Advances in Orthopedic Imaging

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 12534

Special Issue Editors


E-Mail Website
Guest Editor
Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
Interests: orthopedic tumor surgery; tumor imaging

E-Mail Website
Guest Editor
Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
Interests: knee surgery; imaging of the knee joint

Special Issue Information

Dear colleagues,

The most common imaging technique associated with the specialty of trauma surgery and orthopedics has for many years been X-ray imaging. This continues to be the cornerstone of diagnosis in orthopedics and trauma surgery. However, MRI and CT are now also standard procedures in everyday clinical practice for preoperative diagnostics, and procedures such as SPECT or dynamic imaging techniques are also beginning to find their way into the daily routine of trauma surgeons and orthopedists.

The aim of this Special Issue is to show the wide spectrum of modern orthopedic and trauma imaging techniques. The focus is not only on the presentation of new technical methods for indication and surgical planning but also on the presentation of the limitations and pitfalls.

Prof. Dr. Matthias Priemel
Dr. Alexander Korthaus
Guest Editors

Manuscript Submission Information

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Keywords

  • Special imaging of foot and ankle joint surgery
  • Imaging of musculoskeletal tumors
  • Advanced imaging for surgical planning radiological imaging of the knee
  • Elbow fracture imaging

Published Papers (5 papers)

