Other examination methods

Other_Invest

At our institute we use a rather wide range of instrumental and laboratory examination of our patients. We use the optical analysis, stabilometrical control, monitor performance indicators of the heart and external respiration; our specialists perform serious radiological diagnostics. Comprehensive examination usually gives a possibility to receive more information than a simple sum of conclusions.

A wide interdisciplinary approach is one of our undeniable advantages. Diagnostics is most important when prescribing treatment and controlling the results of therapy. Our institute is equipped with up-to-date high technology instruments which help in assessing the condition of our patients and predicting for the near and remote future.

mitri.az X-ray examination is one of the simplest and most popular radiological methods that helps diagnose a lot of diseases. Our institute is equipped with digital roentgenc instruments to perform any type of roentgenographic examinations. The exposure dose will be lower than in conventional roentgenography, while the quality of the image will be distinctly better. The results of the examination can be available on a film or on a disc. X-ray examination is performed in a special room in accordance with safety requirements and with the use of personal protective equipment. During the examination the patient can either stand near the desk or lie on the roentgen table; here everything depends on the area that will be examined. Some types of examination require special preparation.
The examination helps detect the following symptoms and diseases:
  • Foreign bodies;
  • Inflammatory, traumatic, tumour diseases of the osteoarticular system;
  • Lung diseases;
  • Benign and malignant neoplasms in the mammary gland;
  • Inflammatory and non-inflammatory diseases of the paranasal sinuses;
  • Nephrolithiasis, abnormal development of urinary tracts;
  • Assessment of the state of teeth, temporomandibular joints;
  • Urgent X-ray diagnostics in case of acute surgical states (acute intestinal obstruction), etc.
The procedure takes about 5-10 minutes including patient positioning, scanning and processing of results. Contrast examination of the abdominal cavity requires 2 days.
The dose a patient is exposed to during digital examination is considerably lower than the film projection mode. However we have all personal protective equipment available.
  • Radiography of the abdomen
  • Contrast radiography of the stomach and duodenum
  • General plain radiography of the abdomen
  • Radiography of the pelvic bones in anteroposterior view
  • Radiography of the femoral bone
  • Radiography of the knee joint
  • Radiography of the tarsus and metatarsus
  • Radiography of the elbow joint
  • Radiography of the sole
  • Radiography of the ankle joint
  • Radiography of the navicular carpal bone
  • Radiography of the hand
  • Radiography of the brachial zone
  • Radiography of the surae
  • Radiography of the fingers for orthodontic issues
  • Radiography of the calcaneal bone
  • Radiography of the hip joint in anteroposterior view
  • Radiography of the shoulder
  • Radiography of the thoracic cage in one view
  • Radiography of the upper limb girdle
  • Radiography of the diaphragm
  • General plain radiography of the mammary gland in anteroposterior view
  • Radiography of the thoracic cage in anteroposterior view
  • Radiography, radioscopy of the thoracic cage
  • Targeted radiography of the thoracic cage
  • Radiography of the thoracic cage in lateral view
  • General plain radiography of the mammary gland in oblique view
  • Radiography of the thoracic spine
  • Radiography of the sacrum
  • Radiography of the lumbar spine
  • Radiography of the cervical spine
  • Radiography of the coccyx
  • Radiography of the temporal bone
  • Radiography of the sella turcica (Turkish saddle)
  • Radiography of the mastoid
  • Radiography of the черепа
  • Radiography of the paranasal sinuses
  • Radiography of the nasal bones
  • Radiography of the shoulder joint
  • Radiography of the elbow and wrist joints
  • Radiography of the collar bone, ribs, acromial-rib bone joints
  • Radiography of the iliac bone
  • Radiography of the toes
  • Irrigoscopy
  • Radiography of the ischial bone
  • Radiography of the fingers
  • Radiography of the sacroiliac joint, shoulder and hip (large joints)
mitri.az Densitometry is a non-invasive method of determining the mineral density of the osseous tissue. It is used to measure the content of calcium in bones that is their main structural element. Data on the state of the spine and femoral neck are vital, as fractures of these areas are most dangerous and accompanied with loss of mobility for a long period of time. Densitometry is one of important system for diagnosing osteoporosis often caused by age-specific or hormonal changes. This simple examination makes it possible to prescribe therapy in proper time and not to bring the disease to severe stages when it is already incurable. Calcium content in bones begins to decrease after the age of 30 and can reach critical figures by the age of 50; therefore the diagnostics of the state of bones at a mature age becomes especially important. Densitometry makes it possible to analyze the state of the osteoarticular system, ligamentous apparatus, as well as
  • monitor the consolidation of fractures;
  • assess the efficiency of osteoremedial therapy;
  • assess the state and take proper preventive methods for strengthening the osseous apparatus.
