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Prospective evaluation of ultrasound features of magnesium-based bioabsorbable screw resorption in pediatric fractures.
Waelti, Stephan L; Fandak, Jozef; Markart, Stefan; Willems, Erik P; Wildermuth, Simon; Fischer, Tim; Dietrich, Tobias J; Matissek, Christoph; Krebs, Thomas.
Afiliación
  • Waelti SL; Department of Radiology and Nuclear Medicine, Children's Hospital of Eastern Switzerland, Claudiusstrasse 6, 9006, St. Gallen, Switzerland. stephan.waelti@kssg.ch.
  • Fandak J; Department of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland. stephan.waelti@kssg.ch.
  • Markart S; Department of Radiology and Nuclear Medicine, Children's Hospital of Eastern Switzerland, Claudiusstrasse 6, 9006, St. Gallen, Switzerland.
  • Willems EP; Department of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
  • Wildermuth S; Department of Radiology and Nuclear Medicine, Children's Hospital of Eastern Switzerland, Claudiusstrasse 6, 9006, St. Gallen, Switzerland.
  • Fischer T; Department of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
  • Dietrich TJ; Clinical Trials Unit, Biostatistics, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
  • Matissek C; Department of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
  • Krebs T; Department of Radiology and Nuclear Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Eur Radiol ; 34(3): 1556-1566, 2024 Mar.
Article en En | MEDLINE | ID: mdl-37658140
ABSTRACT

OBJECTIVE:

Bioabsorbable magnesium-based alloy screws release gas upon resorption. The resulting findings in the adjacent soft tissues and joints may mimic infection. The aim of the study was to evaluate the ultrasound (US) findings in soft tissues and joints during screw resorption.

METHODS:

Prospectively acquired US studies from pediatric patients treated with magnesium screws were evaluated for screw head visibility, posterior acoustic shadowing, twinkling artifact, foreign body granuloma, gas (soft tissue, intra-articular), alterations of the skin and subcutaneous fat, perifascial fluid, localized fluid collections, hypervascularization, and joint effusion.

RESULTS:

Sixty-six US studies of 28 pediatric patients (nfemale = 9, nmale = 19) were included. The mean age of the patients at the time of surgery was 10.84 years; the mean time between surgery and ultrasound was 128.3 days (range = 6-468 days). The screw head and posterior acoustic shadowing were visible in 100% of the studies, twinkling artifact in 6.1%, foreign body granuloma in 92.4%, gas locules in soft tissue in 100% and intra-articular in 18.2%, hyperechogenicity of the subcutaneous fat in 90.9%, cobblestoning of the subcutaneous fat in 24.2%, loss of normal differentiation between the epidermis/dermis and the subcutaneous fat in 57.6%, localized fluid collection in 9.9%, perifascial fluid in 12.1%, hypervascularization in 27.3%, and joint effusion in 18.2%.

CONCLUSION:

US findings in pediatric patients treated with magnesium screws strongly resemble infection, but are normal findings in the setting of screw resorption. CLINICAL RELEVANCE STATEMENT Bioabsorbable magnesium-based alloy screws release gas during resorption. The resulting US findings in the adjacent soft tissues and joints in pediatric patients may mimic infection, but are normal findings. KEY POINTS • Bioabsorbable magnesium-based alloy screws release gas upon resorption. • The resulting ultrasound findings in children's soft tissues and joints closely resemble those of soft tissue infection or osteosynthesis-associated infection. • Be familiar with these ultrasound findings in order to avoid inadvertently misdiagnosing a soft tissue infection or osteosynthesis-associated infection.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Granuloma de Cuerpo Extraño / Infecciones de los Tejidos Blandos / Fracturas Óseas Tipo de estudio: Risk_factors_studies Límite: Child / Female / Humans / Male Idioma: En Revista: Eur Radiol Asunto de la revista: RADIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Granuloma de Cuerpo Extraño / Infecciones de los Tejidos Blandos / Fracturas Óseas Tipo de estudio: Risk_factors_studies Límite: Child / Female / Humans / Male Idioma: En Revista: Eur Radiol Asunto de la revista: RADIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Suiza