| 1. |
- Thomas, HS, et al.
(författare)
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- 2019
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swepub:Mat__t
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| 2. |
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| 3. |
- Barenius, Björn, et al.
(författare)
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Increased risk of osteoarthritis after anterior cruciate ligament reconstruction : a 14-year follow-up study of a randomized controlled trial.
- 2014
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Ingår i: American Journal of Sports Medicine. - : SAGE Publications. - 0363-5465 .- 1552-3365. ; 42:5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The reported prevalence of radiological osteoarthritis (OA) after anterior cruciate ligament (ACL) reconstruction varies from 10% to 90%. Purpose/HYPOTHESIS: To report the prevalence of OA after ACL reconstruction and to compare the OA prevalence between quadrupled semitendinosus tendon (ST) and bone-patellar tendon-bone (BPTB) grafts. The hypothesis was that there would be no difference in OA prevalence between the graft types. The secondary aim was to study whether patient characteristics and additional injuries were associated with long-term outcomes.STUDY DESIGN: Randomized controlled trial; Level of evidence, 1.METHODS: Radiological examination results, Tegner activity levels, and Knee injury and Osteoarthritis Outcome Score (KOOS) values were determined in 135 (82%) of 164 patients at a mean of 14 years after ACL reconstruction randomized to an ST or a BPTB graft. Osteoarthritis was defined according to a consensus by at least 2 of 3 radiologists of Kellgren-Lawrence grade ≥2. Using regression analysis, graft type, sex, age, overweight, time between injury and reconstruction, additional meniscus injury, and a number of other variables were assessed as risk factors for OA 14 years after ACL reconstruction.RESULTS: Osteoarthritis of the medial compartment was most frequent, with 57% of OA cases in the ACL-reconstructed knee and 18% of OA cases in the contralateral knee (P < .001). There was no difference between the graft types: 49% of OA of the medial compartment for BPTB grafts and 65% for ST grafts (P = .073). The KOOS results were lower for patients with OA in all subscales, indicating that OA was symptomatic. No difference in the KOOS between the graft types was found. Meniscus resection was a strong risk factor for OA of the medial compartment (odds ratio, 3.6; 95% CI, 1.4-9.3) in the multivariable logistic regression analysis.CONCLUSION: A 3-fold increased prevalence of OA was found after an ACL injury treated with reconstruction compared with the contralateral healthy knee. No differences in the prevalence of OA between the BPTB and quadrupled ST reconstructions were found. An initial meniscus resection was a strong risk factor for OA; the time between injury and reconstruction was not.
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| 4. |
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| 5. |
- Eriksson, Thomas, et al.
(författare)
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Are low-dose CT scans a satisfactory substitute for stereoradiographs for migration studies? A preclinical test of low-dose CT scanning protocols and their application in a pilot patient.
- 2019
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Ingår i: Acta Radiologica. - : Sage Publications. - 0284-1851 .- 1600-0455.
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Computed tomography (CT) has the potential to acquire the data needed for migration studies of orthopedic joint implants of patients who have had tantalum beads implanted at the time of joint replacement surgery. This can be accomplished with the same precision as radiostereometric analysis (RSA). Switching to CT would increase availability without the need for the specific facilities required for RSA. However, higher effective dose is a concern.PURPOSE: To investigate if migration measurements can be done with CT with an accuracy and effective dose comparable to that of conventional RSA.MATERIAL AND METHODS: Fourteen scanning protocols were tested in a hip phantom that incorporated tantalum beads and an uncemented femoral stem. The protocols were graded for clinical practice according to the three parameters of image quality, effective dose, and robustness of numerical data. After grading, the two protocols that graded best overall were applied to a pilot patient.RESULTS: All protocols produced scans in which the numerical data were sufficient for a migration analysis at least as precise as would be expected using RSA. A protocol with an effective dose of 0.70 mSv was shown to be applicable in a pilot patient.CONCLUSION: Low-dose CT scans with an effective dose comparable to a set of routine plain radiographs can be used for precise migration measurements.
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| 6. |
- Eriksson, Thomas, et al.
