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  • 1
    Electronic Resource
    Electronic Resource
    Determination of subacromial space width and inferior acromial mineralization by 3D CT (1997)
    Springer
    Surgical and radiologic anatomy 19 (1997), S. 329-337 
    Details
    ISSN: 1279-8517
    Keywords: Shoulder ; Supraspinatus outlet syndrome ; Computed tomography ; Mineralization ; Subacromial space
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Une réduction de l'espace sous-acromial et une augmentation de la pression sous-acromiale avait été considérées comme jouant un rôle très important dans la pathogénie des lésions de la coiffe des rotateurs. L'objectif de cette étude est de développer une méthode basée sur la tomodensitométrie, pour mesurer la distance acromio-humérale et la minéralisation de la partie inférieure de l'acromion. Chez 7 patients avec une rupture unilatérale de la coiffe des rotateurs et deux avec un syndrome de conflit, des images acquises en coupes axiales transverses étaient obtenues avec une section d'épaisseur de 1 mm en situation de relaxation musculaire dans une position standard. Les structures osseuses étaient ensuite reconstruites en trois dimensions, la distance minimale verticale entre l'acromion et l'humérus était déterminée sur trois images frontales des deux côtés. La distribution de la minéralisation à l'intérieur de la surface caudale de l'acromion était évaluée en utilisant une méthode d'ostéo-absorptiométrie. Bien que le score de Constant était significantivement réduit chez les épaules malades, l'épaisseur de l'espace sous-acromial n'était pas systématiquement plus bas que du côté controlatéral. Dans 7 cas, les zones de minéralisation maximale de l'acromion étaient identiques dans les deux épaules et dans 2 cas étaient plus basses du côté affecté. Cette étude préliminaire suggère qu'avec la relaxation musculaire, un amincissement de l'espace sous-acromial ne peut pas être détecté sur des images de reconstruction frontale, par tomodensitométrie tridimensionnelle et qu'un potentiel d'accroissement de la pression subacromiale n'est pas assez élevé pour causer une augmentation de la densité osseuse de l'acromion. La méthode présentée rend possible l'investigation de la pathogénie du défilé du m. supraépineuxin vivo avec une plus grande précision que ce qui a été possible jusqu'alors avec la radiographie conventionnelle.
    Notes: Summary A reduction of the subacromial space and an increased subacromial pressure have been considered to play an important role in the pathogenesis of rotator cuff lesions. The objective of the current study was to develop a CT based method for measuring the acromiohumeral distance and inferior acromial mineralization. In seven patients with unilateral rupture of the rotator cuff and two with impingement syndrome, transverse CT images were obtained at a section thickness of 1 mm with muscular relaxation in a standardized position. The bones were then reconstructed three-dimensionally, and the minimal vertical distance between the acromion and the humerus was determined in three secondary frontal images on both sides. The distribution of mineralization within the inferior surface of the acromion was assessed using CT osteoabsorptiometry. Although the Constant score was significantly reduced in the diseased shoulders, the width of the subacromial space was not routinely lower than on the contralateral side. In seven cases the maximal inferior acromial mineralization was identical in both shoulders, and in two cases it was lower on the affected side. These preliminary data suggest that with muscular relaxation no narrowing of the subacromial space can be detected in secondary frontal CT images, and that a potential increase of subacromial pressure is not high enough to cause a measurable increase in inferior acromial bone density. The method presented makes it possible to investigate the pathogenesis of the supraspinatus outlet syndromein vivo with greater precision than has so far been possible with conventional radiography.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01637604
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  • 2
    Electronic Resource
    Electronic Resource
    Determination of subacromial space width and inferior acromial mineralization by 3D CT (1998)
    Springer
    Surgical and radiologic anatomy 19 (1998), S. 329-337 
    Details
    ISSN: 1279-8517
    Keywords: Shoulder ; Supraspinatus outlet syndrome ; Computed tomography ; Mineralization ; Subacromial space
