Detection of a 0.5-mm-thick thorn using ultrasound: a case report.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to M van Holsbeeck.
Explore the source record for details and available documents.
Fourteen fractures (8 open, 6 closed) were treated with small-diameter interlocking tibial nails and observed for at least 1 year. Radiographs were obtained to monitor the maintenance of reduction and fracture healing. The treating orthopaedic surgeon was blinded to the results of ultrasound studies, which were obtained at 2-week intervals for 10 weeks postoperatively and read by a radiologist who was blinded to the clinical and radiographic progress. Ultrasound correctly predicted fracture healing in all 9 fractures that subsequently progressed to fracture union. Of the 5 fractures that did not heal and required secondary procedures, ultrasound predicted delayed healing in 4 fractures. Overall, ultrasound was able to predict fracture healing before it was radiographically evident. Ultrasound may provide important prognostic information concerning tibial fracture healing after treatment using interlocking nails without reaming. Additional study is warranted.
We studied the integrity of the rotator cuff in both dominant and non-dominant shoulders of 90 asymptomatic adults between the ages of 30 and 99 years using ultrasound. The criteria for diagnosis had been validated on unembalmed cadaver specimens. We found no statistically significant difference in the incidence of impingement findings between dominant and non-dominant arms or between genders. The prevalence of partial- or full-thickness tears increased markedly after 50 years of age: these were present in over 50% of dominant shoulders in the seventh decade and in 80% of subjects over 80 years of age. Our results indicate that rotator-cuff lesions are a natural correlate of ageing, and are often present with no clinical symptoms. Treatment should be based on clinical findings and not on the results of imaging.
Twenty patients with classical or definite rheumatoid arthritis received one intra-articular injection of 40, 80, 120, 160 or 200 mg rimexolone (Org 6216) into one knee joint. Rimexolone was well tolerated and the incidence of side-effects was low. A beneficial effect was sustained over the study period of 94 days and a long-lasting effect was observed in 84% of the patients after one year and in 79% after 2 years. Safety parameters remained unaffected. Individual changes in adrenal response to ACTH and morning cortisol levels did not correlate with the dose or with serum levels of rimexolone. Rimexolone showed linear kinetics. The mean residence time in the intra-articular depot was 44 days (SD +/- 53) with a median of 26 days. Ninety percent was absorbed after 4 months. Outside the intra-articular depot the mean residence time was less than 0.1 days.
We present two cases of cauda equina syndrome in ankylosing spondylitis. Cauda equina syndrome is a rare complication of ankylosing spondylitis, the pathogenesis of which is not well understood. The onset is insidious with pain and sensory symptoms; sphincter disturbances are common. After a period of increasing neurological symptoms, the condition tends to stabilize. The degree of nerve involvement is variable and can be accurately defined by electromyography. The diagnosis has to be confirmed by computed tomography (CT) or magnetic resonance imaging (MRI); myelography must be avoided. There is no specific treatment, except for pain control. The different clinical presentations and the role of new imaging techniques, CT and MRI, are demonstrated.
The purpose of this essay is to illustrate the sonographic findings in patients with abnormalities of the subacromial-subdeltoid bursa. The anatomy of the subacromial-subdeltoid bursa is complex. This paper illustrates the complexity of the normal bursa and the findings in shoulders with bursal distension.
Eight middle-aged women with spontaneous atraumatic subluxation of the sternoclavicular joint were evaluated with radiography and computed tomography. All patients were employed in occupations involving moderate to heavy physical labour, and no patients could recall a specific traumatic incident associated with onset of symptoms. In seven of the eight patients, the displacement of the medial clavicle was in a cranial direction; in four of the eight patients, there was an associated anterior subluxation, and in one patient, the subluxation was purely anterior. All five patients with an anterior component to the sternoclavicular subluxation had associated condensing osteitis of the clavicle. The sclerosis of the medial clavicle is possibly the result of chronic abrasion on the sternum and first costal cartilage in association with normal respiration and with upper extremity motion.
Explore the source record for details and available documents.
The scope of musculoskeletal ultrasonography has broadened considerably since its inception. Ultrasonography has established itself as a reliable cost-effective modality for the diagnosis and follow-up of a wide variety of lesions. Its real-time dynamic capability adds a perspective that other modalities lack. Growth within this field will continue, driven by improved technology, cost consciousness, and the creativity of those who employ this powerful diagnostic tool.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A syndrome of hyperostosis of the thoracic wall, nonspecific signs of inflammatory disease, and palmar and plantar pustulosis is described in eight patients (Table 1). Seven had intersternocostoclavicular ossification, and one had chronic recurrent multifocal osteomyelitis. This complex of findings has been called "pustulotic arthro-osteitis". This report emphasizes the periosseous soft tissue inflammation and the unexplained subclavian and mediastinal vein thrombosis seen in two patients. Inflammatory periosseous and mediastinal lesions were seen on plain films in all eight patients and on computed tomographic (CT) scans in seven. Radiographs of the spine showed a spondyloarthropathy in three patients. This was characterized by ossification of the vertebral ligaments and sclerosis of the vertebral bodies. Awareness of the radiologic features of pustulotic arthro-osteitis is important because the clinical, biochemical and pathologic findings are often nonspecific and misleading.
Three cases of solitary meniscal cyst in the knee have recently been diagnosed in our departments using ultrasound and nuclear magnetic resonance (MRI). Two cysts involved the lateral and one the medial meniscus. The appearance of these lesions on ultrasound and MR images is shown. All three cysts had low intensity on T1-weighted images and high intensity on T2-weighted images and clearly communicated with a large horizontal tear in the meniscus. Ultrasonography showed a relatively hypoechoic lesion and, in the two cases of lateral meniscal cyst, focal areas of relatively increased echoes which are probably due to meniscal debris. Ultrasound showed the abnormal meniscus in both of these cases. MRI is the best way of showing the cyst and an accompanying meniscal tear but, where MRI is not available, ultrasound may be an easy and inexpensive way of making a diagnosis whether or not it is used in conjunction with positive contrast arthrography.
Explore the source record for details and available documents.
Twenty patients with longstanding polyarticular rheumatoid arthritis (including knee involvement) were selected for this study. The severity of the knee synovitis was assessed before and during treatment (with intra-articular corticosteroid injections) using clinical scores, sonography, and thermography. In all patients, the inflammation regressed during treatment. During follow-up, the quantity of synovial fluid, as measured sonographically 10 days after the start of therapy, correlated best with the clinical status. Maximal regression of synovial thickening was noted on delayed sonograms performed three months after treatment. Thermographic peak temperature showed good correlation with the clinical status, but the thermographic index was unreliable.