(författare)
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Low-dose CT of postoperative pelvic fractures : a comparison with radiography
- 2019
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Ingår i: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 60:1, s. 85-91
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Tidskriftsartikel (refereegranskat)abstract
- Background Computed tomography (CT) is superior to conventional radiography (CR) for assessing internal fixation of pelvic fractures, but with a higher radiation exposure. Low-dose CT (LDCT) could possibly have a sufficient diagnostic accuracy but with a lower radiation dose. Purpose To compare postoperative diagnostic accuracy of LDCT and CR after open reduction and internal fixation of pelvic fracture. Material and Methods Twenty-one patients were examined with LDCT and CR 0-9 days after surgery. The examinations were reviewed by two musculoskeletal radiologists. Hardware, degree of fracture reduction, image quality, and reviewing time were assessed, and effective radiation dose was calculated. Inter-reader agreement was calculated. Results LDCT was significantly better than CR in determining whether hardware positioning was assessable ( P < 0.001). Acetabular congruence was assessable in all fractured patients with LDCT. In 12 of the 32 assessments with CR of patients with an acetabular fracture, joint congruence was not assessable due to overlapping hardware ( P = 0.001). Image quality was significantly higher for LDCT. Median time to review was 240 s for LDCT compared to 180 s for CR. Effective dose was 0.79 mSv for LDCT compared to 0.32 mSv for CR ( P < 0.001). Conclusion LDCT is more reliable than CR in assessing hardware position and fracture reduction. Joint congruency is sometimes not possible to assess with CR, due to overlapping hardware. The image quality is higher, but also the effective dose, with LDCT than with CR.
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| 7. |
- Gardin, Anna, et al.
(författare)
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Dynamic contrast enhanced magnetic resonance imaging in chronic Achilles tendinosis
- 2013
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Ingår i: BMC Medical Imaging. - : Springer Science and Business Media LLC. - 1471-2342. ; 13, s. 39-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic Achilles tendinosis is a common problem. When evaluating and comparing different therapies there is a need for reliable imaging methods. Our aim was to evaluate if chronic Achilles tendinosis affects the dynamic contrast-enhancement in the tendon and its surroundings and if short-term eccentric calf-muscle training normalizes the dynamic contrast-enhancement. Methods: 20 patients with chronic Achilles tendinopathy were included. Median duration of symptoms was 31 months (range 6 to 120 months). Both Achilles tendons were examined with dynamic contrast enhanced MRI before and after a 12-week exercise programme of eccentric calf-muscle training. The dynamic MRI was evaluated in tendon, vessel and in fat ventrally of tendon. Area under the curve (AUC), time to peak of signal, signal increase per second (SI/s) and increase in signal between start and peak as a percentage (SI%) was calculated. Pain and performance were evaluated using a questionnaire. Results: In the fat ventrally of the tendon, dynamic contrast enhancement was significantly higher in the symptomatic leg compared to the contralateral non-symptomatic leg before but not after treatment. Despite decreased pain and improved performance there was no significant change of dynamic contrast enhancement in symptomatic tendons after treatment. Conclusion: In Achilles tendinosis there is an increased contrast enhancement in the fat ventrally of the tendon. The lack of correlation with symptoms and the lack of significant changes in tendon contrast enhancement parameters do however indicate that dynamic enhanced MRI is currently not a useful method to evaluate chronic Achilles tendinosis.
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| 8. |
- Geijer, Mats, et al.
(författare)
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MR appearance of the temporal evolution and resolution of spontaneous osteonecrosis of the knee : a case report
- 2017
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Ingår i: Acta Radiologica Open. - : SAGE Publications. - 2058-4601. ; 6:2
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Tidskriftsartikel (refereegranskat)abstract
- Spontaneous osteonecrosis of the knee (SONK) is a feared condition of unknown cause, in its classic form appearing in the medial femoral condyle in middle-aged or elderly subjects. Diagnosis with radiography is notoriously difficult with a long latency before typical changes appear. Magnetic resonance imaging (MRI) is regarded as a diagnostic tool with the possibility to give an earlier diagnosis with improved chances for treatment. However, also with MRI there may be an initial diagnostic blind spot before typical changes appear. Little is known about the temporal evolution of the MRI changes. In the current case report, a case of SONK is reported where serial imaging with MRI was performed, from initial symptoms to eventual resolution after almost three years.
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| 9. |
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| 10. |
- Gärdin, Anna, et al.
