in experiments where the evaporation rate was fixed using feedback methods. Our results suggest that the column area at a particular depth is related to both the current conditions, and hysteretically to the geometry of the pattern at previous depths. We argue that there exists a range of stable column scales allowed for any particular evaporation rate.

  5. Hip joint injection

    MedlinePlus

    ... injected so the provider can see where to place the medicine. The steroid medicine is slowly injected into the joint. After the injection, you will remain on the table for another 5 to 10 minutes or so. ...

  6. Temporomandibular Joint Disorder

    MedlinePlus

    ... 2008 Previous Next Related Articles: Temporomandibular Joint Disorder (TMD) Are You Biting Off More Than You Can Chew? Equilibration May Lessen TMD Pain Fender-benders: Source of TMD? First Comes ...

  7. Panel Post & Diagonal Brace Joint Detail; Crossbracing Center Joint ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Panel Post & Diagonal Brace Joint Detail; Crossbracing Center Joint Detail; Chord, Panel Post, Tie Bar, & Diagonal Brace Joint Detail; Chord, Tie Bar, & Crossbracing Joint Detail - Medora Bridge, Spanning East Fork of White River at State Route 235, Medora, Jackson County, IN

  8. High pressure ceramic joint

    DOEpatents

    Ward, M.E.; Harkins, B.D.

    1993-11-30

    Many recuperators have components which react to corrosive gases and are used in applications where the donor fluid includes highly corrosive gases. These recuperators have suffered reduced life, increased service or maintenance, and resulted in increased cost. The present joint when used with recuperators increases the use of ceramic components which do not react to highly corrosive gases. Thus, the present joint used with the present recuperator increases the life, reduces the service and maintenance, and reduces the increased cost associated with corrosive action of components used to manufacture recuperators. The present joint is comprised of a first ceramic member, a second ceramic member, a mechanical locking device having a groove defined in one of the first ceramic member and the second ceramic member. The joint and the mechanical locking device is further comprised of a refractory material disposed in the groove and contacting the first ceramic member and the second ceramic member. The present joint mechanically provides a high strength load bearing joint having good thermal cycling characteristics, good resistance to a corrosive environment and good steady state strength at elevated temperatures. 4 figures.

  9. High pressure ceramic joint

    DOEpatents

    Ward, Michael E.; Harkins, Bruce D.

    1993-01-01

    Many recuperators have components which react to corrosive gases and are used in applications where the donor fluid includes highly corrosive gases. These recuperators have suffered reduced life, increased service or maintenance, and resulted in increased cost. The present joint when used with recuperators increases the use of ceramic components which do not react to highly corrosive gases. Thus, the present joint used with the present recuperator increases the life, reduces the service and maintenance, and reduces the increased cost associated with corrosive action of components used to manufacture recuperators. The present joint is comprised of a first ceramic member, a second ceramic member, a mechanical locking device having a groove defined in one of the first ceramic member and the second ceramic member. The joint and the mechanical locking device is further comprised of a refractory material disposed in the groove and contacting the first ceramic member and the second ceramic member. The present joint mechanically provides a high strength load bearing joint having good thermal cycling characteristics, good resistance to a corrosive environment and good steady state strength at elevated temperatures.

  10. [Biomechanics of the ankle joint].

    PubMed

    Zwipp, H

    1989-03-01

    According to Fick, the tree-dimensional patterns of foot motion are best characterized as jawlike movement. Anatomically and biomechanically, this process represents conjoined, synchronous motion within the three mobile segments of the hindfoot: the ankle joint, the posterior subtalar joint, and the anterior subtalar joint. Foot kinematics can be described more completely if the anterior subtalar joint is defined not only as the talocalcaneal navicular joint, but as including the calcaneocuboid joint, thus representing the transverse joint of the tarsus, i.e., the Chopart joint. The axes of these three joints can be defined precisely. In some parts they represent a screwlike motion, clockwise or counter-clockwise, around the central ligamentous structures (fibulotibial ligament, talocalcaneal interosseous ligament, bifurcate ligament). The individual anatomy and structure of these ligaments provide variations in the degree and direction of foot motion. A precise knowledge of foot kinematics is important in surgical ligament and joint reconstruction and in selective foot arthrodeses.

  11. Joint ventures in medical services.

    PubMed

    Rublee, D A

    1987-01-01

    This paper is an overview of joint-venture activity in healthcare, describing trends in joint ventures and raising issues for physicians. The purposes are to discuss the major current facets of joint-venture alliances in healthcare and to identify policy issues that arise from the trend to use joint ventures as an organizational tool. Speculation is made about the future role of joint ventures in the organization of healthcare.

  12. Dissimilar metals joint evaluation

    NASA Technical Reports Server (NTRS)

    Wakefield, M. E.; Apodaca, L. E.

    1974-01-01

    Dissimilar metals tubular joints between 2219-T851 aluminum alloy and 304L stainless steel were fabricated and tested to evaluate bonding processes. Joints were fabricated by four processes: (1) inertia (friction) weldings, where the metals are spun and forced together to create the weld; (2) explosive welding, where the metals are impacted together at high velocity; (3) co-extrusion, where the metals are extruded in contact at high temperature to promote diffusion; and (4) swaging, where residual stresses in the metals after a stretching operation maintain forced contact in mutual shear areas. Fifteen joints of each type were prepared and evaluated in a 6.35 cm (2.50 in.) O.D. size, with 0.32 cm (0.13 in.) wall thickness, and 7.6 cm (3.0 in) total length. The joints were tested to evaluate their ability to withstand pressure cycle, thermal cycle, galvanic corrosion and burst tests. Leakage tests and other non-destructive test techniques were used to evaluate the behavior of the joints, and the microstructure of the bond areas was analyzed.

  13. Prosthetic Joint Infection

    PubMed Central

    Tande, Aaron J.

    2014-01-01

    SUMMARY Prosthetic joint infection (PJI) is a tremendous burden for individual patients as well as the global health care industry. While a small minority of joint arthroplasties will become infected, appropriate recognition and management are critical to preserve or restore adequate function and prevent excess morbidity. In this review, we describe the reported risk factors for and clinical manifestations of PJI. We discuss the pathogenesis of PJI and the numerous microorganisms that can cause this devastating infection. The recently proposed consensus definitions of PJI and approaches to accurate diagnosis are reviewed in detail. An overview of the treatment and prevention of this challenging condition is provided. PMID:24696437

  14. Joint Custody and Coparenting.

    ERIC Educational Resources Information Center

    Sell, Kenneth D.

    Results are presented of an intensive search of U.S. newspapers and periodicals on the joint custody of children after divorce, where both parents have continued responsibility for parenting and where the children spend part of each week, month, or year with both of the parents. Areas of concern addressed by these materials include the following:…

  15. Human temporomandibular joint morphogenesis.

    PubMed

    Carini, Francesco; Scardina, Giuseppe Alessandro; Caradonna, Carola; Messina, Pietro; Valenza, Vincenzo

    2007-01-01

    Temporomandibular joint morphogenesis was studied. Ranging in age of fetuses examined was from 6 to14 weeks' gestation. Our results showed the condyle so first element that appear between 6 degrees and 8 degrees week (condylar blastema). After a week appear temporal elements. Disk appear at the same time of glenoid blastema and it reaches an advanced differentation before of the condyle and temporal element, so these don't effect machanical compression on mesenchyma where we find the disk. So we think that the disk result of genetic expression and it isn't the result of mechanical compression. The inferior joint cavity appear to 12 week. The superior joint cavity appear to 13-14 week. In conclusion, the appearance of the condyle is the first event during TMJ morphogenesis, with its initial bud, in form of a mesenchymal thickening, becoming detectable between the sixth and eight week of development, when all the large joints of the limbs are already well defined. PMID:18333411

  16. Clad metal joint closure

    SciTech Connect

    Siebert, O.W.

    1985-04-09

    A plasma arc spray overlay of cladding metals is used over joints between clad metal pieces to provide a continuous cladding metal surface. The technique permits applying an overlay of a high melting point cladding metal to a cladding metal surface without excessive heating of the backing metal.

  17. New Joint Sealants. Criteria, Design and Materials.

    ERIC Educational Resources Information Center

    Building Research Inst., Inc., Washington, DC.

    Contents include--(1) sealing concrete joints, (2) sealing glass and metal joints, (3) metal and glass joint sealants from a fabricator's viewpoint, (4) a theory of adhesion for joint sealants, (5) geometry of simple joint seals under strain, (6) joint sealant specifications from a manufacturer's viewpoint, (7) joint sealant requirements from an…

  18. Anaerobic prosthetic joint infection.

    PubMed

    Shah, Neel B; Tande, Aaron J; Patel, Robin; Berbari, Elie F

    2015-12-01

    In an effort to improve mobility and alleviate pain from degenerative and connective tissue joint disease, an increasing number of individuals are undergoing prosthetic joint replacement in the United States. Joint replacement is a highly effective intervention, resulting in improved quality of life and increased independence [1]. By 2030, it is predicted that approximately 4 million total hip and knee arthroplasties will be performed yearly in the United States [2]. One of the major complications associated with this procedure is prosthetic joint infection (PJI), occurring at a rate of 1-2% [3-7]. In 2011, the Musculoskeletal Infectious Society created a unifying definition for prosthetic joint infection [8]. The following year, the Infectious Disease Society of America published practice guidelines that focused on the diagnosis and management of PJI. These guidelines focused on the management of commonly encountered organisms associated with PJI, including staphylococci, streptococci and select aerobic Gram-negative bacteria. However, with the exception of Propionibacterium acnes, management of other anaerobic organisms was not addressed in these guidelines [1]. Although making up approximately 3-6% of PJI [9,10], anaerobic microorganisms cause devastating complications, and similar to the more common organisms associated with PJI, these bacteria also result in significant morbidity, poor outcomes and increased health-care costs. Data on diagnosis and management of anaerobic PJI is mostly derived from case reports, along with a few cohort studies [3]. There is a paucity of published data outlining factors associated with risks, diagnosis and management of anaerobic PJI. We therefore reviewed available literature on anaerobic PJI by systematically searching the PubMed database, and collected data from secondary searches to determine information on pathogenesis, demographic data, clinical features, diagnosis and management. We focused our search on five commonly

  19. Shoulder Joint For Protective Suit

    NASA Technical Reports Server (NTRS)

    Kosmo, Joseph J.; Smallcombe, Richard D.

    1994-01-01

    Shoulder joint allows full range of natural motion: wearer senses little or no resisting force or torque. Developed for space suit, joint offers advantages in protective garments for underwater work, firefighting, or cleanup of hazardous materials.

  20. Determination of Parachute Joint Factors using Seam and Joint Testing

    NASA Technical Reports Server (NTRS)

    Mollmann, Catherine

    2015-01-01

    This paper details the methodology for determining the joint factor for all parachute components. This method has been successfully implemented on the Capsule Parachute Assembly System (CPAS) for the NASA Orion crew module for use in determining the margin of safety for each component under peak loads. Also discussed are concepts behind the joint factor and what drives the loss of material strength at joints. The joint factor is defined as a "loss in joint strength...relative to the basic material strength" that occurs when "textiles are connected to each other or to metals." During the CPAS engineering development phase, a conservative joint factor of 0.80 was assumed for each parachute component. In order to refine this factor and eliminate excess conservatism, a seam and joint testing program was implemented as part of the structural validation. This method split each of the parachute structural joints into discrete tensile tests designed to duplicate the loading of each joint. Breaking strength data collected from destructive pull testing was then used to calculate the joint factor in the form of an efficiency. Joint efficiency is the percentage of the base material strength that remains after degradation due to sewing or interaction with other components; it is used interchangeably with joint factor in this paper. Parachute materials vary in type-mainly cord, tape, webbing, and cloth -which require different test fixtures and joint sample construction methods. This paper defines guidelines for designing and testing samples based on materials and test goals. Using the test methodology and analysis approach detailed in this paper, the minimum joint factor for each parachute component can be formulated. The joint factors can then be used to calculate the design factor and margin of safety for that component, a critical part of the design verification process.

  1. Implementation of a Shoulder Soft Tissue Injury Triage Service in a UK NHS Teaching Hospital Improves Time to Surgery for Acute Rotator Cuff Tears.

    PubMed Central

    Bateman, Marcus; Davies-Jones, Gareth; Tambe, Amol; Clark, David I

    2016-01-01

    Shoulder problems account for 2.4% of GP consultations in the United Kingdom and of those 70% are related to the rotator cuff. Many rotator cuff tears are of a degenerate nature but they can occur as a result of trauma in 8% of cases. Evidence suggests that patients with traumatic rotator cuff tears gain a better outcome in terms of pain and function if the tear is repaired early after injury. A specialist shoulder soft tissue injury clinic was set up in a large UK NHS teaching hospital with the primary purpose in the first year to halve the length of time patients with traumatic rotator cuff tears had to wait to consult a specialist and double the number of patients undergoing surgical repair within three months. The secondary purpose was to ensure that the new clinic was utilised to capacity by the end of the first year. The clinic was later expanded to manage patients with acute glenohumeral joint (GHJ) or acromioclavicular joint (ACJ) dislocations and identify those patients requiring surgical stabilisation. The new service involved referral of all patients presenting to the Accident & Emergency department with recent shoulder trauma and either an inability to raise the arm over shoulder height with a normal set of radiographs, or a confirmed GHJ or ACJ dislocation; to a specialist clinic run by an experienced upper limb physiotherapist. Patients were reassessed and referred for further imaging if required. Those patients found to have traumatic rotator cuff tears or structural instability lesions were listed for expedited surgery. The clinic ran alongside a consultant-led fracture clinic giving fast access to surgical decision-making. The service was reviewed after 3, 6, and 12 months and findings compared to a sample of 30 consecutive patients having undergone rotator cuff repair surgery via the previous pathway. 144 patients were referred to the clinic in the first year: 62 with rotator cuff symptoms, 38 with GHJ instability, 13 with ACJ instability, and 33

  2. Achieving joint benefits from joint implementation

    SciTech Connect

    Moomaw, W.R.

    1995-11-01

    Joint Implementation (JI) appears to have been born with Applied Energy Services Guatemala project in 1988. That project, to plant 52 million trees, protect existing forests from cutting and fire, and enhance rural development, is being implemented by CARE Guatemala to offset 120 per cent of the emissions of a small coal burning power plant that has been built in Connecticut. Since that time, several utilities and governments have initiated additional projects. Not all of these necessarily consist of tree planting in other countries, but may consist of energy efficiency or energy conservation programs designed to reduce carbon emissions by at least as much as the additional releases from a new facility. All JI projects share the characteristic of linking the release of greenhouse gases in an industrial country with an offset that reduces or absorbs a comparable amount in another country. The emitter in the industrial country is willing to pay for the reduction elsewhere because costs are less than they would be at home.

  3. Phase 1 Program Joint Report

    NASA Technical Reports Server (NTRS)

    Nield, George C. (Editor); Vorobiev, Pavel Mikhailovich (Editor)

    1999-01-01

    This report consists of inputs from each of the Phase I Program Joint Working Groups. The Working Groups were tasked to describe the organizational structure and work processes that they used during the program, joint accomplishments, lessons learned, and applications to the International Space Station Program. This report is a top-level joint reference document that contains information of interest to both countries.

  4. Double slotted socket spherical joint

    DOEpatents

    Bieg, Lothar F.; Benavides, Gilbert L.

    2001-05-22

    A new class of spherical joints is disclosed. These spherical joints are capable of extremely large angular displacements (full cone angles in excess of 270.degree.), while exhibiting no singularities or dead spots in their range of motion. These joints can improve or simplify a wide range of mechanical devices.

  5. Swivel Joint For Liquid Nitrogen

    NASA Technical Reports Server (NTRS)

    Milner, James F.

    1988-01-01

    Swivel joint allows liquid-nitrogen pipe to rotate through angle of 100 degree with respect to mating pipe. Functions without cracking hard foam insulation on lines. Pipe joint rotates on disks so mechanical stress not transmitted to thick insulation on pipes. Inner disks ride on fixed outer disks. Disks help to seal pressurized liquid nitrogen flowing through joint.

  6. Joint hypermobility syndrome pain.

    PubMed

    Grahame, Rodney

    2009-12-01

    Joint hypermobility syndrome (JHS) was initially defined as the occurrence of musculoskeletal symptoms in the presence of joint laxity and hypermobility in otherwise healthy individuals. It is now perceived as a commonly overlooked, underdiagnosed, multifaceted, and multisystemic heritable disorder of connective tissue (HDCT), which shares many of the phenotypic features of other HDCTs such as Marfan syndrome and Ehlers-Danlos syndrome. Whereas the additional flexibility can confer benefits in terms of mobility and agility, adverse effects of tissue laxity and fragility can give rise to clinical consequences that resonate far beyond the confines of the musculoskeletal system. There is hardly a clinical specialty to be found that is not touched in one way or another by JHS. Over the past decade, it has become evident that of all the complications that may arise in JHS, chronic pain is arguably the most menacing and difficult to treat. PMID:19889283

  7. Laundry joint venture.

    PubMed

    Giancola, D; Voyvodich, M

    1984-12-01

    Many hospitals are concerned about the loss of control which is associated with contracting for linen service. On the the hand, many laundries do not have the resources or experience to serve hospitals in a comprehensive and trouble-free manner. In many communities a joint venture, such as the one described here, can successfully combine the interests of the hospital and laundry communities without causing the hospitals to lose control of the service and without requiring the laundry operator to have detailed knowledge of hospital operations. As more hospitals opt for contract service, and if this service is to be provided at the lowest total cost, the hospitals and the laundries must come to grips with the problems surrounding the laundry-hospital interface. A joint venture, such as that described here, is one way to accomplish this.

  8. Analysis of minor fractures associated with joints and faulted joints

    NASA Astrophysics Data System (ADS)

    Cruikshank, Kenneth M.; Zhao, Guozhu; Johnson, Arvid M.

    In this paper, we use fracture mechanics to interpret conditions responsible for secondary cracks that adorn joints and faulted joints in the Entrada Sandstone in Arches National Park, U.S.A. Because the joints in most places accommodated shearing offsets of a few mm to perhaps 1 dm, and thus became faulted joints, some of the minor cracks are due to faulting. However, in a few places where the shearing was zero, one can examine minor cracks due solely to interaction of joint segments at the time they formed. We recognize several types of minor cracks associated with subsequent faulting of the joints. One is the kink, a crack that occurs at the termination of a straight joint and whose trend is abruptly different from that of the joint. Kinks are common and should be studied because they contain a great deal of information about conditions during fracturing. The sense of kinking indicates the sense of shear during faulting: a kink that turns clockwise with respect to the direction of the main joint is a result of right-lateral shear, and a kink that turns counterclockwise is a result of left-lateral shear. Furthermore, the kink angle is related to the ratio of the shear stress responsible for the kinking to the normal stress responsible for the opening of the joint. The amount of opening of a joint at the time it faulted or even at the time the joint itself formed can be estimated by measuring the kink angle and the amount of strike-slip at some point along the faulted joint. Other fractures that form near terminations of pre-existing joints in response to shearing along the joint are horsetail fractures. Similar short fractures can occur anywhere along the length of the joints. The primary value in recognizing these fractures is that they indicate the sense of faulting accommodated by the host fracture and the direction of maximum tension. Even where there has been insignificant regional shearing in the Garden Area, the joints can have ornate terminations. Perhaps

  9. Temporomandibular joint dislocation

    PubMed Central

    Sharma, Naresh Kumar; Singh, Akhilesh Kumar; Pandey, Arun; Verma, Vishal; Singh, Shreya

    2015-01-01

    Temporomandibular joint (TMJ) dislocation is an uncommon but debilitating condition of the facial skeleton. The condition may be acute or chronic. Acute TMJ dislocation is common in clinical practice and can be managed easily with manual reduction. Chronic recurrent TMJ dislocation is a challenging situation to manage. In this article, we discuss the comprehensive review of the different treatment modalities in managing TMJ dislocation. PMID:26668447

  10. Prosthetic elbow joint

    NASA Technical Reports Server (NTRS)

    Weddendorf, Bruce C. (Inventor)

    1994-01-01

    An artificial, manually positionable elbow joint for use in an upper extremity, above-elbow, prosthetic is described. The prosthesis provides a locking feature that is easily controlled by the wearer. The instant elbow joint is very strong and durable enough to withstand the repeated heavy loadings encountered by a wearer who works in an industrial, construction, farming, or similar environment. The elbow joint of the present invention comprises a turntable, a frame, a forearm, and a locking assembly. The frame generally includes a housing for the locking assembly and two protruding ears. The forearm includes an elongated beam having a cup-shaped cylindrical member at one end and a locking wheel having a plurality of holes along a circular arc on its other end with a central bore for pivotal attachment to the protruding ears of the frame. The locking assembly includes a collar having a central opening with a plurality of internal grooves, a plurality of internal cam members each having a chamfered surface at one end and a V-shaped slot at its other end; an elongated locking pin having a crown wheel with cam surfaces and locking lugs secured thereto; two coiled compression springs; and a flexible filament attached to one end of the elongated locking pin and extending from the locking assembly for extending and retracting the locking pin into the holes in the locking wheel to permit selective adjustment of the forearm relative to the frame. In use, the turntable is affixed to the upper arm part of the prosthetic in the conventional manner, and the cup-shaped cylindrical member on one end of the forearm is affixed to the forearm piece of the prosthetic in the conventional manner. The elbow joint is easily adjusted and locked between maximum flex and extended positions.

  11. 49 CFR 213.351 - Rail joints.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Rail joints. 213.351 Section 213.351... Rail joints. (a) Each rail joint, insulated joint, and compromise joint shall be of a structurally sound design and dimensions for the rail on which it is applied. (b) If a joint bar is cracked,...

