[Multicenter study of radiosynoviorthesis. Clinical outcome in osteoarthritis and other disorders with concomitant synovitis in comparison with rheumatoid arthritis]. / Multizenterstudie zur Radiosynoviorthese: klinische Ergebnisse bei aktivierten Arthrosen und anderen Gelenkerkrankungen mit chronischer Synovialitis im Vergleich zur rheumatoiden Arthritis.

AIM: Evaluation of the effectiveness of radiosynoviorthesis (RSO) in osteoarthritis and other disorders with concomitant synovitis versus rheumatoid arthritis by means of a standardized questionnaire. PATIENTS, METHODS: 803 RSO treatments were monitored in 691 patients by standardized questionnaires of 7 centers in 3 countries. Patients were assigned to 3 groups according to their age (20-40, 41-60, 61-80 years). Additionally, the data were analyzed separately for patients with rheumatoid arthritis (group A) and those with osteoarthritis, psoriasis arthritis, pigmental villonodular synovitis or persistent effusions after joint replacement (group B). RESULTS: Ameliorations of joint pain, swelling/effusion or flexibility were found in 80% of group A and 56% of group B (p >0.01). Quality of life improved in 78% of group A and 59% of group B (p >0.01). The response rate was similar for small- and large-sized joints in group A, but significantly higher for large-sized joints in group B (p >0.01). The positive effects on joint pain, swelling/effusion or flexibility lasted longer in group A (p >0.01). Repeated RSOs were as effective as initial ones. The clinical outcome was neither influenced by age, nor gender, nor transient immobilisation for 48 hours after RSO. CONCLUSION: Although slightly more efficient in rheumatoid arthritis, RSO represents an effective treatment option also in osteoarthritis and other disorders with concomitant synovitis.

[Results of follow-up after surgical treatment of Perthes disease: comparison of roentgenologic and and magnetic resonance tomography examination]. / Spätergebnisse nach operativer Behandlung des Morbus Perthes: Vergleich der röntgenologischen und kernspintomographischen Untersuchung.

Twenty patients treated by surgery for Perthes' disease were studied between 4 and 9 years postoperatively. In the clinical investigation eight patients complained of persistent stress-induced pain. In nine patients flexion, extension, ab- and adduction of the hip joint was limited. In the MRI-study of ten hip joints a reduction of fatty marrow was seen in the femoral head. In 11 hip joints of patients complaining of persistent pain, a deformation of the femoral head (n = 2), a dysplasia of the femoral metaphysis (n = 2), and diaphysis (n = 4) or both (n = 2) were seen. In another five patients an additional dysplasia of the acetabulum was visualized. All these findings were diagnosed by X-ray studies as well. However, only by MRI were the extents of the postoperative defects of femoral spongiosa diagnosed in fifteen hip joints.

[Magnetic resonance tomographic diagnosis of internal lesions of the shoulder following luxation. A comparison with arthroscopic findings]. / Kernspintomographische Diagnostik von Binnenläsionen der Schulter nach Luxation. Vergleich mit arthroskopischen Befunden.

Fifteen patients with a recurrent dislocation of the glenohumeral joint were preoperatively investigated by MRI. We created a special protocol with axial T1-, T2-, proton-density- and sagittal T1-weighted images. MRI findings such as defects of the glenoid labrum and Hill-Sachs compression fractures proved to be correct during surgery. In the chosen protocol the diagnostic imaging of rotator cuff lesions was not specific. In 10 cases lesions were seen but in only 5 patients did these findings prove to be correct during surgery. However, MRI imaging of glenohumeral joints is a reliable non-invasive diagnostic method.

[Soft tissue diagnosis of the shoulder joint using sonography, computerized tomography and magnetic resonance tomography (MRT)]. / Weichteildiagnostik am Schultergelenk durch Sonographie, Computertomographie und Magnetresonanztomographie (MRT).

Injuries and degenerative alterations of the shoulder predominantly affect the soft tissue. To investigate this area we use a multitude of diagnostic examinations: apart from clinical and functional diagnosis also the image reproductive methods of arthrography, ultrasound and computer tomography in addition to the classical X-ray. To ascertain pathological changes to shoulder soft tissue the simplest and quickest, least dangerous and most straightforward examination is the sonograph as it includes dynamic movement procedures. Warning: a high degree of experience and anatomical knowledge is a must! Computer- and especially nuclear spin tomography--being static examining forms a comprehensive picture of every anatomic structure and its pathology--may well represent a valuable addition to shoulder diagnostics. Nevertheless, as yet the clinical and material requirements are still enormous.