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15 pages, 3572 KiB  
Article
T2*-Mapping of Knee Cartilage in Response to Mechanical Loading in Alpine Skiing: A Feasibility Study
by Uwe Schütz, Thomas Martensen, Sebastian Kleiner, Jens Dreyhaupt, Martin Wegener, Hans-Joachim Wilke and Meinrad Beer
Diagnostics 2022, 12(6), 1391; https://doi.org/10.3390/diagnostics12061391 - 04 Jun 2022
Cited by 5 | Viewed by 4109
Abstract
Purpose: This study intends to establish a study protocol for the quantitative magnetic resonance imaging (qMRI) measurement of biochemical changes in knee cartilage induced by mechanical stress during alpine skiing with the implementation of new spring-loaded ski binding. Methods: The MRI-knee-scans (T2*-mapping) of [...] Read more.
Purpose: This study intends to establish a study protocol for the quantitative magnetic resonance imaging (qMRI) measurement of biochemical changes in knee cartilage induced by mechanical stress during alpine skiing with the implementation of new spring-loaded ski binding. Methods: The MRI-knee-scans (T2*-mapping) of four skiers using a conventional and a spring-loaded ski binding system, alternately, were acquired before and after 1 h/4 h of exposure to alpine skiing. Intrachondral T2* analysis on 60 defined regions of interest in the femorotibial knee joint (FTJ) was conducted. Intra- and interobserver variability and relative changes in the cartilage T2* signal and thickness were calculated. Results: A relevant decrease in the T2* time after 4 h of alpine skiing could be detected at the majority of measurement times. After overnight recovery, the T2* time increased above baseline. Although, the total T2* signal in the superficial cartilage layers was higher than that in the lower ones, no differences between the layers in the T2* changes could be detected. The central and posterior cartilage zones of the FTJ responded with a stronger T2* alteration than the anterior zones. Conclusions: For the first time, a quantitative MRI study setting could be established to detect early knee cartilage reaction due to alpine skiing. Relevant changes in the T2* time and thus in the intrachondral collagen microstructure and the free water content were observed. Full article
(This article belongs to the Special Issue Advances in Orthopedic Imaging)
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15 pages, 3860 KiB  
Article
Quantitative Assessment of the Restoration of Original Anatomy after 3D Virtual Reduction of Long Bone Fractures
by Moo-Sub Kim, Do-Kun Yoon, Seung-Han Shin, Bo-Young Choe, Jong-Won Rhie, Yang-Guk Chung and Tae Suk Suh
Diagnostics 2022, 12(6), 1372; https://doi.org/10.3390/diagnostics12061372 - 02 Jun 2022
Cited by 3 | Viewed by 2586
Abstract
Background: The purpose of this study was to demonstrate the usefulness of 3D image-based virtual reduction by validating the evaluation criteria according to guidelines suggested by the AO Surgery Reference. Methods: For this experiment, 19 intact radial ORTHObones (ORTHObones radius, 3B Scientific, Germany, [...] Read more.
Background: The purpose of this study was to demonstrate the usefulness of 3D image-based virtual reduction by validating the evaluation criteria according to guidelines suggested by the AO Surgery Reference. Methods: For this experiment, 19 intact radial ORTHObones (ORTHObones radius, 3B Scientific, Germany, Hamburg) without any fractures were prepared. All ORTHObones with six cortical marking holes (three points on the distal part and three points on the proximal part) were scanned using a CT scanner twice (before/after intentional fracture of the ORTHObone). After the virtual reduction of all 19 ORTHObones, accuracy evaluations using the four criteria (length variation, apposition variation, alignment variation, Rotation Variation) suggested in the AO Surgery Reference were performed. Results: The mean (M) length variation was 0.42 mm, with 0.01 mm standard deviation (SD). The M apposition variation was 0.48 mm, with 0.40 mm SD. The M AP angulation variation (for alignment variation) was 3.24°, with 2.95° SD. The M lateral angulation variation (for alignment variation) was 0.09°, with 0.13° SD. The M angle of axial rotation was 1.27° with SD: 1.19°. Conclusions: The method of accuracy evaluation used in this study can be helpful in establishing a reliable plan. Full article
(This article belongs to the Special Issue Advances in Orthopedic Imaging)
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8 pages, 1168 KiB  
Article
Features of Extrinsic Plantar Muscles in Patients with Plantar Fasciitis by Ultrasound Imaging: A Retrospective Case Control Research
by Lorena Canosa-Carro, Daniel López-López, Fernando García-Sanz, Raquel Díaz-Meco-Conde, Paula García-Bermejo, Blanca de-la-Cruz-Torres, Jolanta Marszalek and Carlos Romero-Morales
Diagnostics 2022, 12(4), 897; https://doi.org/10.3390/diagnostics12040897 - 04 Apr 2022
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Abstract
The present study aimed to compare by ultrasound imaging (USI) the tibial posterior (TP), medial gastrocnemius (MG) and soleus muscle in patients with and without plantar fasciitis (PF). A sample of 42 individuals was recruited and divided into two groups: PF and a [...] Read more.
The present study aimed to compare by ultrasound imaging (USI) the tibial posterior (TP), medial gastrocnemius (MG) and soleus muscle in patients with and without plantar fasciitis (PF). A sample of 42 individuals was recruited and divided into two groups: PF and a healthy group. The thickness, cross-sectional area (CSA), echointensity and echovariation were assessed in both groups by USI. TP, soleus and MG variables did not report differences (p > 0.05) for thickness and CSA. For the echotexture parameters significant differences were found for MG echointensity (p = 0.002), MG echovariation (p = 0.002) and soleus echointensity (p = 0.012). Non-significant differences (p > 0.05) were reported for soleus echovariation, TP echointensity and TP echovariation variables. The thickness and CSA of the TP, GM and soleus muscle did not show significant differences between individuals with and without PF measured by USI. Muscle quality assessment reported an increase of the MG echointensity and echovariation, as well as a decrease of echointensity of the soleus muscle in the PF group with respect to the healthy group. Therefore, the evaluation of the structure and muscle quality of the extrinsic foot muscles may be beneficial for the diagnosis and monitoring the physical therapy interventions. Full article
