1
|
Ubl ST, Vieider RP, Seilern und Aspang J, Gaebler C, Platzgummer H. Bone bruise distribution predicts anterior cruciate ligament tear location in non-contact injuries. J Exp Orthop 2024; 11:e12034. [PMID: 38741902 PMCID: PMC11089843 DOI: 10.1002/jeo2.12034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 04/12/2024] [Accepted: 04/26/2024] [Indexed: 05/16/2024] Open
Abstract
Purpose It is unclear whether different injury mechanisms lead to divergent anterior cruciate ligament (ACL) tear locations. This study aims to analyse the relationship between bone bruise (BB) distribution or depth and ACL tear location. Methods A retrospective analysis of 446 consecutive patients with acute non-contact ACL injury was performed. Only patients with complete ACL tears verified during subsequent arthroscopy were included. Magnetic resonance imaging (MRI) was used to classify BB location, BB depth, ACL tear location and concomitant injuries (medial/lateral meniscus and medial/lateral collateral ligament). Demographic characteristics included age, gender, body mass index (BMI), type of sport and time between injury and MRI. Multiple linear regression analysis was used to identify independent predictors of ACL tear location. Results One hundred and fifty-eight skeletally mature patients met the inclusion criteria. The presence of BB in the lateral tibial plateau was associated with a more distal ACL tear location (β = -0.27, p < 0.001). Less BB depth in the lateral femoral condyle showed a tendency towards more proximal ACL tears (β = -0.14; p = 0.054). Older age predicted a more proximal ACL tear location (β = 0.31, p < 0.001). No significant relationship was found between ACL tear location and gender, BMI, type of sport, concomitant injuries and time between injury and MRI. Conclusion ACL tear location after an acute non-contact injury is associated with distinct patterns of BB distribution, particularly involving the lateral compartment, indicating that different injury mechanisms may lead to different ACL tear locations. Level of Evidence Level III.
Collapse
Affiliation(s)
- Steffen T. Ubl
- Department of Orthopaedic Surgery, Trauma Surgery and Sports Medicine, Cologne Merheim Medical CenterWitten/Herdecke UniversityCologneGermany
| | - Romed P. Vieider
- Department of Sports Orthopaedics, Klinikum Rechts der IsarTechnical University of MunichMunichGermany
| | - Jesse Seilern und Aspang
- Department of Orthopaedic Surgery, Grady Memorial HospitalEmory University School of MedicineAtlantaGeorgiaUSA
| | - Christian Gaebler
- Sportambulatorium Wien – Zentrum für Orthopaedie und Sportchirurgie (ZOS)ViennaAustria
| | - Hannes Platzgummer
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaViennaAustria
| |
Collapse
|
2
|
Lorenzana D, Platzgummer H, Peyer AK, Krol A, Eichenberger U. Diagnostic use of ultrasound for patients with neuropathic pain. J Clin Anesth 2023:111314. [PMID: 38030462 DOI: 10.1016/j.jclinane.2023.111314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023]
Affiliation(s)
- David Lorenzana
- Balgrist University Hospital, Department of Anaesthesiology, Intensive Care & Pain Therapy, Forchstrasse 340, Zurich 8008, Switzerland.
| | - Hannes Platzgummer
- Department of Biomedical Imaging und Image-Guided Therapy, Medical University of Vienna, Austria
| | - Anne-Kathrin Peyer
- Neuroliestal, Liestal and Department of Neurology, University Hospital Basel, Switzerland
| | - Andrzej Krol
- Department of Anesthesia and Chronic Pain Service, St. George's University Hospital, London, UK
| | - Urs Eichenberger
- Balgrist University Hospital, Department of Anaesthesiology, Intensive Care & Pain Therapy, Forchstrasse 340, Zurich 8008, Switzerland
| |
Collapse
|
3
|
Laengle G, Gohritz A, Maierhofer U, Sturma A, Boesendorfer A, Gstoettner C, Platzgummer H, Aszmann O. Nerve transfer reversal to treat co-contraction after anatomic brachial plexus reconstruction and Oberlin transfer: A case report. Microsurgery 2023; 43:717-721. [PMID: 37349939 DOI: 10.1002/micr.31076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 04/14/2023] [Accepted: 06/09/2023] [Indexed: 06/24/2023]
Abstract
Distal nerve transfers to restore elbow flexion have become standard of care in brachial plexus reconstruction. The purpose of this report is to draw attention to intractable co-contraction as a rare but significant adverse event of distal nerve transfers. Here we report of treatment of a disabling co-contraction of the brachialis muscle and wrist/finger flexors after median to brachialis fascicular transfer in a 61-year-old male patient. The primary injury was an postganglionic lesion of roots C5/C6 and a preganglionic injury of C7/C8 with intact root Th1 after a motor bicycle accident. After upper brachial plexus reconstruction (C5/C6 to suprascapular nerve and superior trunk) active mobility in the shoulder joint (supraspinatus, deltoid) could be restored. However, due to lacking motor recovery of elbow flexion the patient underwent additional median to brachialis nerve transfer. Shortly after, active elbow flexion commenced with rapid recovery to M4 at 9 months postoperatively. However, despite intensive EMG triggered physiotherapy the patient could not dissociate hand from elbow function and was debilitated by this iatrogenic co-contraction. After preoperative ultrasound-guided block resulted in preserved biceps function, the previously transferred median nerve fascicle was reversed. This was done by dissecting the previous nerve transfer of the median nerve fascicle to the brachialis muscle branch and adapting the fascicles to their original nerve. Postoperatively, the patient was followed up for 10 months without a complication and maintained M4 elbow flexion with independent strong finger flexion. Distal nerve transfers are an excellent option to restore function, however, in some patients cognitive limitations may prevent cortical reorganization and lead to disturbing co-contractions.
Collapse
Affiliation(s)
- Gregor Laengle
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University Vienna, Vienna, Austria
| | - Andreas Gohritz
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University Vienna, Vienna, Austria
- Plastic, Reconstructive and Aesthetic Surgery, Hand Surgery, University Hospital Basel, Basel, Switzerland
| | - Udo Maierhofer
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University Vienna, Vienna, Austria
| | - Agnes Sturma
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University Vienna, Vienna, Austria
- Bachelor's Degree Program Physiotherapy, University of Applied Sciences FH Campus Wien, Vienna, Austria
| | - Anna Boesendorfer
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University Vienna, Vienna, Austria
| | - Clemens Gstoettner
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University Vienna, Vienna, Austria
| | - Hannes Platzgummer
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Oskar Aszmann
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University Vienna, Vienna, Austria
| |
Collapse
|
4
|
Vetchy V, Aszmann OC, Laengle G, Platzgummer H. Intraneural Ganglion Cyst of the Tibial Nerve Originating from a Posterior Knee Joint Branch. Case Report on the Use of High-Resolution Volumetric Ultrasound and Magnetic Resonance Neurography. Ultraschall Med 2023; 44:547-549. [PMID: 36746197 DOI: 10.1055/a-2003-0999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Affiliation(s)
- Veronika Vetchy
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Oskar C Aszmann
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Vienna, Austria
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Vienna, Austria
| | - Gregor Laengle
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Vienna, Austria
| | - Hannes Platzgummer
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
5
|
Bergmeister KD, Platzgummer H, Reichel-Vacariu G, Kretschmer T, Sturma A, Schaefer D, Mende K, Meissl G, Schlenz I, Aszmann OC, Rab M. [Perioperative Diagnostics of Peripheral Nerve Lesions and Compression Syndromes: Position Paper of the German-Speaking Group for Microsurgery of Peripheral Nerves and Vessels]. HANDCHIR MIKROCHIR P 2023; 55:140-147. [PMID: 37023761 DOI: 10.1055/a-1984-8400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
The treatment of peripheral nerve pathologies requires a rapid and precise diagnosis. However, the correct identification of nerve pathologies is often difficult and valuable time is lost in the process. In this position paper of the German-Speaking Group for Microsurgery of Peripheral Nerves and Vessels (DAM), we describe the current evidence for various perioperative diagnostics for the detection of traumatic peripheral nerve lesions or compression syndromes. In detail, we evaluated the importance of clinical examinations, electrophysiology, nerve ultrasound and magnetic resonance neurography. Additionally, we surveyed our members for their diagnostic approach in this regard. The statements are based on a consensus workshop on the 42nd meeting of the DAM in Graz, Austria.
