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Therapierelevante Bildgebung in der modernen Arthrosebehandlung am Beispiel des Schultergelenks

Wissenswertes für den Orthopäden

Therapy relevant imaging in modern surgical treatment of arthrosis of the shoulder

Interesting facts for orthopedic surgeons

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Zusammenfassung

Klinisches/methodisches Problem

Die entsprechende Bildgebung vor Schultereingriffen wird derzeit divergent verwendet. Die schrittweise Darstellung von Vor- und Nachteilen der derzeitigen Möglichkeiten werden in Bezug auf die Pathologie und therapeutische Möglichkeiten erklärt.

Radiologische Standardverfahren

Projektionsradiographie (digital) in 3 Ebenen, Sonographie, MRT, CT, Szintigraphie mit Bezug zur therapeutischen Relevanz.

Methodische Innovationen

Speziell axiale Aufnahme (mit Raster) zur Beurteilung der Glenoidsituation, 3-D-CT bei großen Defekten und Klassifizierung.

Leistungsfähigkeit

Eine Beurteilung der Version und evtl. Erosionen des Glenoids ist erforderlich zur präoperativen Planung und postoperativen Kontrolle.

Bewertung

Anwendung und Beurteilung der Verwendung jeweiliger Bildgebung im Alltag der orthopädischen Chirurgie.

Empfehlung für die Praxis

Röntgen in 3 Ebenen in der gelenkersetzenden Chirurgie der Schulter ist das Mindestmaß. Zur Beurteilung der Rotatorenmanschette Sonographie. Zur Muskulaturbeurteilung MRT, für intraartikuläre Pathologien MRT, bei Knochendefekten CT-Rekonstruktion dreidimensional.

Abstract

Clinical/methodical issue

Imaging for shoulder surgery varies a lot nowadays. Advantages and disadvantages of possible imaging methods according to the pathology and treatment options are described.

Standard radiological methods

Digital projection radiography in 3 planes, ultrasonography, MRI, CT scanning and scintigrams.

Methodical innovations

Special axial view to visualize the glenoid situation, as well as 3-D CT scanning for larger defects and classification.

Performance

Imaging of the glenoid situation, the version and erosion in axial view x-ray is mandatory to plan and control glenoid replacement.

Achievements

Useful application of imaging methods for the daily routine of orthopedic surgeons.

Practical recommendations

Digital 3 plane x-ray imaging in arthroplasty surgery is the minimum requirement. For rotator cuff lesions ultrasonography is good. In order to gain information on fatty infiltration of rotator muscles MRI is needed as well as for intra-articular lesions. For bony defects CT and reconstruction 3-D are recommended.

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Authors and Affiliations

  1. Abteilung für Orthopädie und orthopädische Chirurgie, Krankenhaus Stolzalpe, Stolzalpe 38, A-8852, Stolzalpe, Österreich

    R.M. Krifter, C. Zweiger, W. Lick-Schiffer & R. Radl

  2. Abteilung für Unfallchirurgie, UKH Linz, Linz, Österreich

    G. Mattiassich

  3. Abteilung für Neuroradiologie und muskuloskelettale Radiologie, Universitätsklinik für Radiodiagnostik, Medizinische Universität Wien, Wien, Österreich

    C. Schüller-Weidekamm

Authors
  1. R.M. Krifter
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  2. C. Zweiger
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  3. W. Lick-Schiffer
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  4. G. Mattiassich
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  5. C. Schüller-Weidekamm
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  6. R. Radl
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Correspondence to R.M. Krifter.

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Krifter, R., Zweiger, C., Lick-Schiffer, W. et al. Therapierelevante Bildgebung in der modernen Arthrosebehandlung am Beispiel des Schultergelenks. Orthopäde 42, 177–186 (2013). https://doi.org/10.1007/s00132-013-2061-9

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  • DOI: https://doi.org/10.1007/s00132-013-2061-9

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