В нашем институте установлен денситометр Lunar iDXA, GE Healthcare. Это система обладает чрезвычайно низким Our institute is equipped with Lunar iDXA densitometer (GE Healthcare). This system has an extremely low level of radiation which even makes it possible for the staff to work without protective clothes. The use of the High-Definition Direct-Digital Narrow-Angle Fan-Beam technology provides reliable diagnostics, high performance and availability thanks to:
  • unprecedented imaging and the highest accuracy and reliability;
  • the most advanced technology in diagnosing the osseous tissue and analyzing the composition of the body;
  • innovative technology, simplicity in operation, the highest level of reliability and technical maintenance;
  • unlimited potential in diagnosing a wide range of diseases and states..
Densitometric investigation at our institute can be characterized in the following way:
  • progressive technology in diagnosing the osseous tissue and analysis of the body composition;
  • unlimited potential in diagnosing a wide range of diseases and states;
  • dual energy scanning with a morphometric analysis;
  • high quality of visualization and accuracy;
  • frontal projection investigation of the spine;
  • assessment of fracture risks for 10 years;
  • extended investigation of the femoral neck.
A possibility to examine the spine in all projections. Examination of the femoral neck, its strength and diameter, examination of antebrachium and hand bones. Examination of the whole body with a composition analysis that makes it possible to analyze not only mineral density of bones but also the amount of fat, muscle, connective tissues. Moreover, a densitometer has pediatric programs that allow investigating the mineral density of the osseous tissue of the spine and femoral neck, making a composition analysis of the whole body in children from 5 to 17.
The procedure takes about 15 minutes including patient positioning, scanning and processing of results. It does not require special preparation. The measurement of the mineral density of the osseous tissue of the spine, femoral neck, and whole body is made in the lying position, while the measurement of the mineral density of antebrachium bones is made in the sitting position. The patient receives the result of the examination on the same day.
The dose a patient is exposed to during, for example, an examination of the whole body is 0.3 mR and considered to be very low; it does not require any protective equipment for the patient and the staff. The examination can be made as frequently as required.
Women at the age of 65 and older, women in the menopausal period under 65 with osteoporosis risk factors, people with fractures in case of minimum injuries and with poorly healing fractures, patients with diseases and states that lead to reduction of the bone content (diseases of the endocrine system, joints, digestive organs, kidneys), as well as during osteoporosis treatment efficiency monitoring. In particular, these are:
  • women in the pre- and postmenopausal period;
  • men at the age of 65 and older;
  • people after the age of 40 who had more than one fractures not related with such objective causes for injuries as a traffic accident, falling from elevations, sports and professional injuries;
  • people with diagnosed osteoporosis during X-ray examination of bones;
  • people who suffer from endocrine and rheumatic diseases;
  • patients continuously treated with hormones (prednisolone, etc.);
  • patients treated for osteoporosis, to control the efficiency of treatment.
There are no contraindications as such, however we consider the following:
  • impossibility to stay in the horizontal position;
  • early stages of pregnancy..
Special aspects of densitometry:
  • high speed scanning thanks to fan shaped beam technology (5 times faster than available counterparts);
  • the exposure dose for the patient and the operator is 5-10 times lower than with other densitometers;
  • images as sharp as possible;
  • high accuracy.
  • examination of the spine, antebrachium and proximal femur in less than 30 seconds;
  • examination of two proximal femurs;
  • examination of the lateral projection of the spine;
  • pediatric programs;
  • program for examination of the whole body/analysis of body composition (the time of scanning is 5 minutes);
  • fracture risk assessment for 10 years;
  • extended examination of the femoral neck;
  • examination of the frontal projection of the spine;
  • possibility to simultaneously scan the spine and two femoral bones with extended examination of the femoral neck in 3х10 with printing several images on 1 sheet.
mitri.az A human body is a complex mechanism which is studied by means of advanced however simple device. An optical control system was created to provide clinicians with a high technology instrument for accurate and simple examination of the gait, running and jumping. An analysis of spatial motion of patients combined with ground contact vectors when registering myography makes it possible to detect changes in the motion technique. The analysis gives an exact direction for developing a rehabilitation and correction program to optimize the motion technique of patients with different pathologies of the nervous system and locomotor apparatus. Complete examination of a patient can be performed in less than 30 minutes. Digital synchronization of all types of signals makes it possible for our specialists to assess how patient’s joints move, muscles work and energy is distributed on bearing surfaces. The system can prepare the following protocols:
  • gait analysis protocol
  • spinal mobility analysis protocol
  • body and mass centre mobility protocol
  • augmented reality protocol for force analysis
  • stabilometric analysis.