Collapse
Affiliation(s)
- Konstantin D Bergmeister
- Klinisches Labor für Bionische Extremitätenrekonstruktion, Universitätsklinik für Plastische, Rekonstruktive und Ästhetische Chirurgie, Medizinische Universität Wien, Wien, Austria
- Klinische Abteilung für Plastische, Ästhetische und Rekonstruktive Chirurgie, Universitätsklinikum St Pölten, St Polten, Austria
| | - Hannes Platzgummer
- Universitätsklinik für Radiologie und Nuklearmedizin, Klinische. Abteilung für Neuroradiologie und Muskuloskeletale Radiologie, Medizinische Universität Wien, Wien, Austria
| | - Gerda Reichel-Vacariu
- Institut für Physikalische Medizin und Orthopädische Rehabilitation, Orthopädisches Spital Speising GmbH, Wien, Austria
| | - Thomas Kretschmer
- Abteilung für Neurochirurgie und Neurorestauration, Klinikum Klagenfurt am Worthersee, Klagenfurt, Austria
| | - Agnes Sturma
- Klinisches Labor für Bionische Extremitätenrekonstruktion, Universitätsklinik für Plastische, Rekonstruktive und Ästhetische Chirurgie, Medizinische Universität Wien, Wien, Austria
- Bachelorstudiengang Physiotherapie, Fachhochschule Campus Wien
| | - Dirk Schaefer
- Universitätsspital Basel, Klinik für Plastische, Rekonstruktive, Ästhetische und Handchirurgie, Universität Basel, Schweiz
| | - Konrad Mende
- Universitätsspital Basel, Klinik für Plastische, Rekonstruktive, Ästhetische und Handchirurgie, Universität Basel, Schweiz
| | - Günther Meissl
- Klinisches Labor für Bionische Extremitätenrekonstruktion, Universitätsklinik für Plastische, Rekonstruktive und Ästhetische Chirurgie, Medizinische Universität Wien, Wien, Austria
| | - Ingrid Schlenz
- Abteilung für Plastische, Ästhetische und Wiederherstellungschirurgie, Klinik Ottakring, Wien, Austria
| | - Oskar C Aszmann
- Universitätsklinik für Plastische, Rekonstruktive und Ästhetische Chirurgie, Medizinische Universität Wien
| | - Matthias Rab
- Abteilung für Plastische, Ästhetische und Rekonstruktive Chirurgie, Klinikum Klagenfurt am Wörthersee
| |
Collapse
|
6
|
Hruby LA, Sporer ME, Krusche-Mandl I, Tereshenko V, Platzgummer H, Hajdu S, Aszmann OC. Successful treatment of a painful neuroma using fascicular shifting in the ulnar nerve: Case report. J Reconstr Microsurg Open 2023. [DOI: 10.1055/a-2039-1193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
The authors report the case of a forty-year old man with an inveterate ulnar nerve neuroma following a laceration injury of his left wrist twenty-three years ago. He presented with a typical ulnar claw-hand deformity and debilitating neuropathic pain in his hand (VAS 8.4). Pre-operative imaging revealed a neuroma of the ulnar nerve at the Guyon’s canal. Moreover, a complete atrophy of all intrinsic hand muscles innervated by the ulnar nerve was present. A Zancolli lasso procedure was performed to reduce the clawing effect. The neuroma was resected producing a nerve defect of five centimeters. Since the injury dated back more than two decades and any motor recovery was deemed impossible at that point, the motor fascicle of the ulnar nerve, i.e. the deep branch, was harvested and used as an autologous nerve graft to bridge the defect. The deep branch fascicle was dissected proximally, harvested and shifted into the defect to be coapted with the superficial branch fascicle in an end-to-end fashion. The presented procedure resulted in satisfying and sustained pain reduction (VAS 2.5) at two-year follow-up. Hence, the authors recommend considering fascicular shift procedure in peripheral sensory nerve reconstruction as a cost-effective alternative.
Collapse
Affiliation(s)
- Laura Antonia Hruby
- Department of Orthopaedics and Trauma Surgery, Medical University of Vienna, Wien, Austria
- Clinical Laboratory for Bionic Extremity Reconstruction, Medical University of Vienna, Wien, Austria
| | - Matthias E. Sporer
- Clinical Laboratory for Bionic Extremity Reconstruction, Medical University of Vienna, Wien, Austria
| | - Irena Krusche-Mandl
- Department of Orthopaedics and Trauma Surgery, Medical University of Vienna, Wien, Austria
| | - Vlad Tereshenko
- Clinical Laboratory for Bionic Extremity Reconstruction, Medical University of Vienna, Wien, Austria
| | - Hannes Platzgummer
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Wien, Austria
| | - Stefan Hajdu
- Department of Orthopaedics and Trauma Surgery, Medical University of Vienna, Wien, Austria
| | - Oskar C Aszmann
- Clinical Laboratory for Bionic Extremity Reconstruction, Medical University of Vienna, Wien, Austria
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Wien, Austria
| |
Collapse
|
7
|
Hobusch GM, Platzgummer H. Erratum: Evidenz in der infiltrativen Schmerztherapie des Bewegungsapparates. Z Orthop Unfall 2022; 160:e3. [DOI: 10.1055/a-1766-3112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
8
|
Abstract
Nerve ultrasound has become an integral part of the diagnostic workup of peripheral neuropathies. Especially in the examination of small nerves, ultrasound provides superior image quality by using high frequency transducers. For a selection of small nerves, this article summarizes the local anatomy and common pathologies and offers simple instructions for determining their location with ultrasound including some cases with pathologies. This selection of nerves comprises the great auricular nerve, the supraclavicular nerves, the suprascapular nerve, the medial antebrachial cutaneous nerve, the lateral antebrachial cutaneous nerve, the palmar cutaneous branch of the median nerve, the long thoracic nerve, the intercostobrachial nerve, the posterior cutaneous nerve, the infrapatellar branch of the saphenous nerve, the medial calcaneal nerve, and the deep peroneal nerve at the ankle. Following our recommendations, these nerves can be swiftly located and tracked along their course to the site of the pathology.
Collapse
Affiliation(s)
- Stefan Meng
- Center for Anatomy and Cell Biology, Medical University of Vienna, Austria
- Radiology, Hanusch-Hospital, Vienna, Austria
| | - Hannes Platzgummer
- Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - Alexander Loizides
- Department of Radiology, Innsbruck Medical University Innsbruck, Austria
| | - Ke-Vin Chang
- Department of Physical Medicine and Rehabilitation, NTUH, New Taipei City, Taiwan
| | - Hannes Gruber
- Department of Radiology, Innsbruck Medical University Innsbruck, Austria
| |
Collapse
|
9
|
Baumgartner AC, Platzgummer H, Aszmann O, Amann G, Berghoff A, Kasprian G, Traub-Weidinger T, Azizi AA. NIMG-09. DETECTION OF ASYMPTOMATIC MALIGNANT LESIONS BY [18F]FDG PET/MRI IN CHILDREN AND ADOLESCENTS WITH NEUROFIBROMATOSIS TYPE 1. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab196.509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Plexiform neurofibromas (PN) are a hallmark feature of Neurofibromatosis type 1 (NF1). 10% of PN undergo malignant transformation. As malignant peripheral nerve sheath tumors are a leading cause of death in NF1-patients, early detection of malignancy is essential. 2-deoxy-2-[ 18F]fluoro-D-glucose [18F]FDG PET/CT imaging is used in patients with NF1 to judge malignant transformation. AIMS: The present study evaluated [18F]FDG PET/MRI in pediatric NF1 patients at high risk for MPNST and its utility as a possible screening tool for malignant transformation of yet asymptomatic lesions.