(författare)
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T2 * relaxation time in Achilles tendinosis and controls and its correlation with clinical score
- 2016
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Ingår i: Journal of Magnetic Resonance Imaging. - : Wiley. - 1053-1807 .- 1522-2586. ; 43:6, s. 1417-1422
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To investigate if the T2 * of Achilles tendons can discriminate between chronic Achilles tendinosis and healthy controls; to correlate with clinical score; to evaluate its short-term repeatability; and to estimate minimal detectable change.MATERIALS AND METHODS: Twenty patients, with chronic mid-portion Achilles tendinosis, and 10 controls without history of Achilles tendon symptoms, were examined with a 3T MR scanner with a 3D flash ultrashort time to echo sequence with five different echo times. The sequence was run twice to test repeatability. The tendon border was delineated on axial slices at three different levels in the calculated T2 * maps. The clinical severity of Achilles tendinosis was measured by a VISA-A questionnaire.RESULTS: There was a significant difference in mean T2 * between symptomatic and control tendons (P < 0.001). In patients with unilateral symptoms no significant difference in T2 * was found between symptomatic and contralateral asymptomatic tendons (P = 0.19). There was no significant correlation between clinical severity and T2 * (r = -0.28, P = 0.22). The short-term repeatability of T2 * showed a coefficient of variation of 18%, a least significant change of 50%, and the intraclass correlation coefficient had an average consistency of 0.99.CONCLUSION: T2 * may help to differentiate between chronic Achilles tendinosis and healthy controls but was not associated with the clinical score. However, and notably, the reproducibility of the method was low and the number of patients was small.
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| 11. |
- Gärdin, Anna, et al.
(författare)
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The long-term clinical and MRI results following eccentric calf muscle training in chronic Achilles tendinosis
- 2010
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Ingår i: Skeletal Radiology. - : Springer Science and Business Media LLC. - 0364-2348 .- 1432-2161. ; 39:5, s. 435-442
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To evaluate the long-term results following eccentric calf-muscle training in patients with chronic Achilles tendinopathy.MATERIALS AND METHODS: A total of 24 patients with chronic Achilles tendinopathy were included in a study evaluating MRI findings and clinical symptoms before and after 3 months of daily eccentric calf-muscle strength training. Median duration of symptoms was 18 months (range 6-120). Four of the patients did not perform the prescribed treatment for different reasons and were followed for 14 months. The resulting 20 treated patients completed 4.2-year (range 29-58 months) follow up. Tendon volume was evaluated by using 3D seed growing technique and signal abnormalities were visually semi-quantitatively graded. Level of pain and performance was categorized using a questionnaire completed by the patient.RESULTS: In the symptomatic treated patients, median intensity level of pain decreased from moderate/severe at time of inclusion to mild at follow up (p < 0.05). Median level of performance increased from severe impairment at time of inclusion to normal at follow up (p < 0.05). 12 out of 20 patients had raised intratendinous signal at time of inclusion compared to 2 out of 20 patients at follow up (p < 0.001). Mean tendon-volume measured 6.7 cm(3) (SD 2.0) at time of inclusion and 6.4 cm(3) (SD 2.0) at follow up (p = 0.18). The four symptomatic non-treated tendons did not improve regarding pain, performance, intratendinous signal or tendon volume.CONCLUSION: We found decreased pain, improved performance and decreased intratendinous signal both compared to index examination and immediately after the 3 months training regimen in a 4.2-year clinical and MRI follow up, in a group of patients treated with heavy loaded eccentric calf-muscle training for chronic Achilles tendinopathy. The improvements were greater at 4.2-year follow up, despite no further active treatment, than immediately after the treatment. This may indicate a good long-term prognosis for Achilles tendinosis patients.
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| 12. |
- Liegnell, Rasmus, et al.