  12. 17 CFR 300.105 - Joint accounts.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 17 Commodity and Securities Exchanges 4 2014-04-01 2014-04-01 false Joint accounts. 300.105... Customers of Sipc Members § 300.105 Joint accounts. (a) A joint account shall be deemed to be a “qualifying joint account” if it is owned jointly, whether by the owners thereof as joint tenants with the right...

  13. 17 CFR 300.105 - Joint accounts.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 17 Commodity and Securities Exchanges 3 2012-04-01 2012-04-01 false Joint accounts. 300.105... Customers of Sipc Members § 300.105 Joint accounts. (a) A joint account shall be deemed to be a “qualifying joint account” if it is owned jointly, whether by the owners thereof as joint tenants with the right...

  14. 17 CFR 300.105 - Joint accounts.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 17 Commodity and Securities Exchanges 3 2011-04-01 2011-04-01 false Joint accounts. 300.105... Customers of Sipc Members § 300.105 Joint accounts. (a) A joint account shall be deemed to be a “qualifying joint account” if it is owned jointly, whether by the owners thereof as joint tenants with the right...

  15. 17 CFR 300.105 - Joint accounts.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 17 Commodity and Securities Exchanges 3 2013-04-01 2013-04-01 false Joint accounts. 300.105... Customers of Sipc Members § 300.105 Joint accounts. (a) A joint account shall be deemed to be a “qualifying joint account” if it is owned jointly, whether by the owners thereof as joint tenants with the right...

  16. 49 CFR 213.351 - Rail joints.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Rail joints. 213.351 Section 213.351... Rail joints. (a) Each rail joint, insulated joint, and compromise joint shall be of a structurally sound design and dimensions for the rail on which it is applied. (b) If a joint bar is cracked,...

  17. 49 CFR 213.351 - Rail joints.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Rail joints. 213.351 Section 213.351... Rail joints. (a) Each rail joint, insulated joint, and compromise joint shall be of a structurally sound design and dimensions for the rail on which it is applied. (b) If a joint bar is cracked,...

  18. 49 CFR 213.351 - Rail joints.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Rail joints. 213.351 Section 213.351... Rail joints. (a) Each rail joint, insulated joint, and compromise joint shall be of a structurally sound design and dimensions for the rail on which it is applied. (b) If a joint bar is cracked,...

  19. 49 CFR 213.351 - Rail joints.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Rail joints. 213.351 Section 213.351... Rail joints. (a) Each rail joint, insulated joint, and compromise joint shall be of a structurally sound design and dimensions for the rail on which it is applied. (b) If a joint bar is cracked,...

  20. 17 CFR 300.105 - Joint accounts.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Joint accounts. 300.105... Customers of Sipc Members § 300.105 Joint accounts. (a) A joint account shall be deemed to be a “qualifying joint account” if it is owned jointly, whether by the owners thereof as joint tenants with the right...

  1. Influence of joint topology on the formation of brazed joints

    NASA Astrophysics Data System (ADS)

    Sekulic, Dusan P.; Zellmer, Benjamin P.; Nigro, Nicholas

    2001-09-01

    This paper discusses the influence of joint topology on the formation of brazed joints. For the purposes of this study, the joint topology is defined by dimensionless parameters that characterize: (i) the geometry of the mating surfaces (shape and configuration), (ii) the gap between bonded parts (clearance and tolerances), (iii) the joint orientation in the gravity field and (iv) the volume of the joint. The influence of these parameters is presented for several joints with a topology that is typically found in the manufacture of compact heat exchangers. The results were obtained by employing a method that is based on a variational principle and minimization of the potential energy of the molten aluminium liquid metal just prior to the onset of solidification. The method, which was verified by comparison with experimental data obtained from controlled atmosphere brazing of aluminium alloys, is discussed in an accompanying paper.

  2. Joint hypermobility syndrome.

    PubMed

    Fikree, Asma; Aziz, Qasim; Grahame, Rodney

    2013-05-01

    Although perceived as a rare condition, joint hypermobility syndrome is common. Its prevalence in rheumatology clinics is extremely high. Early estimates suggest that it may be the most common of all rheumatologic conditions. The problem lies in the general lack of awareness of the syndrome, its means of recognition, and the resultant failure to diagnose it correctly when present. It is a worldwide problem. This article provides an overview of hypermobility and hypermobility syndrome, stressing its multisystemic nature and the negative impact that it may have on quality of life, with particular reference to gastrointestinal involvement. PMID:23597972

  3. Arthroscopy and joint lavage.

    PubMed

    Ayral, Xavier

    2005-06-01

    Arthroscopy is used by rheumatologists for research purposes in cases with knee osteoarthritis and inflammatory arthritis. This chapter explains the technical characteristics of 'research arthroscopy' including the simplification of the procedure, video-recording, as well as risks and training. Lavage of the knee joint is proposed as a treatment procedure for osteoarthritis and inflammatory and septic arthritis. Tidal irrigation and the two-needle technique of lavage are described. In the absence of clear predictive factors for efficacy, the indications for these techniques are a matter of debate. PMID:15939366

  4. Joint bone radiobiology workshop

    SciTech Connect

    Tomich, P.A.

    1991-01-01

    The Joint Bone Radiobiology Workshop was held on July 12--13, 1991 in Toronto, Canada. This document contains the papers presented at the meeting. The five sections were: Dose-effects, Endogenous Cofactors, Tumorigenesis, New Methods and Medical Implications. The papers covered risk assessment, tissue distribution of radionuclides, lifetime studies, biological half-lifes, the influence of age at time of exposure, tumor induction by different radionuclides, microscopic localization of radionuclides, and nuclear medicine issues including tissue distribution in the skeleton and bone marrow transplantation. (MHB)

  5. Surgery center joint ventures.

    PubMed

    Zasa, R J

    1999-01-01

    Surgery centers have been accepted as a cost effective, patient friendly vehicle for delivery of quality ambulatory care. Hospitals and physician groups also have made them the vehicles for coming together. Surgery centers allow hospitals and physicians to align incentives and share benefits. It is one of the few types of health care businesses physicians can own without anti-fraud and abuse violation. As a result, many surgery center ventures are now jointly owned by hospitals and physician groups. This article outlines common structures that have been used successfully to allow both to own and govern surgery centers.

  6. Glenohumeral Joint Injections

    PubMed Central

    Gross, Christopher; Dhawan, Aman; Harwood, Daniel; Gochanour, Eric; Romeo, Anthony

    2013-01-01

    Context: Intra-articular injections into the glenohumeral joint are commonly performed by musculoskeletal providers, including orthopaedic surgeons, family medicine physicians, rheumatologists, and physician assistants. Despite their frequent use, there is little guidance for injectable treatments to the glenohumeral joint for conditions such as osteoarthritis, adhesive capsulitis, and rheumatoid arthritis. Evidence Acquisition: We performed a comprehensive review of the available literature on glenohumeral injections to help clarify the current evidence-based practice and identify deficits in our understanding. We searched MEDLINE (1948 to December 2011 [week 1]) and EMBASE (1980 to 2011 [week 49]) using various permutations of intra-articular injections AND (corticosteroid OR hyaluronic acid) and (adhesive capsulitis OR arthritis). Results: We identified 1 and 7 studies that investigated intra-articular corticosteroid injections for the treatment of osteoarthritis and adhesive capsulitis, respectively. Two and 3 studies investigated the use of hyaluronic acid in osteoarthritis and adhesive capsulitis, respectively. One study compared corticosteroids and hyaluronic acid injections in the treatment of osteoarthritis, and another discussed adhesive capsulitis. Conclusion: Based on existing studies and their level of evidence, there is only expert opinion to guide corticosteroid injection for osteoarthritis as well as hyaluronic acid injection for osteoarthritis and adhesive capsulitis. PMID:24427384

  7. Jointly Sponsored Research Program

    SciTech Connect

    Everett A. Sondreal; John G. Hendrikson; Thomas A. Erickson

    2009-03-31

    U.S. Department of Energy (DOE) Cooperative Agreement DE-FC26-98FT40321 funded through the Office of Fossil Energy and administered at the National Energy Technology Laboratory (NETL) supported the performance of a Jointly Sponsored Research Program (JSRP) at the Energy & Environmental Research Center (EERC) with a minimum 50% nonfederal cost share to assist industry in commercializing and effectively applying highly efficient, nonpolluting energy systems that meet the nation's requirements for clean fuels, chemicals, and electricity in the 21st century. The EERC in partnership with its nonfederal partners jointly performed 131 JSRP projects for which the total DOE cost share was $22,716,634 (38%) and the nonfederal share was $36,776,573 (62%). Summaries of these projects are presented in this report for six program areas: (1) resource characterization and waste management, (2) air quality assessment and control, (3) advanced power systems, (4) advanced fuel forms, (5) value-added coproducts, and (6) advanced materials. The work performed under this agreement addressed DOE goals for reductions in CO{sub 2} emissions through efficiency, capture, and sequestration; near-zero emissions from highly efficient coal-fired power plants; environmental control capabilities for SO{sub 2}, NO{sub x}, fine respirable particulate (PM{sub 2.5}), and mercury; alternative transportation fuels including liquid synfuels and hydrogen; and synergistic integration of fossil and renewable resources.

  8. Metal to ceramic sealed joint

    DOEpatents

    Lasecki, J.V.; Novak, R.F.; McBride, J.R.

    1991-08-27

    A metal to ceramic sealed joint which can withstand wide variations in temperature and maintain a good seal is provided for use in a device adapted to withstand thermal cycling from about 20 to about 1000 degrees C. The sealed joint includes a metal member, a ceramic member having an end portion, and an active metal braze forming a joint to seal the metal member to the ceramic member. The joint is positioned remote from the end portion of the ceramic member to avoid stresses at the ends or edges of the ceramic member. The sealed joint is particularly suited for use to form sealed metal to ceramic joints in a thermoelectric generator such as a sodium heat engine where a solid ceramic electrolyte is joined to metal parts in the system. 11 figures.

  9. Metal to ceramic sealed joint

    DOEpatents

    Lasecki, John V.; Novak, Robert F.; McBride, James R.

    1991-01-01

    A metal to ceramic sealed joint which can withstand wide variations in temperature and maintain a good seal is provided for use in a device adapted to withstand thermal cycling from about 20 to about 1000 degrees C. The sealed joint includes a metal member, a ceramic member having an end portion, and an active metal braze forming a joint to seal the metal member to the ceramic member. The joint is positioned remote from the end portion of the ceramic member to avoid stresses at the ends or edges of the ceramic member. The sealed joint is particularly suited for use to form sealed metal to ceramic joints in a thermoelectric generator such as a sodium heat engine where a solid ceramic electrolyte is joined to metal parts in the system.

  10. Ball-joint grounding ring

    NASA Technical Reports Server (NTRS)

    Aperlo, P. J. A.; Buck, P. A.; Weldon, V. A.

    1981-01-01

    In ball and socket joint where electrical insulator such as polytetrafluoroethylene is used as line to minimize friction, good electrical contact across joint may be needed for lightning protection or to prevent static-charge build-up. Electrical contact is maintained by ring of spring-loaded fingers mounted in socket. It may be useful in industry for cranes, trailers, and other applications requiring ball and socket joint.

  11. OIG targets contractual joint ventures.

    PubMed

    O'Hare, Patrick K

    2003-09-01

    A recent OIG Special Advisory Bulletin raises questions for providers involved in joint ventures. The Bulletin describes several characteristics that the OIG views as potentially suspect, including a referral stream controlled by the provider initiating the joint venture and the use of a wholly owned subsidiary of the provider to bill and collect for services. According to the OIG, profits paid by the subsidiary to the provider owner in such "suspect contractual joint ventures" could constitute illegal remuneration for referrals.

  12. Expression of joint moment in the joint coordinate system.

    PubMed

    Desroches, Guillaume; Chèze, Laurence; Dumas, Raphaël

    2010-11-01

    The question of using the nonorthogonal joint coordinate system (JCS) to report joint moments has risen in the literature. However, the expression of joint moments in a nonorthogonal system is still confusing. The purpose of this paper is to present a method to express any 3D vector in a nonorthogonal coordinate system. The interpretation of these expressions in the JCS is clarified and an example for the 3D joint moment vector at the shoulder and the knee is given. A nonorthogonal projection method is proposed based on the mixed product. These nonorthogonal projections represent, for a 3D joint moment vector, the net mechanical action on the JCS axes. Considering the net mechanical action on each axis seems important in order to assess joint resistance in the JCS. The orthogonal projections of the same 3D joint moment vector on the JCS axes can be characterized as "motor torque." However, this interpretation is dependent on the chosen kinematic model. The nonorthogonal and orthogonal projections of shoulder joint moment during wheelchair propulsion and knee joint moment during walking were compared using root mean squares (rmss). rmss showed differences ranging from 6 N m to 22.3 N m between both projections at the shoulder, while differences ranged from 0.8 N m to 3.0 N m at the knee. Generally, orthogonal projections were of lower amplitudes than nonorthogonal projections at both joints. The orthogonal projection on the proximal or distal coordinates systems represents the net mechanical actions on each axis, which is not the case for the orthogonal projection (i.e., motor torque) on JCS axes. In order to represent the net action at the joint in a JCS, the nonorthogonal projection should be used.

  13. Rotary Joint for Heat Transfer

    NASA Technical Reports Server (NTRS)

    Shauback, R.

    1986-01-01

    Rotary joint exchanges heat between two heat pipes - one rotating and one stationary. Joint accommodates varying heat loads with little temperature drop across interface. According to concept, heat pipe enters center of disklike stationary section of joint. There, wicks in central artery of heat pipe separate into multiple strands that lead to concentric channels on rotaryinterface side of stationary disk. Thin layer of liquid sodium/potassium alloy carries heat from one member of rotary joint to other. Liquid conducts heat efficiently while permitting relative motion between members. Polypropylene rings contain liquid without interfering with rotation.

  14. Variable Joint Elasticities in Running

    NASA Astrophysics Data System (ADS)

    Peter, Stephan; Grimmer, Sten; Lipfert, Susanne W.; Seyfarth, Andre

    In this paper we investigate how spring-like leg behavior in human running is represented at joint level. We assume linear torsion springs in the joints and between the knee and the ankle joint. Using experimental data of the leg dynamics we compute how the spring parameters (stiffness and rest angles) change during gait cycle. We found that during contact the joints reveal elasticity with strongly changing parameters and compare the changes of different parameters for different spring arrangements. The results may help to design and improve biologically inspired spring mechanisms with adjustable parameters.

  15. Joint shape morphogenesis precedes cavitation of the developing hip joint

    PubMed Central

    Nowlan, Niamh C; Sharpe, James

    2014-01-01

    The biology and mechanobiology of joint cavitation have undergone extensive investigation, but we have almost no understanding of the development of joint shape. Joint morphogenesis, the development of shape, has been identified as the ‘least understood aspect of joint formation’ (2005, Birth Defects Res C Embryo Today 75, 237), despite the clinical relevance of shape morphogenesis to postnatal skeletal malformations such as developmental dysplasia of the hip. In this study, we characterise development of early hip joint shape in the embryonic chick using direct capture 3D imaging. Contrary to formerly held assumptions that cavitation precedes morphogenesis in joint development, we have found that the major anatomical features of the adult hip are present at Hamburger Hamilton (HH)32, a full day prior to cavitation of the joint at HH34. We also reveal that the pelvis undergoes significant changes in orientation with respect to the femur, despite the lack of a joint cavity between the rudiments. Furthermore, we have identified the appearance of the ischium and pubis several developmental stages earlier than was previously reported, illustrating the value and importance of direct capture 3D imaging. PMID:24266523

  16. Passive Ball Capture Joint

    NASA Technical Reports Server (NTRS)

    Cloyd, Richard A. (Inventor); Bryan, Thomas C. (Inventor)

    2003-01-01

    A passive ball capture joint has a sleeve with a plurality of bores distributed about a circumference thereof and formed therethrough at an acute angle relative to the sleeve's longitudinal axis. A spring-loaded retainer is slidingly fitted in each bore and is biased such that, if allowed, will extend at least partially into the sleeve to retain a ball therein. A ring, rotatably mounted about the bores, has an interior wall defining a plurality of shaped races that bear against the spring-loaded retainers. A mechanized rotational force producer is coupled to the ring. The ring can be rotated from a first position (that presses the retainers into the sleeve to lock the ball in place) to a second position (that allows the retainers to springback out of the sleeve to release the ball).

  17. CRUCIFORM CONTROL ROD JOINT

    DOEpatents

    Thorp, A.G. II

    1962-08-01

    An invention is described which relates to nuclear reactor control rod components and more particularly to a joint between cruciform control rod members and cruciform control rod follower members. In one embodiment this invention provides interfitting crossed arms at adjacent ends of a control rod and its follower in abutting relation. This holds the members against relative opposite longitudinal movement while a compression member keys the arms against relative opposite rotation around a common axis. Means are also provided for centering the control rod and its follower on a common axis and for selectively releasing the control rod from its follower for the insertion of a replacement of the control rod and reuse of the follower. (AEC)

  18. Corynebacterium Prosthetic Joint Infection

    PubMed Central

    Cazanave, Charles; Greenwood-Quaintance, Kerryl E.; Hanssen, Arlen D.

    2012-01-01

    Identification of Corynebacterium species may be challenging. Corynebacterium species are occasional causes of prosthetic joint infection (PJI), but few data are available on the subject. Based on the literature, C. amycolatum, C. aurimucosum, C. jeikeium, and C. striatum are the most common Corynebacterium species that cause PJI. We designed a rapid PCR assay to detect the most common human Corynebacterium species, with a specific focus on PJI. A polyphosphate kinase gene identified using whole-genome sequence was targeted. The assay differentiates the antibiotic-resistant species C. jeikeium and C. urealyticum from other species in a single assay. The assay was applied to a collection of human Corynebacterium isolates from multiple clinical sources, and clinically relevant species were detected. The assay was then tested on Corynebacterium isolates specifically associated with PJI; all were detected. We also describe the first case of C. simulans PJI. PMID:22337986

  19. Temporomandibular joint vibration in bruxers.

    PubMed

    Li, Xueling; Lin, Xuefeng; Wang, Yan

    2009-07-01

    Temporomandibular joint vibration is considered an important physical sign of joint dysfunction and/or joint pathology. The aim of this study was to compare the difference of joint vibration between bruxers and asymptomatic individuals, evaluate the effect of bruxism on the temporomandibular joint (TMJ) and the association between bruxism and temporomandibular disorders. Twenty-four (24) bruxers and 16 asymptomatic subjects were included in the study. Bilateral joint vibrations with jaw tracking were recorded using a TMJ detecting instrument during rhythmic jaw opening and closing movement. The results showed that the vibratory energy and amplitude of the moderate to severe bruxers were significantly higher than that of the mild bruxers and asymptomatic subjects. The percentage of joint vibration occurrence in asymptomatic subjects, mild bruxers, and moderate to severe bruxers was 75.0%, 77.8%, and 100%, respectively. It was concluded that bruxism might induce abnormal joint vibrations, and that the energy of abnormal vibrations might increase with the degree of bruxism.

  20. Review of Rock Joint Models

    SciTech Connect

    Morris, J P

    2003-06-06

    This report discusses several constitutive models for joint behavior with emphasis upon the experimental data which motivates them. Particular emphasis is placed upon data available for granite. The LDEC joint model is presented in detail and LDEC simulations using this model are compared against data from constant normal stiffness and constant normal load tests.

  1. Robotic joint experiments under ultravacuum

    NASA Technical Reports Server (NTRS)

    Borrien, A.; Petitjean, L.

    1988-01-01

    First, various aspects of a robotic joint development program, including gearbox technology, electromechanical components, lubrication, and test results, are discussed. Secondly, a test prototype of the joint allowing simulation of robotic arm dynamic effects is presented. This prototype is tested under vacuum with different types of motors and sensors to characterize the functional parameters: angular position error, mechanical backlash, gearbox efficiency, and lifetime.

  2. Joint Attention and Early Language.

    ERIC Educational Resources Information Center

    Tomasello, Michael; Farrar, Michael Jeffrey

    1986-01-01

    Findings from studies exploring role of joint attentional focus in children's acquisition of language indicated that language of 24 mothers and their 15- to 21-month-olds inside episodes of joint attentional focus involved more utterances, shorter sentences, more comments, and longer conversations than outside of episodes. Also, object references…

  3. Exercise and the Knee Joint.

    ERIC Educational Resources Information Center

    Clarke, H. Harrison, Ed.

    1976-01-01

    This report by the President's Council on Physical Fitness and Sports examines the effects of various forms of physical exercise on the knee joint which, because of its vulnerability, is especially subject to injury. Discussion centers around the physical characteristics of the joint, commonly used measurements for determining knee stability,…

  4. Structuring managed care joint ventures.

    PubMed

    Williams, L

    1995-08-01

    Providers that undertake joint ventures to secure managed care contracts must understand the important governance, operational, legal, and political issues involved. Careful planning in all these areas can help ensure that the joint venture will meet its goals and avoid problems such as inappropriately negotiated contracts and legal violations.

  5. 14 CFR 27.935 - Shafting joints.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Shafting joints. 27.935 Section 27.935... STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 27.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation must...

  6. 14 CFR 29.935 - Shafting joints.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Shafting joints. 29.935 Section 29.935... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 29.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation...

  7. 7 CFR 97.14 - Joint applicants.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 3 2014-01-01 2014-01-01 false Joint applicants. 97.14 Section 97.14 Agriculture... PLANT VARIETY AND PROTECTION The Application § 97.14 Joint applicants. (a) Joint owners shall file a joint application by signing as joint applicants. (b) If an application for certificate is made by...

  8. 14 CFR 27.935 - Shafting joints.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Shafting joints. 27.935 Section 27.935... STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 27.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation must...

  9. 7 CFR 97.14 - Joint applicants.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 3 2012-01-01 2012-01-01 false Joint applicants. 97.14 Section 97.14 Agriculture... PLANT VARIETY AND PROTECTION The Application § 97.14 Joint applicants. (a) Joint owners shall file a joint application by signing as joint applicants. (b) If an application for certificate is made by...

