Sonografie in Orthopädie, Unfallchirurgie und Rheumatologie

Gruber, Gerd; Schamberger, Christian; Konermann, W.

doi:10.1007/978-3-662-57659-5

Cited by 5 publications

(12 citation statements)

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“…In typical sectional imaging methods, such as MRI and CT, the maximum expression of the acromion may lie between the slices, which are usually 2–4 mm thick [ 23 ]. This source of error can be eliminated in ultrasound, as it is a dynamic examination with live imaging [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Inclusion criteria were meticulously defined to ensure the validity of the study. They determined that a valid MRI examination in T1 and/or TSE weighting in the coronal plane should be available and that a sonographic examination of the same shoulder joint in the superior longitudinal section should be performed timely in accordance with the guidelines of the German Society for Ultrasound in Medicine (DEGUM) [ 17 ]. The additional inclusion criteria included being of legal age and having the capacity to provide consent for the study.…”

Section: Methodsmentioning

confidence: 99%

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The Modified Ultrasound-Assisted Method: A Study of the Correlation between Magnetic Resonance Imaging and the Ultrasound-Assisted Evaluation of the Critical Shoulder Angle

Schamberger,

Grossner,

Fischer

et al. 2024

Diagnostics

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Background: An increased or decreased critical shoulder angle (CSA) is a known risk factor for osteoarthritis, lesions, and re-ruptures in the rotator cuff. A CSA greater than 35° correlates with degenerative rotator cuff tears, while a CSA of less than 30° correlates with osteoarthritis in the glenohumeral joint. The diagnostic gold standard for its determination is X-ray or MRI. Objectives: The primary objective of this research was to assess the viability of utilizing sonography imaging as a diagnostic tool to determine the modified critical shoulder angle (mCSA). This study aimed to investigate the feasibility and effectiveness of sonographic techniques in accurately diagnosing CSA compared to MRI. Study Design and Methods: A cohort study was carried out (level of evidence 3). The CSA (MRI) and the mCSA (ultrasound) were assessed retrospectively by two independent board-certified investigators in 109 patients with shoulder pain by MRI and musculoskeletal sonography. The CSA in the MRI dataset was determined using routine protocols and then compared to the values assessed using the modified sonography-assisted method (mCSA). Both results were analyzed with linear regression to determine a possible correlation. All investigations were performed by a DEGUM (German Society for Medical Ultrasound)-certified specialist in musculoskeletal sonography. Results: A total of 112 patients were included in this study, namely 40 female patients and 72 male patients with a mean age of 54.7 years at the time of the investigation. The mean CSA in MRI was 31.5° ± 3.899, and the mCSA in sonography was 30.1° ± 4.753. The inter- and intraobserver reliability for the CSA was factual with values of 0.993 and 0.967. The inter- and intraobserver reliability for mCSA was factual as well, with values of 0.989 and 0.948. The ANOVA analysis did not reveal a significant difference between the CSA and the mCSA values, and linear regression determined the R2 value to be 0.358 with p < 0.05. Conclusions: Diagnosing the mCSA using sonography is a safe and valid method. No statistically significant differences between the results in MRI and sonography could be seen. Although this is a retrospective, single-center study including only Caucasian mid-Europeans, and with the known limitations of ultrasound imaging, it nevertheless shows that sonography can be used as a simple, cheap, and fast technique to assess a modified CSA, which shows very good correlation with the standard CSA without losing the diagnostic quality.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

The Modified Ultrasound-Assisted Method: A Study of the Correlation between Magnetic Resonance Imaging and the Ultrasound-Assisted Evaluation of the Critical Shoulder Angle

Schamberger,

Grossner,

Fischer

et al. 2024

Diagnostics

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“…location, which was easy to scan when the leg was bent maximally. The ultrasound examination was performed in a slightly modified scanning plane (Suprapatellar Transverse Section) compared to the plane predefined by the German Society of Ultrasound in Medicine (Deutsche Gesellschaft für Ultraschall in der Medizin) [13]. This modification provided the advantage that the entire transducer could be placed parallel to the patella ensuring the same stop on every measurement.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound‐guided determination demonstrates influence of age, sex and type of sport on medial femoral condyle cartilage thickness in children and adolescents