(författare)
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Validity of ultrasonography-derived predictions for estimating skeletal muscle volume : a systematic literature review
- 2021
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Ingår i: BMC Medical Imaging. - : BioMed Central (BMC). - 1471-2342. ; 21:1
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Forskningsöversikt (refereegranskat)abstract
- BackgroundThe amount of muscle volume (MV) varies between individuals and is important for health, well-being and performance. Therefore, the monitoring of MV using different imaging modalities is important. Magnetic resonance imaging (MRI) is considered the gold standard, but is not always easily accessible, and the examinations are expensive. Ultrasonography (US) is a much less expensive imaging method widely used to measure changes in muscle thickness (MT). Whether MT may translate into MV needs further investigation.PurposeThe aim of this review is to clarify whether US-derived equations based on MT predict MV based on MRI.MethodsA systematic literature review was conducted according to the PRISMA statement, searching the electronic databases PubMed, CINAHL and Web of Science, for currently published equations to estimate MV with US.ResultsThe literature search resulted in 363 citations. Twelve articles met the eligibility criteria. Ten articles scored eight out of eleven on QUADAS and two scored nine. Thirty-six prediction equations were identified. R values ranged between 0.53 and 0.961 and the standard error of the estimate (SEE) ranged between 6 and 12% for healthy adult populations, and up to 25.6% for children with cerebral palsy. Eight studies evaluated the results with a Bland–Altman plot and found no systematic errors. The overall strength and quality of the evidence was rated “low quality” as defined by the GRADE system.ConclusionsThe validity of US-derived equations based on MT is specific to the populations from which it is developed. The agreement with MV based on MRI is moderate with the SEE ranging between 6 and 12% in healthy adult populations. Suggestions for future research include investigations as to whether testing positions or increasing the number of measuring sites could improve the validity for prediction equations.
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| 13. |
- Malinovschi, Andrei, 1978-, et al.
(författare)
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Consequences of Using Post- or Prebronchodilator Reference Values in Interpreting Spirometry
- 2023
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Ingår i: American Journal of Respiratory and Critical Care Medicine. - : American Thoracic Society. - 1073-449X .- 1535-4970. ; 208:4, s. 461-471
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Tidskriftsartikel (refereegranskat)abstract
- RATIONALE: Post-bronchodilator (BD) spirometry is used for diagnosis of chronic obstructive pulmonary disease (COPD). However, pre-BD reference values are used for spirometry interpretation.OBJECTIVES: To compare the resulting prevalence rates of abnormal spirometry and study the consequences of using pre- or post-BD reference values generated within the Swedish CArdioPulmonary bioImage Study (SCAPIS) when interpreting post-BD spirometry in a general population.METHODS: SCAPIS reference values for post-BD and pre-BD spirometry were based on 10,156 and 1,498 never-smoking, healthy participants, respectively. We studied the associations of abnormal spirometry, defined by using pre- or post-BD reference values, with respiratory burden in the SCAPIS general population (28,851 individuals).MEASUREMENTS AND MAIN RESULTS: Bronchodilation resulted in higher predicted median and lower limit of normal (LLN) for FEV1/FVC ratio. The prevalence of post-BD FEV1/FVC < pre-bronchodilator LLN was 4.8% and that of post-BD FEV1/FVC < post-bronchodilator LLN was 9.9% for the general population. An additional 5.1% was identified as having an abnormal post-BD FEV1/FVC ratio and this group had more respiratory symptoms, emphysema (13.5% vs. 4.1%, p<0.001) and self-reported physician-diagnosed COPD (2.8% vs. 0.5%, p<0.001) than subjects with post-BD FEV1/FVC ratio > LLN for both pre- and post-bronchodilation).CONCLUSIONS: Pre- and post-bronchodilator spirometry reference values differ with regard to FEV1/FVC ratio. Use of post-bronchodilator reference values doubled the population prevalence of airflow obstruction; this was related to a higher respiratory burden. Using post-bronchodilator reference values when interpreting post-bronchodilator spirometry might enable identification of individuals with mild disease and be clinically relevant.
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| 14. |
- Samir, A., et al.
