Sonography of tendons.

Recent advances in ultrasound technology and the development of high-resolution ultrasound transducers have enabled detailed depiction of superficial musculoskeletal structures. While in the past considered as complementary to magnetic resonance (MR) imaging, modern ultrasound has clearly become competitive. It is now the imaging modality of choice for evaluating tendon pathology. The major advantages of ultrasound include dynamic evaluation of structures, low cost and wide availability. The main disadvantage is a high degree of operator dependency. This article discusses the current ultrasound characteristics of normal tendon, the artefacts that may mimic tendon disease and reviews the applications of ultrasound to the evaluation of tendon disorders, including tendon tears, tendinitis, tenosynovitis, ganglion cysts and bursitis.

[Ultrasonography as a diagnostic method in suspected meniscal lesion of the knee. A prospective single blind study of 52 patients]. / UL-scanning som diagnostisk metode ved mistanke om menisklaesion i knaeet. Prospektiv blindet undersøgelse af 52 patienter.

To evaluate the value of ultrasonography as a diagnostic tool in patients with clinical and anamnestic signs of meniscal lesions of the knee, a prospective, blinded study of 52 patients was carried out. A dynamic ultrasound scan of the menisci was performed before the arthroscopy. At arthroscopy, the surgeon did not know the result of the ultrasonography. One patient was excluded. We found agreement between the results of the ultrasound scan and the arthroscopy in 43 patients. There were four false negative and four false positive results. The sensitivity of ultrasonography was 0.86 and the specificity was 0.83. We conclude that it is possible to diagnose meniscal lesions by ultrasonography. The method is, however, extremely dependent on the examiner, and it takes a long learning period to become experienced in the technique of performing the dynamic investigation of the menisci with a high grade of specificity within five to ten minutes.

Analysis of somatic hybrids between two sterile dihaploid Solanum tuberosum L. breeding lines. Restoration of fertility and complementation of G. pallida Pa2 and Pa3 resistance.

Fourteen somatic hybrids generated by electrofusion of mesophyll protoplasts from a non-flowering dihaploid S. tuberosum clone, DHAK-11, and a male-sterile dihaploid clone S. tuberosum, DHAK-33, were grown in the greenhouse and subjected to morphological assessments and tests for fertility and resistance to the white potato cyst nematode Globodera pallida pathotypes Pa2 and Pa3. The ploidy level of the hybrids ranged from 38 to 63 chromosomes. All hybrids developed flowers with violet petals except for one, hy-56, that possessed red petals. The colour of the tuber skin was purple in all hybrids except in hy-56 where the tuber skin was red. All of the hybrids were female fertile and generated viable seeds. Near-tetraploid hybrids produced the highest number of seeds per fruit and these seeds had a normal size. Hybrids with 58 or more chromosomes produced smaller seeds and less seeds per fruit. The germination frequency of the seeds was not influenced by the chromosome number of the hybrids. Pollen viability was determined and the male fertility of three hybrids was tested. Pollination with these three hybrids gave rise to fruit development, but only one produced viable seeds. The hybrids were tested for resistance to G. pallida pathotypes Pa2 and Pa3. A high level of resistance to Pa3, inherited from one parental clone, DHAK-11, and a high level of resistance to Pa2, inherited from the other parental clone, DHAK-33, was combined in four hybrids. These results demonstrate, that protoplast fusion is an efficient method for restoring the fertility of somatic hybrids generated from sterile parent clones, and is a powerful procedure for the complementation of multigenetic disease resistance traits in potato breeding lines.

Intraarticular findings in the chronically painful shoulder. A study of 32 posttraumatic cases.

32 consecutive patients suffering from chronic shoulder pain for more than 6 months after a single, nondislocating shoulder trauma were examined clinically and by special radiographs, dynamic sonography, MRI and arthroscopy. Typical complaints were pain during loading, especially during over the head activities. Symptoms of a "dead arm" and instability were also present. Patients with previous dislocations, traumas or radiographic signs of degenerative shoulder lesions were excluded. The patients had a decreased active range of motion and positive signs of apprehension and impingement, but only 4 had clinical signs of shoulder instability. Diagnostic evaluation identified labral tears, partial and total rotator cuff lesions with subacromial impingement and tendinitis of the biceps tendon. Surgery was performed in 24 patients, using capsulolabral and rotator cuff reconstruction, arthroscopic labral resection and open subacromial decompression. In conclusion, patients with chronic posttraumatic shoulder pain have intraarticular injuries, especially tears of the glenoid labrum. History, clinical findings, radiography and sonography are seldom diagnostic. MRI is valuable, particularly for identification of labral pathology, but arthroscopy appears necessary for a preoperative assessment.

[Ultrasonic diagnosis of the locomotor system. A review]. / Ultralydundersøgelse af bevaegeapparatet. En oversigt.

The purpose of this overview is to discuss the numerous potential applications of diagnostic ultrasound in the evaluation of diseases affecting the musculoskeletal system. Traumatic and inflammatory conditions of tendons, intraarticular effusions and synovial thickening, derangement of articular cartilage, meniscal tears, rotator-cuff lesions and hip anomalies in neonates can be detected by sonography. In addition, hematomas, abscesses, cysts, soft tissue neoplasms and foreign bodies are readily identified using this technique. Sonography is noninvasive, readily accepted by the patients, relatively inexpensive and widely available. In future, further expansion of its role in the diagnostic work-up of musculoskeletal disorders is to be anticipated.

Ultrasound guided puncture of pleural fluid collections and superficial thoracic masses.

Fluoroscopically guided percutaneous aspiration biopsy of pulmonary masses and conventional needle thoracocentesis for the diagnostic evaluation and treatment of pleural fluid collections, are well established procedures. In the abdomen, ultrasonographic guidance is a widely accepted method, but is usually considered to be of limited values in the chest because of overlying ribs and aerated lung tissue. Nevertheless, ultrasound is well suited as a guiding modality for both aspiration of pleural fluid collections and biopsy of pleural thoracic masses. We describe and discuss the method on the basis of 55 punctures in 46 patients, in most of whom previous attempts guided by radiography and clinical examination had failed. Diagnostic/therapeutic results were obtained in all cases but one. The only complication was minor pneumothorax in two patients.

Patellectomy--a 20-year follow-up.

Twenty-seven patients with 28 patellectomies were re-examined after an average of 20 years. Twelve knees rated as excellent, ten as good and six as fair. Even though 12 patients had strenuous work, only three patients had changed occupation. Quadriceps power was on average two-thirds that of the opposite limb. Radiographs showed incipient femoro-tibial arthrosis in four patients only.

Preoperative radiographically guided wire marking of nonpalpable breast lesions.

In 37 women with possibly malignant lesions detected at radiography of the breast, 42 excisional biopsies were performed using preoperative guide wire marking at radiography. The wire transfixed or missed the lesion by less than one cm in 95 per cent of the cases, and in all but three cases a precise localization was obtained with only one wire. Full removal of the lesion was obtained at the first excision in 40 procedures and a second excision was necessary in only two patients. Minor wound complications occurred in two patients. The malignancy rate was 13.5 per cent and metastatic lymph node involvement was not observed in any of the patients. The localization method described is easy to perform and highly recommendable.