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A reduction of the subacromial space and an increased subacromial pressure have been considered to play an important role in the pathogenesis of rotator cuff lesions. The objective of the current study was to develop a CT based method for measuring the acromiohumeral distance and inferior acromial mineralization. In seven patients with unilateral rupture of the rotator cuff and two with impingement syndrome, transverse CT images were obtained at a section thickness of 1 mm with muscular relaxation in a standardized position. The bones were then reconstructed three-dimensionally, and the minimal vertical distance between the acromion and the humerus was determined in three secondary frontal images on both sides. The distribution of mineralization within the inferior surface of the acromion was assessed using CT osteoabsorptiometry. Although the Constant score was significantly reduced in the diseased shoulders, the width of the subacromial space was not routinely lower than on the contralateral side. In seven cases the maximal inferior acromial mineralization was identical in both shoulders, and in two cases it was lower on the affected side. These preliminary data suggest that with muscular relaxation no narrowing of the subacromial space can be detected in secondary frontal CT images, and that a potential increase of subacromial pressure is not high enough to cause a measurable increase in inferior acromial bone density. The method presented makes it possible to investigate the pathogenesis of the supraspinatus outlet syndrome in vivo with greater precision than has so far been possible with conventional radiography.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s00276-997-0329-7
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  • 3
    Electronic Resource
    Electronic Resource
    Determination of Calcaneal Ultrasound Properties Ex Situ: Reproducibility, Effects of Storage, Formalin Fixation, Maceration, and Changes in Anatomic Measurement Site (1999)
    Springer
    Calcified tissue international 65 (1999), S. 192-197 
    Details
    ISSN: 1432-0827
    Keywords: Key words: Ultrasound — Calcaneus — Fixation — Reproducibility — Maceration.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract. The objective of this study was to determine the reproducibility of ultrasonic bone properties with a system for measuring calcanei ex situ; the influence of changes of the measurement site; and the effects of fixation, storage, and maceration. We examined 14 fixed calcanei and 12 fresh bones. Ultrasonic measurements were performed ex situ after degassing, using an Achilles+ system and a special positioning device. The instrument precision was 0.16% for speed of sound (SOS), 1.4% for broadband ultrasonic attenuation (BUA), and 1.8% for the stiffness index (SI). The short-term precision was 0.54%, 1.9%, and 2.8%, respectively. A defined shift of the measurement site (5 mm distal of the middle) led to unpredictable changes in ultrasound (US) properties (r = 0.65 for SOS, 0.82 for BUA, and 0.75 for SI). Embalment with 4% formalin/96% alcohol caused a systematic decrease in SOS, an increase in BUA, and a decrease in SI (mean =−12.7 units; P 〈 0.001), the effect increasing with time. However, values at 6 months of fixation and later were highly correlated with those in fresh specimens (r = 0.95 for the SI). Two weeks storage in degassed and normal solution had only modest effects on ultrasound properties. Maceration did not lead to a systematic increase or decrease of ultrasound variables, but introduced unpredictable changes (r = 0.64–0.94). We conclude that in comparative biomechanical studies it is feasible to measure calcaneal specimens embalmed in formalin/alcohol ex situ, if the primary interest is not in the absolute values but in the correlation with mechanical failure loads at other skeletal sites.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002239900681
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  • 4
    Electronic Resource
    Electronic Resource
    Acromiohumeral distance and acromial shape assessed by three-dimensional computed tomography in patients with supraspinatus outlet syndrome (1997)
    Springer
    Der Unfallchirurg 100 (1997), S. 874-879 
    Details
    ISSN: 1433-044X
    Keywords: Key words Supraspinatus outlet syndrome ; computed tomography ; 3D reconstruction ; shoulder ; acromion ; Schlüsselwörter Supraspinatus-outlet-Syndrom • CT • 3D-Rekonstruktion • Schulter • Akromion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Eine mechanische Irritation der Supraspinatussehne aufgrund einer Einengung des subakromialen Raumes wird als mögliche Ursache des Supraspinatus-outlet-Syndroms angesehen. Ziel der vorliegenden Studie war die Entwicklung einer Methode zur verbesserten räumlichen Messung akromiohumeraler Distanzen und zur Beurteilung der Akromionform in der dreidimensional rekonstruierten Computertomographie (CT). An 7 Patienten mit einseitigem Supraspinatus-outlet-Syndrom wurde das Akromion und der subakromiale Raum aus hochauflösenden CT-Schnitten dreidimensional (3D-) rekonstruiert. Die akromiohumerale Distanz wurde in 3 rekonstruierten Frontalschnitten gemessen und auf der gesunden und erkrankten Seite verglichen. Die Akromionform wurde der Klassifikation nach Bigliani im konventionellen Röntgenbild gegenübergestellt. Die akromiohumerale Distanz war an der betroffenen Schulter nicht signifikant kleiner als auf der gesunden Seite. In 5 Fällen konnte die Klassifikation der Akromionform im Röntgenbild in der 3D-CT bestätigt werden, in 2 Fällen ergab sich eine abweichende Beurteilung. Die Ergebnisse legen nahe, daß mit der 3D-CT eine verbesserte Beurteilung der Akromionform und der akromiohumeralen Distanz möglich ist.
