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Assessment of the Rectum and Anus01:25

Assessment of the Rectum and Anus

Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
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Basilar Invagination Diagnosis, Classification, and Radiology: WFNS Spine Committee Recommendations.

Onur Yaman1, Mehmet Zileli2, İdris Avci1

  • 1Department of Neurosurgery, Memorial Bahçelievler Hospital, Istanbul, Türkiye.

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|May 7, 2025
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Summary

Basilar invagination (BI) diagnosis and classification have evolved, but inconsistencies persist. This review provides consensus-based recommendations for BI diagnosis, classification, and radiologic assessment.

Keywords:
McRae linebasal anglebasilar invaginationchamberlain linesyringomyeliawackenheim line

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Area of Science:

  • Neurosurgery
  • Radiology
  • Orthopedics

Background:

  • Basilar invagination (BI) diagnosis, classification, and radiologic characteristics have evolved significantly over the past decade.
  • Debatable criteria for BI hinder standardized clinical research and comparison.
  • A common language is essential for advancing research in BI.

Purpose of the Study:

  • To analyze recent literature on the diagnosis, classification, and radiologic characteristics of Basilar Invagination (BI).
  • To generate consensus-based recommendations on BI diagnosis, classification, and radiologic assessment.
  • To address the need for standardized criteria in BI research.

Main Methods:

  • Systematic literature review.
  • Consensus development using the Delphi method.
  • Two consensus meetings organized by the WFNS Spine Committee involving voting on statements.

Main Results:

  • Basilar invagination (BI) is primarily a congenital abnormality of the craniocervical junction (CVJ), often linked with other congenital anomalies.
  • Acquired BI can result from bone softening conditions like rheumatoid arthritis.
  • BI is classified into Type I (with atlantoaxial dislocation) and Type II (without atlantoaxial dislocation).
  • Clinical signs stem from brainstem or cervical spinal cord compression and instability.
  • Reliable radiologic measurements include the McRae line, Chamberlain line, and Boogard angle.

Conclusions:

  • Diagnosis of Basilar Invagination (BI) should utilize midsagittal craniocervical X-rays, CT, or MRI.
  • Type I BI is associated with instability, potentially requiring stabilization.
  • Type II BI may necessitate decompressive surgical interventions.