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[en] With technical advances, ultrasonography of musculoskeletal system has been an important imaging modality in variable disorders and has been popular. Real-time imaging and possible dynamic motion study are special advantages of ultrasonography, and particularly helpful in evaluation of tendon or ligament injury. The purpose of this article is to review the basic technique and disorders that dynamic ultrasonography is helpful or essential in diagnosis in upper extremity
[en] The MR features of a 57-year-old man with multiple tendinous xanthomas are reported. The lesions of the peroneus longus tendons and the Achilles tendons showed diffuse reticulated pattern, which is the typical MR finding of tendinous xanthomas. However, the lesions of the patellar tendons showed no diffuse pattern and contained focal regions of high signal intensity on T 1-weighted images suggesting the deposition of triglycerides. The regions showed high signal intensity on T 2-weighted images and moderate enhancement on contrast-enhanced T 1-weighted images suggesting the presence of associated inflammation. (orig.). With 2 figs
[en] In routine clinical practice the variations of the radial artery are the main reason for technical failure during transradial catheterization. If these variations are well documented, however, they do not represent a problem in the transradial approach. Therefore, we report here a rare case of the radial artery which is very strange but potentially valuable for the clinical practice: it arises at a right angle from the brachial artery and passes behind the biceps brachii tendon. Based on our findings and on an extensive literature review, we propose for the first time a clinically oriented classification of the variations of the radial artery. This classification is related to the catheterization success at the usual access site of the radial artery at the wrist.
[en] Fibrodysplasia ossificans progressiva is a rare disorder progressing to ossification of tissues causing disability. We report a case of father and daughter in a family presenting with this condition. The diagnosis was made with X-rays. However, Technetium-99m Methylene Diphosphonate bone scan showed extensive extra-osseous localization of tracer suggesting ossification of multiple ligaments, tendons, muscles and connective tissue
[en] To evaluate the long-term results following eccentric calf-muscle training in patients with chronic Achilles tendinopathy. A total of 24 patients with chronic Achilles tendinopathy were included in a study evaluating MRI findings and clinical symptoms before and after 3 months of daily eccentric calf-muscle strength training. Median duration of symptoms was 18 months (range 6-120). Four of the patients did not perform the prescribed treatment for different reasons and were followed for 14 months. The resulting 20 treated patients completed 4.2-year (range 29-58 months) follow up. Tendon volume was evaluated by using 3D seed growing technique and signal abnormalities were visually semi-quantitatively graded. Level of pain and performance was categorized using a questionnaire completed by the patient. In the symptomatic treated patients, median intensity level of pain decreased from moderate/severe at time of inclusion to mild at follow up (p < 0.05). Median level of performance increased from severe impairment at time of inclusion to normal at follow up (p < 0.05). 12 out of 20 patients had raised intratendinous signal at time of inclusion compared to 2 out of 20 patients at follow up (p < 0.001). Mean tendon-volume measured 6.7 cm3 (SD 2.0) at time of inclusion and 6.4 cm3 (SD 2.0) at follow up (p = 0.18). The four symptomatic non-treated tendons did not improve regarding pain, performance, intratendinous signal or tendon volume. We found decreased pain, improved performance and decreased intratendinous signal both compared to index examination and immediately after the 3 months training regimen in a 4.2-year clinical and MRI follow up, in a group of patients treated with heavy loaded eccentric calf-muscle training for chronic Achilles tendinopathy. The improvements were greater at 4.2-year follow up, despite no further active treatment, than immediately after the treatment. This may indicate a good long-term prognosis for Achilles tendinosis patients. (orig.)
[en] To evaluate the efficacy of steroid injection into the subacromial bursa and biceps tendon sheath for painful shoulders and the usefulness of ultrasound-guided approach. Seventeen shoulders of twelve patients with shoulder pain and limited motion were included, and these patient were clinically diagnosed as a painful arc syndrome. Under ultrasound guidance, steroid injection was performed into the subacormial bursa (13 cases) and biceps tendon sheath (4 cases). In 7 cases, 1 mL of steroid was used while the remaining six patients received a mixture of 1 mL of steroid and 1 ml of lidocaine. Both shoulders of two patients received 0.5 mL of steroid. The location of needle and injection duration of fluid were continuously monitored, and complications such as leakage of steroid were recorded. Medical records were reviewed for the presence of pain relief and increasing range of motion following the injection. On ultrasonogram, the needle within the subacromial bursa and biceps tendon sheath was seen as a linear echogenic structure, and injected fluid was identified. There was neither the leakage of steroid injection nor any other complications. In 16 (94%) of 17 shoulders, there was decreased intensity of shoulder pain while increased range of motion was noted in three patients following the injection. Steroid injection into the subacormial bursa and biceps tendon sheath is effective in treating shoulder pain and limited range of motion of the shoulder, and ultrasound is useful guiding method.