  10. 14 CFR 27.935 - Shafting joints.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Shafting joints. 27.935 Section 27.935... STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 27.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation must...

  11. 14 CFR 29.935 - Shafting joints.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Shafting joints. 29.935 Section 29.935... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 29.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation...

  12. 20 CFR 410.645 - Joint hearings.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Joint hearings. 410.645 Section 410.645..., Finality of Decisions, and Representation of Parties § 410.645 Joint hearings. When two or more hearings... joint hearing, a joint hearing may not be held. Where joint hearings are held, a single record of...

  13. 49 CFR 213.121 - Rail joints.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Rail joints. 213.121 Section 213.121..., DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.121 Rail joints. (a) Each rail joint, insulated joint, and compromise joint shall be of a structurally sound design and dimensions...

  14. 49 CFR 213.121 - Rail joints.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Rail joints. 213.121 Section 213.121..., DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.121 Rail joints. (a) Each rail joint, insulated joint, and compromise joint shall be of a structurally sound design and dimensions...

  15. 49 CFR 213.121 - Rail joints.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Rail joints. 213.121 Section 213.121..., DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.121 Rail joints. (a) Each rail joint, insulated joint, and compromise joint shall be of a structurally sound design and dimensions...

  16. 49 CFR 213.121 - Rail joints.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Rail joints. 213.121 Section 213.121..., DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.121 Rail joints. (a) Each rail joint, insulated joint, and compromise joint shall be of a structurally sound design and dimensions...

  17. 37 CFR 1.45 - Joint inventors.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2012-07-01 2012-07-01 false Joint inventors. 1.45 Section... Patent § 1.45 Joint inventors. (a) Joint inventors must apply for a patent jointly and each must make the... joint application under 35 U.S.C. 116. If multiple inventors are named in a provisional...

  18. 37 CFR 1.45 - Joint inventors.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Joint inventors. 1.45 Section... Patent § 1.45 Joint inventors. (a) Joint inventors must apply for a patent jointly and each must make the... joint application under 35 U.S.C. 116. If multiple inventors are named in a provisional...

  19. 7 CFR 97.14 - Joint applicants.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 3 2011-01-01 2011-01-01 false Joint applicants. 97.14 Section 97.14 Agriculture... PLANT VARIETY AND PROTECTION The Application § 97.14 Joint applicants. (a) Joint owners shall file a joint application by signing as joint applicants. (b) If an application for certificate is made by...

  20. 14 CFR 27.935 - Shafting joints.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Shafting joints. 27.935 Section 27.935... STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 27.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation must...

  1. 14 CFR 29.935 - Shafting joints.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Shafting joints. 29.935 Section 29.935... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 29.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation...

  2. 14 CFR 29.935 - Shafting joints.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Shafting joints. 29.935 Section 29.935... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 29.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation...

  3. 7 CFR 97.14 - Joint applicants.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Joint applicants. 97.14 Section 97.14 Agriculture... PLANT VARIETY AND PROTECTION The Application § 97.14 Joint applicants. (a) Joint owners shall file a joint application by signing as joint applicants. (b) If an application for certificate is made by...

  4. 20 CFR 410.645 - Joint hearings.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Joint hearings. 410.645 Section 410.645..., Finality of Decisions, and Representation of Parties § 410.645 Joint hearings. When two or more hearings... joint hearing, a joint hearing may not be held. Where joint hearings are held, a single record of...

  5. 49 CFR 213.121 - Rail joints.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Rail joints. 213.121 Section 213.121..., DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.121 Rail joints. (a) Each rail joint, insulated joint, and compromise joint shall be of a structurally sound design and dimensions...

  6. 7 CFR 97.14 - Joint applicants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 3 2013-01-01 2013-01-01 false Joint applicants. 97.14 Section 97.14 Agriculture... PLANT VARIETY AND PROTECTION The Application § 97.14 Joint applicants. (a) Joint owners shall file a joint application by signing as joint applicants. (b) If an application for certificate is made by...

  7. 14 CFR 29.935 - Shafting joints.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Shafting joints. 29.935 Section 29.935... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 29.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation...

  8. 37 CFR 1.45 - Joint inventors.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Joint inventors. 1.45 Section... Patent § 1.45 Joint inventors. (a) Joint inventors must apply for a patent jointly and each must make the... patent for an invention invented by them jointly, except as provided in § 1.47. (b) Inventors may...

  9. Method of forming a joint

    DOEpatents

    Butt, Darryl Paul; Cutler, Raymond Ashton; Rynders, Steven Walton; Carolan, Michael Francis

    2006-08-22

    A method of joining at least two sintered bodies to form a composite structure, including providing a first multicomponent metallic oxide having a perovskitic or fluorite crystal structure; providing a second sintered body including a second multicomponent metallic oxide having a crystal structure of the same type as the first; and providing at an interface a joint material containing at least one metal oxide containing at least one metal identically contained in at least one of the first and second multicomponent metallic oxides. The joint material is free of cations of Si, Ge, Sn, Pb, P and Te and has a melting point below the sintering temperatures of both sintered bodies. The joint material is heated to a temperature above the melting point of the metal oxide(s) and below the sintering temperatures of the sintered bodies to form the joint. Structures containing such joints are also disclosed.

  10. General joint hypermobility and temporomandibular joint derangement in adolescents.

    PubMed Central

    Westling, L; Mattiasson, A

    1992-01-01

    Joint mobility was assessed in each member of an epidemiological sample of 96 girls and 97 boys, 17 years old, and graded by means of the hypermobility score of Beighton et al. Twenty two per cent of the girls and 3% of the boys could perform five or more of the nine manoeuvres. The prevalence of symptoms and signs of internal derangement in the temporomandibular joint was higher in adolescents with hypermobility of joints (score greater than or equal to 5/9). In subjects with a high mobility score oral parafunctions (overuse) correlated more strongly with several signs and symptoms of craniomandibular disorder than in those with a low score. PMID:1540046

  11. Joint services electronics program

    NASA Astrophysics Data System (ADS)

    Peters, Leon, Jr.

    1992-11-01

    The report represents the fifteenth annual summary of The Ohio State University Joint Services Electronics Program (JSEP). The transfer of the compact range identification technology initiated under JSEP support for time domain studies continues to make large advances. We are also assisting Rockwell (Tulsa) to update their RCS facilities. This work is on a subcontract to the ESL from the Air Force. This has lead to involvement in the study of Ultra Wide Band radar systems. The research activities devoted to the Generalized Ray and Gaussian Beams continues. Our JSEP research continues to be expanded by external funding. This program is being expanded by use of such funds which are more focussed on the requirements of the sponsors which includes both the Air Force and the Navy. Our JSEP research continues to focus on electromagnetic related topics. There are four major electromagnetics areas that were pursued in the past year. The Diffraction Studies Work Unit has initiated research on a time domain version of the Uniform Theory of Diffraction. A second topic under the Diffraction Studies Work Unit involves further extensions of the generalized resistive boundary condition and the generalized impedance boundary condition. These have been applied to scattering from a chiral slab. A third topic of interest is the diffraction from a corner. A fourth task involves the reflection/diffraction of a Gaussian beam. This represents an approach to replace the usual ray optics solution for very complex geometries where the versatile ray optics solution becomes cumbersome.

  12. Arthritis: joints inflamed.

    PubMed

    Casey, Georgina

    2015-06-01

    ARTHRITIS IS a generic term for inflammatory joint disease. There are various forms of arthritis, including osteoarthritis, rheumatoid arthritis and spondyloarthritis. Arthritis can be a chronic debilitating condition or a transient effect of bacterial or viral infections. As a chronic condition, arthritis can cause loss of quality of life, disability and, with rheumatoid disease, early death. The economic burden of arthritis, in terms of management and loss of productivity due to disability, is high and set to increase with the ageing population. Recent advances in our understanding of the causes and progression of a number of forms of arthritis have raised hopes of better management and possible remission. Pharmacotherapy has moved from symptom management to addressing underlying disease processes. However, therapies that prevent or cure arthritis remain elusive. Current care for people with arthritis relies on a multidisciplinary approach and substantial pharmacological intervention. Nurses have a key role to play in guiding patients through treatment, ensuring they receive optimal therapy to reduce the impact of arthritis and its management on their lives.

  13. Qualification of improved joint heaters

    NASA Technical Reports Server (NTRS)

    Cook, M.

    1989-01-01

    Qualification testing of the Redesigned Solid Rocket Motor improved igniter-to-case joint and field joint heaters was conducted on the fired TEM-04 static test motor and was completed on 7 Sep. 1989. The purpose of the test was to certify the installation and performance of the improved joint heaters for use on flight motors. The changes incorporated in the improved heaters improve durability and should reduce handling damage. The igniter-to-case joint and field joint primary heater circuits were subjected to five 20-hr ON cycles. The heater redundant circuits were then subjected to one 20-hr ON cycle. Voltage, current, and temperature set point values were maintained within the specified limits for both heaters during each ON cycle. When testing was complete, both heaters were removed and inspected. No discolorations or any other anomalies were found on either of the heaters. Based on the successful completion of this test, it is recommended that the improved igniter-to-case joint and field joint heaters be used on future flight motors.

  14. Common Bolted Joint Analysis Tool

    NASA Technical Reports Server (NTRS)

    Imtiaz, Kauser

    2011-01-01

    Common Bolted Joint Analysis Tool (comBAT) is an Excel/VB-based bolted joint analysis/optimization program that lays out a systematic foundation for an inexperienced or seasoned analyst to determine fastener size, material, and assembly torque for a given design. Analysts are able to perform numerous what-if scenarios within minutes to arrive at an optimal solution. The program evaluates input design parameters, performs joint assembly checks, and steps through numerous calculations to arrive at several key margins of safety for each member in a joint. It also checks for joint gapping, provides fatigue calculations, and generates joint diagrams for a visual reference. Optimum fastener size and material, as well as correct torque, can then be provided. Analysis methodology, equations, and guidelines are provided throughout the solution sequence so that this program does not become a "black box:" for the analyst. There are built-in databases that reduce the legwork required by the analyst. Each step is clearly identified and results are provided in number format, as well as color-coded spelled-out words to draw user attention. The three key features of the software are robust technical content, innovative and user friendly I/O, and a large database. The program addresses every aspect of bolted joint analysis and proves to be an instructional tool at the same time. It saves analysis time, has intelligent messaging features, and catches operator errors in real time.

  15. Compliant Prosthetic Or Robotic Joint

    NASA Technical Reports Server (NTRS)

    Kerley, James J.; Eklund, Wayne D.

    1989-01-01

    Rotation partly free and partly restrained by resilience and damping. Joint includes U-shaped x- and y-axis frames joined by cables that cross in at center piece. The y-axis frame rotates about y-axis on roller bearing within predetermined angular range. The y-axis frame rotates slightly farther when arm strikes stop, because cables can twist. This mimics compliant resistance of knee joint reaching limit of its forward or backward motion. Used in prosthetic device to replace diseased or damage human joint, or in robot linkage to limit movement and cushion overloads.

  16. Joint ventures in health care.

    PubMed

    Pelfrey, S; Theisen, B A

    1989-04-01

    To remain competitive, many not-for-profit hospitals have turned to joint ventures with for-profit and other not-for-profit entities. The authors examine the organizational structures that are used most often to form joint ventures (contractual agreements, subsidiary corporations, partnerships, and not-for-profit title-holding corporations), as well as the advantages and disadvantages associated with each form. Nurse executives must be aware of the opportunities that joint ventures provide their institutions. These arrangements can help improve and expand services and profitability.

  17. Shoulder separation - aftercare

    MedlinePlus

    Separated shoulder - aftercare; Acromioclavicular joint separation - aftercare; A/C separation - aftercare ... slower if you have: Arthritis in your shoulder joint Damaged cartilage (cushioning tissue) between your collarbone and ...

  18. Osteochondral Lesions of Major Joints

    PubMed Central

    Durur-Subasi, Irmak; Durur-Karakaya, Afak; Yildirim, Omer Selim

    2015-01-01

    This paper provides information about osteochondral lesions (OCL) and example cases of OCL occurring in major joints, some of which are rarely seen. This simple tutorial is presented in question and answer format. PMID:26180500

  19. Campus/Industry Joint Ventures.

    ERIC Educational Resources Information Center

    McDonald, Eugene J.

    1985-01-01

    Opportunities for joint economic ventures of colleges and industry are discussed, and a variety of ventures undertaken by Duke University are outlined, including a health club, hotel, and office building. Tax and financing considerations are noted. (MSE)

  20. Joint probabilities and quantum cognition

    SciTech Connect

    Acacio de Barros, J.

    2012-12-18

    In this paper we discuss the existence of joint probability distributions for quantumlike response computations in the brain. We do so by focusing on a contextual neural-oscillator model shown to reproduce the main features of behavioral stimulus-response theory. We then exhibit a simple example of contextual random variables not having a joint probability distribution, and describe how such variables can be obtained from neural oscillators, but not from a quantum observable algebra.

  1. Rothia prosthetic knee joint infection.

    PubMed

    Trivedi, Manish N; Malhotra, Prashant

    2015-08-01

    Rothia species - Gram-positive pleomorphic bacteria that are part of the normal oral and respiratory flora - are commonly associated with dental cavities and periodontal disease although systemic infections have been described. We describe a 53-year-old female with rheumatoid arthritis complicated by prosthetic knee joint infection due to Rothia species, which was successfully treated by surgical removal of prosthesis and prolonged antimicrobial therapy. The issue of antibiotic prophylaxis before dental procedures among patients with prosthetic joint replacements is discussed.

  2. Pyrothermal treatment of welded joints

    SciTech Connect

    Serikov, S.V.; Idiyatullin, R.S.; Myakushkin, S.N.; Yaufman, V.V.

    1992-03-01

    The results of investigation of the structure and distribution of residual stresses in welded joints in pipes after heat treatment, which includes heating of the surface being treated due to combustion of plates formed from a thermite-type material of pyrotechnic composition, placed around the perimeter of the welded joint, and also an assessment of the level of residual stresses prior to and after pyrotechnic treatment demonstrated the promising nature of the proposed method. 5 refs., 5 figs.

  3. Joint probabilities and quantum cognition

    NASA Astrophysics Data System (ADS)

    de Barros, J. Acacio

    2012-12-01

    In this paper we discuss the existence of joint probability distributions for quantumlike response computations in the brain. We do so by focusing on a contextual neural-oscillator model shown to reproduce the main features of behavioral stimulus-response theory. We then exhibit a simple example of contextual random variables not having a joint probability distribution, and describe how such variables can be obtained from neural oscillators, but not from a quantum observable algebra.

  4. IRS memorandum limits joint ventures.

    PubMed

    Herman, A W

    1992-08-01

    Based on a new memorandum, the Internal Revenue Service (IRS) will be looking at joint hospital/physician activities with greater attention to the nuances of public versus private benefit. As a result, hospitals face greater risk of losing their tax-exempt status in the maze of joint ventures, physician recruitment, and practice acquisition. To be successful, ventures will have to be backed by sound reasoning and thorough documentation.

  5. "Fraud alert": joint venture arrangements.

    PubMed

    Vipperman, R M

    1989-01-01

    The Office of Inspector General of the Department of Health and Human Services recently issued a special "Fraud Alert" identifying those characteristics of joint venture arrangements that it views as indicators of potentially unlawful activity. As discussed in this article, participants in joint ventures should examine their arrangements to see if one or more of the questionable features are present, and, if so, should take steps to eliminate them, to the extent possible.

  6. Sound Transmission at Pipe Joints.

    NASA Astrophysics Data System (ADS)

    Servis, Dimitris C.

    Available from UMI in association with The British Library. A model was developed using beam and plane wave theory to describe the sound transmission at pipe joints. This approach greatly simplifies the modelling of the pipe joint and the solution is presented in a manner which can be applied in both the Frequency and the Time domain, for the solution of acoustic and fluid dynamics problems related to pipe joint transmission. This form of modelling can be extended to describe a wide range of pipe joints and discontinuities and lend itself to the study of piping networks by incorporating its solution in existing models used to describe the performance of large systems. A variety of experimental techniques have been explored and applied for the measurement of the sound transmission at pipe joints. The model predictions were found to be in good agreement with experimental data and form the basis of a simple and effective method for the study of sound transmission at pipe joints.

  7. 12 CFR 347.107 - Joint ventures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 5 2013-01-01 2013-01-01 false Joint ventures. 347.107 Section 347.107 Banks... INTERNATIONAL BANKING § 347.107 Joint ventures. (a) Joint ventures. If a bank, directly or indirectly, acquires or holds an equity interest in a foreign organization that is a joint venture, and the bank or...

  8. 47 CFR 76.912 - Joint certification.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Joint certification. 76.912 Section 76.912... CABLE TELEVISION SERVICE Cable Rate Regulation § 76.912 Joint certification. (a) Franchising authorities may apply for joint certification and may engage in joint regulation, including, but not limited...

  9. 49 CFR 234.233 - Rail joints.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Rail joints. 234.233 Section 234.233..., Inspection, and Testing Maintenance Standards § 234.233 Rail joints. Each non-insulated rail joint located... than joint bars and the bonds shall be maintained in such condition to ensure electrical conductivity....

  10. 14 CFR 23.693 - Joints.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Joints. 23.693 Section 23.693 Aeronautics... Systems § 23.693 Joints. Control system joints (in push-pull systems) that are subject to angular motion... factor may be reduced to 2.0 for joints in cable control systems. For ball or roller bearings,...

  11. 30 CFR 36.24 - Engine joints.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Engine joints. 36.24 Section 36.24 Mineral... Construction and Design Requirements § 36.24 Engine joints. (a) Cylinder head. The joint between the cylinder.... This joint shall provide an adequate flame barrier with the gasket in place. (b) Valve guides....

  12. 32 CFR 536.54 - Joint tortfeasors.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 3 2013-07-01 2013-07-01 false Joint tortfeasors. 536.54 Section 536.54... AGAINST THE UNITED STATES Investigation and Processing of Claims § 536.54 Joint tortfeasors. When joint... United States rather than pay the claim in full and then bring suit against the joint tortfeasor...

  13. 14 CFR 23.693 - Joints.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Joints. 23.693 Section 23.693 Aeronautics... Systems § 23.693 Joints. Control system joints (in push-pull systems) that are subject to angular motion... factor may be reduced to 2.0 for joints in cable control systems. For ball or roller bearings,...

  14. 49 CFR 234.233 - Rail joints.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Rail joints. 234.233 Section 234.233... joints. Each non-insulated rail joint located within the limits of a highway-rail grade crossing train detection circuit shall be bonded by means other than joint bars and the bonds shall be maintained in...

  15. 14 CFR 23.693 - Joints.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Joints. 23.693 Section 23.693 Aeronautics... Systems § 23.693 Joints. Control system joints (in push-pull systems) that are subject to angular motion... factor may be reduced to 2.0 for joints in cable control systems. For ball or roller bearings,...

  16. 42 CFR 422.1040 - Joint hearings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Joint hearings. 422.1040 Section 422.1040 Public...) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Appeal procedures for Civil Money Penalties § 422.1040 Joint... conference or hearing and conduct all proceedings jointly. If joint hearings are held, a single record of...

  17. 47 CFR 76.912 - Joint certification.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 4 2012-10-01 2012-10-01 false Joint certification. 76.912 Section 76.912... CABLE TELEVISION SERVICE Cable Rate Regulation § 76.912 Joint certification. (a) Franchising authorities may apply for joint certification and may engage in joint regulation, including, but not limited...

  18. 47 CFR 76.912 - Joint certification.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 4 2013-10-01 2013-10-01 false Joint certification. 76.912 Section 76.912... CABLE TELEVISION SERVICE Cable Rate Regulation § 76.912 Joint certification. (a) Franchising authorities may apply for joint certification and may engage in joint regulation, including, but not limited...

  19. 42 CFR 422.1040 - Joint hearings.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Joint hearings. 422.1040 Section 422.1040 Public...) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Appeal procedures for Civil Money Penalties § 422.1040 Joint... conference or hearing and conduct all proceedings jointly. If joint hearings are held, a single record of...

  20. 12 CFR 347.107 - Joint ventures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 5 2014-01-01 2014-01-01 false Joint ventures. 347.107 Section 347.107 Banks... INTERNATIONAL BANKING § 347.107 Joint ventures. (a) Joint ventures. If a bank, directly or indirectly, acquires or holds an equity interest in a foreign organization that is a joint venture, and the bank or...

  1. 49 CFR 234.233 - Rail joints.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Rail joints. 234.233 Section 234.233... joints. Each non-insulated rail joint located within the limits of a highway-rail grade crossing train detection circuit shall be bonded by means other than joint bars and the bonds shall be maintained in...

  2. 32 CFR 536.54 - Joint tortfeasors.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 3 2011-07-01 2009-07-01 true Joint tortfeasors. 536.54 Section 536.54 National... UNITED STATES Investigation and Processing of Claims § 536.54 Joint tortfeasors. When joint tortfeasors... United States rather than pay the claim in full and then bring suit against the joint tortfeasor...

  3. 14 CFR 23.693 - Joints.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Joints. 23.693 Section 23.693 Aeronautics... Systems § 23.693 Joints. Control system joints (in push-pull systems) that are subject to angular motion... factor may be reduced to 2.0 for joints in cable control systems. For ball or roller bearings,...

  4. 49 CFR 234.233 - Rail joints.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Rail joints. 234.233 Section 234.233..., Inspection, and Testing Maintenance Standards § 234.233 Rail joints. Each non-insulated rail joint located... than joint bars and the bonds shall be maintained in such condition to ensure electrical conductivity....

  5. 32 CFR 536.54 - Joint tortfeasors.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 3 2014-07-01 2014-07-01 false Joint tortfeasors. 536.54 Section 536.54... AGAINST THE UNITED STATES Investigation and Processing of Claims § 536.54 Joint tortfeasors. When joint... United States rather than pay the claim in full and then bring suit against the joint tortfeasor...

