Traumatologie Achsenskelett

Stäbler, Axel

doi:10.1007/3-540-26389-6_5

Cited by 1 publication

(4 citation statements)

References 135 publications

(78 reference statements)

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“…The leg was rotated slightly outwardly. It is known that an external rotation of the leg by 10-15° makes it possible to visualize the entire course of the anterior cruciate ligament on sagittal images (Stäbler & Freyschmidt 2005; Reiser et al 1992; Reiser & Semmler 2002). …”

Section: Methodsmentioning

confidence: 99%

“…The following signs were listed as direct signs of an ACL rupture (Stäbler & Freyschmidt 2005; Fritz 2003; Brandser et al 1996; Falchook et al 1996; Boeree & Ackroyd 1992; Robertson et al 1994; Tung et al 1993): Ligament interruption, depiction of ligament fragments or a lack of depiction of the ligament.Wavy course of the ligament or fibers.Fluid-equivalent signal within the ligament.ACL, which is diffusely signal-elevated, swollen, which can be distinguished in an unfocussed manner.Abnormally inclined course of ligament portions with a clear deviation from the Blumensaat’s line.…”

Section: Methodsmentioning

confidence: 99%

“…Listed as indirect signs of an ACL rupture were (Stäbler & Freyschmidt 2005; Katz & Weitzel 2009; Kam et al 2010; De Smet et al 1994; Reiser & Semmler 2002; Boeree & Ackroyd 1992; Robertson et al 1994): Anterior subluxational of the tibia compared to the femur.Posterior subluxational of the posterior horn of the lateral meniscus in relation to the tibia.Posterior cruciate ligament extending in a partially concave manner.Contusion oedema in the postero-lateral portion of the tibia and in the central to anterior portion of the lateral femoral condyle.Concomitant injuries: depression fracture on the lateral femoral condyle, inner ligament lesion, meniscus tear, Segond fracture, contusions to the Hoffa fat pad.…”

Section: Methodsmentioning

confidence: 99%

“…An ACL tear typically includes valgus-flexion, and external rotation. This type of injury results in rupture of the medial collateral ligament, the dorsomedial capsule including the posterior horn of the medial meniscus, and the anterior cruciate ligament (Barry et al 1996; De Smet & Graf 1994; Duncan et al 1995; Stäbler & Freyschmidt 2005; Korn et al 2011; Subhas et al 2011). …”

Section: Introductionmentioning

confidence: 99%

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Diagnosis of ACL and meniscal injuries: MR imaging of knee flexion versus extension compared to arthroscopy

2013

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The aim of the study was to evaluate whether MR Imaging of the knee at 30° and 55° of flexion can improve the diagnosis of anterior cruciate ligament and menisci injuries compared to arthroscopy and imaging during extension of the knee joint. Knee joints from 40 patients with clinical suspicion of an anterior cruciate ligament (ACL) rupture were examined using MRI while the knee joint was either extended or flexed at 30° and 55° of knee flexion. A standard MR knee coil was used at extension, whereas at 30° and 55° of flexion a non-metallic positioning device and a flexible surface coil was placed ventral to the patella. Sagittal T2-weighted TSE sequences were acquired. In 29 of 40 patients, arthroscopy results were compared to the MRI examinations. Image quality of MRI examinations was evaluated using a three-point rating scale in a blinded fashion. Images were compared between groups and rated as better quality, same quality, or worse quality. Additionally, each angle MRI was compared to arthroscopy results. Partial ACL ruptures were diagnosed with 63% accuracy using MR imaging at 30° and 55° of knee flexion compared to 50% accuracy during knee extension. MRI imaging of complete ACL ruptures resulted in 83% accuracy of diagnosis when imaged at 30° flexion, 93% accuracy at 55° flexion, and 83% accuracy at extension. The accuracy of diagnosing medial meniscus lesions was 73% at extension, 64% at 30° flexion and 73% at 55° of flexion. MR imaging was only able to diagnose lateral meniscus tears with 55% accuracy in all three knee positions. The diagnosis of meniscal tears was more difficult due to small peripheral tears. The improved results in the diagnosis of ACL tears in response to 30° flexion and in particular in response to 55° flexion were based on the fact that the anterior cruciate ligament moved further away from the intercondylar roof with increased knee flexion. During flexion the ligament tension decreased, which causes the anterior cruciate ligament to have cylindrical shape and therefore made visualization of the injury easier. In conclusion, MR Imaging of the knee at 55° of flexion and less at 30° of flexion allows an improved diagnosis of injuries to the anterior cruciate ligament as compared to MRI examinations at extension. The diagnosis of meniscal injuries, however, was not superior at both flexion positions compared to commonly performed examinations at knee extension.

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Section: Methodsmentioning

confidence: 99%