Triangga, Aditya Fuad Robby
Department Of Orthopaedics And Traumatology, Dr. Sardjito General Hospital/Faculty Of Medicine, Public Health, And Nursing, Universitas Gadjah Mada

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Comparison of diagnostic accuracy between clinical examination and magnetic resonance imaging (MRI) in diagnosing anterior cruciate ligament (ACL) rupture on Indonesian population Luthfi Hidayat; Aditya Fuad Robby Triangga; Muhamad Afrizal Farkhan; Bernadeta Fuad Paramita Rahayu; Rahadyan Magetsari
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 2 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (872.563 KB) | DOI: 10.19106/JMedSci005302202107

Abstract

Anterior cruciate ligament (ACL) injury is the most common knee ligament injured. Anterior drawer and Lachman tests are the most common physical examinations for helping diagnose ACL injuries, while magnetic resonance imaging (MRI) is the first choice of supporting examination for evaluating any internal abnormality of the knee. However, studies concerning the accuracy of those examinations in the Indonesian population are limited. This study aimed to compare the accuracy between the anterior drawer test, Lachman test, and MRI in diagnosing ACL injury in Javanese patients. This retrospective study used medical records data of patients who underwent knee arthroscopy in the Department of Orthopaedics and Traumatology, Dr. Sardjito General Hospital, Yogyakarta in 2018. The MRI and the clinical examination results were compared to the arthroscopy results as the gold standard. The study showed the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for the anterior drawer test were 86.67% (95%CI: 69.28-96.24%), 80% (CI: 44.39-97.48%), 92.86% (CI: 78.88-97.84), 66.67% (CI: 43.28-83.98%), and 85% (CI: 70.16-94.29%), respectively. Lachman test had 96.67% (CI: 82.78-99.92%) sensitivity, 90% (CI: 55.50-99.75%) specificity, 96.67% (CI: 81.86-99.47%) PPV, 90% (CI: 56.44-98.43%) NPV, and 95% (CI: 83.08-99.39%) accuracy. The diagnostic parameters of MRI were 83.33% (CI: 65.28-94.36%) for sensitivity, 60% (CI: 26.24-87.84%) for specificity, 86.21% (CI: 74.21-93.14%) for PPV, 54.55% (CI: 31.77-75.57%) for NPV, and 77.50% (CI: 61.55-89.16%) for accuracy. In conclusion, the Lachman test has better accuracy than the anterior drawer test. Both the anterior drawer and Lachman tests had higher accuracy compared to the MRI.
Scurvy with Musculoskeletal Pain in Indonesian Pediatric Patient: A Case Report Muhammad, Hilmi; Meirizal, Meirizal; Sakti, Yudha Mathan; Triangga, Aditya Fuad Robby; Lanodiyu, Zikrina Abiyanti; Putra, Ginanjar Reza; Yasser, Yasser; Putro, Yuni Artha Prabowo
Jurnal Kedokteran Diponegoro (Diponegoro Medical Journal) Vol 13, No 5 (2024): JURNAL KEDOKTERAN DIPONEGORO (DIPONEGORO MEDICAL JOURNAL)
Publisher : Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dmj.v13i5.44840

Abstract

Background: Scurvy is a potentially fatal disease caused by a severe deficiency of vitamin C, which can manifest as a musculoskeletal problem. Early diagnosis and treatment of vitamin C deficiency are crucial to prevent severe symptoms. Unfortunately, vitamin C level evaluations in Indonesia are very limited due to the lack of laboratory facilities. As a result, patients with scurvy are often underdiagnosed and do not receive adequate management. Case Presentation: 5-year-old boy with musculoskeletal pain and inability to walk. Radiographic findings showed a pathognomonic line of Fränkel, Trümmerfeld zone, and Wimberger ring sign, with laboratory evaluation showing an anemia and vitamin D deficiency. We did not perform a laboratory examination for vitamin C due to a lack of test facilities but the patient was given oral 250 mg of vitamin C daily instead. The patient showed significant improvement in symptoms and laboratory results after three months of vitamin C supplementation. To summarize, that vitamin C deficiency should be considered among patients with related musculoskeletal manifestations supported by imaging results.