    Notes: Summary Mechanical irritations of the supraspinatus tendon due to a reduction of the subacromial space are considered to be a potential cause of supraspinatus outlet syndrome. The aim of the current study was, therefore, to provide a method of improved measurement of the acromiohumeral distance and the evaluation of the acromial shape. In seven patients aged 50–60 years with unilateral supraspinatus outlet syndrome, imaging with standardized, high-resolution computed tomography (CT) was performed in order to demonstrate the acromion and the subacromial space three-dimensionally. The acromiohumeral distance was measured in three reconstructed frontal sections, and the two sides of each patient were directly compared. The acromial shape was compared with the classification of Bigliani as derived from conventional radiography. Whereas the Constant Score was found to be significantly reduced in the diseased shoulders (p 〈 0.01), the acromiohumeral distance was not significantly lower in three standardized frontal sections. In five cases the classification of the acromial form from the conventional radiograph was confirmed by 3D CT, whereas in two cases it was shown to be different. Our results suggest that primary or secondary changes of the acromial form can be more accurately evaluated with 3D CT than with conventional radiography. A direct comparison of the two sides in patients with supraspinatus syndrome does not suggest a reduction of acromiohumeral distance in the diseased shoulder.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001130050207
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  • 5
    Electronic Resource
    Electronic Resource
    Correlation of Femoral and Lumbar DXA and Calcaneal Ultrasound, Measured In Situ with Intact Soft Tissues, with the In Vitro Failure Loads of the Proximal Femur (1998)
    Springer
    Osteoporosis international 8 (1998), S. 591-598 
    Details
    ISSN: 1433-2965
    Keywords: Key words:Bone mineral density – DXA – Femoral failure loads – Hip fracture – Osteoporosis – Ultrasound
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: The objective of this study was to determine experimentally the sex-specific correlation of femoral and lumbar DXA and calcaneal ultrasound, measured in situ, with the in vitro failure loads of the proximal femur. Fifty-eight cadavers with intact skin and soft tissues (34 male, aged 81.2 ± 8.7 years; 24 female, aged 83.7 ± 10.6 years) were examined. The bone mass of the proximal femur and the lumbar spine were determined using dual-energy X-ray absorptiometry and the ultrasonic properties of the calcaneus with quantitative ultrasound. Afterwards, the right femora were excised 18 cm distal to the minor trochanter, and their load to failure determined with a material testing machine. Femoral fracture loads were significantly higher in males than in females, both before and after correcting for body height and weight. Femoral neck bone mineral density (BMD) was significantly correlated with femoral failure loads (r= 0.65 all specimens, 0.57 males (0.64 after excluding trochanteric fractures) and 0.77 females; p 〈0.001). The correlations with the ultrasonic Stiffness Index of the calcaneus were in a similar range (r= 0.67 all specimens, 0.48 males (0.64 after excluding trochanteric fractures) and 0.65 females; p 〈0.001). The correlations between femoral failure loads and the spinal BMD were lower (r= 0.40, p 〈0.01), particularly in males (r= 0.30, not significant). In contrast to previous experimental investigations on excised bones, our results are consistent with clinical studies that have reported that ultrasound and femoral DXA have a similar ability to predict the risk of hip fracture.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001980050104
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  • 6
    Electronic Resource
    Electronic Resource
    In Situ Femoral Dual-Energy X-ray Absorptiometry Related to Ash Weight, Bone Size and Density, and its Relationship with Mechanical Failure Loads of the Proximal Femur (2000)