mitri.az A digital optical motion analysis helps detect changes in the posture and movements in an unbiased, accurate and non-invasive form. The objective is to assess the ability to move in space, abnormalities and the need to correct or use auxiliary facilities. A gait analysis consists in collecting kinematic, dynamic and electromyographic parameters. This service is created for patients suffering from neurologic (hemiplegia, infantile cerebral palsy, Parkinson’s disease, spinal cord injuries) and orthopedic diseases (arthritis, trauma consequences, surgeries, patients with an amputated lower extremity and disabled persons with prostheses). In particular, a gait analysis helps:
  • determine the level of functional restriction and loss of working capacity as a result of a disease, applied compensation, pathogenic mechanisms caused by this change and their development with the growth and/or aging of a person;
  • participate in the planning of treatment promoting the development of an adequate personal rehabilitation program which will be able to determine the clinical state of a patient before, during and after the program objectively and with measurable indicators;
  • in sports, receive a quantitative analysis of athletic motion to improve sports results and prevent injuries through studying preventive mechanisms of motor activity management that underlie sports movements;
  • for injured athletes, optimize the rehabilitation program and assure functional recovery before returning to sports activity;
  • assess the ergonomics of sports equipment and devices, ortheses and prostheses.
A comprehensive gait analysis can help a physician select, before the treatment, the most suitable therapy: orthopedic surgeries, botulinum toxin injections, use of ortheses or prostheses, intrathecal therapy, etc. A comparative analysis of data before and after treatment makes it possible to evaluate the results of corrective therapy, improvement. Protocol therapy Using self-adhesive tape, spherical reflective markers are fixed in some anatomic fixed points on the patient’s skin according to the relevant protocols. Infrared cameras record the movement of the markers in space: as a result, three-dimensional reconstruction of the movement of every segment of the body is recorded. The received data is processed by special software and a report is made. The report is analyzed thoroughly by qualified specialists, a medical opinion is given; a diagnosis is made and adequate therapeutic recommendations are given. Duration of a session depends on the type of analyzed motion and number of passive markers required by the analysis protocol. For example, the evaluation of gait kinematics can last 60 minutes.
CardioInvest КCardiologic examination of patients for their further rehabilitation at our institute can be provided in full. As a rule, we are addressed by patients with verified diagnosis of the ischemic heart disease after previous myocardial infarction, balloon dilatation, stenting, coronary artery bypass surgery, radio frequency ablation, with chronic cardiac insufficiency. The need in preliminary, interim and final check examination is not compulsory in all cases, but in a number of complex clinical cases it is associated with the need to exactly dose physical load and observe its acceptability. This makes it possible to prevent problems in advance or more actively extend the motion mode. We also examine patients with rhythm impairment of various etiology, increase in blood pressure, collaptoid state and unexpected transient loss of consciousness normalizing the medication therapy and physical activity. We perform stress test including echocardiographically controlled 24-hour pulse monitoring, ECG and blood pressure.
CfrdioPulmonary
A cardiopulmonary test is a non-invasive diagnostic method that makes it possible to detect heart diseases (such as cardiac insufficiency, ischemic heart disease, cardiac angina, etc.), check the performance of the cardiovascular and respiratory systems, respiratory metabolism between cells and the environment.
Ergospirometry makes it possible to evaluate the impact, acceptability and optimal level of physical exercises for each patient individually. This diagnostic method evaluates different treatment methods used, for example, physical training or use of medication.
This diagnostic method takes a rather short period of time, brings no inconveniences to patients, needs no preliminary preparation, and imposes no limitations on the patients. The advantage of ergospirometry combined with ECG is the evaluation of the cardiac and pulmonary functions during one test. The information value of this combined test for cardiac patients is considerably higher than that of an isolated stress test; it gives real-time measurement results.
holter2
24-hour (Holter) ECG monitoring is a method of continuous registration of cardiac electrical activity under normal living conditions. This provides detailed information about heart functioning for physicians: cardiac rate, rhythmicity, cardiac conducting system, presence of ischemia (insufficient blood supply).
Holter monitoring is an absolutely safe method of examination performed under outpatient treatment. This method has no contraindications.
Holter ECG monitoring makes it possible to:
  • evaluate cardiac performance under normal activity of the patient (heart reaction to physical and emotional load).
  • evaluate the state of the heart when sleeping, heart rhythm and conductivity during 24 hours.
  • clarify the cause of faintness and precollaptoid states, etc.
  • detect and analyze all types of arrhythmia.
  • detect episodes of painful and painless myocardial ischemia, their number, duration, threshold level of load and pulse when ischemia appears.