  6. 42 CFR 423.1040 - Joint hearings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Joint hearings. 423.1040 Section 423.1040 Public... § 423.1040 Joint hearings. When two or more affected parties have requested hearings and the same or... the prehearing conference or hearing and conduct all proceedings jointly. If joint hearings are...

  7. 47 CFR 76.912 - Joint certification.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 4 2011-10-01 2011-10-01 false Joint certification. 76.912 Section 76.912... CABLE TELEVISION SERVICE Cable Rate Regulation § 76.912 Joint certification. (a) Franchising authorities may apply for joint certification and may engage in joint regulation, including, but not limited...

  8. 32 CFR 536.54 - Joint tortfeasors.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Joint tortfeasors. 536.54 Section 536.54 National... UNITED STATES Investigation and Processing of Claims § 536.54 Joint tortfeasors. When joint tortfeasors... United States rather than pay the claim in full and then bring suit against the joint tortfeasor...

  9. 42 CFR 423.1040 - Joint hearings.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Joint hearings. 423.1040 Section 423.1040 Public... § 423.1040 Joint hearings. When two or more affected parties have requested hearings and the same or... the prehearing conference or hearing and conduct all proceedings jointly. If joint hearings are...

  10. 42 CFR 422.1040 - Joint hearings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Joint hearings. 422.1040 Section 422.1040 Public....1040 Joint hearings. When two or more affected parties have requested hearings and the same or... the prehearing conference or hearing and conduct all proceedings jointly. If joint hearings are...

  11. 49 CFR 234.233 - Rail joints.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Rail joints. 234.233 Section 234.233... joints. Each non-insulated rail joint located within the limits of a highway-rail grade crossing train detection circuit shall be bonded by means other than joint bars and the bonds shall be maintained in...

  12. 42 CFR 422.1040 - Joint hearings.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Joint hearings. 422.1040 Section 422.1040 Public....1040 Joint hearings. When two or more affected parties have requested hearings and the same or... the prehearing conference or hearing and conduct all proceedings jointly. If joint hearings are...

  13. 12 CFR 347.107 - Joint ventures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 5 2012-01-01 2012-01-01 false Joint ventures. 347.107 Section 347.107 Banks... INTERNATIONAL BANKING § 347.107 Joint ventures. (a) Joint ventures. If a bank, directly or indirectly, acquires or holds an equity interest in a foreign organization that is a joint venture, and the bank or...

  14. 21 CFR 26.73 - Joint Committee.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Joint Committee. 26.73 Section 26.73 Food and...Frameworkâ Provisions § 26.73 Joint Committee. (a) A Joint Committee consisting of representatives of the United States and the European Community (EC) will be established. The Joint Committee shall...

  15. 30 CFR 36.24 - Engine joints.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Engine joints. 36.24 Section 36.24 Mineral... Construction and Design Requirements § 36.24 Engine joints. (a) Cylinder head. The joint between the cylinder.... This joint shall provide an adequate flame barrier with the gasket in place. (b) Valve guides....

  16. 30 CFR 36.24 - Engine joints.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Engine joints. 36.24 Section 36.24 Mineral... Construction and Design Requirements § 36.24 Engine joints. (a) Cylinder head. The joint between the cylinder.... This joint shall provide an adequate flame barrier with the gasket in place. (b) Valve guides....

  17. 42 CFR 422.1040 - Joint hearings.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Joint hearings. 422.1040 Section 422.1040 Public....1040 Joint hearings. When two or more affected parties have requested hearings and the same or... the prehearing conference or hearing and conduct all proceedings jointly. If joint hearings are...

  18. 32 CFR 536.54 - Joint tortfeasors.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 3 2012-07-01 2009-07-01 true Joint tortfeasors. 536.54 Section 536.54 National... UNITED STATES Investigation and Processing of Claims § 536.54 Joint tortfeasors. When joint tortfeasors... United States rather than pay the claim in full and then bring suit against the joint tortfeasor...

  19. 30 CFR 36.24 - Engine joints.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Engine joints. 36.24 Section 36.24 Mineral... Construction and Design Requirements § 36.24 Engine joints. (a) Cylinder head. The joint between the cylinder.... This joint shall provide an adequate flame barrier with the gasket in place. (b) Valve guides....

  20. 30 CFR 36.24 - Engine joints.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Engine joints. 36.24 Section 36.24 Mineral... Construction and Design Requirements § 36.24 Engine joints. (a) Cylinder head. The joint between the cylinder.... This joint shall provide an adequate flame barrier with the gasket in place. (b) Valve guides....

  1. 21 CFR 26.73 - Joint Committee.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 1 2014-04-01 2014-04-01 false Joint Committee. 26.73 Section 26.73 Food and...Frameworkâ Provisions § 26.73 Joint Committee. (a) A Joint Committee consisting of representatives of the United States and the European Community (EC) will be established. The Joint Committee shall...

  2. 47 CFR 76.912 - Joint certification.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 4 2014-10-01 2014-10-01 false Joint certification. 76.912 Section 76.912... CABLE TELEVISION SERVICE Cable Rate Regulation § 76.912 Joint certification. (a) Franchising authorities may apply for joint certification and may engage in joint regulation, including, but not limited...

  3. 12 CFR 347.107 - Joint ventures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Joint ventures. 347.107 Section 347.107 Banks... INTERNATIONAL BANKING § 347.107 Joint ventures. (a) Joint ventures. If a bank, directly or indirectly, acquires or holds an equity interest in a foreign organization that is a joint venture, and the bank or...

  4. 38 CFR 4.45 - The joints.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false The joints. 4.45 Section... DISABILITIES Disability Ratings The Musculoskeletal System § 4.45 The joints. As regards the joints the factors... (from flail joint, resections, nonunion of fracture, relaxation of ligaments, etc.). (c)...

  5. 38 CFR 4.45 - The joints.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false The joints. 4.45 Section... DISABILITIES Disability Ratings The Musculoskeletal System § 4.45 The joints. As regards the joints the factors... (from flail joint, resections, nonunion of fracture, relaxation of ligaments, etc.). (c)...

  6. 38 CFR 4.45 - The joints.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false The joints. 4.45 Section... DISABILITIES Disability Ratings The Musculoskeletal System § 4.45 The joints. As regards the joints the factors... (from flail joint, resections, nonunion of fracture, relaxation of ligaments, etc.). (c)...

  7. 38 CFR 4.45 - The joints.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false The joints. 4.45 Section... DISABILITIES Disability Ratings The Musculoskeletal System § 4.45 The joints. As regards the joints the factors... (from flail joint, resections, nonunion of fracture, relaxation of ligaments, etc.). (c)...

  8. 38 CFR 4.45 - The joints.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false The joints. 4.45 Section... DISABILITIES Disability Ratings The Musculoskeletal System § 4.45 The joints. As regards the joints the factors... (from flail joint, resections, nonunion of fracture, relaxation of ligaments, etc.). (c)...

  9. Condylar hyperplasia following unilateral temporomandibular joint replacement.

    PubMed

    Machon, V; Levorova, J; Hirjak, D; Foltan, R

    2015-06-01

    Total joint replacement of the temporomandibular joint (TJR) can be associated with intraoperative and postoperative complications. We report herein the occurrence of a postoperative open bite malocclusion, the result of condylar hyperplasia affecting the non-operated joint at 1 year after unilateral total joint replacement. PMID:25662429

  10. Strength evaluation of socket joints

    NASA Technical Reports Server (NTRS)

    Rash, Larry C.

    1994-01-01

    This report documents the development of a set of equations that can be used to provide a relatively simple solution for identifying the strength of socket joints and for most cases avoid the need of more lengthy analyses. The analytical approach was verified by comparison of the contact load distributions to results obtained from a finite element analysis. The contacting surfaces for the specific joint in this analysis are in the shape of frustrums of a cone and are representative of the tapered surfaces in the socket-type joints used to join segments of model support systems for wind tunnels. The results are in the form of equations that can be used to determine the contact loads and stresses in the joint from the given geometry and externally applied loads. Equations were determined to define the bending moments and stresses along the length of the joints based on strength and materials principles. The results have also been programmed for a personal computer and a copy of the program is included.

  11. An analysis of a joint shear model for jointed media with orthogonal joint sets; Yucca Mountain Site Characterization Project

    SciTech Connect

    Koteras, J.R.

    1991-10-01

    This report describes a joint shear model used in conjunction with a computational model for jointed media with orthogonal joint sets. The joint shear model allows nonlinear behavior for both joint sets. Because nonlinear behavior is allowed for both joint sets, a great many cases must be considered to fully describe the joint shear behavior of the jointed medium. An extensive set of equations is required to describe the joint shear stress and slip displacements that can occur for all the various cases. This report examines possible methods for simplifying this set of equations so that the model can be implemented efficiently form a computational standpoint. The shear model must be examined carefully to obtain a computationally efficient implementation that does not lead to numerical problems. The application to fractures in rock is discussed. 5 refs., 4 figs.

  12. Denervation of the wrist joint.

    PubMed

    Buck-Gramcko, D

    1977-01-01

    A collective review was made of the results of denervation of the wrist joint for painful restrictiorn of motion done in 313 patients and follow-up studies on 195 (average 4.1 years, ranging from 9 months to 14 years). Complete denervation was done in only 30, partial denervation in the others being done after testing with local anesthetic blocks. Sixty-nine of the patients retained a moble wrist without pain or with slight pain with heavy work. No evidence of Charcot-like joints was seen. Poorest results followed when the operation was done for sequelae of intra-articular fracture of the radius, fracture dislocations, unstable ligamentous support, joint surface destruction, or for those required to do heavy manual labor. Arthrodesis was done secondarily in nine patients. PMID:839055

  13. Joint attention and language evolution

    NASA Astrophysics Data System (ADS)

    Kwisthout, Johan; Vogt, Paul; Haselager, Pim; Dijkstra, Ton

    2008-06-01

    This study investigates how more advanced joint attentional mechanisms, rather than only shared attention between two agents and an object, can be implemented and how they influence the results of language games played by these agents. We present computer simulations with language games showing that adding constructs that mimic the three stages of joint attention identified in children's early development (checking attention, following attention, and directing attention) substantially increase the performance of agents in these language games. In particular, the rates of improved performance for the individual attentional mechanisms have the same ordering as that of the emergence of these mechanisms in infants' development. These results suggest that language evolution and joint attentional mechanisms have developed in a co-evolutionary way, and that the evolutionary emergence of the individual attentional mechanisms is ordered just like their developmental emergence.

  14. Uncertainty of knee joint muscle activity during knee joint torque exertion: the significance of controlling adjacent joint torque.

    PubMed

    Nozaki, Daichi; Nakazawa, Kimitaka; Akai, Masami

    2005-09-01

    In the single-joint torque exertion task, which has been widely used to control muscle activity, only the relevant joint torque is specified. However, the neglect of the neighboring joint could make the procedure unreliable, considering our previous result that even monoarticular muscle activity level is indefinite without specifying the adjacent joint torque. Here we examined the amount of hip joint torque generated with knee joint torque and its influence on the activity of the knee joint muscles. Twelve healthy subjects were requested to exert various levels of isometric knee joint torque. The knee and hip joint torques were obtained by using a custom-made device. Because no information about hip joint torque was provided to the subjects, the hip joint torque measured here was a secondary one associated with the task. The amount of hip joint torque varied among subjects, indicating that they adopted various strategies to achieve the task. In some subjects, there was a considerable internal variability in the hip joint torque. Such variability was not negligible, because the knee joint muscle activity level with respect to the knee joint torque, as quantified by surface electromyography (EMG), changed significantly when the subjects were requested to change the strategy. This change occurred in a very systematic manner: in the case of the knee extension, as the hip flexion torque was larger, the activity of mono- and biarticular knee extensors decreased and increased, respectively. These results indicate that the conventional single knee joint torque exertion has the drawback that the intersubject and/or intertrial variability is inevitable in the relative contribution among mono- and biarticular muscles because of the uncertainty of the hip joint torque. We discuss that the viewpoint that both joint torques need to be considered will bring insights into various controversial problems such as the shape of the EMG-force relationship, neural factors that help

  15. Using joint interactions to estimate paleostress ratios

    NASA Astrophysics Data System (ADS)

    Dyer, R.

    Because they grow perpendicular to a minimum principal stress ( σ3), joints are paleostress markers. Younger joints may show a systematic change in orientation as they approach older, throughgoing, joints. This change in orientation reflects a change in the stress field in which the younger joint set is growing. Analytical solutions for the stress field around a single joint subject to a combination of opening (Mode I) and anti-plane shear (Mode III) loadings are given. The sense of rotation and change in magnitude of principal stresses near an existing joint are functions of the orientation and ratio of magnitudes of the far-field stresses and the coefficient of friction across the joint. Assuming that a later, non-parallel joint nucleates distant from, and grows toward, the throughgoing joint, the stress field in which it is growing will be systematically rotated and changed by the presence of the throughgoing joint. The effect of interaction between the older and younger joints is ignored in the analysis. The systematic change in orientation of the later joint reflects the change in principal stresses near the throughgoing joint, and can be used to place approximate limits on the ratio of the far-field horizontal stresses. Zoned joints are individual, subparallel en échelon joints which are confined to a narrow zone, separated from adjacent zones by a characteristic distance, and confined to a single lithologic interval. A joint zone can be modeled as a single, infinitely long joint with a characteristic height. Comparison of analytic stress field solutions with field examples of interacting zoned joints in Arches National Park, Utah, suggest that a curving-parallel geometry of younger joints is indicative of a stress field in which -3 < σ 2∞/σ 3∞ < - {1}/{3}. A curving-perpendicular geometry of younger zones is compatible with principal stress ratios of - {1}/{3} < σ 2∞/σ 3∞ < 1 .

  16. [Divorce and joint physical custody].

    PubMed

    Golse, B

    2014-04-01

    This work first recalls the definition of joint physical custody, as well as the current legal procedure for obtaining it, its practical implementation, the financial implications for parents, and finally some statistics. Some psychological and psychopathological reflections on the impact of divorce on children are then presented before considering the question of joint physically custody with regard to attachment theory and depending on the age of the child (a great caution seems to be required before three years). The article concludes with a brief discussion of parental alienation syndrome. PMID:24630624

  17. Solder Joint Health Monitoring Testbed

    NASA Technical Reports Server (NTRS)

    Delaney, Michael M.; Flynn, James G.; Browder, Mark E.

    2009-01-01

    A method of monitoring the health of selected solder joints, called SJ-BIST, has been developed by Ridgetop Group Inc. under a Small Business Innovative Research (SBIR) contract. The primary goal of this research program is to test and validate this method in a flight environment using realistically seeded faults in selected solder joints. An additional objective is to gather environmental data for future development of physics-based and data-driven prognostics algorithms. A test board is being designed using a Xilinx FPGA. These boards will be tested both in flight and on the ground using a shaker table and an altitude chamber.

  18. [Divorce and joint physical custody].

    PubMed

    Golse, B

    2014-04-01

    This work first recalls the definition of joint physical custody, as well as the current legal procedure for obtaining it, its practical implementation, the financial implications for parents, and finally some statistics. Some psychological and psychopathological reflections on the impact of divorce on children are then presented before considering the question of joint physically custody with regard to attachment theory and depending on the age of the child (a great caution seems to be required before three years). The article concludes with a brief discussion of parental alienation syndrome.

  19. [Prevention of periprosthetic joint infections].

    PubMed

    Harrasser, Norbert; Harnoss, Tobias

    2012-03-01

    High numbers of primary joint replacement procedures lead to increasing numbers of revision surgeries due to periprosthetic joint infections. Several studies revealed different patient-associated and intervention-associated risk factors. Importance should be pointed on short operating times to avoid intraoperative colonisation of the implant with microorganisms. Patient-associated diseases such as diabetes and obesity should be influenced positively in the preoperative setting. Cessation of smoking should be started two months before surgery and continued until wound healing is completed. Intraoperative single-shot antibiotic prophylaxis has become clinical routine. Prolonged perioperative antibiotic prophylaxis is often conducted but has not shown to be effective in lowering infection rates.

  20. Joint BioEnergy Institute

    SciTech Connect

    Keasling, Jay; Simmons, Blake; Tartaglino, Virginia; Baidoo, Edward; Kothari, Ankita

    2015-06-15

    The Joint BioEnergy Institute (JBEI) is a U.S. Department of Energy (DOE) Bioenergy Research Center dedicated to developing advanced biofuels—liquid fuels derived from the solar energy stored in plant biomass that can replace gasoline, diesel and jet fuels.

  1. Plating To Reinforce Welded Joints

    NASA Technical Reports Server (NTRS)

    Otousa, J. E.

    1982-01-01

    Electrodeposition used to strengthen welded joints gouged, nicked, or suffered other mechanical damage. Plating cell, typically of acrylic plastic such as poly (Methylmetacrylate), is assembled around part to be plated. Areas not to be plated are masked with plater's tape. Weld area is plated in standard nickel-plating process.

  2. Cryopumping field joint can testing

    NASA Astrophysics Data System (ADS)

    Johnson, Wesley; Fesmire, James; Meneghelli, Barry

    2012-06-01

    For long installations, vacuum jacketed piping often comes in 40 foot sections that are butt welded together in the field. A short can is then welded over the bare pipe connection to allow for insulation to be protected from the environment. Traditionally, the field joint is insulated with multilayer insulation and a vacuum is pulled on the can to minimize heat leak through the bare section and prevent frost from forming on the pipe section. The vacuum jacketed lines for the Ares I mobile launch platform were to be a combined 2000 feet long, with 60+ pipe sections and field joint cans. Historically, Kennedy Space Center has drilled a hole in the long sections to create a common vacuum with the field joint can to minimize maintenance on the vacuum jacketed piping. However, this effort looked at ways to use a passive system that didn't require a vacuum, but may cryopump to create its own vacuum. Various forms of aerogel, multilayer insulations, and combinations thereof were tested to determine the best method of insulating the field joint while minimizing maintenance and thermal losses.

  3. Cryopumping Field Joint Can Testing

    NASA Technical Reports Server (NTRS)

    Johnson, Wesley L.; Fesmire, James E.; Meneghelli, Barry E.

    2011-01-01

    For long installations, vacuum jacketed piping often comes in 40 foot sections that are butt welded together in the field. A short can is then welded over the bare pipe connection to allow for insulation to be protected from the environment. Traditionally, the field joint is insulated with multilayer insulation and a vacuum is pulled on the can to minimize heat leak through the bare section and prevent frost from forming on the pipe section. The vacuum jacketed lines for the Ares I mobile launch platform were to be a combined 2000 feet long, with 60+ pipe sections and field joint cans. Historically, Kennedy Space Center has drilled a hole in the long sections to create a common vacuum with the field joint can to minimize maintenance on the vacuum jacketed piping. However, this effort looked at ways to use a passive system that didn't require a vacuum, but may cryopump to create its own vacuum. Various forms of aerogel, multilayer insulations, and combinations thereof were tested to determine the best method of insulating the field joint while minimizing maintenance and thermal losses.

  4. Learning to Regulate Joint Action.

    ERIC Educational Resources Information Center

    Vila, Ignasi; Zanon, Javier

    Reported are implications of the genesis and development of joint action between Spanish adults and their infants for early first language acquisition. Focusing on the naturally occurring context of the "give and take" game format, this investigation discloses the role of the interaction pattern in the language acquisition process, including the…

  5. The Rationale for Joint Mobilization.

    ERIC Educational Resources Information Center

    Burkhardt, Sandy

    This paper presents an overview of the functions of connective tissue and the mechanisms of joint injury and contracture formation in relation to therapeutic exercise. The components of connective tissue operation are explained, including fibroblasts, macrophages, plasma cells, and collagen. An examination of the histology of connective tissue as…

  6. Stress-relieved solder joints

    NASA Technical Reports Server (NTRS)

    Zemenick, C. J.

    1980-01-01

    Mechanical stress on solder joints is reduced by procedure for soldering electronic components to circuit boards. Procedure was developed for radio-frequency (RF) strip-line circuits, for which dimensions must be carefully controlled to minimize parasitic capacitance and inductance. Procedure consists of loosening component from its mounting after each lead is soldered relieving induced stresses before next soldering step.

  7. The Joint Accomplishment of Identity

    ERIC Educational Resources Information Center

    Hand, Victoria; Gresalfi, Melissa

    2015-01-01

    Identity has become a central concept in the analysis of learning from social perspectives. In this article, we draw on a situative perspective to conceptualize identity as a "joint accomplishment" between individuals and their interactions with norms, practices, cultural tools, relationships, and institutional and cultural contexts.…

  8. Arthritis Mechanisms May Vary by Joint

    MedlinePlus

    ... Molecular differences between knee and hip joints with rheumatoid arthritis may inform more personal treatment strategies. Sebastian Kaulitzki/Hemera/Thinkstock Knee and hip joints with rheumatoid arthritis have differing genetic markers linked to inflammation, suggesting ...

  9. JAWS coordinates chondrogenesis and synovial joint positioning.

    PubMed

    Sohaskey, Michael L; Yu, Jane; Diaz, Michael A; Plaas, Anna H; Harland, Richard M

    2008-07-01

    Properly positioned synovial joints are crucial to coordinated skeletal movement. Despite their importance for skeletal development and function, the molecular mechanisms that underlie joint positioning are not well understood. We show that mice carrying an insertional mutation in a previously uncharacterized gene, which we have named Jaws (joints abnormal with splitting), die perinatally with striking skeletal defects, including ectopic interphalangeal joints. These ectopic joints develop along the longitudinal axis and persist at birth, suggesting that JAWS is uniquely required for the orientation and consequent positioning of interphalangeal joints within the endochondral skeleton. Jaws mutant mice also exhibit severe chondrodysplasia characterized by delayed and disorganized maturation of growth plate chondrocytes, together with impaired chondroitin sulfation and abnormal metabolism of the chondroitin sulfate proteoglycan aggrecan. Our findings identify JAWS as a key regulator of chondrogenesis and synovial joint positioning required for the restriction of joint formation to discrete stereotyped locations in the embryonic skeleton.