    Springer
    Osteoporosis international 11 (2000), S. 361-367 
    Details
    ISSN: 1433-2965
    Keywords: Key words:Ash weight – Bone density – Bone size – DXA – Mechanical failure – Proximal femur
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: The objective of this study was to directly compare in situ femoral dual-energy X-ray absorptiometry (DXA) and in vitro chemical analysis (ash weight and calcium) with mechanical failure loads of the proximal femur, and to determine the influence of bone size (volume) and density on mechanical failure and DXA-derived areal bone mineral density (BMD, in g/cm2). We performed femoral DXA in 52 fixed cadavers (age 82.1 ± 9.7 years; 30 male, 22 female) with intact skin and soft tissues. The femora were then excised, mechanically loaded to failure in a stance phase configuration, their volume measured with a water displacement method (proximal neck to lesser trochanter), and the ash weight and calcium content of this region determined by chemical analysis. The correlation coefficient between the bone mineral content (measured in situ with DXA) and the ash weight was r= 0.87 (standard error of the estimate = 16%), the ash weight allowing for a better prediction of femoral failure loads (r= 0.78; p〈0.01) than DXA (r= 0.67; p〈0.01). The femoral volume (r= 0.61; p〈0.01), but not the volumetric bone density (r= 0.26), was significantly associated with the failure load. The femoral bone volume had a significant impact (r= 0.35; p〈 0.01) on the areal BMD (DXA), and only 63% of the variability of bone volume could be predicted (based on the basis of body height, weight and femoral projectional bone area. The results suggest that accuracy errors of femoral DXA limit the prediction of mechanical failure loads, and that the influence of bone size on areal BMD cannot be fully corrected by accounting for body height, weight and projected femoral area.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001980070126
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  • 7
    Electronic Resource
    Electronic Resource
    Precision and intersite correlation of bone densitometry at the radius, tibia and femur with peripheral quantitative CT (1999)
    Springer
    Skeletal radiology 28 (1999), S. 696-702 
    Details
    ISSN: 1432-2161
    Keywords: Key words pQCT ; Osteoporosis ; Bone densitometry ; Femur ; Tibia ; Precision
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To compare the in situ precision of peripheral quantitative CT (pQCT) at the radius, tibia and femur, and to analyze the intersite correlation, in order to determine whether measurements at the lower extremity reproduce results at the radius or are of additional informative value. Design and material. pQCT measurements were performed in 86 elderly cadavers (mean age 80.5 years) at trabecular and cortical locations in the radius, tibia and femur, determining densitometric (bone mineral content and density) as well as geometric parameters (cross-sectional area, cortical thickness, polar moment of inertia and others). In 14 cadavers, repeated measurements were obtained at all sites on four different days. Results and conclusions. At cortical sites, the precision for the densitometric and geometric variables ranged from 0.4% to 4.3%, and was similar for the radius, tibia and femur. At trabecular locations, the reproducibility of the density measurements ranged from 1.8% to 2.5% at the radius, and from 3.2% to 5.9% at the femur and tibia. The intersite correlation of the total bone mineral content ranged from 0.87 and 0.97 at cortical sites, and from 0.63 to 0.85 at trabecular locations. The trabecular density showed a higher similarity between the tibia and femur (r=0.68–0.78) than between the radius and the lower extremity (r=0.41–0.45). The results demonstrate a substantial heterogeneity of trabecular bone in elderly individuals and advocate measurements directly at the site of clinical or scientific interest.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050576
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