METHODS
Patients aged 0-25 with symptomatic and asymptomatic neurofibromas who underwent PET/MRI from 2014 to 2021 were included. Chart review of imaging data, clinical and histological findings was performed retrospectively.
RESULTS
41 patients (18 female) with a median age at first PET/MRI of 16.87 years (6.21-24.41) were included. 40 lesions were operated as indicated by clinical (e.g. pain, rapid growth) or imaging findings. Based on histopathological analysis 7 lesions in 4 patients were categorized as malignant, 3 as atypical neurofibromatous neoplasms of uncertain biologic potential (ANNUBP). 4/7 malignant and 2/3 ANNUBP lesions were asymptomatic (i.e. without rapid growth, pain, neurologic dysfunction). 5/7 symptomatic tumors were without significant FDG-PET and proven benign by histology. 18 lesions (2 symptomatic) in 9 patients that showed an increased uptake suspect of malignant transformation were histologically classified as benign. None of the patients died during follow-up, 1 symptomatic MPNST patient received postsurgical radio- and chemotherapy.
CONCLUSION
Our data indicate that malignant transformation of PN also occurs in asymptomatic patients. [18F]FDG PET/MRI is feasible in pediatric and adolescent patients with the tumor predisposition syndrome NF1 and is an alternative to PET/CT when assessing for malignancy thereby drastically reducing radiation exposure. Early detection through screening of high-risk NF1 patients with [18F]FDG PET/MRI could potentially increase overall survival by facilitating early curative resection.
Collapse
Affiliation(s)
| | | | - Oskar Aszmann
- Institute of Surgery, Medical University of Vienna, Wien, Austria
| | - Gabriele Amann
- Institute of Pathology, Medical University Vienna, Wien, Austria
| | - Anna Berghoff
- Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - Gregor Kasprian
- Institute of Radiology, Medical University of Vienna, Wien, Austria
| | | | - Amedeo A Azizi
- Medical University of Vienna - Department of Pediatrics and Adolescent Medicine, Vienna, Austria
| |
Collapse
|
10
|
Hobusch GM, Platzgummer H. [Evidence in Infiltrative Pain Therapy of the Musculoskeletal System]. Z Orthop Unfall 2021; 160:229-248. [PMID: 33567456 DOI: 10.1055/a-0968-9792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Musculoskeletal pain symptoms frequently generate limitations in daily work and life in many patients. Usually, symptomatic treatment is possible before clarifying the in depth diagnosis. A symptom-based infiltration therapy will never replace a thoroughly done physical examination and thoughtful collection of patient history, however, it can be of great benefit for the patient when done focused on the point of pain and executed with profound anatomical knowledge. Furthermore, the knowledge of the level of evidence of therapeutic infiltrations improves their outcomes and shapes realistic patients' expectations. Ultrasound-guided therapeutic infiltrations improve the outcome despite the use of lower amounts of active agents by pinpointed applications. This article provides an overview of the scientific evidence of effectiveness of (ultrasound-guided) infiltration techniques in diverse musculoskeletal regions.
Collapse
|
11
|
Abstract
Hintergrund Nach Verlust einer Gliedmaße ist es die Aufgabe des Chirurgen, einen möglichst schmerzfreien und belastbaren Stumpf zu formen. Hierbei kommt insbesondere an der oberen Extremität ein funktioneller Aspekt hinzu, da zur Steuerung myoelektrischer Prothesen entsprechende Muskelsignale notwendig sind. Der Umgang mit peripheren Nerven im Stumpfbereich nimmt sowohl hinsichtlich der Schmerztherapie als auch der funktionellen Mensch-Maschinen-Anbindung eine zentrale Rolle ein. Ziel der Arbeit Die Darstellung aktueller chirurgischer Verfahren zum Umgang mit peripheren Nerven nach Extremitätenamputation. Material und Methoden Es erfolgt eine Literaturrecherche bzgl. chirurgischer Prophylaxe und Therapie von Neurom- und Phantomschmerzen, sowie zu Techniken zur Verbesserung der funktionellen Schnittstelle zwischen Stumpf und Prothese. Anhand relevanter Arbeiten sowie der Erfahrungen der Autoren werden entsprechende Empfehlungen formuliert. Ergebnisse und Diskussion Es gibt eine große Anzahl an verschiedenen Operationstechniken, insbesondere im Umgang mit schmerzhaften Neuromen. Von den klassischen Verfahren findet besonders häufig die intramuskuläre Verlagerung der endständiger Nerven Anwendung. Neuere Techniken wie Targeted Muscle Reinnervation (TMR) und Regenerative Peripheral Nerve Interface (RPNI) zielen erstmals darauf ab, dem Nerven auch nach Amputation funktionelle Endorgane zu liefern. Neben der verbesserten Steuerung myoelektrischer Prothesen zeigen diese Verfahren auch exzellente Ergebnisse in Bezug auf Neurom- und Phantomschmerzen.
Collapse
Affiliation(s)
- Clemens Gstoettner
- Klinisches Labor für Bionische Extremitätenrekonstruktion, Universitätsklinik für Chirurgie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | - Gregor Laengle
- Klinisches Labor für Bionische Extremitätenrekonstruktion, Universitätsklinik für Chirurgie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | - Stefan Salminger
- Klinisches Labor für Bionische Extremitätenrekonstruktion, Universitätsklinik für Chirurgie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.,Klinische Abteilung für Plastische und Rekonstruktive Chirurgie, Universitätsklinik für Chirurgie, Medizinische Universität Wien, Wien, Österreich
| | - Christopher Festin
- Klinisches Labor für Bionische Extremitätenrekonstruktion, Universitätsklinik für Chirurgie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | - Hannes Platzgummer
- Univ. Klinik für Radiologie und Nuklearmedizin, Medizinische Universität Wien, Wien, Österreich
| | - Oskar C Aszmann
- Klinisches Labor für Bionische Extremitätenrekonstruktion, Universitätsklinik für Chirurgie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich. .,Klinische Abteilung für Plastische und Rekonstruktive Chirurgie, Universitätsklinik für Chirurgie, Medizinische Universität Wien, Wien, Österreich.
| |
Collapse
|
12
|
Gstoettner C, Mayer JA, Rassam S, Hruby LA, Salminger S, Sturma A, Aman M, Harhaus L, Platzgummer H, Aszmann OC. Neuralgic amyotrophy: a paradigm shift in diagnosis and treatment. J Neurol Neurosurg Psychiatry 2020; 91:879-888. [PMID: 32487526 DOI: 10.1136/jnnp-2020-323164] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 05/07/2020] [Accepted: 05/10/2020] [Indexed: 01/22/2023]
Abstract
Neuralgic amyotrophy (NA), also known as Parsonage-Turner syndrome, is characterised by sudden pain attacks, followed by patchy muscle paresis in the upper extremity. Recent reports have shown that incidence is much higher than previously assumed and that the majority of patients never achieve full recovery. Traditionally, the diagnosis was mainly based on clinical observations and treatment options were confined to application of corticosteroids and symptomatic management, without proven positive effects on long-term outcomes. These views, however, have been challenged in the last years. Improved imaging methods in MRI and high-resolution ultrasound have led to the identification of structural peripheral nerve pathologies in NA, most notably hourglass-like constrictions. These pathognomonic findings have paved the way for more accurate diagnosis through high-resolution imaging. Furthermore, surgery has shown to improve clinical outcomes in such cases, indicating the viability of peripheral nerve surgery as a valuable treatment option in NA. In this review, we present an update on the current knowledge on this disease, including pathophysiology and clinical presentation, moving on to diagnostic and treatment paradigms with a focus on recent radiological findings and surgical reports. Finally, we present a surgical treatment algorithm to support clinical decision making, with the aim to encourage translation into day-to-day practice.