  10. Organizational aspects of physician joint ventures.

    PubMed

    Rublee, D A; Rosenfield, R H

    1987-03-01

    This article describes organizational forms of physician joint ventures. Four models are described that typify physician involvement in health care joint ventures: limited partnership syndication, venture capital company, provider network, and alternative delivery system. Important practical issues are discussed.

  11. Seismic response of rock joints and jointed rock mass

    SciTech Connect

    Ghosh, A.; Hsiung, S.M.; Chowdhury, A.H.

    1996-06-01

    Long-term stability of emplacement drifts and potential near-field fluid flow resulting from coupled effects are among the concerns for safe disposal of high-level nuclear waste (HLW). A number of factors can induce drift instability or change the near-field flow patterns. Repetitive seismic loads from earthquakes and thermal loads generated by the decay of emplaced waste are two significant factors. One of two key technical uncertainties (KTU) that can potentially pose a high risk of noncompliance with the performance objectives of 10 CFR Part 60 is the prediction of thermal-mechanical (including repetitive seismic load) effects on stability of emplacement drifts and the engineered barrier system. The second KTU of concern is the prediction of thermal-mechanical-hydrological (including repetitive seismic load) effects on the host rock surrounding the engineered barrier system. The Rock Mechanics research project being conducted at the Center for Nuclear Waste Regulatory Analyses (CNWRA) is intended to address certain specific technical issues associated with these two KTUs. This research project has two major components: (i) seismic response of rock joints and a jointed rock mass and (ii) coupled thermal-mechanical-hydrological (TMH) response of a jointed rock mass surrounding the engineered barrier system (EBS). This final report summarizes the research activities concerned with the repetitive seismic load aspect of both these KTUs.

  12. Joint laxity in the performing arts.

    PubMed

    Bird, H

    2016-05-25

    Traditional scoring systems for the assessment of joint flexibility are reviewed and reasons for variation in joint laxity are defined. The value of controlled joint laxity in the hands and arms of musicians is then discussed as well as the desirability of adjusting laxity at the various joints used in the different styles of dance, some of them ethnic, that depend on the specific articular characteristics of each different dancer.

  13. Revamped, joint ventures make a comeback.

    PubMed

    Peters, G R

    1991-08-01

    After a period of declining popularity, joint ventures are beginning to re-emerge as viable solution to challenges facing health care. Future joint ventures likely will be different, however, in response to problems and resulting legislation. Healthcare providers interested in starting a joint venture should consider five basic formats and some guidelines for developing them. Joint ventures ultimately may become a focal point for renewed efforts at regional healthcare planning.

  14. 49 CFR 583.15 - Joint ownership.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Joint ownership. 583.15 Section 583.15... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AUTOMOBILE PARTS CONTENT LABELING § 583.15 Joint... joint owners of a carline may designate, by written agreement, the manufacturer of record of...

  15. 49 CFR 583.15 - Joint ownership.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Joint ownership. 583.15 Section 583.15... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AUTOMOBILE PARTS CONTENT LABELING § 583.15 Joint... joint owners of a carline may designate, by written agreement, the manufacturer of record of...

  16. 14 CFR 399.37 - Joint fares.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Joint fares. 399.37 Section 399.37... STATEMENTS STATEMENTS OF GENERAL POLICY Policies Relating to Rates and Tariffs § 399.37 Joint fares. There should be joint fares in all markets over all routings within the contiguous 48 states and the...

  17. 49 CFR 1112.5 - Joint pleadings.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 8 2011-10-01 2011-10-01 false Joint pleadings. 1112.5 Section 1112.5... OF TRANSPORTATION RULES OF PRACTICE MODIFIED PROCEDURES § 1112.5 Joint pleadings. Parties with common interests are encouraged to prepare joint pleadings whenever possible....

  18. 49 CFR 225.23 - Joint operations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Joint operations. 225.23 Section 225.23....23 Joint operations. (a) Any reportable death, injury, or illness of an employee arising from an accident/incident involving joint operations must be reported on Form FRA F 6180.55a by the...

  19. 49 CFR 178.338-4 - Joints.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Joints. 178.338-4 Section 178.338-4 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... Containers for Motor Vehicle Transportation § 178.338-4 Joints. (a) All joints in the tank, and in the...

  20. 18 CFR 154.307 - Joint facilities.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Joint facilities. 154... Changes § 154.307 Joint facilities. The Statements required by § 154.312 must show all costs (investment... in the subject rate change and are associated with joint facilities. The methods used in making...

  1. 7 CFR 1400.203 - Joint operations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 10 2012-01-01 2012-01-01 false Joint operations. 1400.203 Section 1400.203... AND SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS Payment Eligibility § 1400.203 Joint operations. (a) A member of a joint operation will be considered to be actively engaged in farming with respect to...

  2. 49 CFR 178.337-4 - Joints.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., see the List of CFR Sections Affected, which appears in the Finding Aids section of the printed volume... 49 Transportation 3 2012-10-01 2012-10-01 false Joints. 178.337-4 Section 178.337-4 Transportation... Containers for Motor Vehicle Transportation § 178.337-4 Joints. (a) Joints shall be as required in...

  3. 7 CFR 1956.110 - Joint debtors.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 14 2014-01-01 2014-01-01 false Joint debtors. 1956.110 Section 1956.110 Agriculture... REGULATIONS (CONTINUED) DEBT SETTLEMENT Debt Settlement-Community and Business Programs § 1956.110 Joint debtors. Settlements may not be approved for one joint debtor unless approved for all debtors....

  4. 14 CFR 25.693 - Joints.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Joints. 25.693 Section 25.693 Aeronautics... STANDARDS: TRANSPORT CATEGORY AIRPLANES Design and Construction Control Systems § 25.693 Joints. Control system joints (in push-pull systems) that are subject to angular motion, except those in ball and...

  5. 7 CFR 1956.110 - Joint debtors.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 14 2012-01-01 2012-01-01 false Joint debtors. 1956.110 Section 1956.110 Agriculture... REGULATIONS (CONTINUED) DEBT SETTLEMENT Debt Settlement-Community and Business Programs § 1956.110 Joint debtors. Settlements may not be approved for one joint debtor unless approved for all debtors....

  6. 42 CFR 498.54 - Joint hearings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Joint hearings. 498.54 Section 498.54 Public Health... PROGRAM Hearings § 498.54 Joint hearings. When two or more affected parties have requested hearings and... joint hearings are held, a single record of the preceedings is made and a separate decision issued...

  7. 7 CFR 1956.110 - Joint debtors.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 14 2011-01-01 2011-01-01 false Joint debtors. 1956.110 Section 1956.110 Agriculture... REGULATIONS (CONTINUED) DEBT SETTLEMENT Debt Settlement-Community and Business Programs § 1956.110 Joint debtors. Settlements may not be approved for one joint debtor unless approved for all debtors....

  8. 14 CFR 296.4 - Joint loading.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Joint loading. 296.4 Section 296.4... REGULATIONS INDIRECT AIR TRANSPORTATION OF PROPERTY General § 296.4 Joint loading. Nothing in this part shall preclude joint loading, meaning the pooling of shipments and their delivery to a direct air carrier...

  9. 14 CFR 296.4 - Joint loading.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Joint loading. 296.4 Section 296.4... REGULATIONS INDIRECT AIR TRANSPORTATION OF PROPERTY General § 296.4 Joint loading. Nothing in this part shall preclude joint loading, meaning the pooling of shipments and their delivery to a direct air carrier...

  10. 14 CFR 25.693 - Joints.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Joints. 25.693 Section 25.693 Aeronautics... STANDARDS: TRANSPORT CATEGORY AIRPLANES Design and Construction Control Systems § 25.693 Joints. Control system joints (in push-pull systems) that are subject to angular motion, except those in ball and...

  11. 7 CFR 1400.203 - Joint operations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 10 2013-01-01 2013-01-01 false Joint operations. 1400.203 Section 1400.203... AND SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS Payment Eligibility § 1400.203 Joint operations. (a) A member of a joint operation will be considered to be actively engaged in farming with respect to...

  12. 42 CFR 423.1040 - Joint hearings.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Joint hearings. 423.1040 Section 423.1040 Public... Penalties § 423.1040 Joint hearings. When two or more affected parties have requested hearings and the same... and place for the prehearing conference or hearing and conduct all proceedings jointly. If...

  13. 14 CFR 25.693 - Joints.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Joints. 25.693 Section 25.693 Aeronautics... STANDARDS: TRANSPORT CATEGORY AIRPLANES Design and Construction Control Systems § 25.693 Joints. Control system joints (in push-pull systems) that are subject to angular motion, except those in ball and...

  14. 49 CFR 225.23 - Joint operations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Joint operations. 225.23 Section 225.23....23 Joint operations. (a) Any reportable death, injury, or illness of an employee arising from an accident/incident involving joint operations must be reported on Form FRA F 6180.55a by the...

  15. 14 CFR 297.4 - Joint loading.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Joint loading. 297.4 Section 297.4... REGULATIONS FOREIGN AIR FREIGHT FORWARDERS AND FOREIGN COOPERATIVE SHIPPERS ASSOCIATIONS General § 297.4 Joint loading. Nothing in this part shall preclude joint loading, meaning the pooling of shipments and...

  16. 49 CFR 178.345-4 - Joints.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Joints. 178.345-4 Section 178.345-4 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... Containers for Motor Vehicle Transportation § 178.345-4 Joints. (a) All joints between the cargo tank...

  17. 14 CFR 297.4 - Joint loading.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Joint loading. 297.4 Section 297.4... REGULATIONS FOREIGN AIR FREIGHT FORWARDERS AND FOREIGN COOPERATIVE SHIPPERS ASSOCIATIONS General § 297.4 Joint loading. Nothing in this part shall preclude joint loading, meaning the pooling of shipments and...

  18. 11 CFR 9034.8 - Joint fundraising.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 11 CFR 110.11, a joint fundraising notice shall be included with every solicitation for contributions... CFR 100.5; (B) The allocation formula to be used for distributing joint fundraising proceeds; (C) A... as defined in 11 CFR 110.3 prior to the joint fundraising activity and are not committees of the...

  19. 49 CFR 583.15 - Joint ownership.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Joint ownership. 583.15 Section 583.15... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AUTOMOBILE PARTS CONTENT LABELING § 583.15 Joint... joint owners of a carline may designate, by written agreement, the manufacturer of record of...

  20. 14 CFR 399.37 - Joint fares.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Joint fares. 399.37 Section 399.37... STATEMENTS STATEMENTS OF GENERAL POLICY Policies Relating to Rates and Tariffs § 399.37 Joint fares. There should be joint fares in all markets over all routings within the contiguous 48 states and the...

  1. 49 CFR 1112.5 - Joint pleadings.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 8 2014-10-01 2014-10-01 false Joint pleadings. 1112.5 Section 1112.5... OF TRANSPORTATION RULES OF PRACTICE MODIFIED PROCEDURES § 1112.5 Joint pleadings. Parties with common interests are encouraged to prepare joint pleadings whenever possible....

  2. 49 CFR 178.345-4 - Joints.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Joints. 178.345-4 Section 178.345-4 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... Containers for Motor Vehicle Transportation § 178.345-4 Joints. (a) All joints between the cargo tank...

  3. 14 CFR 297.4 - Joint loading.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Joint loading. 297.4 Section 297.4... REGULATIONS FOREIGN AIR FREIGHT FORWARDERS AND FOREIGN COOPERATIVE SHIPPERS ASSOCIATIONS General § 297.4 Joint loading. Nothing in this part shall preclude joint loading, meaning the pooling of shipments and...

  4. 49 CFR 178.337-4 - Joints.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., see the List of CFR Sections Affected, which appears in the Finding Aids section of the printed volume... 49 Transportation 3 2014-10-01 2014-10-01 false Joints. 178.337-4 Section 178.337-4 Transportation... Containers for Motor Vehicle Transportation § 178.337-4 Joints. (a) Joints shall be as required in...

  5. 14 CFR 296.4 - Joint loading.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Joint loading. 296.4 Section 296.4... REGULATIONS INDIRECT AIR TRANSPORTATION OF PROPERTY General § 296.4 Joint loading. Nothing in this part shall preclude joint loading, meaning the pooling of shipments and their delivery to a direct air carrier...

  6. 18 CFR 154.307 - Joint facilities.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Joint facilities. 154... Changes § 154.307 Joint facilities. The Statements required by § 154.312 must show all costs (investment... in the subject rate change and are associated with joint facilities. The methods used in making...

  7. 11 CFR 9034.8 - Joint fundraising.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 11 CFR 110.11, a joint fundraising notice shall be included with every solicitation for contributions... CFR 100.5; (B) The allocation formula to be used for distributing joint fundraising proceeds; (C) A... as defined in 11 CFR 110.3 prior to the joint fundraising activity and are not committees of the...

  8. 42 CFR 498.54 - Joint hearings.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Joint hearings. 498.54 Section 498.54 Public Health... PROGRAM Hearings § 498.54 Joint hearings. When two or more affected parties have requested hearings and... joint hearings are held, a single record of the preceedings is made and a separate decision issued...

  9. 18 CFR 154.307 - Joint facilities.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Joint facilities. 154... Changes § 154.307 Joint facilities. The Statements required by § 154.312 must show all costs (investment... in the subject rate change and are associated with joint facilities. The methods used in making...

  10. 7 CFR 1956.110 - Joint debtors.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 14 2013-01-01 2013-01-01 false Joint debtors. 1956.110 Section 1956.110 Agriculture... REGULATIONS (CONTINUED) DEBT SETTLEMENT Debt Settlement-Community and Business Programs § 1956.110 Joint debtors. Settlements may not be approved for one joint debtor unless approved for all debtors....

  11. 42 CFR 423.1040 - Joint hearings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Joint hearings. 423.1040 Section 423.1040 Public... Penalties § 423.1040 Joint hearings. When two or more affected parties have requested hearings and the same... and place for the prehearing conference or hearing and conduct all proceedings jointly. If...

  12. 49 CFR 178.338-4 - Joints.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Joints. 178.338-4 Section 178.338-4 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... Containers for Motor Vehicle Transportation § 178.338-4 Joints. (a) All joints in the tank, and in the...

  13. 49 CFR 1112.5 - Joint pleadings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 8 2013-10-01 2013-10-01 false Joint pleadings. 1112.5 Section 1112.5... OF TRANSPORTATION RULES OF PRACTICE MODIFIED PROCEDURES § 1112.5 Joint pleadings. Parties with common interests are encouraged to prepare joint pleadings whenever possible....

  14. 7 CFR 1400.203 - Joint operations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Joint operations. 1400.203 Section 1400.203... AND SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS Payment Eligibility § 1400.203 Joint operations. (a) A member of a joint operation will be considered to be actively engaged in farming with respect to...

  15. 49 CFR 225.23 - Joint operations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Joint operations. 225.23 Section 225.23....23 Joint operations. (a) Any reportable death, injury, or illness of an employee arising from an accident/incident involving joint operations must be reported on Form FRA F 6180.55a by the...

  16. 49 CFR 178.338-4 - Joints.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Joints. 178.338-4 Section 178.338-4 Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION... Containers for Motor Vehicle Transportation § 178.338-4 Joints. (a) All joints in the tank, and in the...

  17. 49 CFR 225.23 - Joint operations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Joint operations. 225.23 Section 225.23....23 Joint operations. (a) Any reportable death, injury, or illness of an employee arising from an accident/incident involving joint operations must be reported on Form FRA F 6180.55a by the...

  18. 22 CFR 228.34 - Joint ventures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Joint ventures. 228.34 Section 228.34 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES ON SOURCE, ORIGIN AND NATIONALITY FOR COMMODITIES AND... Financing § 228.34 Joint ventures. A joint venture or unincorporated association is eligible only if each...

  19. 49 CFR 178.345-4 - Joints.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 3 2014-10-01 2014-10-01 false Joints. 178.345-4 Section 178.345-4 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... Containers for Motor Vehicle Transportation § 178.345-4 Joints. (a) All joints between the cargo tank...

  20. 7 CFR 1400.203 - Joint operations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 10 2014-01-01 2014-01-01 false Joint operations. 1400.203 Section 1400.203... AND SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS Payment Eligibility § 1400.203 Joint operations. (a) A member of a joint operation will be considered to be actively engaged in farming with respect to...

  1. 18 CFR 154.307 - Joint facilities.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Joint facilities. 154... Changes § 154.307 Joint facilities. The Statements required by § 154.312 must show all costs (investment... in the subject rate change and are associated with joint facilities. The methods used in making...

  2. 49 CFR 178.338-4 - Joints.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 3 2014-10-01 2014-10-01 false Joints. 178.338-4 Section 178.338-4 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... Containers for Motor Vehicle Transportation § 178.338-4 Joints. (a) All joints in the tank, and in the...

  3. 42 CFR 498.54 - Joint hearings.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Joint hearings. 498.54 Section 498.54 Public Health... PROGRAM Hearings § 498.54 Joint hearings. When two or more affected parties have requested hearings and... joint hearings are held, a single record of the preceedings is made and a separate decision issued...

  4. 49 CFR 192.233 - Miter joints.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 3 2014-10-01 2014-10-01 false Miter joints. 192.233 Section 192.233... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Welding of Steel in Pipelines § 192.233 Miter joints. (a) A miter joint on steel pipe to be operated at a pressure that produces a hoop stress of...

  5. 14 CFR 297.4 - Joint loading.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Joint loading. 297.4 Section 297.4... REGULATIONS FOREIGN AIR FREIGHT FORWARDERS AND FOREIGN COOPERATIVE SHIPPERS ASSOCIATIONS General § 297.4 Joint loading. Nothing in this part shall preclude joint loading, meaning the pooling of shipments and...

  6. 49 CFR 1112.5 - Joint pleadings.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 8 2012-10-01 2012-10-01 false Joint pleadings. 1112.5 Section 1112.5... OF TRANSPORTATION RULES OF PRACTICE MODIFIED PROCEDURES § 1112.5 Joint pleadings. Parties with common interests are encouraged to prepare joint pleadings whenever possible....

  7. 14 CFR 399.37 - Joint fares.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Joint fares. 399.37 Section 399.37... STATEMENTS STATEMENTS OF GENERAL POLICY Policies Relating to Rates and Tariffs § 399.37 Joint fares. There should be joint fares in all markets over all routings within the contiguous 48 states and the...

  8. 11 CFR 9034.8 - Joint fundraising.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 11 CFR 110.11, a joint fundraising notice shall be included with every solicitation for contributions... CFR 100.5; (B) The allocation formula to be used for distributing joint fundraising proceeds; (C) A... as defined in 11 CFR 110.3 prior to the joint fundraising activity and are not committees of the...

  9. 49 CFR 1112.5 - Joint pleadings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Joint pleadings. 1112.5 Section 1112.5... OF TRANSPORTATION RULES OF PRACTICE MODIFIED PROCEDURES § 1112.5 Joint pleadings. Parties with common interests are encouraged to prepare joint pleadings whenever possible....

  10. 49 CFR 583.15 - Joint ownership.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Joint ownership. 583.15 Section 583.15... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AUTOMOBILE PARTS CONTENT LABELING § 583.15 Joint... joint owners of a carline may designate, by written agreement, the manufacturer of record of...

  11. 49 CFR 178.337-4 - Joints.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., see the List of CFR Sections Affected which appears in the Finding Aids section of the printed volume... 49 Transportation 3 2011-10-01 2011-10-01 false Joints. 178.337-4 Section 178.337-4 Transportation... Containers for Motor Vehicle Transportation § 178.337-4 Joints. (a) Joints shall be as required in...

  12. 18 CFR 154.307 - Joint facilities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Joint facilities. 154... Changes § 154.307 Joint facilities. The Statements required by § 154.312 must show all costs (investment... in the subject rate change and are associated with joint facilities. The methods used in making...

  13. 49 CFR 178.338-4 - Joints.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Joints. 178.338-4 Section 178.338-4 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... Containers for Motor Vehicle Transportation § 178.338-4 Joints. (a) All joints in the tank, and in the...

  14. 42 CFR 423.1040 - Joint hearings.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Joint hearings. 423.1040 Section 423.1040 Public... Penalties § 423.1040 Joint hearings. When two or more affected parties have requested hearings and the same... and place for the prehearing conference or hearing and conduct all proceedings jointly. If...

  15. 14 CFR 25.693 - Joints.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Joints. 25.693 Section 25.693 Aeronautics... STANDARDS: TRANSPORT CATEGORY AIRPLANES Design and Construction Control Systems § 25.693 Joints. Control system joints (in push-pull systems) that are subject to angular motion, except those in ball and...

  16. 49 CFR 225.23 - Joint operations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Joint operations. 225.23 Section 225.23....23 Joint operations. (a) Any reportable death, injury, or illness of an employee arising from an accident/incident involving joint operations must be reported on Form FRA F 6180.55a by the...

  17. 14 CFR 296.4 - Joint loading.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Joint loading. 296.4 Section 296.4... REGULATIONS INDIRECT AIR TRANSPORTATION OF PROPERTY General § 296.4 Joint loading. Nothing in this part shall preclude joint loading, meaning the pooling of shipments and their delivery to a direct air carrier...

  18. 14 CFR 399.37 - Joint fares.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Joint fares. 399.37 Section 399.37... STATEMENTS STATEMENTS OF GENERAL POLICY Policies Relating to Rates and Tariffs § 399.37 Joint fares. There should be joint fares in all markets over all routings within the contiguous 48 states and the...

  19. 49 CFR 178.345-4 - Joints.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Joints. 178.345-4 Section 178.345-4 Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION... Containers for Motor Vehicle Transportation § 178.345-4 Joints. (a) All joints between the cargo tank...

