Comparing ultrasonography, magnetic resonance imaging and scintigraphy in evaluating an experimentally induced muscular hematoma

Thorsson, Ola; Leander, Peter; Lilja, B.; Nilsson, Patric; Obrant, Karl; Westlin, Nils E.

doi:10.1111/j.1600-0838.1993.tb00371.x

Cited by 13 publications

(10 citation statements)

References 23 publications

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“…In calculating the volume of the lesion we assumed that it was a spherical ellipsoidal hematoma. This has previously been shown to correlate to in vitro measurement of the volume of a hematoma (22). Notably the volume of the lesion was not correlated with the severity of the injury as indicated by recovery time.…”

Section: Ultrasonographymentioning

confidence: 74%

“…In our study an elevated serum CK value was found only during the first visit, whereas all individuals were back to their individual these types of muscle injuries in larger animals or in humas. In a diagnostic study in our laboratory (22) the formation of an extensive muscle hematoma after a contusion injury in rabbit was established within 30 seconds. If a similar situation exists in humans, it may be that the traditional treatment with the application of a compression bandage, at best completed within 2-3 min after the trauma, or indeed the application of ice where the effect on blood flow will not be seen until after 5-10 min (29), probably is of little value in reducing the hematoma.…”

Section: Creatine Kinasementioning

confidence: 99%

“…The most common echostructure displayed at the ultrasonographic examination within 1-3 days of the trauma was a diffuse hyperechogenicity in the muscles. This was considered a diffuse fresh intramuscular hemorrhage as previously described experimentally (22).…”

Section: Ultrasonographymentioning

confidence: 99%

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Immediate external compression in the management of an acute muscle injury

Thorsson

Lilja

Nilsson

et al. 1997

Scandinavian Med Sci Sports

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In a prospective, non‐randomized study 40 athletes with contusion or distension injuries to the thigh or the calf muscle were followed with tests of range of motion (ROM) of knee or ankle joint, test of serum creatine kinase (CK) and ultrasonography of the injury until completely recovered. An experimental group of 19 injuries where subjects received treatment with application of a maximum compression bandage within 5 min (mean=2 min) of the injury was compared to a control group of 21 injuries where subjects were treated with rest and elevation only, and in some cases non‐maximum compression after 10–30 min. No significant differences were noted with respect to time to complete subjective recovery, ultrasonic size of the injury or time to normal findings on ultrasound between treatment and control groups. Strain injuries, although showing a tendency to be smaller in size, took a longer time to complete recovery than contusion injuries (mean±SD=26±22 days and 19±9 days, respectively, P=0.02). Diagnostic CK values and reductions in ROM were not correlated to the severity of the trauma, while ROM showed weak correlation to the sonographically measured size of the hematoma (r=0.42; P<0.01). Injuries displaying a circumscript anechoic, low‐echogenic or mixed lesion at the diagnostic ultrasound investigation normalized more slowly (P=0.001) and took longer to complete recovery (P=0.001) than injuries with diffuse hyperechogenic lesions. We conclude that in this study the application of a maximum compression bandage within 5 min of a muscle trauma did not significantly reduce the size of the hematoma nor significantly shorten the time to complete subjective recovery compared with no immediate treatment. The diagnostic ultrasound investigation was valuable in predicting the severity of the trauma.

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Section: Ultrasonographymentioning

confidence: 74%

Section: Creatine Kinasementioning

confidence: 99%

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Immediate external compression in the management of an acute muscle injury

Thorsson

Lilja

Nilsson

et al. 1997

Scandinavian Med Sci Sports

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“…However, ultrasonographic examination of hematomas has suggested that they are often inaccurately measured. 34 In addition, it has been shown that the drain contents are less than 50% blood. 33 Given this, equating drain volume to blood loss is methodologically incorrect.…”

Section: Discussionmentioning

confidence: 98%

Effect of Intra-articular Injection of Tranexamic Acid on Postoperative Hemoglobin in Total Hip Arthroplasty

Bagsby¹,

Hur²

2014

Orthopedics

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Postoperative anemia is a significant risk factor in total hip arthroplasty, leading to increased length of hospital stay and delayed mobility and rehabilitation, and is poorly tolerated by patients with peripheral vascular and cardiovascular disease. Intravenous tranexamic acid, an antifibrinolytic drug, has been shown to reduce postoperative anemia in total joint replacement. Intra-articular administration eliminates the risk of systemic effects, the most concerning of which is thrombosis. Although this method of administering tranexamic acid has been studied in total knee replacement, currently no literature has been published on its efficacy in primary total hip replacement. The purpose of this study was to examine postoperative hemoglobin decrease and the transfusion rate following intra-articular tranexamic acid administration in primary total hip arthroplasty. The authors conducted a retrospective review of 181 consecutive total hip replacements, 91 of which received tranexamic acid. No statistical significance was found between these groups in any of the demographic variables. Postoperative hemoglobin decrease in the control group was 4.4±1.0 g/dL compared with a decrease of 3.6±1.1 g/dL in the tranexamic group, demonstrating an 18% reduction in blood loss (P<.001). No significant difference was found between the number of patients transfused (P=.777) or the number of units used (P=.993). No clotting events were seen in either group. Overall, the study demonstrates that intra-articular tranexamic acid in primary total hip arthroplasty is associated with a significant improvement in postoperative hemoglobin decrease without systemic hypercoagulability.

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“…The extent of injury (see Fig. 2) and repair progress can be followed by ultrasound (Thorsson et al, 1993).…”

Section: The Nature Of Muscle Injurymentioning

confidence: 99%

Rehabilitation of muscle after injury – the role of anti‐inflammatory drugs

Mackey

Mikkelsen

Magnusson

et al. 2012

Scandinavian Med Sci Sports

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Non-steroidal anti-inflammatory drugs (NSAIDs) are widely consumed among athletes worldwide in relation to muscle injury and soreness. This review aims to provide an overview of studies investigating their effects on skeletal muscle, in particular the repair processes in injured muscle. Muscle injury occurs in diverse situations and the nature of muscle injuries varies significantly, complicating extrapolations between experimental models and "real life." Classical muscle strain injuries occur at the interphase between the muscle fibers and connective tissue, most often in the myotendinuous junction, whereas contusion or overload injury can damage both myofibers and intramuscular connective tissue. The role of NSAIDs in muscle repair is complicated by differences in injury models used, variables evaluated, and time point(s) selected for evaluations. While the temporal pattern of the influence of NSAIDs on muscle repair is difficult to settle on, it appears that a potential beneficial effect of NSAIDs in the early phase after injury is not maintained in the long term, or is even negated by a long-term repair deficit. At the cellular level, evidence exists for a negative influence of NSAIDs on the muscle stem cell population (satellite cells). At a structural level, it is known that muscle connective tissue undergoes significant remodeling during muscle regeneration, but the potential of NSAID exposure to alter this response in humans needs investigation.

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Comparing ultrasonography, magnetic resonance imaging and scintigraphy in evaluating an experimentally induced muscular hematoma

Cited by 13 publications

References 23 publications

Immediate external compression in the management of an acute muscle injury

Immediate external compression in the management of an acute muscle injury

Effect of Intra-articular Injection of Tranexamic Acid on Postoperative Hemoglobin in Total Hip Arthroplasty

Rehabilitation of muscle after injury – the role of anti‐inflammatory drugs

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