(This article belongs to the Special Issue Advances in Orthopedic Imaging)
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16 pages, 2507 KiB  
Technical Note
Optimization of Revision Hip Arthroplasty Workflow by Means of Detailed Pre-Surgical Planning Using Computed Tomography Data, Open-Source Software and Three-Dimensional-Printed Models
by Krzysztof Andrzejewski, Marcin Domżalski, Piotr Komorowski, Jan Poszepczyński, Bożena Rokita and Marcin Elgalal
Diagnostics 2023, 13(15), 2516; https://doi.org/10.3390/diagnostics13152516 - 28 Jul 2023
Viewed by 940
Abstract
Background. In revision hip arthroplasty (RHA), establishing the center of rotation (COR) can be technically challenging due to the acetabular bone destruction that is usually present, particularly in severe cases such as Paprosky type II and III defects. The aim of this study [...] Read more.
Background. In revision hip arthroplasty (RHA), establishing the center of rotation (COR) can be technically challenging due to the acetabular bone destruction that is usually present, particularly in severe cases such as Paprosky type II and III defects. The aim of this study was to demonstrate the use of open-source medical image reconstruction software and low-cost 3D anatomical models in pre-surgical planning of RHA. Methods. A total of 10 patients, underwent RHA and were included in the study. Computed tomography (CT) scans were performed for all cases, before surgery and approximately 1 week after the procedure. The reconstruction of CT data, 3D virtual planning of the COR and positioning of acetabular cups, including their inclination and anteversion angles, was carried out using the free open source software platform 3D Slicer. In addition, anatomical models of the pelvis were built on a desktop 3D printer from polylactic acid (PLA). Preoperative and postoperative reconstructed imaging data were compared for each patient, and the position of the acetabular cups as well as the COR were evaluated for each case. Results. Analysis of the pre- and post-op center of rotation position data indicated statistically insignificant differences for the location of the COR on the X-axis (1.5 mm, t = 0.5741, p = 0.5868) with a fairly strong correlation of the results (r = −0.672, p = 0.0982), whilst for the location of the COR in the Y and Z-axes, there was statistical dependence (Y axis, 4.7 mm, t = 3.168 and p = 0.0194; Z axis, 1.9 mm, t = 1.887 and p = 0.1081). A strong correlation for both axes was also observed (Y and Z) (Y-axis, r = 0.9438 and p = 0.0014; Z-axis, r = 0.8829 and p = 0.0084). Analysis of inclination angle values showed a statistically insignificant difference between mean values (3.9 degrees, t = 1.111, p = 0.3092) and a moderate correlation was found between mean values (r = −0.4042, p = 0.3685). Analysis of the anteversion angle showed a statistically insignificant difference between mean values (1.9 degrees, t = 0.8671, p = 0.4192), while a moderate correlation between mean values was found (r = −0.4782, p = 0.2777). Conclusions. Three-dimensional reconstruction software, together with low-cost anatomical models, are very effective tools for pre-surgical planning, which have great potential use in orthopedic surgery, particularly RHA. In up and in- and up and out-type defects, it is essential to establish a new COR and to identify three support points within the revision acetabulum in order to correctly position acetabular cups. Full article
(This article belongs to the Special Issue Advances in Orthopedic Imaging)
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14 pages, 2295 KiB  
Systematic Review
Clinical Presentation and MRI Characteristics of Appendicular Soft Tissue Lymphoma: A Systematic Review
by Sebastian Weiss, Valentin Weisse, Alexander Korthaus, Peter Bannas, Karl-Heinz Frosch, Carsten Schlickewei, Alexej Barg and Matthias Priemel
Diagnostics 2022, 12(7), 1623; https://doi.org/10.3390/diagnostics12071623 - 04 Jul 2022
Viewed by 1387
Abstract
Appendicular soft tissue lymphoma (ASTL) is rare and is frequently misinterpreted as soft tissue sarcoma (STS). Studies investigating magnet resonance imaging (MRI) characteristics of ASTL are scarce and showed heterogenous investigation criteria and results. The purpose of this study was to systematically review [...] Read more.
Appendicular soft tissue lymphoma (ASTL) is rare and is frequently misinterpreted as soft tissue sarcoma (STS). Studies investigating magnet resonance imaging (MRI) characteristics of ASTL are scarce and showed heterogenous investigation criteria and results. The purpose of this study was to systematically review clinical presentations and MRI characteristics of ASTL as described in the current literature. For that purpose, we performed a systematic literature review in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Patient demographics, clinical presentation and MRI imaging characteristics of ASTL were investigated, resulting in a total of nine included studies reporting a total of 77 patients. Signal intensity of lymphoma compared to muscle tissue was mostly described as isointense (53%) or slightly hyperintense (39%) in T1-weighted images and always as hyperintense in proton-and T2-weighted images. Multicompartmental involvement was reported in 59% of cases and subcutaneous stranding in 74%. Long segmental involvement was present in 80% of investigated cases. Involvement of neurovascular structures was reported in 41% of cases and the presence of traversing vessels in 83% of patients. The presence of these findings should lead to the inclusion of ASTL in the differential diagnosis of soft tissue masses. Full article
(This article belongs to the Special Issue Advances in Orthopedic Imaging)
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