(författare)
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Splenomegaly versus pathological lung volume during COVID-19 infection with or without cytokine storm; a linear regression analysis using CT volumetry
- 2022
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Ingår i: Egyptian Journal of Radiology and Nuclear Medicine. - : Springer Science and Business Media LLC. - 2090-4762. ; 53:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Due to the paucity of scientific evidence, it is unclear among pulmonologists and physicians in critical care units if and when splenomegaly in novel coronavirus disease (2019) (COVID-19) patients is worrisome. This study aims to evaluate the significance of splenic volume during COVID-19 infection with or without cytokine storm and correlates splenic volume to the volume of pathological lung changes through linear regression analysis. Results: A retrospective study collected 509 polymerase chain reaction proved COVID-19 patients (399 males, 110 females; mean age 48 years, age range 24-78 years) between June and November 2021, without a history of splenic pathology. A control group of age and sex-matched 509 healthy subjects was used and analyzed according to the splenic volume. Five consulting radiologists evaluated initial and follow-up computed tomography (CT) examinations using lung CT volumetry and splenic volume calculation in consensus. Three consulting pulmonologists correlated the severity of clinical and laboratory findings, including oxygen requirements and interleukin-6 (IL-6) levels. The T test results for comparison between the COVID-19 patients and the healthy subjects control group regarding the splenic volume were significant (Tvalue was - 4.731452 and p value was 0.00002). There was no significant correlation between the severity of the disease and normal-sized spleen (26% of patients, p= 0.916) or splenomegaly (24% of patients, p= 0.579). On the other hand, all patients with a small spleen or progressive splenomegaly during serial follow-up imaging had clinically severe disease with a statistically significant correlation (p= 0.017 and 0.003, respectively). Ninety-seven percent of patients with clinically mild disease and splenomegaly had 0-20% lung involvement (CT-severity score 1) while all patients with clinically severe disease and splenomegaly had 27-73% lung involvement (CT-severity score 2 and 3) (r = 0.305, p = 0.030). Conclusions: Splenomegaly is a non-specific sign that may be found during mild and severe COVID-19 infection, it was not statistically correlated with the clinical severity and a weak positive relationship was found between the splenic size and the CT-severity score of the pathological lung volume. On the other hand, the presence of splenic atrophy or progressive splenomegaly was correlated with severe COVID-19 presentation and "cytokine storm". Therefore, the splenic volume changes should not be overlooked in COVID-19 serial CT examinations, particularly in severe or critically ill patients with cytokine storms.
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| 15. |
- Shalabi, Adel
(författare)
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Magnetic resonance imaging in chronic Achilles tendinopathy
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main objective of this thesis was to evaluate and monitor the morphological response following treatment interventions in patients with chronic Achilles tendinopathy by using different MRI-techniques. For this purpose. we investigated different types of sequences, including gadolinium contrast medium enhanced T1-WI images (CME T1-WI) and developed a precise method to measure tendon volume and mean intratendinous signal of the Achilles tendon. Study I aimed at evaluating 15 patients with chronic painful Achilles tendinosis, before and two years after - surgical treatment. There was marked regression of the intratendinous signal postoperatively. The most sensitive sequence for depicting an intratendinous lesion in this study was CME T1-WI images. They showed a regression of the intratendinous signal abnormality from 13/15 patients preoperatively to 4/15 postoperatively. The clinical outcome was excellent in 8. good in 5. fair in I and poor in I patient. In study II, the early contrast agent enhancement in the dynamically enhanced MRI signal (DEMRI) was correlated to the histopathological findings in 15 patients with chronic Achilles tendinopathy. Early contrast enhancement (within the first 72 seconds) was seen in DEMRI in the symptomatic Achilles tendons with a significant difference compared to the asymptomatic contralateral tendons. Increased severity of tendon changes, including fiber structure abnormality, increased vascularity, rounding of nuclei and increased amount of glycosaminoglycans, correlated to CME. In study III, we developed a computerized 3-D seed growing MRI-technique to measure tendon volume and mean intratendinous signal. This technique showed an excellent inter- and intraobserver reliability. The technique was also used to prospectively follow tip the tendon adaptation and healing described in studies IV-VI. In study IV, using serial MRI during a period of one year we evaluated the biological effect of tendon repair following iatrogenic tendon injury by five transversal ultrasoundguided core-biopsies employing a needle technique in patients with chronic Achilles tendinopathy. Alterations found during healing, such as tendon volume and intratendinous reactive changes could be monitored by MR imaging, and subsided as noted in the seven and twelve months follow-tip. In study V, we evaluated the effect of treatment with three months daily-performed heavy loaded calf muscle strength training program in 25 patients who had been suffering from chronic painful Achilles tendinopathy. The tendon volume decreased with 14%. and the mean intratendinous signal with 23%. The clinical outcome was improved. In study VI we revealed tendon adaptation immediately following calf muscle strength training. An MRI examination within 30 minutes of the performed exercises resulted in increased total tendon volume (12%) and mean intratendinous signal (3 1%). In conclusion, MRI-techniques can be used as an adjunct to clinical evaluation by monitoring morphological effects following different treatment interventions, thereby adding evidence in clinical studies on patients with chronic Achilles tendinopathy.
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| 16. |
- Sten, Sabine, et al.