Collapse
Affiliation(s)
- Clemens Gstoettner
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - Johannes A Mayer
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Surgery, Medical University of Vienna, Vienna, Austria.,Department for Hand, Plastic, Reconstructive and Burn Surgery, BG Trauma Center Tuebingen at the Eberhard Karls University Tuebingen, Tuebingen, Germany
| | - Stephanie Rassam
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Surgery, Medical University of Vienna, Vienna, Austria.,Department of General, Visceral, Endocrine and Transplantation Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Laura A Hruby
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Surgery, Medical University of Vienna, Vienna, Austria.,Department of Orthopaedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria
| | - Stefan Salminger
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Surgery, Medical University of Vienna, Vienna, Austria.,Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - Agnes Sturma
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Surgery, Medical University of Vienna, Vienna, Austria.,Department of Bioengineering, Imperial College London, London, UK
| | - Martin Aman
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Surgery, Medical University of Vienna, Vienna, Austria.,Department of Hand, Plastic and Reconstructive Surgery, Burn Center-Hand and Plastic Surgery, University of Heidelberg, BG Trauma Center Ludwigshafen, Ludwigshafen, Germany
| | - Leila Harhaus
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center-Hand and Plastic Surgery, University of Heidelberg, BG Trauma Center Ludwigshafen, Ludwigshafen, Germany
| | - Hannes Platzgummer
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Oskar C Aszmann
- Clinical Laboratory for Bionic Extremity Reconstruction, Department of Surgery, Medical University of Vienna, Vienna, Austria .,Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
13
|
Kristen KH, Seilern und Aspang J, Wiedemann J, Hartenbach F, Platzgummer H. Reliability of ultrasonography measurement of the anterior talofibular ligament (ATFL) length in healthy subjects (in vivo), based on examiner experience and patient positioning. J Exp Orthop 2019; 6:30. [PMID: 31267337 PMCID: PMC6606687 DOI: 10.1186/s40634-019-0199-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 06/21/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The most common cause of ankle injury is the supination trauma, inflicting a partial or complete rupture of the anterior talofibular ligament (ATFL). Among conventional diagnostic tools and procedures of sports injuries, the method of stress-ultrasonography is reportedly a promising diagnostic tool for examining injuries of the lateral ligaments of the ankle. Preceding studies predominantly examined the comparability of stress-ultrasonography and other established diagnostic tools in terms of efficacy, viability and quality. The purpose of this study was to assess the reliability of stress-ultrasonography of the ATFL based on varying examiner experience and patient positioning. METHOD Sixteen healthy subjects were examined by four examiners with differing levels of skill and experience in ultrasonography, ranging from laymen to specialist. Measurements were recorded and interrater correlation coefficient (ICC) was applied in four positions, including a neutral position (A), medial rotation (B), plantar flexion (C) and inversion of the foot (D). RESULTS The length of the ATFL was 14.958 ± 2.145 mm in position A, 15.886 ± 1.994 mm in position B, 16.270 ± 1.858 mm in position C and 15.170 ± 1.781 mm in position D. The average length change was 0.928 ± 0.804 mm (6.656 ± 6.299%) in position B, 1.313 ± 1.266 mm (9.746 ± 9.484%) in position C and 0.213 ± 1.807 mm (2.604 ± 12.308%) in position D. The correlation of the combined results of all four investigators was 0.333 for position A, 0.386 for position B, 0.320 for position C and 0.517 for position D. The highest ICC (0.811) was recorded between the orthopedic specialist and the radiology specialist. The lowest ICC (0.299) was recorded between the laymen and the radiology specialist. CONCLUSION The reliability of the ATFL examination seems to be exceedingly dependent on the examiner's experience and skill in ultrasonographic (US) diagnostic. Moreover, the inversion positioning of the foot, described by the European Society of Musculoskeletal Radiology (ESSR) yielded the highest measurement reliability.
Collapse
Affiliation(s)
| | | | | | | | - Hannes Platzgummer
- Department of Musculoskeletal Radiology, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria
| |
Collapse
|
14
|
Riegler G, Jengojan S, Mayer JA, Pivec C, Platzgummer H, Brugger PC, Aszmann O, Bodner G. Ultrasound Anatomic Demonstration of the Infrapatellar Nerve Branches. Arthroscopy 2018; 34:2874-2883. [PMID: 30181057 DOI: 10.1016/j.arthro.2018.05.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 05/27/2018] [Accepted: 05/28/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE To (1) confirm the correct identification of the infrapatellar branches of the saphenous nerve (IPBSNs) by high-resolution ultrasound (HRUS) with ink marking and consecutive dissection in anatomic specimens; (2) evaluate the origin, course, and end-branch distribution in healthy volunteers; and (3) visualize the variable anatomic course of the IPBSN by HRUS. METHODS HRUS with high-frequency probes (15-22 MHz) was used to locate the IPBSN in 14 fresh anatomic specimens at 4 different locations. The correct identification of the IPBSN was verified by ink marking and consecutive dissection. Moreover, the IPBSNs were located in both knees of 20 healthy volunteers (n = 40). Their courses were marked on the volunteers' skin in a flexed-knee position. Distances were measured from the IPBSN branch closest to the median of the patella base (D1), center (D2), and apex (D3) and in a 45° (D4) and 0° (D5) relation to the median patella apex. Standardized photographs of all knees were mapped on 1 typically shaped knee. RESULTS Dissection confirmed the correct identification of the IPBSN in 86% to 100% of branches, depending on their location. Intraindividual differences for distance measurements were observed for D1 (P < .001) and D2 (P = .002). The coefficient of variation was highest for D5 (0.86) and lowest for D1 (0.14). Mapping of the nerve branches on a typical knee showed a highly variable course for the IPBSN. CONCLUSIONS This study confirmed the reliable ability to visualize the IPBSN and its variations with HRUS in anatomic specimens and in healthy volunteers; such visualization may therefore enhance the diagnostic and therapeutic management of patients with anteromedial knee pain. CLINICAL RELEVANCE Ultrasound successfully pinpoints the variable course of the IPBSN from the origin to the most distal point and, therefore, may enable the correct identification of (iatrogenic) nerve damage in every location.
Collapse
Affiliation(s)
- Georg Riegler
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.
| | - Suren Jengojan
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Johannes A Mayer
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna, Austria
| | - Christopher Pivec
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Hannes Platzgummer
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Peter C Brugger
- Department of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Oskar Aszmann
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna, Austria
| | - Gerd Bodner
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
15
|
Staats K, Sabeti-Aschraf M, Apprich S, Platzgummer H, Puchner SE, Holinka J, Windhager R, Schuh R. Preoperative MRI is helpful but not sufficient to detect associated lesions in patients with chronic ankle instability. Knee Surg Sports Traumatol Arthrosc 2018; 26:2103-2109. [PMID: 28508294 PMCID: PMC6061436 DOI: 10.1007/s00167-017-4567-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 05/03/2017] [Indexed: 01/29/2023]
Abstract
PURPOSE The aim of this study was to determine the reliability and validity of preoperative magnetic resonance imaging (MRI) scans for the detection of additional pathologies in patients with chronic ankle instability (CAI) compared to arthroscopic findings. METHODS Preoperative MRI images of 30 patients were evaluated regarding articular and periarticular comorbidities and compared to intraoperative findings. The reliability of MRI was determined by calculating specificity, sensitivity, as well as positive and negative predictive values. The accuracy of the classification of cartilage lesions by Outerbridge and Berndt and Harty rating scales was determined by calculating the area under the receiver operating curve (AUC). RESULTS In total, 72 additional pathologies were found arthroscopically compared to 73 lesions gathered from MRI images. Sensitivity ranged from 89% for peroneal tendinopathy to 28% for additional ligamentous lesions. Specificity ranged from 100% for anterolateral impingement, loose bodies and peroneal tendinopathy to 38% for additional ligamentous lesions. For cartilage lesions, sensitivity was at 91% and specificity was at 55% for the Outerbridge grading scale. For the Berndt and Harty classification system, sensitivity was at 91% and specificity was at 28%. Correlation of additional pathologies ranged from weak (r s = 0.48; p = 0.02) to moderate results (r s = 0.67; p < 0.001). CONCLUSION CAI is associated with a high incidence of additional pathologies. In some cases, MRI delivers insufficient results, which may lead to misinterpretation of present comorbidities. MRI is a helpful tool for preoperative evaluation, but arthroscopy remains gold standard in the diagnosis of associated lesions in patients with CAI. LEVEL OF EVIDENCE III.