Simultaneously with cardiac rhythm monitoring, 24-hour blood pressure monitoring is performed. In combination this gives more complete information and makes it possible to give a conclusion or correct the treatment.
StabillometryPt A force plate is designed for diagnosing disorders of equilibrium, concentration, coordination, pathologies of the locomotor apparatus, central and peripheral nervous system, visual and vestibular analyzers, general kinetotherapy. Besides diagnostic application, the training effect of a force plate is used. The basic objective of a training session on a force plate is to stimulate sections of the nervous system and locomotor apparatus responsible for equilibrium control as well as to develop muscles responsible for postural stability. A force plate is a diagnosing advice and training equipment consisting of a movable platform and a monitor located at the level of patient’s eyes. The monitor displays testing and gaming tasks and the patient should react to the image or control its movement displacing the mass centre of his/her body. The feedback system of the training equipment makes it possible for specialists of the institute to receive a report on the training. Stabilometrics gives additional opportunities to detect functional disorders in case of diseases of the spine, nervous system, vestibular and visual analyzers; support ability of extremities; functional state of ankle joints; equilibrium disorders in case of scoliosis, after injuries and surgeries. The force plate method makes it possible to clarify the diagnosis; manage the remedial treatment and fix the dynamics; examine clinically difficult patients; perform additional training sessions for patients according to biological feedback principles (search for a motion strategy, training of motor skills). The force plate method is indispensible in case of neurological diseases (consequences of strokes and traumatic brain injuries, infantile cerebral palsy, dyscirculatory encephalopathy, Parkinson’s disease, ataxy, hyperkinesis, falling, polyneuropathy); visual disorders; dysfunction of oculomotor muscles (squinting); pathology of the vestibular apparatus (giddiness); spinal diseases (postural disorders, scoliosis, spinal ostechondrosis, vertebral artery syndrome); foot pathologies (deformation, platypodia); evaluation of the results of treatment (medication, physical, remedial physical training, manual therapy, etc.); express estimation of the psychophysiological state of a person; review of the working capacity.
First of all, a force plate is more effective than the drug effect. Dynamic training sessions on force plates do not cause side effects unlike taking of drugs that desensitize the vestibular apparatus. Any taking of tablets usually causes accustomization which significantly reduces their effect. Secondly, a force plate strengthens an untrained organism. A sedentary lifestyle leads to a dysfunction of the vestibular apparatus. While regular training on force plates restore the physical form of a patient. Thanks to this the sensitivity of the vestibular apparatus increases and, consequently, the patient tolerates a disease less painfully or does not feel it at all. Thirdly, a force plate has a form building effect. Regular training of the vestibular apparatus using this training equipment increases the tolerance and dexterity of the patient, improves motion coordination, strengthens the muscles of the back and extremities, makes it possible to correct and improve the motion stereotype.
MiographyPts Electromyography is a method that helps examine the bioelectrical activity of muscles and nerves. The information makes it possible to determine the level of injury of the nervous system as a whole and the state of individual groups of muscles. Myography is prescribed if patients complaint of convulsions, spasms, tics or muscle weakness. Moreover, a neurologist can prescribe this method to examine the activity of the urinary bladder sphincter, palsy or ICP. Myographic examination is performed both separately for a specific distal muscle or nerve and together with such comprehensive examinations as electrotensomyography, isokinetic examination, optico-kinematic examination.
Myography is the only method that can determine the exact place of damage of one or another nerve, give specific information about the cause of palsy, muscle atrophy or excessive nervous sensibility. Myography is indispensible in diagnosing acute traumatic damage of the nervous system (for example, after an accident) and in case of impaired functioning of muscles caused by injuries or stress.
In case of electrotensomyographic examination a myograph registers the electrical potential of muscle fibres at rest. Then the muscles are activated in one of the three ways and the force of muscle response is measured.
Myography does not require any special preparation. Electrodes of the myograph are connected to the patient’s muscles. Depending on the type of examination electrodes can be fixed in two ways:
  • through the skin (transcutaneous wireless) when electrodes are placed on the muscle under examination;
  • by means of a needle when a small needle is inserted into a muscle. This method is more informative although brings slight discomfort.
The information from electrodes is transformed into a graph and transferred to the myograph, then it is recorded to a tape or displayed on the computer screen, printed and analyzed. The duration of the examination depends on the volume of examination and can be within 30-60 minutes. It should be taken into account that during some period of time after myography you can feel pain in muscles that disappear without any help.
Electrodes should not be placed on injured skin (infectious diseases, rash). This examination should not be performed if the patient has a cardiostimulator or psychic disorders and epilepsy as the impact on muscles can cause a stroke.
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