(författare)
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Erik den heliges skelett : [Saint Erik's skeleton]
- 2016
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Ingår i: Fornvännen. - 0015-7813 .- 1404-9430. ; 111:1, s. 27-40
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Saint Erik was King of Sweden for a few years up to 1160, when he was killed. A skeleton attributed to him is kept in Uppsala Cathedral. It underwent scientific reappraisal in 2014. The analyses included computer tomography, Xray absorptiometry, isotope analysis and DNA sampling. Radiocarbon confirms the alleged age of the bones. They belong to a 35–40yearold man inexcellent physical shape. The many wounds that he received in connectionwith his death fit surprisingly well with the saint's legend, whose preservedversion was written 130 years after the event.
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| 17. |
- Sten, Sabine, et al.
(författare)
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Erik den heliges skelett
- 2016
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Ingår i: Fornvännen. - 0015-7813 .- 1404-9430. ; 111:1, s. 27-40
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Tidskriftsartikel (refereegranskat)abstract
- Saint Erik was King of Sweden for a few years up to 1160, when he was killed. A skeleton attributed to him is kept in Uppsala Cathedral. It underwent scientific reappraisal in 2014. The analyses included computer tomography, Xray absorptiometry, isotope analysis and DNA sampling. Radiocarbon confirms the alleged age of the bones. They belong to a 35-40-year-old man in excellent physical shape. The many wounds that he received in connection with his death fit surprisingly well with the saint's legend, whose preserved version was written 130 years after the event.
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| 18. |
- Strandberg, Soren, et al.
(författare)
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Muscle morphometric effect of anterior cruciate ligament injury measured by computed tomography : aspects on using non-injured leg as control
- 2013
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 14, s. 150-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Anterior cruciate ligament (ACL) tears are common, functionally disabling, and predispose to subsequent injuries and early onset of osteoarthritis in the knee. Injuries result in muscular atrophy and impaired muscular activation. To optimize surgical methods and rehabilitation strategies, knowledge of the effects of ACL injuries on muscles size and function is needed. Asymmetry due to limb dominance implies that the effect of ACL-injury might be different in right-sided and left-sided injuries which, should be taken in account when evaluating the effect of an injury. Evaluation of the effects of injuries is usually made with the contralateral leg as control. The aim of this study is to describe the effect of ACL-injuries on thigh muscle size and also to analyze feasibility of using contralateral limb as control. Methods: Sixty-two patients scheduled to undergo ACL reconstruction were examined with computed tomography (CT). Muscle cross sectional area (CSA) was recorded for quadriceps, hamstrings, gracilis and sartorius 15 cm above the knee joint. Comparisons were made between the injured and non-injured side and between individuals separated by gender and side of injury. Comparisons were also made for patients with or without concomitant meniscal tear, for patients differing in time between injury and examinations and for patients with different level of physical activity after the injury. Results: Quadriceps CSA was 5% smaller on the injured side. There was an indication that the muscles of the right thigh were generally bigger than those of the left thigh. The difference between the injured and the non-injured side was larger for right-sided injuries than for left-sided. There was also a greater difference in semimembranosus for women than for men. There were no differences related to meniscal injury, time since injury or physical activity. Conclusion: The use of contralateral leg for evaluating the effect of ACL-injury is often the only available alternative but our study indicates that the difference in CSA between injured and non-injured side does not necessarily reflect the true degree of atrophy, as there are side differences both in muscle size in general and in the effect of an ACL-injury on muscle size.
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| 19. |
- Strandberg, Sören, et al.
(författare)
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Reliability of computed tomography measurements in assessment of thigh muscle cross-sectional area and attenuation
- 2010
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Ingår i: BMC Medical Imaging. - : Springer Science and Business Media LLC. - 1471-2342. ; 10, s. 18-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Advancement in technology of computer tomography (CT) and introduction of new medical imaging softwares enables easy and rapid assessment of muscle cross-sectional area (CSA) and attenuation. Before using these techniques in clinical studies there is a need for evaluation of the reliability of the measurements. The purpose of the study was to evaluate the inter- and intra-observer reliability of ImageJ in measuring thigh muscles CSA and attenuation in patients with anterior cruciate ligament (ACL) injury by computer tomography.METHODS: 31 patients from an ongoing study of rehabilitation and muscle atrophy after ACL reconstruction were included in the study. Axial CT images with slice thickness of 10 mm at the level of 150 mm above the knee joint were analyzed by two investigators independently at two times with a minimum of 3 weeks between the two readings using NIH ImageJ. CSA and the mean attenuation of individual thigh muscles were analyzed for both legs.RESULTS: Mean CSA and mean attenuation values were in good agreement both when comparing the two observers and the two replicates. The inter- and intraclass correlation (ICC) was generally very high with values from 0.98 to 1.00 for all comparisons except for the area of semimembranosus. All the ICC values were significant (p < 0,001). Pearson correlation coefficients were also generally very high with values from 0.98 to 1.00 for all comparisons except for the area of semimembranosus (0.95 for intraobserver and 0.92 for interobserver).CONCLUSION: This study has presented ImageJ as a method to monitor and evaluate CSA and attenuation of different muscles in the thigh using CT-imaging. The method shows an overall excellent reliability with respect to both observer and replicate.
