Überlastungssyndrome des Fußes

Kainberger, Franz; Peloschek, Philipp; Weidekamm, Claudia; Uffmann, Martin

doi:10.1007/s00117-007-1483-y

Cited by 6 publications

(2 citation statements)

References 27 publications

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“…In general, recent traumatic events (from ankle sprains, hitting objects in the living room, or overuse [21]) are rarely recalled precisely by elderly subjects [22], and less so by subjects with sensory deficits. A MRI-based study in asymptomatic feet of patients with peripheral sensory nerve dysfunction from leprosy has found residual lesions of prior traumatic injuries in 4 out of 6 of cases (67%) [11], whereas a previous X-ray based study has observed such lesions in 22% of 54 asymptomatic feet with diabetic polyneuropathy [8].…”

Section: Discussionmentioning

confidence: 99%

Routine MRI findings of the asymptomatic foot in diabetic patients with unilateral Charcot foot

Poll

Chantelau²

2010

Diabetol Metab Syndr

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BackgroundImaging studies of bones in patients with sensory deficits are scarce.AimTo investigate bone MR images of the lower limb in diabetic patients with severe sensory polyneuropathy, and in control subjects without sensory deficits.MethodsRoutine T1 weighted and T2-fat-suppressed-STIR-sequences without contrast media were performed of the asymptomatic foot in 10 diabetic patients with polyneuropathy and unilateral inactive Charcot foot, and in 10 matched and 10 younger, non-obese unmatched control subjects. Simultaneously, a Gadolinium containing phantom was also assessed for reference. T1 weighted signal intensity (SI) was recorded at representative regions of interest at the peritendineal soft tissue, the tibia, the calcaneus, and at the phantom. Any abnormal skeletal morphology was also recorded.ResultsMean SI at the soft tissue, the calcaneus, and the tibia, respectively, was 105%, 105% and 84% of that at the phantom in the matched and unmatched control subjects, compared to 102% (soft tissue), 112% (calcaneus) and 64% (tibia) in the patients; differences of tibia vs. calcaneus or soft tissue were highly significant (p < 0.005). SI at the tibia was lower in the patients than in control subjects (p < 0.05). Occult traumatic skeletal lesions were found in 8 of the 10 asymptomatic diabetic feet (none in the control feet).ConclusionMR imaging did not reveal grossly abnormal bone marrow signalling in the limbs with severe sensory polyneuropathy, but occult sequelae of previous traumatic injuries.

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Section: Discussionmentioning

confidence: 99%

Routine MRI findings of the asymptomatic foot in diabetic patients with unilateral Charcot foot

Poll

Chantelau²

2010

Diabetol Metab Syndr

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“…Skeletal inflammation of whatever aetiology corresponds to so-called bone marrow oedema on MRI [32]. Hence, X-ray-negative stress injuries (from overuse or sprain [29][30][31]33]) as well as Xray-positive fractures [34] can be visualised by use of MRI because of the inflammatory reaction they induce (table 2) [32,[34][35][36]. True oedema of the bone marrow -in-creased interstitial fluid induced by posttraumatic release of cytokines like tumour necrosis factor-alpha (TNF-α), interleukins, prostaglandin-E2 and leukotrienes -"is minor in most conditions so labelled on the MRI findings" [32].…”

Section: Mri Should Replace X-ray For Diagnosing and Monitoring The C...mentioning

confidence: 99%

Is the Eichenholtz classification still valid for the diabetic Charcot foot?

Chantelau¹,

G²

2014

Swiss Med Wkly

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In his 1966 monograph "Charcot joints", Sidney N. Eichenholtz (1909-2000) described "three well defined stages … in the course and development of a Charcot joint", based on plain X-rays of 68 patients. Since then, medical imaging has advanced very much: computed tomography and magnetic resonance imaging (MRI) scans exceed plain X-ray by far in detecting foot fractures and other injuries. The earliest, nondeforming, X-ray-negative inflammatory stage of the acute Charcot joint of the diabetic foot can be visualised only by use of MRI. This stage, which Eichenholtz evidently failed to recognise, will heal without significant arthropathy, if treated in time. By contrast, the stages considered by Eichenholtz inevitably result in major arthropathy and foot deformity. Hence, superseding the Eichenholtz classification is overdue. We propose an MRI-based classification comprising two severity grades (0 and 1, according to absence/presence of cortical fractures) and two stages (active/inactive, according to presence/absence of skeletal inflammation).

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Apophysenschäden im Sport

Neubauer

Nehrer

2021

Orthopäde

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ZusammenfassungDie Zahl an Jugendlichen und Kindern im Spitzen- oder hochintensiven Breitensport ist – bezogen auf Industrienationen – im Steigen begriffen. Hochintensives Training kann Überlastungen durch die vermehrte Zugwirkung besonders auf Sehnen- und Muskelinsertionsstellen bedingen. Apophysen als Ossifikationskerne in Sehnen- und Muskelinsertionen sind bei Heranwachsenden besonders vulnerabel für überlastungsbedingte Pathologien. Zentrale Maßnahmen in der Prävention sind eine systematische Trainingsplanung und die Vermeidung mechanischer Überbeanspruchung im Wachstumsalter. Eine exakte Bildgebung ermöglicht die Diagnose von Frühstadien apophysärer Strukturschäden, die in dieser Phase durch Trainingspause und konservative Maßnahmen geheilt werden können.

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Überlastungssyndrome des Fußes

Cited by 6 publications

References 27 publications

Routine MRI findings of the asymptomatic foot in diabetic patients with unilateral Charcot foot

Routine MRI findings of the asymptomatic foot in diabetic patients with unilateral Charcot foot

Is the Eichenholtz classification still valid for the diabetic Charcot foot?

Apophysenschäden im Sport

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