Schneider,

Weber,

Nourkami‐Tutdibi

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeTo analyse the reliability of ultrasound‐guided measurement of the cartilage thickness at the medial femoral condyle in athletically active children and adolescents before and after mechanical load in relation to age, sex and type of sport.MethodsThree successive measurements were performed in 157 participants (median/min–max age: 13.1/6.0–18.0 years, 106 males) before and after mechanical load by squats at the same site of the medial femoral condyle by defined transducer positioning. Test–retest reliability was examined using Cronbach's calculation. Differences in cartilage thickness were analysed with respect to age, sex and type of practiced sports, respectively.ResultsExcellent reliability was achieved both before and after mechanical load by 30 squats with a median cartilage thickness of 1.9 mm (range: 0.5–4.8 mm) before and 1.9 mm (0.4–4.6 mm) after mechanical load. Male cartilages were thicker (p < 0.01) before (median: 2.0 mm) and after (2.0 mm) load when compared to female cartilage (before: 1.6 mm; after: 1.7 mm). Median cartilage thickness was about three times higher in karate athletes (before: 2.3 mm; after: 2.4 mm) than in sports shooters (0.7; 0.7 mm). Cartilage thickness in track and field athletes, handball players and soccer players were found to lay in‐between. Sport type related thickness changes after mechanical load were not significant.ConclusionMedial femoral condyle cartilage thickness in childhood correlates with age, sex and practiced type of sports. Ultrasound is a reliable and simple, pain‐free approach to evaluate the cartilage thickness in children and adolescents.Level of EvidenceLevel III.

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“…A meticulous selection of this specific technique was made as it represents a practical approach in everyday settings that requires no specialized equipment. Ultrasound-guided marking was conducted using the dorsal transversal plane as recommended by DEGUM guidelines [20,23] with the help of a paperclip as described by Konermann et al [24]. The described method was previously demonstrated to the participants by an instructional video.…”

Section: Ultrasound-guided Localization Of the Dorsal Joint Spacementioning

confidence: 99%

“…In summary, ultrasound examination demonstrates great potential as a valuable tool for successful and sufficient arthrocentesis of the glenohumeral joint due to its cost effectiveness, avoidance of ionizing radiation, and capability for dynamic imaging [ 19 , 20 ]. However, further research and validation studies are needed to establish ultrasound-assisted puncture of the shoulder as a safe and practicable method, especially for inexperienced physicians.…”

Section: Introductionmentioning

confidence: 99%

Comparison between Ultrasound-Guided and Palpatory Localization of the Dorsal Joint Space of the Shoulder Joint

Stein,

Weimer,

Berthold

et al. 2024

Diagnostics

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Aim of the study: Arthroscopy ranks among the frequently performed interventions in orthopedics. The aim of this study was to compare the palpation technique with the ultrasound technique for locating the dorsal glenohumeral joint space (JS) in shoulder joint punctures. Material and Methods: Participants inexperienced in ultrasound examinations were included. Palpatory and ultrasound finding of the joint space by the participants was performed according to current recommendations and was initially demonstrated by an instructional video. The ideal point (IP) was marked under ultrasound visualization by an experienced ultrasound examinator and shoulder–elbow surgeon. Furthermore, a corridor for a safe puncture was defined. The palpatorily determined point (pdP) was marked by the participants and evaluated by means of a coordinate system. The evaluation of the sonographically determined point (sdP) was performed similarly to that of the palpatory procedure. Results: Fifty-four participants were included in the study, and the mean length of work experience was 6.3 years. On average, participants had performed 16.5 punctures of the shoulder joint and 6.8 arthroscopies of the shoulder joint. The mean experience in performing sonographic examinations of the shoulder was 27.6 examinations. A total of 100 shoulder joints were examined (54 left, 46 right shoulders). The mean deviation from the ideal point (IP) for the palpatory approach was 17.1 mm with a maximum deviation of 59.5 mm; for the sonographic technique, the mean deviation was 10.3 mm (max. 30.2 mm). Overall, 22% of pdPs were within the defined corridor, while 42% of sdPs were within the target corridor. The average difference between palpatory and sonographic approaches was 9.0 mm in favor of the sonographic technique (max. 46.5 mm). A significantly greater deviation (p < 0.001) from the IP was observed with the palpatory approach than with the sonographic approach. Conclusion: Based on the results, the authors recommend ultrasound imaging of the shoulder joint as well as ultrasound-assisted punctures, especially for inexperienced users. Furthermore, training in ultrasound-assisted interventions should be implemented in future training curricula.

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Sonografie in Orthopädie, Unfallchirurgie und Rheumatologie

Cited by 5 publications

References 0 publications

The Modified Ultrasound-Assisted Method: A Study of the Correlation between Magnetic Resonance Imaging and the Ultrasound-Assisted Evaluation of the Critical Shoulder Angle

The Modified Ultrasound-Assisted Method: A Study of the Correlation between Magnetic Resonance Imaging and the Ultrasound-Assisted Evaluation of the Critical Shoulder Angle

Ultrasound‐guided determination demonstrates influence of age, sex and type of sport on medial femoral condyle cartilage thickness in children and adolescents

Comparison between Ultrasound-Guided and Palpatory Localization of the Dorsal Joint Space of the Shoulder Joint

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