Collapse
Affiliation(s)
- Kevin Staats
- Department of Orthopaedic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Manuel Sabeti-Aschraf
- Department of Orthopaedic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Sebastian Apprich
- Department of Orthopaedic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Hannes Platzgummer
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Stephan E Puchner
- Department of Orthopaedic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Johannes Holinka
- Department of Orthopaedic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Reinhard Windhager
- Department of Orthopaedic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Reinhard Schuh
- Department of Orthopaedic Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| |
Collapse
|
16
|
Schreiner MM, Platzgummer H, Unterhumer S, Weber M, Mistelbauer G, Loewe C, Schernthaner RE. A BMI-adjusted ultra-low-dose CT angiography protocol for the peripheral arteries—Image quality, diagnostic accuracy and radiation exposure. Eur J Radiol 2017; 93:149-156. [DOI: 10.1016/j.ejrad.2017.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 05/13/2017] [Accepted: 06/01/2017] [Indexed: 11/30/2022]
|
17
|
Riegler G, Lieba-Samal D, Brugger PC, Pivec C, Platzgummer H, Vierhapper M, Muschitz G, Jengojan S, Bodner G. High-resolution ultrasound visualization of the deep branch of the ulnar nerve. Muscle Nerve 2017; 56:1101-1107. [DOI: 10.1002/mus.25614] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 02/03/2017] [Accepted: 02/14/2017] [Indexed: 01/21/2023]
Affiliation(s)
- Georg Riegler
- Department of Biomedical Imaging and Image-Guided Therapy; Medical University of Vienna; Währingergürtel 18-20, 1090 Vienna Austria
| | - Doris Lieba-Samal
- Department of Neurology; Medical University of Vienna; Vienna Austria
| | - Peter C. Brugger
- Department of Anatomy, Center for Anatomy and Cell Biology; Medical University of Vienna; Vienna Austria
| | - Christopher Pivec
- Department of Biomedical Imaging and Image-Guided Therapy; Medical University of Vienna; Währingergürtel 18-20, 1090 Vienna Austria
| | - Hannes Platzgummer
- Department of Biomedical Imaging and Image-Guided Therapy; Medical University of Vienna; Währingergürtel 18-20, 1090 Vienna Austria
| | | | | | - Suren Jengojan
- Department of Biomedical Imaging and Image-Guided Therapy; Medical University of Vienna; Währingergürtel 18-20, 1090 Vienna Austria
| | - Gerd Bodner
- Department of Biomedical Imaging and Image-Guided Therapy; Medical University of Vienna; Währingergürtel 18-20, 1090 Vienna Austria
| |
Collapse
|
18
|
Teh J, Grainger A, Schueller-Weidekamm C, Sudoł-Szopińska I, Rennie W, Åström G, Feydy A, Giraudo C, Guerini H, Guglielmi G, Isaac A, Jans L, Jurik A, Kainberger F, Maas M, Martinoli C, Mascarenhas V, Miese F, O'Connor P, Oei E, Østergaard M, Peetrons P, Platzgummer H, Reijnierse M, Robinson P, Rupreht M, Simoni P, Wick M, Zejden A, Klauser A, Plagou A. Recommendations of the ESSR Arthritis Subcommittee on Ultrasonography in Inflammatory Joint Disease. Semin Musculoskelet Radiol 2016; 20:496-506. [DOI: 10.1055/s-0036-1593533] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- James Teh
- Department of Musculoskeletal Radiology, University of Oxford, Oxford, United Kingdom
| | - Andrew Grainger
- Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals, Leeds, United Kingdom
| | | | - Iwona Sudoł-Szopińska
- Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Winston Rennie
- Department of Musculoskeletal Radiology, University of Loughborough, Leicester Royal Infirmary, Leicester, United Kingdom
| | - Gunnar Åström
- Department of Radiology, University Hospital, Uppsala, Sweden
| | - Antoine Feydy
- Department of Radiology B, Hôpital Cochin, APHP, Paris, France
| | - Chiara Giraudo
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Henri Guerini
- Department of Radiology B, Cochin Hospital, Paris, France
| | | | - Amanda Isaac
- Department of Musculoskeletal Radiology, Guys and St Thomas' Hospitals Foundation Trust, Kings College London and GKT, London, United Kingdom
| | - Lennart Jans
- Department of Radiology, Ghent University Hospital, Ghent, Belgium
| | - Anne Jurik
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
| | - Franz Kainberger
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Mario Maas
- Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Carlo Martinoli
- Department of Radiology, Università degli Studi di Genova, Genova, Italy
| | - Vasco Mascarenhas
- Unidade de Imagem Musculoesquelética (UIME), Hospital da Luz, Lisbon, Portugal
| | - Falk Miese
- Department of Diagnostic and Interventional Radiology, Institute of Radiology, Nuclear Medicine and Radiotherapy, Bottrop, Denmark
| | - Philip O'Connor
- The NIHR Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospital NHS Trust, Leeds, United Kingdom
| | - Edwin Oei
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Mikkel Østergaard
- Department of Rheumatology, Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | | | - Hannes Platzgummer
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Monique Reijnierse
- Department of Musculoskeletal Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Philip Robinson
- Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Mitja Rupreht
- Department of Radiology, University Medical Center Maribor, Maribor, Slovenia
| | - Paolo Simoni
- Department of Radiology, Université Libre de Bruxelles (ULB), “Reine Fabiola” Children's University Hospital, Brussels, Belgium
| | - Marius Wick
- Functional Unit for Diagnostic and Interventional Musculoskeletal Radiology, Function Imaging and Physiology, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Zejden
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
| | - Andrea Klauser
- Section Rheumatology and Sports Imaging, Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
| | - Athena Plagou
- Department of Radiology, Private Institution of Ultrasonography, Athens, Greece
| |
Collapse
|
19
|
Riegler G, Pivec C, Platzgummer H, Lieba-Samal D, Brugger P, Jengojan S, Vierhapper M, Bodner G. High-resolution ultrasound visualization of the recurrent motor branch of the median nerve: normal and first pathological findings. Eur Radiol 2016; 27:2941-2949. [PMID: 27957641 PMCID: PMC5486794 DOI: 10.1007/s00330-016-4671-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 09/11/2016] [Accepted: 11/21/2016] [Indexed: 12/31/2022]
Abstract
Purpose To evaluate in a prospective study the possibility of visualization and diagnostic assessment of the recurrent motor branch (RMB) of the median nerve with high-resolution ultrasound (HRUS). Materials and methods HRUS with high-frequency probes (18–22 MhZ) was used to locate the RMB in eight fresh cadaveric hands. To verify correct identification, ink-marking and consecutive dissection were performed. Measurement of the RMB maximum transverse-diameter, an evaluation of the origin from the median nerve and its course in relation to the transverse carpal ligament, was performed in both hands of ten healthy volunteers (n = 20). Cases referred for HRUS examinations for suspected RMB lesions were also assessed. Results The RMB was clearly visible in all anatomical specimens and all volunteers. Dissection confirmed HRUS findings in all anatomical specimens. Mean RMB diameter in volunteers was 0.7 mm ± 0.1 (range, 0.6–1). The RMB originated from the radial aspect in 11 (55%), central aspect in eight (40%) and ulnar aspect in one (5%) hand. Nineteen (95%) extraligamentous courses and one (5%) subligamentous course were detected. Three patients with visible RMB abnormalities on HRUS were identified. Conclusion HRUS is able to reliably visualize the RMB, its variations and pathologies. Key Points • Ultrasound allows visualization of the recurrent motor branch of the median nerve. • Ultrasound may help clinicians to assess patients with recurrent motor branch pathologies. • Patient management may become more appropriate and targeted therapy could be improved. Electronic supplementary material The online version of this article (doi:10.1007/s00330-016-4671-1) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Georg Riegler
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währingergürtel 18-20, 1090, Vienna, Austria.