  20. 7 CFR 1956.110 - Joint debtors.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 14 2010-01-01 2009-01-01 true Joint debtors. 1956.110 Section 1956.110 Agriculture... REGULATIONS (CONTINUED) DEBT SETTLEMENT Debt Settlement-Community and Business Programs § 1956.110 Joint debtors. Settlements may not be approved for one joint debtor unless approved for all debtors....

  1. 14 CFR 296.4 - Joint loading.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Joint loading. 296.4 Section 296.4... REGULATIONS INDIRECT AIR TRANSPORTATION OF PROPERTY General § 296.4 Joint loading. Nothing in this part shall preclude joint loading, meaning the pooling of shipments and their delivery to a direct air carrier...

  2. 42 CFR 498.54 - Joint hearings.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Joint hearings. 498.54 Section 498.54 Public Health... PROGRAM Hearings § 498.54 Joint hearings. When two or more affected parties have requested hearings and... joint hearings are held, a single record of the proceedings is made and a separate decision issued...

  3. 49 CFR 178.345-4 - Joints.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Joints. 178.345-4 Section 178.345-4 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... Containers for Motor Vehicle Transportation § 178.345-4 Joints. (a) All joints between the cargo tank...

  4. 22 CFR 228.34 - Joint ventures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Joint ventures. 228.34 Section 228.34 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES ON SOURCE, ORIGIN AND NATIONALITY FOR COMMODITIES AND... Financing § 228.34 Joint ventures. A joint venture or unincorporated association is eligible only if each...

  5. 42 CFR 498.54 - Joint hearings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Joint hearings. 498.54 Section 498.54 Public Health... PROGRAM Hearings § 498.54 Joint hearings. When two or more affected parties have requested hearings and... joint hearings are held, a single record of the proceedings is made and a separate decision issued...

  6. 49 CFR 583.15 - Joint ownership.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Joint ownership. 583.15 Section 583.15... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AUTOMOBILE PARTS CONTENT LABELING § 583.15 Joint... joint owners of a carline may designate, by written agreement, the manufacturer of record of...

  7. 7 CFR 1400.203 - Joint operations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Joint operations. 1400.203 Section 1400.203... AND SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS Payment Eligibility § 1400.203 Joint operations. (a) A member of a joint operation will be considered to be actively engaged in farming with respect to...

  8. 11 CFR 9034.8 - Joint fundraising.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 11 CFR 110.11, a joint fundraising notice shall be included with every solicitation for contributions... CFR 100.5; (B) The allocation formula to be used for distributing joint fundraising proceeds; (C) A... as defined in 11 CFR 110.3 prior to the joint fundraising activity and are not committees of the...

  9. 14 CFR 297.4 - Joint loading.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Joint loading. 297.4 Section 297.4... REGULATIONS FOREIGN AIR FREIGHT FORWARDERS AND FOREIGN COOPERATIVE SHIPPERS ASSOCIATIONS General § 297.4 Joint loading. Nothing in this part shall preclude joint loading, meaning the pooling of shipments and...

  10. 11 CFR 9034.8 - Joint fundraising.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 11 CFR 110.11, a joint fundraising notice shall be included with every solicitation for contributions... CFR 100.5; (B) The allocation formula to be used for distributing joint fundraising proceeds; (C) A... as defined in 11 CFR 110.3 prior to the joint fundraising activity and are not committees of the...

  11. 38 CFR 4.66 - Sacroiliac joint.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Sacroiliac joint. 4.66... DISABILITIES Disability Ratings The Musculoskeletal System § 4.66 Sacroiliac joint. The common cause of... joints should be considered as one anatomical segment for rating purposes. X-ray changes from...

  12. Navigating Joint Projects in Telephone Conversations

    ERIC Educational Resources Information Center

    Bangerter, Adrian; Clark, Herbert H.; Katz, Anna R.

    2004-01-01

    Conversation coordinates joint activities and the joint projects that compose them. Participants coordinate (1) vertical transitions on entering and exiting joint projects; and (2) horizontal transitions in continuing within them. Transitions are coordinated using project markers such as uh-huh, yeah, right, and okay. In the authors' proposal,…

  13. Approach to the child with joint inflammation.

    PubMed

    Berard, Roberta

    2012-04-01

    Arthritis is manifested as a swollen joint having at least 2 of the following conditions: limited range of motion, pain on movement, or warmth overlying the joint. This article discusses an approach to the evaluation of a child with arthritis of one (mono) or several (poly) joints. PMID:22560569

  14. 46 CFR 385.38 - Joint funding.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 8 2013-10-01 2013-10-01 false Joint funding. 385.38 Section 385.38 Shipping MARITIME... AGREEMENTS REGULATIONS General Policies § 385.38 Joint funding. (a) Pursuant to section 10(c) of the Act, MarAd is authorized to participate in joint funded projects with other Federal agencies in any...

  15. 46 CFR 385.38 - Joint funding.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 8 2012-10-01 2012-10-01 false Joint funding. 385.38 Section 385.38 Shipping MARITIME... AGREEMENTS REGULATIONS General Policies § 385.38 Joint funding. (a) Pursuant to section 10(c) of the Act, MarAd is authorized to participate in joint funded projects with other Federal agencies in any...

  16. 46 CFR 385.38 - Joint funding.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Joint funding. 385.38 Section 385.38 Shipping MARITIME... AGREEMENTS REGULATIONS General Policies § 385.38 Joint funding. (a) Pursuant to section 10(c) of the Act, MarAd is authorized to participate in joint funded projects with other Federal agencies in any...

  17. 46 CFR 385.38 - Joint funding.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 8 2014-10-01 2014-10-01 false Joint funding. 385.38 Section 385.38 Shipping MARITIME... AGREEMENTS REGULATIONS General Policies § 385.38 Joint funding. (a) Pursuant to section 10(c) of the Act, MarAd is authorized to participate in joint funded projects with other Federal agencies in any...

  18. 46 CFR 385.38 - Joint funding.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 8 2011-10-01 2011-10-01 false Joint funding. 385.38 Section 385.38 Shipping MARITIME... AGREEMENTS REGULATIONS General Policies § 385.38 Joint funding. (a) Pursuant to section 10(c) of the Act, MarAd is authorized to participate in joint funded projects with other Federal agencies in any...

  19. Approach to the child with joint inflammation.

    PubMed

    Berard, Roberta

    2012-04-01

    Arthritis is manifested as a swollen joint having at least 2 of the following conditions: limited range of motion, pain on movement, or warmth overlying the joint. This article discusses an approach to the evaluation of a child with arthritis of one (mono) or several (poly) joints.

  20. 12 CFR 347.107 - Joint ventures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Joint ventures. 347.107 Section 347.107 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION REGULATIONS AND STATEMENTS OF GENERAL POLICY INTERNATIONAL BANKING § 347.107 Joint ventures. (a) Joint ventures. If a bank, directly or indirectly,...

  1. Establishing joint goals through observation

    NASA Astrophysics Data System (ADS)

    Van Wie, Michael

    1997-09-01

    When interacting with intelligent agents, it is vital to understand something of their intentions. Agents' intentions provide context in spoken deluge, help to define their future plans (and thus actions), and reveal information about their beliefs. We propose a method by which agents' intentions are inferred by observing their actions. Explicit communication among agents is not permitted. The joint intentions framework specifies the behaviors and obligations of agents that share in a cooperative intention. Our work focuses on the creation of such joint intentions through observation and plan recognition. The plan recognition structure uses Bayes nets to reason from observations to actions, and hidden Markov models to reason from sequences of actions to intent.

  2. Foldable self-erecting joint

    NASA Technical Reports Server (NTRS)

    Pelischek, T. E. (Inventor)

    1986-01-01

    The invention relates to a foldable self erecting joint which may be used to deploy the tetratruss frame of the proposed shuttle launched triangular space station. The frame must be folded into the payload bay of the space shuttle orbiter. To deploy the frame the tubes are automatically unfolded and once in position should remain safely. A pair of hinged, tubular members in which the hinging is located at corresponding portions of the members are used. The opposite edge portions are connected by spring-based toggle links which in the unfolded position of the members are nested against one of the members in substantial alignment and over-center for securely locking the joint in the unfolded position.

  3. Ultrasonic Welding of Hybrid Joints

    NASA Astrophysics Data System (ADS)

    Wagner, Guntram; Balle, Frank; Eifler, Dietmar

    2012-03-01

    A central research field of the Institute of Materials Science and Engineering at the University of Kaiserslautern (WKK), Germany, is the realization of innovative hybrid joints by ultrasonic metal welding. This article gives an overview of suitable ultrasonic welding systems as well as of essential machine and material parameters, which influence the quality of the welds. Besides the ultrasonic welding of dissimilar metals such as Al to Cu or Al to steels, the welds between newly developed materials like aluminum foam sandwiches or flat flexible cables also can be realized. Moreover, the joining of glass and ceramic to sheet metals is a point of interest at the WKK. By using the ultrasonic metal welding process, it is possible to realize metal/glass welds with tensile shear strengths of 50 MPa. For metal/ceramic joints, the shear strengths values up to 150 MPa were measured. Finally, selected results about the occurring bonding mechanisms will be discussed.

  4. Intermetallic Layers in Soldered Joints

    1998-12-10

    ILAG solves the one-dimensional partial differential equations describing the multiphase, multicomponent, solid-state diffusion-controlled growth of intermetallic layers in soldered joints. This software provides an analysis capability for materials researchers to examine intermetallic growth mechanisms in a wide variety of defense and commercial applications involving both traditional and advanced materials. ILAG calculates the interface positions of the layers, as well as the spatial distribution of constituent mass fractions, and outputs the results at user-prescribed simulation times.

  5. Metal-ceramic joint assembly

    DOEpatents

    Li, Jian

    2002-01-01

    A metal-ceramic joint assembly in which a brazing alloy is situated between metallic and ceramic members. The metallic member is either an aluminum-containing stainless steel, a high chromium-content ferritic stainless steel or an iron nickel alloy with a corrosion protection coating. The brazing alloy, in turn, is either an Au-based or Ni-based alloy with a brazing temperature in the range of 9500 to 1200.degree. C.

  6. Spring joint with overstrain sensor

    NASA Technical Reports Server (NTRS)

    Phelps, Peter M. (Inventor); Gaither, Bryan W. (Inventor)

    2011-01-01

    A flexible joint may include a conductive compression spring and a pair of non-conductive spring cages disposed at opposite ends of the compression spring to support the compression spring. A conductive member disposed inside the compression spring may extend between the pair of spring cages. One end of the conductive member may be fixed for movement with one of the spring cages and another end of the conductive member may be fixed for movement with the other of the spring cages.

  7. Jointed Holder For Welding Electrodes

    NASA Technical Reports Server (NTRS)

    Gilbert, Jeffrey L.

    1991-01-01

    Adjustable-angle holder enables use of standard straight electrode with custom-fabricated bent gas cup for welding in difficult-to-reach places. Electrode replaced easily, without removing cup, with aid of tool loosening miniature collet nut on holder. Consumes fewer electrodes for given amount of welding. Angle of holder continuously adjustable to fit angle of gas cup or geometry of part welded. Holder made double-jointed to accommodate gas cup having compound angles.

  8. [Gout in the temporomandibular joint].

    PubMed

    Deferm, J T; Barkhuysen, R; de Rooy, J; Coppen, C; Merkx, M Aw

    2016-06-01

    A 76-year-old woman, with a medical history of diabetes mellitus and hypertension, presented herself to an oral and maxillofacial surgeon with a sudden pre-auricular swelling of the right temporomandibular joint. As a result of the atypical clinical appearance and signs of local destruction in the initial panoramic x-ray, a malign process was first eliminated from consideration. With the aid of extensive diagnostics and an open biopsy, the diagnosis of gout was established. PMID:27275659

  9. Joint stabilizing projects in defense

    SciTech Connect

    Canavan, G.H.; Browne, J.C.; Joseph, R.J.

    1992-06-01

    Joint defensive projects could increase stability and decrease the alert rates of strategic forces. Areas include the defense of the US, Commonwealth of Independent States (CIS), and their allies against third world threats; protection against each other's accidental or unauthorized launches; and defense against intentional attacks. The most promising area appears to be defining interfaces for the handover of satellite warning and trajectory information, which applies to most phases of theater defense and mutual protection. 19 refs.

  10. Joint stabilizing projects in defense

    SciTech Connect

    Canavan, G.H.; Browne, J.C.; Joseph, R.J.

    1992-06-01

    Joint defensive projects could increase stability and decrease the alert rates of strategic forces. Areas include the defense of the US, Commonwealth of Independent States (CIS), and their allies against third world threats; protection against each other`s accidental or unauthorized launches; and defense against intentional attacks. The most promising area appears to be defining interfaces for the handover of satellite warning and trajectory information, which applies to most phases of theater defense and mutual protection. 19 refs.

  11. Laboratory experiments on columnar jointing

    NASA Astrophysics Data System (ADS)

    Goehring, L.; Morris, S. W.

    2003-12-01

    The mechanism causing columnar jointing has remained an enticing mystery since the basalt columns of the Giant's Causeway in N. Ireland were first reported to science in the 17th century. This phenomenon, in which shrinkage cracks form a quasi-hexagonal arrangement, has been shown to produce columns in starch, glass, coal, sandstone, and ice, as well as in a variety of lava flows. This suggests that this pattern-forming process is very general in nature. However, most studies of columnar jointing have been confined to field studies of basalt flows. Following Muller, we have experimented with desiccating corn starch in an effort to understand this pattern from a more general point of view. The diffusion and evaporation of water in starch is thought to be analogous to the diffusion and extraction of heat from a basalt flow. By combining direct sampling and x-ray tomography, fully 3D descriptions of columnar jointing were obtained with starch samples. We have characterized the pattern with several statistical indices, which describe its structure and relative disorder. These methods can resolve the ordering of the colonnade near the free surface. We identified two distinct mechanisms by which the mean column area increases during pattern evolution. We found both a slow, almost power-law increase in column area, as well as episodes of sudden catastrophic jumps in scale. The latter suggests that the column scale is not a simple single-valued function of drying rate, but rather a metastable state subject to hysteresis. Such metastable behaviour might explain a fundamental question about columnar jointing -- why the columns are so regular in the direction of their growth. Moreover, these experiments may help discriminate between the various theoretical models of this pattern forming process. Finally, our results lead to predictions that could be tested by field measurements on basaltic colonnades.

  12. Hydraulic fracturing of jointed formations

    SciTech Connect

    Murphy, H.D.; Fehler, M.C.

    1986-01-01

    Measured by volume, North America's largest hydraulic fracturing operations have been conducted at Fenton Hill, New Mexico to create geothermal energy reservoirs. In the largest operation 21,000 m/sup 3/ of water were injected into jointed granitic rock at a depth of 3.5 km. Microearthquakes induced by this injection were measured with geophones placed in five wells drilled into, or very close, to the reservoir, as well as 11 surface seismometers. The large volume of rock over which the microearthquakes were distributed indicates a mechanism of hydraulic stimulation which is at odds with conventional fracturing theory, which predicts failure along a plane which is perpendicular to the least compressive earth stress. A coupled rock mechanics/fluid flow model provides much of the explanation. Shear slippage along pre-existing joints in the rock is more easily induced than conventional tensile failure, particularly when the difference between minimum and maximum earth stresses is large and the joints are oriented at angles between 30 and 60 degrees to the principal earth stresses, and a low viscosity fluid like water is injected. Shear slippage results in local redistribution of stresses, which allows a branching, or dendritic, stimulation pattern to evolve, in agreement with the patterns of microearthquake locations. These results are qualitatively similar to the controversial process known as ''Kiel'' fracturing, in which sequential injections and shut-ins are repeated to create dendritic fractures for enhanced oil and gas recovery. However, we believe that the explanation is shear slippage of pre-existing joints and stress redistribution, not proppant bridging and fluid blocking as suggested by Kiel. 15 refs., 10 figs.

  13. Boom and chassis articulation joints

    NASA Technical Reports Server (NTRS)

    Murphy, Joel T., Jr.; Nguyen, Vien; Turner, Bonnie; Wheeler, Bobby; Williams, Kimberlyn

    1992-01-01

    The primary goal of our design project was to develop articulation joints for the chassis and boom of the proof-of-concept lunar vehicle. This is an ongoing project and the work of previous student groups was extensively reviewed. Some of the ideas generated are variations of past proposals. Although the project is funded by NASA/USRA, it is totally a student design effort.

  14. Symptomatic carpal coalition: scaphotrapezial joint.

    PubMed

    Campaigniac, Erin; Eskander, Mark; Jones, Marci

    2013-12-01

    Carpal coalition is an uncommon congenital abnormality that arises from incomplete cavitation of the common cartilaginous precursor that forms the carpal bones. When carpal coalition is discovered, it is typically an asymptomatic incidental radiographic finding, and is often bilateral. We present a case of symptomatic unilateral carpal coalition of the scaphotrapezial joint, which was treated by excising the fibrous coalition and placing an interposition fat graft. This treatment was effective in alleviating the patient's symptoms.

  15. Joint Commission on rock properties

    NASA Astrophysics Data System (ADS)

    A joint commission on Rock Properties for Petroleum Engineers (RPPE) has been established by the International Society of Rock Mechanics and the Society of Petroleum Engineers to set up data banks on the properties of sedimentary rocks encountered during drilling. Computer-based data banks of complete rock properties will be organized for sandstones (GRESA), shales (ARSHA) and carbonates (CARCA). The commission hopes to access data sources from members of the commission, private companies and the public domain.

  16. Space Suit Joint Torque Testing

    NASA Technical Reports Server (NTRS)

    Valish, Dana J.

    2011-01-01

    In 2009 and early 2010, a test was performed to quantify the torque required to manipulate joints in several existing operational and prototype space suits in an effort to develop joint torque requirements appropriate for a new Constellation Program space suit system. The same test method was levied on the Constellation space suit contractors to verify that their suit design meets the requirements. However, because the original test was set up and conducted by a single test operator there was some question as to whether this method was repeatable enough to be considered a standard verification method for Constellation or other future space suits. In order to validate the method itself, a representative subset of the previous test was repeated, using the same information that would be available to space suit contractors, but set up and conducted by someone not familiar with the previous test. The resultant data was compared using graphical and statistical analysis and a variance in torque values for some of the tested joints was apparent. Potential variables that could have affected the data were identified and re-testing was conducted in an attempt to eliminate these variables. The results of the retest will be used to determine if further testing and modification is necessary before the method can be validated.

  17. The Joint Damping Experiment (JDX)

    NASA Technical Reports Server (NTRS)

    Folkman, Steven L.; Bingham, Jeff G.; Crookston, Jess R.; Dutson, Joseph D.; Ferney, Brook D.; Ferney, Greg D.; Rowsell, Edwin A.

    1997-01-01

    The Joint Damping Experiment (JDX), flown on the Shuttle STS-69 Mission, is designed to measure the influence of gravity on the structural damping of a high precision three bay truss. Principal objectives are: (1) Measure vibration damping of a small-scale, pinjointed truss to determine how pin gaps give rise to gravity-dependent damping rates; (2) Evaluate the applicability of ground and low-g aircraft tests for predicting on-orbit behavior; and (3) Evaluate the ability of current nonlinear finite element codes to model the dynamic behavior of the truss. Damping of the truss was inferred from 'Twang' tests that involve plucking the truss structure and recording the decay of the oscillations. Results are summarized as follows. (1) Damping, rates can change by a factor of 3 to 8 through changing the truss orientation; (2) The addition of a few pinned joints to a truss structure can increase the damping by a factor as high as 30; (3) Damping is amplitude dependent; (4) As gravity induced preloads become large (truss long axis perpendicular to gravity vector) the damping is similar to non-pinjointed truss; (5) Impacting in joints drives higher modes in structure; (6) The torsion mode disappears if gravity induced preloads are low.

  18. Joint Acoustic and Modulation Frequency

    NASA Astrophysics Data System (ADS)

    Atlas, Les; Shamma, Shihab A.

    2003-12-01

    There is a considerable evidence that our perception of sound uses important features which is related to underlying signal modulations. This topic has been studied extensively via perceptual experiments, yet there are few, if any, well-developed signal processing methods which capitalize on or model these effects. We begin by summarizing evidence of the importance of modulation representations from psychophysical, physiological, and other sources. The concept of a two-dimensional joint acoustic and modulation frequency representation is proposed. A simple single sinusoidal amplitude modulator of a sinusoidal carrier is then used to illustrate properties of an unconstrained and ideal joint representation. Added constraints are required to remove or reduce undesired interference terms and to provide invertibility. It is then noted that the constraints would also apply to more general and complex cases of broader modulation and carriers. Applications in single-channel speaker separation and in audio coding are used to illustrate the applicability of this joint representation. Other applications in signal analysis and filtering are suggested.

  19. Temporomandibular joint diagnostics using CBCT.

    PubMed

    Larheim, T A; Abrahamsson, A-K; Kristensen, M; Arvidsson, L Z

    2015-01-01

    The present review will give an update on temporomandibular joint (TMJ) imaging using CBCT. It will focus on diagnostic accuracy and the value of CBCT compared with other imaging modalities for the evaluation of TMJs in different categories of patients; osteoarthritis (OA), juvenile OA, rheumatoid arthritis and related joint diseases, juvenile idiopathic arthritis and other intra-articular conditions. Finally, sections on other aspects of CBCT research related to the TMJ, clinical decision-making and concluding remarks are added. CBCT has emerged as a cost- and dose-effective imaging modality for the diagnostic assessment of a variety of TMJ conditions. The imaging modality has been found to be superior to conventional radiographical examinations as well as MRI in assessment of the TMJ. However, it should be emphasized that the diagnostic information obtained is limited to the morphology of the osseous joint components, cortical bone integrity and subcortical bone destruction/production. For evaluation of soft-tissue abnormalities, MRI is mandatory. There is an obvious need for research on the impact of CBCT examinations on patient outcome.