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| 20. |
- Söderman, Tomas, et al.
(författare)
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Higher frequency of osteoarthritis in patients with ACL graft rupture than in those with intact ACL grafts 30 years after reconstruction
- 2020
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 28:7, s. 2139-2146
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim was to assess the results of anterior cruciate ligament (ACL) reconstruction regarding graft failure, knee laxity, and osteoarthritis (OA) from a longterm perspective. It was hypothesized that intact ACL graft reduces the risk for increased OA development.METHODS: The cohort comprised 60 patients with a median follow-up 31 (range 28-33) years after ACL reconstruction. They were evaluated with magnetic resonance imaging, radiography, KT-1000 arthrometer and the pivot shift test.RESULTS: Out of the 60 patients, 30 (50%) showed an intact ACL graft and 30 (50%) a ruptured or absent ACL graft. Patients with ruptured ACL grafts had more medial tibiofemoral compartment OA than those with an intact ACL graft (p = 0.0003). OA was asymmetric in patients with ruptured ACL grafts with more OA in the medial than in the lateral tibiofemoral compartment (p = 0.013) and the patellofemoral compartment (p = 0.002). The distribution of OA between compartments was similar in patients with an intact ACL graft. KT-1000 values of anterior knee laxity were higher in patients with ruptured compared to those with intact ACL grafts (p = 0.012). Side-to-side comparisons of anterior knee laxity showed higher KT-1000 values in patients with ruptured ACL graft (p = 0.0003) and similar results in those with intact graft (p = 0.09). The pivot shift grade was higher in the group with a ruptured ACL graft (p < 0.0001).CONCLUSIONS: Median 31 (range 28-33) years after ACL reconstruction, 50% of the patients showed an intact ACL graft and no side-to-side difference regarding anterior knee laxity. Patients with ruptured ACL grafts had more OA of the medial tibiofemoral compartment than those with intact ACL grafts.LEVEL OF EVIDENCE: Retrospective cohort study, Level III.
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| 21. |
- Söderman, Tomas, et al.
(författare)
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Knee function 30 years after ACL reconstruction : a case series of 60 patients.
- 2021
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Ingår i: Acta Orthopaedica. - : Taylor & Francis. - 1745-3674 .- 1745-3682. ; 92:6, s. 716-721
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - Until now, there have been no studies beyond 30 years after anterior cruciate ligament (ACL) reconstruction. We report knee function a mean 31 years after ACL reconstruction.Patients and methods - This cohort comprised a case series of 60 patients with a mean follow-up of 31 years (28-33) after ACL reconstruction. Patients were evaluated with the International Knee Documentation Committee (IKDC) objective assessment, Knee injury Osteoarthritis Outcome Score (KOOS), Tegner Activity Scale, radiography, and MRI.Results - 30 patients showed an intact ACL graft and 30 a ruptured or missing ACL graft. 40 patients had osteoarthritis in the tibiofemoral compartment and 24 patients in the patellofemoral compartment. Patients with intact ACL grafts scored higher than those with ruptured or missing ACL grafts when it comes to KOOS Sport/Rec. The Hodges Lehmann estimated median difference between groups was 15 (95% CI 0-35). The KOOS scores were lower in the group with ruptured or missing ACL grafts when compared with a healthy-knee reference group of males in terms of Pain, mean difference -8 (CI -15 to -1), Symptoms, mean difference -18 (CI -27 to -9), and Sport/Rec, mean difference -21 (CI -34 to -8). In the group with intact ACL grafts, the KOOS score was lower than a healthy-knee reference group of males in terms of Symptoms, mean difference -12 (CI -21 to -3). Scores for all subgroups of KOOS were higher in patients without osteoarthritis. The IKDC overall clinical assessment outcome was worse in patients with a ruptured or missing ACL graft. The Hodges Lehmann estimated median difference between groups was 1 (CI 0-1).Interpretation - Patients with an intact ACL graft reported higher sports activity and recreation, as measured with KOOS, than patients with a ruptured or missing ACL graft. Patients with severe osteoarthritis reported lower sports activity and recreation, as measured with KOOS.