| | - Christopher Pivec
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währingergürtel 18-20, 1090, Vienna, Austria
| | - Hannes Platzgummer
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währingergürtel 18-20, 1090, Vienna, Austria
| | - Doris Lieba-Samal
- Department of Neurology, Medical University of Vienna, Währingergürtel 18-20, 1090, Vienna, Austria
| | - Peter Brugger
- Department of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Währingerstrasse 13, 1090, Vienna, Austria
| | - Suren Jengojan
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währingergürtel 18-20, 1090, Vienna, Austria
| | - Martin Vierhapper
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Medical University of Vienna, Währingergürtel 18-20, 1090, Vienna, Austria
| | - Gerd Bodner
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währingergürtel 18-20, 1090, Vienna, Austria
| |
Collapse
|
20
|
Bodner G, Platzgummer H, Meng S, Brugger PC, Gruber GM, Lieba-Samal D. Successful Identification and Assessment of the Superior Cluneal Nerves with High-Resolution Sonography. Pain Physician 2016; 19:197-202. [PMID: 27008294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Low back pain is a disabling and common condition, whose etiology often remains unknown. A suggested, however rarely considered, cause is neuropathy of the medial branch of the superior cluneal nerves (mSCN)-either at the level of the originating roots or at the point where it crosses the iliac crest, where it is ensheathed by an osseo-ligamentous tunnel. Diagnosis and treatment have, to date, been restricted to clinical assessment and blind infiltration with local anesthetics. OBJECTIVE To determine whether visualization and assessment of the mSCN with high-resolution ultrasound (HRUS) is feasible. STUDY DESIGN Interventional cadaver study and case series. METHODS Visualization of the mSCN was assessed in 7 anatomic specimens, and findings were confirmed by HRUS-guided ink marking of the nerve and consecutive dissection. Further, a patient chart and image review was performed of patients assessed at our department with the diagnosis of mSCN neuropathy. RESULTS The mSCN could be visualized in 12 of 14 cases in anatomical specimens, as confirmed by dissection. Nine patients were diagnosed with mSCN syndrome of idiopathic or traumatic origin. Diagnosis was confirmed in all of them, with complete resolution of symptoms after HRUS-guided selective nerve block. LIMITATIONS These findings are first results that need to be evaluated in a systematic, prospective and controlled manner. CONCLUSION We hereby confirm that it is possible to visualize the mSCN in the majority of anatomical specimens. The patients described may indicate a higher incidence of mSCN syndrome than has been recognized. mSCN syndrome should be considered in patients with low back pain of unknown origin, and HRUS may be able to facilitate nerve detection and US-guided nerve block.
Collapse
Affiliation(s)
| | - Hannes Platzgummer
- Department of Applied Radiology and Image-guided Therapy, Medical University of Vienna
| | - Stefan Meng
- Department of Radiology, KFJ Hospital, Austria
| | - Peter C Brugger
- Centre for Anatomy and Cell Biology, Department of Systematic Anatomy, Medical University of Vienna
| | - Gerlinde Maria Gruber
- Centre for Anatomy and Cell Biology, Department of Systematic Anatomy, Medical University of Vienna
| | | |
Collapse
|
21
|
Ruedl G, Schnitzer M, Kirschner W, Spiegel R, Platzgummer H, Kopp M, Burtscher M, Pocecco E. Sports injuries and illnesses during the 2015 Winter European Youth Olympic Festival. Br J Sports Med 2016; 50:631-6. [DOI: 10.1136/bjsports-2015-095665] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2016] [Indexed: 11/03/2022]
|
22
|
Sudoł-Szopińska I, Jurik AG, Eshed I, Lennart J, Grainger A, Østergaard M, Klauser A, Cotten A, Wick MC, Maas M, Miese F, Egund N, Boutry N, Rupreht M, Reijnierse M, Oei EHG, Meier R, O'Connor P, Feydy A, Mascarenhas V, Plagou A, Simoni P, Platzgummer H, Rennie WJ, Mester A, Teh J, Robinson P, Guglielmi G, Åström G, Schueller-Weiderkamm C. Recommendations of the ESSR Arthritis Subcommittee for the Use of Magnetic Resonance Imaging in Musculoskeletal Rheumatic Diseases. Semin Musculoskelet Radiol 2015; 19:396-411. [PMID: 26583367 DOI: 10.1055/s-0035-1564696] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This article presents the recommendations of the European Society of Musculoskeletal Radiology Arthritis Subcommittee regarding the standards of the use of MRI in the diagnosis of musculoskeletal rheumatic diseases. The recommendations discuss (1) the role of MRI in current classification criteria of musculoskeletal rheumatic diseases (including early diagnosis of inflammation, disease follow-up, and identification of disease complications); (2) the impact of MRI on the diagnosis of axial and peripheral spondyloarthritis, rheumatoid arthritis, and juvenile spondyloarthritis; (3) MRI protocols for the axial and peripheral joints; (4) MRI interpretation and reporting for axial and peripheral joints; and finally, (5) methods for assessing MR images including quantitative, semiquantitative, and dynamic contrast-enhanced MRI studies.