  20. Mechanical flexible joint design document

    NASA Technical Reports Server (NTRS)

    Daily, Vic

    1993-01-01

    The purpose of this report is to document the status of the Mechanical Flexible Joint (MFJ) Design Subtask with the intent of halting work on the design. Recommendations for future work is included in the case that the task is to be resumed. The MFJ is designed to eliminate two failure points from the current flex joint configuration, the inner 'tripod configuration' and the outer containment jacket. The MFJ will also be designed to flex 13.5 degrees and have three degrees of freedom. By having three degrees of freedom, the MFJ will allow the Low Pressure Fuel Duct to twist and remove the necessity to angulate the full 11 degrees currently required. The current flex joints are very labor intensive and very costly and a simple alternative is being sought. The MFJ is designed with a greater angular displacement, with three degrees of freedom, to reside in the same overall envelope, to meet weight constraints of the current bellows, to be compatible with cryogenic fuel and oxidizers, and also to be man-rated.

  1. Temporomandibular joint diagnostics using CBCT

    PubMed Central

    Abrahamsson, A-K; Kristensen, M; Arvidsson, L Z

    2015-01-01

    The present review will give an update on temporomandibular joint (TMJ) imaging using CBCT. It will focus on diagnostic accuracy and the value of CBCT compared with other imaging modalities for the evaluation of TMJs in different categories of patients; osteoarthritis (OA), juvenile OA, rheumatoid arthritis and related joint diseases, juvenile idiopathic arthritis and other intra-articular conditions. Finally, sections on other aspects of CBCT research related to the TMJ, clinical decision-making and concluding remarks are added. CBCT has emerged as a cost- and dose-effective imaging modality for the diagnostic assessment of a variety of TMJ conditions. The imaging modality has been found to be superior to conventional radiographical examinations as well as MRI in assessment of the TMJ. However, it should be emphasized that the diagnostic information obtained is limited to the morphology of the osseous joint components, cortical bone integrity and subcortical bone destruction/production. For evaluation of soft-tissue abnormalities, MRI is mandatory. There is an obvious need for research on the impact of CBCT examinations on patient outcome. PMID:25369205

  2. Study of joint designing on composite structures

    NASA Astrophysics Data System (ADS)

    Kazushi, Haruna

    In this paper, strength design techniques of CFRP mechanical joints and adhesively bonded joints were examined. Remarkable stress concentration generates at the mechanical hole edge and the adhesive edge, therefore an unskillful design of joints often causes a reduction in the strength of composite structures. In mechanical joints, a study on predicting the joint strength has been performed, but bearing failure that is most important failure mode for designing joints can not be predicted. So in this paper, the strength prediction method in consideration with bearing failure was examined. On the other hand, the criterion using the intensity of stress singularity was suggested in adhesive joints, but it was clarified in this paper, that this method can not be applied the prediction of the final failure strength. So the critical stress distribution of single-lap adhesive bonded carbon/epoxy joints was examined to obtain the failure criterion of the final failure. Moreover the simulation method for an internal stress generated by cure shrinkage of adhesive was also examined. In the proposed method for mechanical joint, 2-parameter criterion, that is combined the characteristic length with the Yamada-Sun criterion, was applied and the characteristic length for compression was determined from "bearing failure test" that was newly conceived to take bearing failure into consideration. In case of adhesive joints, it was thought that 2-parameter criterion was effective. So the prediction method using 2-parameter criterion was applied to other adhesive joints. Good agreement was obtained between predicted and experimental results in both mechanical and adhesive joints. And it was cleared that an internal stress could be simulated by the proposed method. Moreover, in mechanical joints, the most suitable stacking sequence, the reduction technique of interlaminar stress, and the elevation of joint strength by application of high toughness matrix were also shown. Consequently

  3. Analysis of NSTX TF Joint Voltage Measurements

    SciTech Connect

    R, Woolley

    2005-10-07

    This report presents findings of analyses of recorded current and voltage data associated with 72 electrical joints operating at high current and high mechanical stress. The analysis goal was to characterize the mechanical behavior of each joint and thus evaluate its mechanical supports. The joints are part of the toroidal field (TF) magnet system of the National Spherical Torus Experiment (NSTX) pulsed plasma device operating at the Princeton Plasma Physics Laboratory (PPPL). Since there is not sufficient space near the joints for much traditional mechanical instrumentation, small voltage probes were installed on each joint and their voltage monitoring waveforms have been recorded on sampling digitizers during each NSTX ''shot''.

  4. Small Joint Arthroscopy in the Foot.

    PubMed

    Reeves, Christopher L; Shane, Amber M; Payne, Trevor; Cavins, Zac

    2016-10-01

    Arthroscopy has advanced in the foot and ankle realm, leading to new innovative techniques designed toward treatment of small joint abnormality. A range of abnormalities that are currently widespread for arthroscopic treatment in larger joints continues to be translated to congruent modalities in the small joints. Small joint arthroscopy offers relief from foot ailments with a noninvasive element afforded by arthroscopy. Early studies have found comparable results from arthroscopic soft tissue procedures as well as arthrodesis of the small joints when compared with the standard open approach. PMID:27599441

  5. Peripheral joint involvement in psoriatic arthritis patients.

    PubMed

    Acosta Felquer, Maria Laura; FitzGerald, Oliver

    2015-01-01

    Peripheral joint involvement is a common, potentially debilitating feature of psoriatic arthritis (PsA). Joint involvement is commonly symmetrical and polyarticular similar to rheumatoid arthritis (RA) but it can also be oligoarticular, asymmetrical or occasionally monoarticular. Involvement of the distal interphalangeal joints is a feature which distinguishes PsA from RA. Articular involvement in PsA can be severe with a mutilating arthropathy found in about 5%. These patients are characterised clinically by digital shortening and on radiographs by erosion on both sides of the joint and/or osteolysis. Treatments targeting joint disease frequently reduces symptoms and signs resulting in prevention of damage progression.

  6. Evaluation and management of joint pain.

    PubMed

    Collyott, Cindy L; Brooks, Mirella Vasquez

    2008-01-01

    The purpose of this article was to provide a review for orthopaedic nurses and nurse practitioners who evaluate, manage, and care for patients with joint pain. Joint pain is a common complaint evaluated by primary care providers. The causation of joint pain is complicated to identify because of an extensive range of differential diagnosis. The history and physical examination are crucial components in evaluating and managing joint pain. The primary care provider uses clinical factors such as patient demographics, presence of inflammation, acute/chronic duration, extra-articular manifestations, pattern of joint involvement, and disease chronology. Many rheumatologic laboratory tests are nonspecific, but aspiration of the joint with synovial fluid analysis may provide diagnostic clues, especially to differentiate infection versus inflammation. Primary care providers utilize both pharmacologic and nonpharmacologic regimens to manage acute and chronic joint pain.

  7. Biotribology of artificial hip joints

    PubMed Central

    Di Puccio, Francesca; Mattei, Lorenza

    2015-01-01

    Hip arthroplasty can be considered one of the major successes of orthopedic surgery, with more than 350000 replacements performed every year in the United States with a constantly increasing rate. The main limitations to the lifespan of these devices are due to tribological aspects, in particular the wear of mating surfaces, which implies a loss of matter and modification of surface geometry. However, wear is a complex phenomenon, also involving lubrication and friction. The present paper deals with the tribological performance of hip implants and is organized in to three main sections. Firstly, the basic elements of tribology are presented, from contact mechanics of ball-in-socket joints to ultra high molecular weight polyethylene wear laws. Some fundamental equations are also reported, with the aim of providing the reader with some simple tools for tribological investigations. In the second section, the focus moves to artificial hip joints, defining materials and geometrical properties and discussing their friction, lubrication and wear characteristics. In particular, the features of different couplings, from metal-on-plastic to metal-on-metal and ceramic-on-ceramic, are discussed as well as the role of the head radius and clearance. How friction, lubrication and wear are interconnected and most of all how they are specific for each loading and kinematic condition is highlighted. Thus, the significant differences in patients and their lifestyles account for the high dispersion of clinical data. Furthermore, such consideration has raised a new discussion on the most suitable in vitro tests for hip implants as simplified gait cycles can be too far from effective implant working conditions. In the third section, the trends of hip implants in the years from 2003 to 2012 provided by the National Joint Registry of England, Wales and Northern Ireland are summarized and commented on in a discussion. PMID:25621213

  8. Space nuclear system expansion joints

    NASA Technical Reports Server (NTRS)

    Whitaker, W. D.; Shimazki, T. T.

    1973-01-01

    The engineering, design, and fabrication status of the expansion joint unit (EJU) to be employed in the NaK primary coolant piping loop of the 5-kwe Reactor thermoelectric system are described. Four EJU's are needed in the NaK primary coolant piping loop. The four EJU's which will be identical, utilize bellows as the flexing member, are hermetically sealed, and provide double containment. The bellows are of a nested-formed design, and are to be constructed of 1-ply thickness of 0.010-in. Inconel 718. The EJU's provide a minimum piping load margin of safety of +0.22.

  9. Adaptive strategy for joint measurements

    NASA Astrophysics Data System (ADS)

    Uola, Roope; Luoma, Kimmo; Moroder, Tobias; Heinosaari, Teiko

    2016-08-01

    We develop a technique to find simultaneous measurements for noisy quantum observables in finite-dimensional Hilbert spaces. We use the method to derive lower bounds for the noise needed to make incompatible measurements jointly measurable. Using our strategy together with recent developments in the field of one-sided quantum information processing we show that the attained lower bounds are tight for various symmetric sets of quantum measurements. We use this characterisation to prove the existence of so called 4-Specker sets, i.e. sets of four incompatible observables with compatible subsets in the qubit case.

  10. Joint venture on degree course.

    PubMed

    1987-12-19

    A ground breaking joint venture between South Glamorgan's Health Authority and Institute of Higher Education will bear fruit next year when the first students enrol for a new part time post registration degree course in nursing studies. The four-year course will be split into two equal sections, diploma and degree, and will be open to any first level registered nurse. Nurses who have already obtained their diploma will be able to opt in for the degree course only and there are plans to introduce access courses for applicants with the old London University Diploma so they too can qualify.

  11. Joint Center for Artificial Photosynthesis

    SciTech Connect

    Koval, Carl; Lee, Kenny; Houle, Frances; Lewis, Nate

    2013-12-10

    The Joint Center for Artificial Photosynthesis (JCAP) is the nation's largest research program dedicated to the development of an artificial solar-fuel generation technology. Established in 2010 as a U.S. Department of Energy (DOE) Energy Innovation Hub, JCAP aims to find a cost-effective method to produce fuels using only sunlight, water, and carbon dioxide as inputs. JCAP brings together more than 140 top scientists and researchers from the California Institute of Technology and its lead partner, Berkeley Lab, along with collaborators from the SLAC National Accelerator Laboratory, and the University of California campuses at Irvine and San Diego.

  12. Joint Center for Artificial Photosynthesis

    ScienceCinema

    Koval, Carl; Lee, Kenny; Houle, Frances; Lewis, Nate

    2016-07-12

    The Joint Center for Artificial Photosynthesis (JCAP) is the nation's largest research program dedicated to the development of an artificial solar-fuel generation technology. Established in 2010 as a U.S. Department of Energy (DOE) Energy Innovation Hub, JCAP aims to find a cost-effective method to produce fuels using only sunlight, water, and carbon dioxide as inputs. JCAP brings together more than 140 top scientists and researchers from the California Institute of Technology and its lead partner, Berkeley Lab, along with collaborators from the SLAC National Accelerator Laboratory, and the University of California campuses at Irvine and San Diego.

  13. Automatic locking knee brace joint

    NASA Technical Reports Server (NTRS)

    Weddendorf, Bruce (Inventor)

    1995-01-01

    This invention is an apparatus for controlling the pivotal movement of a knee brace comprising a tang-and-clevis joint that has been uniquely modified. Both the tang and the clevis have a set of teeth that, when engaged, can lock the tang and the clevis together. In addition, the tang is biased away from the clevis. Consequently, when there is no axial force (i.e., body weight) on the tang, the tang is free to pivot within the clevis. However, when an axial force is exerted on the tang, the tang is pushed into the clevis, both sets of teeth engage, and the tang and the clevis lock together.

  14. The Planar Shape of Rock Joints

    NASA Astrophysics Data System (ADS)

    Zhang, Lianyang; Einstein, Herbert H.

    2010-02-01

    Knowing the planar shape of discontinuities is important when characterizing discontinuities in a rock mass. However, the real discontinuity shape is rarely known, since the rock mass is usually inaccessible in three dimensions. Information on discontinuity shape is limited and often open to more than one interpretation. This paper discusses the planar shape of rock joints, the most common discontinuities in rock. First, a brief literature review about the shape of joints is presented, including some information on joint-surface morphology, inferences from observed trace lengths on different sampling planes, information based on experimental studies, and joint shapes assumed by different researchers. This review shows that joints not affected by adjacent geological structures such as bedding boundaries or pre-existing fractures tend to be elliptical (or approximately circular but rarely). Joints affected by or intersecting such geological structures tend to be rectangular. Then, using the general stereological relationship between trace length distributions and joint size distributions developed by Zhang et al. (Geotechnique 52(6):419-433, 2002) for elliptical joints, the effect of sampling plane orientation on trace lengths is investigated. This study explains why the average trace lengths of non-equidimensional (elliptical or similar polygonal) joints on two sampling planes can be about equal and thus the conclusion that rock joints are equidimensional (circular) drawn from the fact that the average trace lengths on two sampling planes are approximately equal can be wrong. Finally, methods for characterizing the shape and size of joints (elliptical or rectangular) from trace length data are recommended, and the appropriateness of using elliptical joint shapes to represent polygonal, especially rectangular, joints is discussed.

  15. Exploring Joint Disease Risk Prediction

    PubMed Central

    Wang, Xiang; Wang, Fei; Hu, Jianying; Sorrentino, Robert

    2014-01-01

    Disease risk prediction has been a central topic of medical informatics. Although various risk prediction models have been studied in the literature, the vast majority were designed to be single-task, i.e. they only consider one target disease at a time. This becomes a limitation when in practice we are dealing with two or more diseases that are related to each other in terms of sharing common comorbidities, symptoms, risk factors, etc., because single-task prediction models are not equipped to identify these associations across different tasks. In this paper we address this limitation by exploring the application of multi-task learning framework to joint disease risk prediction. Specifically, we characterize the disease relatedness by assuming that the risk predictors underlying these diseases have overlap. We develop an optimization-based formulation that can simultaneously predict the risk for all diseases and learn the shared predictors. Our model is applied to a real Electronic Health Record (EHR) database with 7,839 patients, among which 1,127 developed Congestive Heart Failure (CHF) and 477 developed Chronic Obstructive Pulmonary Disease (COPD). We demonstrate that a properly designed multi-task learning algorithm is viable for joint disease risk prediction and it can discover clinical insights that single-task models would overlook. PMID:25954429

  16. Cell Therapy in Joint Disorders

    PubMed Central

    Counsel, Peter D.; Bates, Daniel; Boyd, Richard; Connell, David A.

    2015-01-01

    Context: Articular cartilage possesses poor natural healing mechanisms, and a variety of non-cell-based and cell-based treatments aim to promote regeneration of hyaline cartilage. Data Sources: A review of the literature to December 2013 using PubMed with search criteria including the keywords stem cell, cell therapy, cell transplantation, cartilage, chondral, and chondrogenic. Study Selection: Forty-five articles were identified that employed local mesenchymal stem cell (MSC) therapy for joint disorders in humans. Nine comparative studies were identified, consisting of 3 randomized trials, 5 cohort studies, and 1 case-control study. Study Type: Clinical review. Level of Evidence: Level 4. Data Extraction: Studies were assessed for stem cell source, method of implantation, comparison groups, and concurrent surgical techniques. Results: Two studies comparing MSC treatment to autologous chondrocyte implantation found similar efficacy. Three studies reported clinical benefits with intra-articular MSC injection over non-MSC controls for cases undergoing debridement with or without marrow stimulation, although a randomized study found no significant clinical difference at 2-year follow-up but reported better 18-month magnetic resonance imaging and histologic scores in the MSC group. No human studies have compared intra-articular MSC therapy to non-MSC techniques for osteoarthritis in the absence of surgery. Conclusion: Mesenchymal stem cell–based therapies appear safe and effective for joint disorders in large animal preclinical models. Evidence for use in humans, particularly, comparison with more established treatments such as autologous chondrocyte implantation and microfracture, is limited. PMID:25553210

  17. Factors to consider in joint prosthesis systems

    PubMed Central

    Wolford, Larry M.

    2006-01-01

    In joint reconstruction, the techniques and materials that provide the best outcomes for patients have been debated. The main points of controversy relate to the use of hemiarthroplasties versus total joint prostheses with metal-on-metal versus metal-on-polyethylene articulations. This article investigates these areas as well as the applicability of the techniques and materials and the complications that can occur. Hypersensitivity to materials used in joint prostheses is relatively common but often unrecognized. Although the discussion applies to all joints, the temporomandibular joint (TMJ) is emphasized. For TMJ reconstruction, metal-on-polyethylene articulation in total joint prostheses provides better treatment outcomes than metal-on-metal articulation. PMID:17252041

  18. Synovial joints: from development to homeostasis.

    PubMed

    Longobardi, Lara; Li, Tieshi; Tagliafierro, Lidia; Temple, Joseph D; Willcockson, Helen H; Ye, Ping; Esposito, Alessandra; Xu, Fuhua; Spagnoli, Anna

    2015-02-01

    Synovial joint morphogenesis occurs through the condensation of mesenchymal cells into a non-cartilaginous region known as the interzone and the specification of progenitor cells that commit to the articular fate. Although several signaling molecules are expressed by the interzone, the mechanism is poorly understood. For treatments of cartilage injuries, it is critical to discover the presence of joint progenitor cells in adult tissues and their expression gene pattern. Potential stem cell niches have been found in different joint regions, such as the surface zone of articular cartilage, synovium, and groove of Ranvier. Inherited joint malformations as well as joint-degenerating conditions are often associated with other skeletal defects and may be seen as the failure of morphogenic factors to establish the correct microenvironment in cartilage and bone. Therefore, exploring how joints form can help us understand how cartilage and bone are damaged and develop drugs to reactivate this developing mechanism.

  19. Synovial Joints: from Development to Homeostasis

    PubMed Central

    Li, Tieshi; Tagliafierro, Lidia; Temple, Joseph D.; Willcockson, Helen H.; Ye, Ping; Esposito, Alessandra; Xu, Fuhua; Spagnoli, Anna

    2015-01-01

    Synovial joint morphogenesis occurs through the condensation of mesenchymal cells into a non-cartilaginous region known as interzone, and the specification of progenitor cells that commit to the articular fate. Although several signaling molecules are expressed by the interzone, the mechanism is poorly understood. For treatments of cartilage injuries, it is critical to discover the presence of joint progenitor cells in adult tissues and their expression gene pattern. Potential stem cells niches have been found in different joint regions, such as the surface zone of articular cartilage, synovium and groove of Ranvier. Inherited joint malformation as well as joint degenerating conditions are often associated with other skeletal defects, and may be seen as the failure of morphogenic factors to establish the correct microenvironment in cartilage and bone. Therefore, exploring how joints form can help us understand how cartilage and bone are damaged and to develop drugs to reactivate this developing mechanism. PMID:25431159

  20. Using Joint Interviews to Add Analytic Value.

    PubMed

    Polak, Louisa; Green, Judith

    2016-10-01

    Joint interviewing has been frequently used in health research, and is the subject of a growing methodological literature. We review this literature, and build on it by drawing on a case study of how people make decisions about taking statins. This highlights two ways in which a dyadic approach to joint interviewing can add analytic value compared with individual interviewing. First, the analysis of interaction within joint interviews can help to explicate tacit knowledge and to illuminate the range of often hard-to-access resources that are drawn upon in making decisions. Second, joint interviews mitigate some of the weaknesses of interviewing as a method for studying practices; we offer a cautious defense of the often-tacit assumption that the "naturalness" of joint interviews strengthens their credibility as the basis for analytic inferences. We suggest that joint interviews are a particularly appropriate method for studying complex shared practices such as making health decisions. PMID:25850721

  1. Flat H Frangible Joint Evolution

    NASA Technical Reports Server (NTRS)

    Diegelman, Thomas E.; Hinkel, Todd J.; Benjamin, Andrew; Rochon, Brian V.; Brown, Christopher W.

    2016-01-01

    Space vehicle staging and separation events require pyrotechnic devices. They are single-use mechanisms that cannot be tested, nor can failure-tolerant performance be demonstrated in actual flight articles prior to flight use. This necessitates the implementation of a robust design and test approach coupled with a fully redundant, failure-tolerant explosive mechanism to ensure that the system functions even in the event of a single failure. Historically, NASA has followed the single failure-tolerant (SFT) design philosophy for all human-rated spacecraft, including the Space Shuttle Program. Following the end of this program, aerospace companies proposed building the next generation human-rated vehicles with off-the-shelf, non-redundant, zero-failure-tolerant (ZFT) separation systems. Currently, spacecraft and launch vehicle providers for both the Orion and Commercial Crew Programs (CCPs) plan to deviate from the heritage safety approach and NASA's SFT human rating requirements. Both programs' partners have base-lined ZFT frangible joints for vehicle staging and fairing separation. These joints are commercially available from pyrotechnic vendors. Non-human-rated missions have flown them numerous times. The joints are relatively easy to integrate structurally within the spacecraft. In addition, the separation event is debris free, and the resultant pyro shock is lower than that of other design solutions. It is, however, a serious deficiency to lack failure tolerance. When used for critical applications on human-rated vehicles, a single failure could potentially lead to loss of crew (LOC) or loss of mission (LOM)). The Engineering and Safety & Mission Assurance directorates within the NASA Johnson Space Center took action to address this safety issue by initiating a project to develop a fully redundant, SFT frangible joint design, known as the Flat H. Critical to the ability to retrofit on launch vehicles being developed, the SFT mechanisms must fit within the same

  2. [Septic arthritis of thoracic facet joint].