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| 23. |
- Söderman, Tomas
(författare)
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Radiological methods in rheumatoid arthritis and osteoarthritis
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The dissertation's theme is the critical role of radiology when evaluating two different groups of patients. Firstly, patients with rheumatoid arthritis (RA) of the cervical spine were studied to evaluate upper spine instability with dynamic computed tomography (CT). Secondly, after anterior cruciate ligament (ACL) reconstruction, patients with a long-term follow-up were studied to evaluate osteoarthritis (OA). In paper I, 21 consecutive patients with atlantoaxial subluxation due to RA planned for atlantoaxial fusion were included. Radiographs were obtained in neutral and flexed positions, CT and Magnetic Resonance Imaging (MRI) was performed with the neck in the neutral position and CT also in flexion. Radiographs and CT measurements of atlantoaxial subluxation correlated but were larger using radiographs than CT in flexion. The spinal cord compression was significantly worse at CT obtained in flexed position than MRI in the neutral position. In papers II and III, the cohort consisted of 60 patients, and in paper IV, 73 patients. Mean follow-up was 31 years after ACL reconstruction. MRI, radiographs, International Knee Documentation Committee (IKDC) clinical assessment, Knee injury Osteoarthritis Outcome Score (KOOS), Short Form-36 (SF-36), Tegner Activity Scale, and KT-1000 arthrometer were used in order to evaluate the patients. Thirty-three patients showed an intact ACL graft, and 40 a ruptured ACL graft. Forty-nine patients had tibiofemoral OA, and 28 patients had patellofemoral OA. Patients with ruptured ACL grafts had more OA in the medial tibiofemoral compartment than those with an intact ACL graft. Sport and Recreation Function and Quality of life scores were higher in patients with an intact ACL graft than those with a ruptured ACL graft. All subscales of KOOS were higher in the group without OA. KOOS Quality of life score was lower than for a control group of men. The IKDC overall clinical assessment was worse in patients with a ruptured ACL graft. This thesis suggests that radiographs remain the primary imaging method for evaluating atlantoaxial instability. However, CT in flexed position is useful in the preoperative imaging workup. Patients with a ruptured ACL graft presented with more OA of the medial tibiofemoral compartment than those with an intact graft. Patients with an intact ACL graft and those without OA reported higher sports activity and recreation and better knee-related Quality of life. Knee-related Quality of life in the study group was reduced compared to a reference group.
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| 24. |
- Söderman, Tomas, et al.
(författare)
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Static and dynamic CT imaging of the cervical spine in patients with rheumatoid arthritis
- 2015
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Ingår i: Skeletal Radiology. - : Springer Science and Business Media LLC. - 0364-2348 .- 1432-2161. ; 44:2, s. 241-248
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:To compare CR with CT (static and dynamic) to evaluate upper spine instability and to determine if CT in flexion adds value compared to MR imaging in neutral position to assess compression of the subarachnoid space and of the spinal cord.MATERIALS AND METHODS:Twenty-one consecutive patients with atlantoaxial subluxation due to rheumatoid arthritis planned for atlantoaxial fusion were included. CT and MRI were performed with the neck in the neutral position and CT also in flexion. CR in neutral position and flexion were obtained in all patients except for one subject who underwent examination in flexion and extension.RESULTS:CR and CT measurements of atlantoaxial subluxation correlated but were larger by CR than CT in flexion, however, the degree of vertical dislocation was similar with both techniques irrespective of the position of the neck. Cervical motion was larger at CR than at CT. The spinal cord compression was significantly worse at CT obtained in the flexed position as compared to MR imaging in the neutral position.CONCLUSIONS:Functional CR remains the primary imaging method but CT in the flexed position might be useful in the preoperative imaging work-up, as subarachnoid space involvement may be an indicator for the development of neurologic dysfunction.
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