Collapse
Affiliation(s)
- Iwona Sudoł-Szopińska
- Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland, and Imaging Diagnostic Department, Warsaw Medical University, Poland
| | | | - Iris Eshed
- Department of Diagnostic Imaging, The Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Jans Lennart
- Department of Radiology, Ghent University Hospital, Ghent, Belgium
| | - Andrew Grainger
- Department of MSK Radiology, Leeds Teaching Hospitals, Chapel Allerton Orthopaedic Centre, Leeds, United Kingdom
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup and University of Copenhagen, Glostrup, Denmark
| | - Andrea Klauser
- Department of Radiology, Medical University Innsbruck, Section Rheumatology and Sports Imaging, Innsbruck, Austria
| | - Anne Cotten
- Department of Musculoskeletal Radiology, University Hospital of Lille, Lille, France
| | - Marius C Wick
- Department of Radiology, Karolinska University Hospital, Stockholm, Sweden
| | - Mario Maas
- Division of Musculoskeletal Radiology, Department of Radiology, University of Amsterdam, Academic Medical Center, Amsterdam, The Netherlands
| | - Falk Miese
- Department of Diagnostic and Interventional Radiology, University Düsseldorf and Practice for Radiology, Nuklear Medicine and Radiotherapy, Bottop, German
| | - Niels Egund
- Department of Radiology, Aarhus University Hospital Aarhus C, Aarhus, Denmark
| | - Nathalie Boutry
- Service de Radiopédiatrie, Hôpital Jeanne de Flandre, CHRU de Lille, Lille, France
| | - Mitja Rupreht
- Department of Radiology, UMC Maribor, Maribor, Slovenia
| | - Monique Reijnierse
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Edwin H G Oei
- Department of Radiology, Erasmus MC Rotterdam, Rotterdam, The Netherlands
| | - Reinhard Meier
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Phil O'Connor
- NIHR Leeds Musculoskeletal Biomedical Imaging Unit, Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Antoine Feydy
- Department of Radiology B, Cochin Hospital, Paris University of Descartes, Paris Cedex, France
| | - Vasco Mascarenhas
- Department of Diagnostic Imaging, Hospital da Luz, Luz-Saude, Lisbon, Portugal
| | - Athena Plagou
- Ultrasound Unit, Private Radiological Institution, Athens, Greece
| | - Paolo Simoni
- Department of Radiology, University of Bruxelles, Reine Fabiola Children's University Hospital of Bruxelles, Brussels, Belgium
| | - Hannes Platzgummer
- Department of Biomedical Imaging und Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Winston J Rennie
- Department of Radiology, Hospitals of Leicester, Leicester Royal Infirmary, Leicester, United Kingdom
| | - Adam Mester
- Department of Radiology, National Institute of Rheumatology and Physiotherapy, Budapest, Hungary
| | - James Teh
- Department of Radiology, Oxford University Hospitals NHS Trust, Nuffield Orthopaedic Centre, Oxford, United Kingdom
| | - Philip Robinson
- Department of MSK Radiology, Leeds Teaching Hospitals, Chapel Allerton Orthopaedic Centre, Leeds, United Kingdom
| | - Giuseppe Guglielmi
- Department of Radiology, Scientific Institute Hospital "Casa Sollievo della Sofferenza," San Giovanni Rotondo, Italy
| | - Gunnar Åström
- Department of Radiology, Akademiska Sjukhuset, University Hospital, Uppsala, Sweden
| | - Claudia Schueller-Weiderkamm
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-guided Therapy, University of Vienna, Vienna, Austria
| |
Collapse
|
23
|
Meng S, Lieba-Samal D, Reissig LF, Gruber GM, Brugger PC, Platzgummer H, Bodner G. High-resolution ultrasound of the posterior femoral cutaneous nerve: visualization and initial experience with patients. Skeletal Radiol 2015; 44:1421-6. [PMID: 26105014 DOI: 10.1007/s00256-015-2177-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 05/20/2015] [Accepted: 05/21/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The posterior femoral cutaneous nerve (PFCN) is a sensory nerve originating from the sacral plexus. PFCN neuropathy leads to pain within the inferior gluteal region and the posterior aspect of the thigh. As electrophysiological assessment is challenging, diagnosis of PFCN neuropathy has been, thus far, primarily based on clinical findings, which can result in misdiagnosis. Therefore, alternative confirmatory assessments such as an imaging modality that could aid in the diagnosis of PFCN neuropathy would be desirable. The purpose of this study was to determine the feasibility of visualization of the PFCN with high-resolution ultrasound (HRUS) and to test this technique in our clinical routine. MATERIALS AND METHODS The study consisted of two parts. In the first part, HRUS-guided perineural ink injections along the course of the PFCN were performed at the posterior aspect of the thigh in 26 lower limbs of 14 fresh non-embalmed cadavers. Subsequent dissection confirmed correct identification of the nerve. In the second part, patients with a suspected PFCN neuropathy were examined and a selective HRUS-guided nerve block was performed to verify the suspected diagnosis. RESULTS The PFCN was correctly identified with HRUS in 96.2% (25/26) of cadavers. Further, six patients with a suspected lesion of the PFCN were examined, and the diagnosis was proven by successful HRUS-guided block in all cases. CONCLUSION We confirmed the reliable visualization of the PFCN using HRUS. This offers a new technique for the assessment of the PFCN, which could also be demonstrated with the case series presented.
Collapse
Affiliation(s)
- Stefan Meng
- Department of Radiology, KFJ Hospital, Vienna, Austria,
| | | | | | | | | | | | | |
Collapse
|
24
|
Lieba-Samal D, Pivec C, Platzgummer H, Gruber GM, Seidel S, Bernathova M, Bodner G, Moritz T. High-Resolution Ultrasound for Diagnostic Assessment of the Great Auricular Nerve--Normal and First Pathologic Findings. Ultraschall Med 2015; 36:342-347. [PMID: 24824761 DOI: 10.1055/s-0034-1366354] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE The great auricular nerve (GAN) is a sensory branch of the superficial cervical plexus. While its blockade is an established procedure, little is known about the ultrasound appearance of pathologic conditions of the GAN itself. We, therefore, aimed to evaluate the possibility of the visualization and diagnostic assessment of the GAN along its entire course by means of high-resolution ultrasound (HRUS). MATERIALS AND METHODS To assess the feasibility of visualization, we performed HRUS with an 18 MHz probe, HRUS-guided, fine-needle ink markings and consecutive dissection in six anatomical specimens. Then, we measured the diameter of the GAN in healthy volunteers and finally performed a retrospective review of patients referred for HRUS examinations because of pain within GAN territory between August 1, 2012 and August 1, 2013. RESULTS The GAN was clearly visible with HRUS from its formation to the final branches, and was marked successfully on both sides in all anatomical specimens (n = 12). The mean average in-vivo was 0.14 cm ± 0.03 (range 0.08-0.2). Seven cases of patients with GAN pathologies of various origins (idiopathic, traumatic, tumorous and iatrogenic) were identified, of which 6 were visible on HRUS and all of which could be confirmed by complete resolution of symptoms after selective HRUS-guided GAN block. CONCLUSION This study confirms the reliable ability to visualize the GAN with HRUS throughout its course, both in anatomical specimens and in vivo. The provided cases show that pathologies of the GAN seem to have a variety of causes and may not be rare. We, therefore, encourage the use of HRUS in patients with unclear pain in the auricular, periauricular and posterior-lateral head.
Collapse
Affiliation(s)
| | - C Pivec
- Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - H Platzgummer
- Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - G M Gruber
- Systematic Anatomy, Medical University of Vienna, Austria
| | - S Seidel
- Neurology, Medical University of Vienna, Austria
| | - M Bernathova
- Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - G Bodner
- Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - T Moritz
- Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| |
Collapse
|
25
|
Platzgummer H, Moritz T, Gruber GM, Pivec C, Wöber C, Bodner G, Lieba-Samal D. The lesser occipital nerve visualized by high-resolution sonography—normal and initial suspect findings. Cephalalgia 2014; 35:816-24. [DOI: 10.1177/0333102414559293] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 10/15/2014] [Indexed: 01/03/2023]
Abstract
Background The lesser occipital nerve (LON) supplies the lateral part of the occiput and is—together with the greater occipital nerve (GON)—involved in headache pathogenesis. While the GON was described in high-resolution ultrasound (HRUS), the same does not apply to the LON. We aimed at characterizing the LON in HRUS, and present cases of suspect findings in the course of the LON identified by HRUS. Methods The LON was examined bilaterally in eight anatomical specimens with HRUS ( n = 16). HRUS-guided ink marking and consecutive dissection was performed. Further, measurements of the LON diameter were performed in 10 healthy volunteers ( n = 20), and patient charts were reviewed to identify patients who were considered to have possible pathology of the LON. Results The LON was identified correctly in all cadavers on both sides and all volunteers except for one side ( n = 19). The average diameter was 1.08 ± 0.30 mm. Four patients with pain within the LON territory and presumed peripheral origin of headache (defined as resolution of headache after diagnostic HRUS-guided selective blockade) were identified, and three of these showed interference of the LON with lymph nodes or an accessory muscle belly. Discussion We confirm the possibility of visualization of the LON using HRUS. HRUS may be a helpful adjunct tool in the assessment of patients with atypical headache.