    PubMed

    Ben Abdelghani, K; Gérard-Dran, D; Combe, B

    2009-08-01

    Septic arthritis of the facet joint is a rare condition. We report a case of septic arthritis of both a thoracic facet joint and a wrist. Clinical manifestations were consistent with a spondylodiscitis. Magnetic resonance imaging of the spine demonstrated infection of facet joints of T1 and T2. A surgical biopsy of the wrist isolated a type B streptococcus. The same organism was found in urine culture. The patient had an uneventful recovery on antibiotics.

  3. Hydraulic-Leak Detector for Hidden Joints

    NASA Technical Reports Server (NTRS)

    Anderson, G. E.; Loo, S.

    1986-01-01

    Slow leakage of fluid made obvious. Indicator consists of wick wrapped at one end around joint to be monitored. Wick absorbs hydraulic fluid leaking from joint and transmits to opposite end, located outside cover plate and visible to inspector. Leakage manifested as discoloration of outside end of wick. Indicator reveals leaks in hidden fittings on hydraulic lines. Fast inspection of joints without disassembly. Used in aerospace, petroleum, chemical, nuclear, and other industries where removing covers for inspection impossible, difficult, or time-consuming.

  4. Thermal treatment of dissimilar steels' welded joints

    NASA Astrophysics Data System (ADS)

    Nikulina, A. A.; Denisova, A. S.; Gradusov, I. N.; Ryabinkina, P. A.; Rushkovets, M. V.

    2016-04-01

    In this paper combinations of chrome-nickel steel and high-carbon steel, produced by flash butt welding after heat treatment, are investigated. Light and electron microscopic studies show that the welded joints after heat treatment have a complex structure consisting of several phases as initial welded joints. A martensite structure in welded joints after thermal treatment at 300... 800 °C has been found.

  5. Design and optimization of a bend-and-sweep compliant mechanism

    NASA Astrophysics Data System (ADS)

    Tummala, Y.; Frecker, M. I.; Wissa, A. A.; Hubbard, J. E., Jr.

    2013-09-01

    A novel contact aided compliant mechanism called bend-and-sweep compliant mechanism is presented in this paper. This mechanism has nonlinear stiffness properties in two orthogonal directions. An angled compliant joint (ACJ) is the fundamental element of this mechanism. Geometric parameters of ACJs determine the stiffness of the compliant mechanism. This paper presents the design and optimization of bend-and-sweep compliant mechanism. A multi-objective optimization problem was formulated for design optimization of the bend-and-sweep compliant mechanism. The objectives of the optimization problem were to maximize or minimize the bending and sweep displacements, depending on the situation, while minimizing the von Mises stress and mass of each mechanism. This optimization problem was solved using NSGA-II (a genetic algorithm). The results of this optimization for a single ACJ during upstroke and downstroke are presented in this paper. Results of two different loading conditions used during optimization of a single ACJ for upstroke are presented. Finally, optimization results comparing the performance of compliant mechanisms with one and two ACJs are also presented. It can be inferred from these results that the number of ACJs and the design of each ACJ determines the stiffness of the bend-and-sweep compliant mechanism. These mechanisms can be used in various applications. The goal of this research is to improve the performance of ornithopters by passively morphing their wings. In order to achieve a bio-inspired wing gait called continuous vortex gait, the wings of the ornithopter need to bend, and sweep simultaneously. This can be achieved by inserting the bend-and-sweep compliant mechanism into the leading edge wing spar of the ornithopters.

  6. Failure Assessment Diagram for Titanium Brazed Joints

    NASA Technical Reports Server (NTRS)

    Flom, Yury; Jones, Justin S.; Powell, Mollie M.; Puckett, David F.

    2011-01-01

    The interaction equation was used to predict failure in Ti-4V-6Al joints brazed with Al 1100 filler metal. The joints used in this study were geometrically similar to the joints in the brazed beryllium metering structure considered for the ATLAS telescope. This study confirmed that the interaction equation R(sub sigma) + R(sub Tau) = 1, where R(sub sigma) and R(sub Tau)are normal and shear stress ratios, can be used as conservative lower bound estimate of the failure criterion in ATLAS brazed joints as well as for construction of the Failure Assessment Diagram (FAD).

  7. Life Estimation of Hip Joint Prosthesis

    NASA Astrophysics Data System (ADS)

    Desai, C.; Hirani, H.; Chawla, A.

    2014-11-01

    Hip joint is one of the largest weight-bearing structures in the human body. In the event of a failure of the natural hip joint, it is replaced with an artificial hip joint, known as hip joint prosthesis. The design of hip joint prosthesis must be such so as to resist fatigue failure of hip joint stem as well as bone cement, and minimize wear caused by sliding present between its head and socket. In the present paper an attempt is made to consider both fatigue and wear effects simultaneously in estimating functional-life of the hip joint prosthesis. The finite element modeling of hip joint prosthesis using HyperMesh™ (version 9) has been reported. The static analysis (load due to the dead weight of the body) and dynamic analysis (load due to walking cycle) have been described. Fatigue life is estimated by using the S-N curve of individual materials. To account for progressive wear of hip joint prosthesis, Archard's wear law, modifications in socket geometry and dynamic analysis have been used in a sequential manner. Using such sequential programming reduction in peak stress has been observed with increase in wear. Finally life is estimated on the basis of socket wear.

  8. Structural analysis of Aircraft fuselage splice joint

    NASA Astrophysics Data System (ADS)

    Udaya Prakash, R.; Kumar, G. Raj; Vijayanandh, R.; Senthil Kumar, M.; Ramganesh, T.

    2016-09-01

    In Aviation sector, composite materials and its application to each component are one of the prime factors of consideration due to the high strength to weight ratio, design flexibility and non-corrosive so that the composite materials are widely used in the low weight constructions and also it can be treated as a suitable alternative to metals. The objective of this paper is to estimate and compare the suitability of a composite skin joint in an aircraft fuselage with different joints by simulating the displacement, normal stress, vonmises stress and shear stress with the help of numerical solution methods. The reference Z-stringer component of this paper is modeled by CATIA and numerical simulation is carried out by ANSYS has been used for splice joint presents in the aircraft fuselage with three combinations of joints such as riveted joint, bonded joint and hybrid joint. Nowadays the stringers are using to avoid buckling of fuselage skin, it has joined together by rivets and they are connected end to end by splice joint. Design and static analysis of three-dimensional models of joints such as bonded, riveted and hybrid are carried out and results are compared.

  9. First Metatarsophalangeal Joint Arthroscopy for Osteochondral Lesions.

    PubMed

    Sherman, Thomas I; Kern, Michael; Marcel, John; Butler, Alexander; McGuigan, Francis X

    2016-06-01

    Small-joint arthroscopy has supplanted open procedures because it offers the potential for improvement in joint visualization, reduced scarring, and accelerated recovery. Despite these advantages, arthroscopy of the first metatarsophalangeal joint is not commonly performed and reports of its use are lacking. The reason for this is not clear but may be because of perceived technical complexity and poorly defined indications. In our experience, however, arthroscopy of the first metatarsophalangeal joint is a versatile procedure that facilitates treatment of many different pathologic processes through a minimally invasive approach with few complications. We present our technique for arthroscopic management of osteochondral lesions of the hallux. PMID:27656371

  10. [Temporomandibular joint, occlusion and bruxism].

    PubMed

    Orthlieb, J D; Ré, J P; Jeany, M; Giraudeau, A

    2016-09-01

    Temporomandibular joint and dental occlusion are joined for better and worse. TMJ has its own weaknesses, sometimes indicated by bad functional habits and occlusal disorders. Occlusal analysis needs to be addressed simply and clearly. The term "malocclusion" is not reliable to build epidemiological studies, etiologic mechanisms or therapeutic advice on this "diagnosis". Understanding the impact of pathogenic malocclusion is not just about occlusal relationships that are more or less defective, it requires to locate them within the skeletal framework, the articular and behavioural context of the patient, and above all to assess their impact on the functions of the masticatory system. The TMJ-occlusion couple is often symbiotic, developing together in relation to its environment, compensating for its own shortcomings. However, a third partner may alter this relationship, such as bruxism, or more generally oral parafunctions, trauma or an interventionist practitioner. PMID:27523443

  11. Temperomandibular joint ankylosis in children

    PubMed Central

    Jayavelu, Perumal; Shrutha, S. P.; Vinit, G. B.

    2014-01-01

    Temperomandibular joint (TMJ) ankylosis or hypo mobility involves fusion of the mandibular condyle to the base of the skull. Impairment of speech, difficulty in mastication, poor oral hygiene, rampant caries, and acute compromise of the airway pose a severe psychological burden on the tender minds of children. The treatment of TMJ ankylosis poses a significant challenge because of technical difficulties and a high incidence of recurrence. This report describes a case of 7-year-old with inability to open mouth, diagnosed with unilateral right bony TMJ ankylosis. The surgical approach consisted of inter-positional arthroplasty followed by physiotherapy. A detailed history, clinical and functional examination, and radiographic examination facilitating correct diagnosis followed by immediate surgical intervention and physiotherapy can help us to restore physical, psychological and emotional health of the child patient. PMID:25210367

  12. Pressure-actuated joint system

    NASA Technical Reports Server (NTRS)

    McGuire, John R. (Inventor)

    2004-01-01

    A pressure vessel is provided that includes first and second case segments mated with one another. First and second annular rubber layers are disposed inboard of the first and second case segments, respectively. The second annular rubber layer has a slot extending from the radial inner surface across a portion of its thickness to define a main body portion and a flexible portion. The flexible portion has an interfacing surface portion abutting against an interfacing surface portion of the first annular rubber layer to follow movement of the first annular rubber layer during operation of the pressure vessel. The slot receives pressurized gas and establishes a pressure-actuated joint between the interfacing surface portions. At least one of the interfacing surface portions has a plurality of enclosed and sealed recesses formed therein.

  13. Multistep joint bilateral depth upsampling

    NASA Astrophysics Data System (ADS)

    Riemens, A. K.; Gangwal, O. P.; Barenbrug, B.; Berretty, R.-P. M.

    2009-01-01

    Depth maps are used in many applications, e.g. 3D television, stereo matching, segmentation, etc. Often, depth maps are available at a lower resolution compared to the corresponding image data. For these applications, depth maps must be upsampled to the image resolution. Recently, joint bilateral filters are proposed to upsample depth maps in a single step. In this solution, a high-resolution output depth is computed as a weighted average of surrounding low-resolution depth values, where the weight calculation depends on spatial distance function and intensity range function on the related image data. Compared to that, we present two novel ideas. Firstly, we apply anti-alias prefiltering on the high-resolution image to derive an image at the same low resolution as the input depth map. The upsample filter uses samples from both the high-resolution and the low-resolution images in the range term of the bilateral filter. Secondly, we propose to perform the upsampling in multiple stages, refining the resolution by a factor of 2×2 at each stage. We show experimental results on the consequences of the aliasing issue, and we apply our method to two use cases: a high quality ground-truth depth map and a real-time generated depth map of lower quality. For the first use case a relatively small filter footprint is applied; the second use case benefits from a substantially larger footprint. These experiments show that the dual image resolution range function alleviates the aliasing artifacts and therefore improves the temporal stability of the output depth map. On both use cases, we achieved comparable or better image quality with respect to upsampling with the joint bilateral filter in a single step. On the former use case, we feature a reduction of a factor of 5 in computational cost, whereas on the latter use case, the cost saving is a factor of 50.

  14. Biofluid lubrication for artificial joints

    NASA Astrophysics Data System (ADS)

    Pendleton, Alice Mae

    This research investigated biofluid lubrication related to artificial joints using tribological and rheological approaches. Biofluids studied here represent two categories of fluids, base fluids and nanostructured biofluids. Base fluids were studied through comparison of synthetic fluids (simulated body fluid and hyaluronic acid) as well as natural biofluids (from dogs, horses, and humans) in terms of viscosity and fluid shear stress. The nano-structured biofluids were formed using molecules having well-defined shapes. Understanding nano-structured biofluids leads to new ways of design and synthesis of biofluids that are beneficial for artificial joint performance. Experimental approaches were utilized in the present research. This includes basic analysis of biofluids' property, such as viscosity, fluid shear stress, and shear rate using rheological experiments. Tribological investigation and surface characterization were conducted in order to understand effects of molecular and nanostructures on fluid lubrication. Workpiece surface structure and wear mechanisms were investigated using a scanning electron microscope and a transmission electron microscope. The surface topography was examined using a profilometer. The results demonstrated that with the adding of solid additives, such as crown ether or fullerene acted as rough as the other solids in the 3-body wear systems. In addition, the fullerene supplied low friction and low wear, which designates the lubrication purpose of this particular particle system. This dissertation is constructed of six chapters. The first chapter is an introduction to body fluids, as mentioned earlier. After Chapter II, it examines the motivation and approach of the present research, Chapter III discusses the experimental approaches, including materials, experimental setup, and conditions. In Chapter IV, lubrication properties of various fluids are discussed. The tribological properties and performance nanostructured biofluids are

  15. Joint Attention in Autism: Teaching Smiling Coordinated with Gaze to Respond to Joint Attention Bids

    ERIC Educational Resources Information Center

    Krstovska-Guerrero, Ivana; Jones, Emily A.

    2013-01-01

    Children with autism demonstrate early deficits in joint attention and expressions of affect. Interventions to teach joint attention have addressed gaze behavior, gestures, and vocalizations, but have not specifically taught an expression of positive affect such as smiling that tends to occur during joint attention interactions. Intervention was…

  16. Experimental Investigation of Composite Pressure Vessel Performance and Joint Stiffness for Pyramid and Inverted Pyramid Joints

    NASA Technical Reports Server (NTRS)

    Verhage, Joseph M.; Bower, Mark V.; Gilbert, Paul A. (Technical Monitor)

    2001-01-01

    The focus of this study is on the suitability in the application of classical laminate theory analysis tools for filament wound pressure vessels with adhesive laminated joints in particular: pressure vessel wall performance, joint stiffness and failure prediction. Two 18-inch diameter 12-ply filament wound pressure vessels were fabricated. One vessel was fabricated with a 24-ply pyramid laminated adhesive double strap butt joint. The second vessel was fabricated with the same number of plies in an inverted pyramid joint. Results from hydrostatic tests are presented. Experimental results were used as input to the computer programs GENLAM and Laminate, and the output compared to test. By using the axial stress resultant, the classical laminate theory results show a correlation within 1% to the experimental results in predicting the pressure vessel wall pressure performance. The prediction of joint stiffness for the two adhesive joints in the axial direction is within 1% of the experimental results. The calculated hoop direction joint stress resultant is 25% less than the measured resultant for both joint configurations. A correction factor is derived and used in the joint analysis. The correction factor is derived from the hoop stress resultant from the tank wall performance investigation. The vessel with the pyramid joint is determined to have failed in the joint area at a hydrostatic pressure 33% value below predicted failure. The vessel with the inverted pyramid joint failed in the wall acreage at a hydrostatic pressure within 10% of the actual failure pressure.

  17. Calculation of tubular joints as compound shells

    NASA Astrophysics Data System (ADS)

    Golovanov, A. I.

    A scheme for joining isoparametric finite shell elements with a bend in the middle surface is described. A solution is presented for the problem of the stress-strain state of a T-joint loaded by internal pressure. A refined scheme is proposed for calculating structures of this kind with allowance for the stiffness of the welded joint.

  18. The Role of Rehearsal in Joint Control

    ERIC Educational Resources Information Center

    Gutierrez, Rick D.

    2006-01-01

    Behavior analysts have offered accounts of the behavior involved in matching to sample and delayed matching to sample. But until recently have not offered a behavioral analysis of generalized matching-to-sample. The concept of joint control, however, seems especially suited to such an analysis The present study used a joint-control procedure to…

  19. 38 CFR 36.4308 - Joint loans.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Joint loans. 36.4308 Section 36.4308 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) LOAN GUARANTY Guaranty or Insurance of Loans to Veterans With Electronic Reporting § 36.4308 Joint loans....

  20. 38 CFR 36.4509 - Joint loans.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Joint loans. 36.4509 Section 36.4509 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) LOAN GUARANTY Direct Loans § 36.4509 Joint loans. (a) No loan will be made unless an eligible veteran is...

  1. 12 CFR 612.2157 - Joint employees.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 7 2012-01-01 2012-01-01 false Joint employees. 612.2157 Section 612.2157 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM STANDARDS OF CONDUCT AND REFERRAL OF KNOWN OR SUSPECTED CRIMINAL VIOLATIONS Standards of Conduct § 612.2157 Joint employees. No officer of...

  2. 12 CFR 612.2157 - Joint employees.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Joint employees. 612.2157 Section 612.2157 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM STANDARDS OF CONDUCT AND REFERRAL OF KNOWN OR SUSPECTED CRIMINAL VIOLATIONS Standards of Conduct § 612.2157 Joint employees. No officer of...

  3. 38 CFR 36.4210 - Joint loans.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Joint loans. 36.4210 Section 36.4210 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) LOAN... General Provisions § 36.4210 Joint loans. (a) Except as provided in paragraph (b) of this section,...

  4. 12 CFR 612.2157 - Joint employees.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 7 2013-01-01 2013-01-01 false Joint employees. 612.2157 Section 612.2157 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM STANDARDS OF CONDUCT AND REFERRAL OF KNOWN OR SUSPECTED CRIMINAL VIOLATIONS Standards of Conduct § 612.2157 Joint employees. No officer of...

  5. 38 CFR 36.4210 - Joint loans.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Joint loans. 36.4210 Section 36.4210 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) LOAN... General Provisions § 36.4210 Joint loans. (a) Except as provided in paragraph (b) of this section,...

  6. 38 CFR 36.4509 - Joint loans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Joint loans. 36.4509 Section 36.4509 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) LOAN GUARANTY Direct Loans § 36.4509 Joint loans. (a) No loan will be made unless an eligible veteran is...

  7. 12 CFR 612.2157 - Joint employees.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 7 2014-01-01 2014-01-01 false Joint employees. 612.2157 Section 612.2157 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM STANDARDS OF CONDUCT AND REFERRAL OF KNOWN OR SUSPECTED CRIMINAL VIOLATIONS Standards of Conduct § 612.2157 Joint employees. No officer of...

  8. 38 CFR 36.4308 - Joint loans.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Joint loans. 36.4308 Section 36.4308 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) LOAN GUARANTY Guaranty or Insurance of Loans to Veterans With Electronic Reporting § 36.4308 Joint loans....

  9. 38 CFR 36.4210 - Joint loans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Joint loans. 36.4210 Section 36.4210 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) LOAN... General Provisions § 36.4210 Joint loans. (a) Except as provided in paragraph (b) of this section,...

  10. 24 CFR 570.308 - Joint requests.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... submission requirements of 24 CFR part 91 and covers all members of the joint recipient. ... 24 Housing and Urban Development 3 2012-04-01 2012-04-01 false Joint requests. 570.308 Section 570... DEVELOPMENT COMMUNITY FACILITIES COMMUNITY DEVELOPMENT BLOCK GRANTS Entitlement Grants § 570.308...

  11. 38 CFR 36.4509 - Joint loans.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Joint loans. 36.4509 Section 36.4509 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) LOAN GUARANTY Direct Loans § 36.4509 Joint loans. (a) No loan will be made unless an eligible veteran is...

  12. 38 CFR 36.4210 - Joint loans.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Joint loans. 36.4210 Section 36.4210 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) LOAN... General Provisions § 36.4210 Joint loans. (a) Except as provided in paragraph (b) of this section,...

  13. 38 CFR 36.4210 - Joint loans.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Joint loans. 36.4210 Section 36.4210 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) LOAN... General Provisions § 36.4210 Joint loans. (a) Except as provided in paragraph (b) of this section,...

  14. 38 CFR 36.4308 - Joint loans.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Joint loans. 36.4308 Section 36.4308 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) LOAN GUARANTY Guaranty or Insurance of Loans to Veterans With Electronic Reporting § 36.4308 Joint loans....

  15. 24 CFR 570.308 - Joint requests.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... submission requirements of 24 CFR part 91 and covers all members of the joint recipient. ... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Joint requests. 570.308 Section 570... DEVELOPMENT COMMUNITY FACILITIES COMMUNITY DEVELOPMENT BLOCK GRANTS Entitlement Grants § 570.308...

  16. 38 CFR 36.4308 - Joint loans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Joint loans. 36.4308 Section 36.4308 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) LOAN GUARANTY Guaranty or Insurance of Loans to Veterans With Electronic Reporting § 36.4308 Joint loans....

  17. 38 CFR 36.4509 - Joint loans.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Joint loans. 36.4509 Section 36.4509 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) LOAN GUARANTY Direct Loans § 36.4509 Joint loans. (a) No loan will be made unless an eligible veteran is...

  18. 24 CFR 570.308 - Joint requests.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... submission requirements of 24 CFR part 91 and covers all members of the joint recipient. ... 24 Housing and Urban Development 3 2011-04-01 2010-04-01 true Joint requests. 570.308 Section 570... DEVELOPMENT COMMUNITY FACILITIES COMMUNITY DEVELOPMENT BLOCK GRANTS Entitlement Grants § 570.308...

  19. 38 CFR 36.4509 - Joint loans.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Joint loans. 36.4509 Section 36.4509 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) LOAN GUARANTY Direct Loans § 36.4509 Joint loans. (a) No loan will be made unless an eligible veteran is...

  20. 24 CFR 570.308 - Joint requests.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... submission requirements of 24 CFR part 91 and covers all members of the joint recipient. ... 24 Housing and Urban Development 3 2013-04-01 2013-04-01 false Joint requests. 570.308 Section 570... DEVELOPMENT COMMUNITY FACILITIES COMMUNITY DEVELOPMENT BLOCK GRANTS Entitlement Grants § 570.308...