The aim of this study was to determine conventional ultrasonography characteristics of calcium deposits in patients diagnosed with calcific tendinopathy, to determine vascularization around deposits by power Doppler, and to compare morphological and power Doppler findings with clinical findings by use of two questionnaires. Pain and function were evaluated using the visual analog scale and two questionnaires, Constant Shoulder Score and Oxford Shoulder Score. All subjects underwent ultrasonography examination and evaluation of vascularization (flow) along calcium deposit using power Doppler. Fifty-one subjects were included in the study. The χ 2-test, a non-parametric statistics method was used because of the categorical type of variables. The level of statistical significance was set at p<0.05. In the inactive phase, calcium deposit was shown as a hyperechoic focal point with dorsal acoustic shadow and negative power Doppler finding, whereas in the resorptive phase it appeared as fragmented irregular hyperechoic focal points with positive power Doppler findings. This study showed the patients with fragmented, cloudy calcification to have statistically significantly worse results on functional questionnaires and more positive power Doppler findings (grades II and III) and to experience stronger pain (visual analog scale 8-10). Upon defining the stage of calcific tendinopathy, the method of treatment can be determined and further course of the disease predicted. Defining the stage of calcification precisely helps avoid unnecessary and long-lasting physical therapy while introducing an effective treatment option, depending on the stage of the disease.

AimTo evaluate visual impairment (VI) in children with cerebral palsy (CP).MethodsThis population-based study included 419 children from the Surveillance of Cerebral Palsy in Europe (SCPE) C28 RCP-HR – Register of Cerebral Palsy of Croatia born 2003-2008. Vision in children with CP (according to SCPE) was classified as normal or impaired, with the subcategory of severe VI. The proportion of children with VI was assessed in groups with different CP type/subtype, gross and fine motor function, and gestational age (GA).ResultsA total of 266 children had some degree of VI (266/400; 66.5%), 134 had normal vision, and data on VI were unknown for 19 children. Severe VI was present in 44 children (44/400; 11%). The proportion of children with VI and severe VI increased with the Gross Motor Function Classification System and Bimanual Fine Motor Function levels. Children with bilateral spastic CP had the highest frequency of severe VI (14.9%). The percentage of severe VI in children with bilateral spastic CP was 53.8% in the group born <28 weeks of GA, 13.3% in the group born 28-31 weeks of GA, 11.1% in the group born 32-36 weeks of GA, and 24.4% in the group born >36 weeks of GA (λ2 = 4.95; df = 6; P < 0.001).ConclusionChildren with CP have a high prevalence of VI and severe VI, which is increasing with the level of motor impairment. Severe VI is significantly more common in children with bilateral spastic CP, especially among extremely premature infants.

The aim of this population-based study was to evaluate the characteristics of cerebral palsy (CP) in relation to the predominant pattern of the magnetic resonance imaging Classification System (mriCS) that was analogously applied to the neonatal/early infant cranial ultrasound (CuS). The study included children born during the 2004-2007 period from the Croatian part (C28 rCP-hr) of the Surveillance of Cerebral Palsy in europe (SCPe) CP register. motor functions, accompanying impairments and brain mri were evaluated in 227 children, 185 of which also had CuS. Concerning CP types, 56% of children had bilateral spastic, 34% unilateral spastic, 9% dyskinetic and 1% ataxic CP type. gross motor function Classification System (gmfCS) revealed that 62.05% had mild (gmfCS i-iii) and 37.85% had severe motor impairment (gmfCS iv-v). CuS showed white matter injury in 60%, gray matter injury in 12%, maldevelopments in 8%, miscellaneous changes in 14%, while 6% were normal; mri showed significant agreement (κ=0.675, p<0.001). neuroimaging findings of maldevelopments and predominant gray matter injury were associated with more severe CP, but 7% of children with CP had normal mri. As we found very good agreement between CuS and mri findings, CuS is recommended in children at an increased risk of CP if mri is not available.

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