Collapse
Affiliation(s)
| | - Thomas Moritz
- Department of Applied Radiology and Image-Guided Therapy
| | | | | | - Christian Wöber
- Department of Neurology, Medical University of Vienna, Austria
| | - Gerd Bodner
- Department of Applied Radiology and Image-Guided Therapy
| | | |
Collapse
|
26
|
Mascarenhas V, Sudol-Szopinska I, Boutry N, Plagou A, Klauser A, Wick M, Platzgummer H, Jans L, Mester A, Kainberger F, Aström G, Guglielmi G, Eshed I, Schueller-Weidekamm C. Imaging and Interpretation of Axial Spondylarthritis: The Radiologist's Perspective—Consensus of the Arthritis Subcommittee of the ESSR. Semin Musculoskelet Radiol 2014. [DOI: 10.1055/s-0034-1395421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Iwona Sudol-Szopinska
- Department of Radiology, Institute of Rheumatology, Warsaw and Department of Diagnostic Imaging, Warsaw Medical University, Warsaw, Poland
| | - Nathalie Boutry
- Department of Musculoskeletal Radiology, Centre Hospitalier Universitaire de Lille and Hôpital Roger Salengro, Lille, France
| | | | - Andrea Klauser
- Department of Radiology, Innsbruck Medical University, Section Rheumatology and Sports Imaging, Innsbruck, Austria
| | - Marius Wick
- Department of Radiology, Karolinska University Hospital, Stockholm, Sweden
| | - Hannes Platzgummer
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna/Vienna General Hospital, Vienna, Austria
| | - Lennart Jans
- Department of Radiology, Ghent University Hospital, Ghent, Beligium
| | - Adam Mester
- Department of Radiology, National Institute of Rheumatology and Physiotherapy, Budapest, Hungary
| | - Franz Kainberger
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna/Vienna General Hospital, Vienna, Austria
| | - Gunnar Aström
- Department of Radiology, Oncology and Radiation Sciences, Section of Radiology, Uppsala University, Uppsala, Sweden
| | | | - Iris Eshed
- Department of Diagnostic Imaging, Sheba Medical Center, Sackler School of Medical, Tel Aviv, Israel
| | - Claudia Schueller-Weidekamm
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna/Vienna General Hospital, Vienna, Austria
| |
Collapse
|
27
|
Mascarenhas V, Sudol-Szopinska I, Boutry N, Plagou A, Klauser A, Wick M, Platzgummer H, Jans L, Mester A, Kainberger F, Aström G, Guglielmi G, Eshed I, Schueller-Weidekamm C. Imaging and Interpretation of Axial Spondylarthritis: The Radiologist's Perspective—Consensus of the Arthritis Subcommittee of the ESSR. Semin Musculoskelet Radiol 2014; 18:265-79. [DOI: 10.1055/s-0034-1375569] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Iwona Sudol-Szopinska
- Department of Radiology, Institute of Rheumatology, Warsaw and Department of Diagnostic Imaging, Warsaw Medical University, Warsaw, Poland
| | - Nathalie Boutry
- Department of Musculoskeletal Radiology, Centre Hospitalier Universitaire de Lille and Hôpital Roger Salengro, Lille, France
| | | | - Andrea Klauser
- Department of Radiology, Innsbruck Medical University, Section Rheumatology and Sports Imaging, Innsbruck, Austria
| | - Marius Wick
- Department of Radiology, Karolinska University Hospital, Stockholm, Sweden
| | - Hannes Platzgummer
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging und Image-guided Therapy, Medical University of Vienna/Vienna General Hospital, Vienna, Austria
| | - Lennart Jans
- Department of Radiology, Ghent University Hospital, Ghent, Beligium
| | - Adam Mester
- Department of Radiology, National Institute of Rheumatology and Physiotherapy, Budapest, Hungary
| | - Franz Kainberger
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging und Image-guided Therapy, Medical University of Vienna/Vienna General Hospital, Vienna, Austria
| | - Gunnar Aström
- Department of Radiology, Oncology and Radiation Sciences, Section of Radiology, Uppsala University, Uppsala, Sweden
| | | | - Iris Eshed
- Department of Diagnostic Imaging, Sheba Medical Center, Sackler School of Medical, Tel Aviv, Israel
| | - Claudia Schueller-Weidekamm
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging und Image-guided Therapy, Medical University of Vienna/Vienna General Hospital, Vienna, Austria
| |
Collapse
|
28
|
Schueller-Weidekamm C, Lodemann KP, Grisar J, Schueller G, Weber M, Kainberger F, Platzgummer H. Contrast-enhanced MR Imaging of Hand and Finger Joints in Patients with Early Rheumatoid Arthritis: Do We Really Need a Full Dose of Gadobenate Dimeglumine for Assessing Synovial Enhancement at 3 T? Radiology 2013; 268:161-9. [DOI: 10.1148/radiol.13121733] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
29
|
Platzgummer H, Schueller-Weidekamm C. [Radiological imaging in early diagnosis of rheumatoid arthritis. The role of ultrasound and magnetic resonance imaging]. Radiologe 2012; 52:124-31. [PMID: 22290453 DOI: 10.1007/s00117-011-2233-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
CLINICAL/METHODICAL ISSUE For optimal therapy management of patients with rheumatoid arthritis (RA) specific and sensitive diagnostic methods are essential for assessment of disease activity. STANDARD RADIOLOGICAL METHODS In addition to projection radiography, imaging techniques, in particular magnetic resonance imaging (MRI) and ultrasound (US) are becoming increasingly more important for the early diagnosis of RA. PRACTICAL RECOMMENDATIONS The MRI and US techniques play a key role in the early imaging diagnostics of RA. Measurement of inflammation activity represents the basis of therapeutic decision-making and can be quantitatively and qualitatively determined with MRI and US. Synovitis and bone marrow edema are predictors of erosion.
Collapse
Affiliation(s)
- H Platzgummer
- Universitätsklinik für Radiodiagnostik, AKH, Medizinische Universität Wien, Wien, Österreich.
| | | |
Collapse
|
30
|
Schueller-Weidekamm C, Kainberger FM, Platzgummer H. „Welchen Stellenwert hat die hochauflösende MRT der Hände in der Differentialdiagnose rheumatischer Erkrankungen?“. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1310650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
31
|
|
32
|
Platzgummer H, Radner H, Grisar J, Schueller G, Kainberger F, Schueller-Weidekamm C. Quantifizierung der Entzündungsaktivität bei Patienten mit Rheumatoider Arthritis mit Power Doppler Ultraschall und Kontrastmittel-verstärktem Pulse-Inversion Harmonic Imaging. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
33
|
Platzgummer H. [Conservative management of synovial knee-joint tuberculosis]. Z Orthop Ihre Grenzgeb 1968; 105:83-9. [PMID: 4247841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|
34
|
Platzgummer H. [Geriatric surgery from the view-point of the orthopedist--introduction]. Landarzt 1968; 44:1253-4. [PMID: 5702803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
|
35
|
Platzgummer H. [On a simple procedure for the operative therapy of habitual peroneal tendon luxation]. Arch Orthop Unfallchir 1967; 61:144-50. [PMID: 5593432 DOI: 10.1007/bf00418812] [Citation(s) in RCA: 38] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|
36
|
Platzgummer H. [Unsatisfactory results of Voss' operation in coxarthrosis]. Landarzt 1965; 41:1153-7. [PMID: 5863948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
|
37
|
Platzgummer H. [Misdiagnosis with serious consequences in surgery on the basis of concrete examples. I. From orthopedics]. Landarzt 1964; 40:1023-1025. [PMID: 5826145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
|
38
|
Platzgummer H, Ravelli A. Zum Bilde der „ossalen“ Arthropathia deformans. ROFO-FORTSCHR RONTG 1955. [DOI: 10.1055/s-0029-1212694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
39
|
|
40
|
Platzgummer H. Zur Kenntnis der Luxatio pelvis totalis und deren Behandlung. Langenbecks Arch Surg 1951. [DOI: 10.1007/bf01403372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|