41 results on '"H Sattler"'
Search Results
2. [Imaging techniques in rheumatology: sonography in rheumatoid arthritis]
- Author
-
W A, Schmidt, M, Backhaus, H, Sattler, and H, Kellner
- Subjects
Arthritis, Rheumatoid ,Synovitis ,Germany ,Practice Guidelines as Topic ,Transducers ,Image Processing, Computer-Assisted ,Humans ,Joints ,Tenosynovitis ,Ultrasonography, Doppler, Color ,Image Enhancement ,Sensitivity and Specificity ,Ultrasonography - Abstract
Musculoskeletal ultrasonography has become an important diagnostic tool in rheumatoid arthritis. In Germany it is part of the rheumatology training, and many ultrasound courses provide further education. Only in the last five years the international importance of ultrasound in rheumatology has increased dramatically. Sonography can be performed as a bedside procedure and as an extension of the clinical investigation. It is easily tolerated by the patients, and it can be repeated any time. Sonography can have a great impact on therapeutic decisions. Aor = 5 MHz linear transducer is needed. Most transducers that are used for musculoskeletal ultrasound have about 7.5 MHz. Modern transducers with higher frequencies (7.5 MHz) and high resolution improve the diagnostic value of the investigation. Sonography is superior to plain radiography to detect erosions as far as the region is accessible by ultrasound. It is more sensitive than the clinical investigation for the detection of synovitis, tenosynovitis, tendinitis, and bursitis as well as for the differentiation of these lesions. Color Doppler sonography aids in evaluating the activity of inflammation and in differentiating intraarticular structures. Carpal- and ulnar neuropathy occur secondary to rheumatoid arthritis and may lead to characteristic nerve swelling. Ultrasound-guided injections into joints and tendon sheets can be performed.
- Published
- 2003
3. [Technique and diagnostic value of musculoskeletal ultrasonography in rheumatology. Part 6: ultrasonography of the wrist/hand]
- Author
-
M, Backhaus, W A, Schmidt, H, Mellerowicz, M, Bohl-Bühler, D, Banzer, J, Braun, H, Sattler, and R-W, Hauer
- Subjects
Arthritis, Rheumatoid ,Wrist Joint ,Synovitis ,Quality Assurance, Health Care ,Finger Joint ,Osteoarthritis ,Critical Pathways ,Humans ,Tenosynovitis ,Carpal Tunnel Syndrome ,Sensitivity and Specificity ,Joint Capsule ,Ultrasonography - Abstract
Sonography of the hands is especially helpful in the diagnosis of early arthritis. Sonography allows for a very sensitive detection of small joint-effusion, tenosynovitis and small erosive bone lesions earlier than conventional radiography. Musculoskeletal sonography is also helpful in morphological analysis of changes of the median nerve in patients with carpal tunnel syndrome. The following standard scans are suggested for the sonographic evaluation of the wrist: 1. dorsal longitudinal scan along the radio-carpal joint, 2) along the ulno-carpal joint, and 3) dorsal transverse scan along the wrist to detect joint fluid collection, synovitis, tenosynovitis, ganglia, irregularities of the bone surface in osteoarthritis, and erosions due to inflammatory disease, 4) volar longitudinal scan along the radio-carpal joint, and 5) along the ulno-carpal joint, and 6) volar transverse scan along the wrist to diagnose the same objective as the above mentioned scans and to evaluate the median nerve in cases of carpal tunnel syndrome. Optional scans are the following: 7) ulnar longitudinal 8) transverse scan along the ulnar joint space and the extensor carpi ulnaris muscle to detect tenosynovitis and caput ulnae syndrome, 9) radial longitudinal, and 10). transverse scan along the joint space to diagnose synovitis and tenosynovitis. The following standard scans are suggested for the sonographic evaluation of the fingers: 1) volar longitudinal, 2) volar transverse scan in extension along the finger joints to detect effusion and synovial proliferation, tenosynovitis, irregularities of the bone surface (osteophytes, erosions), 3) dorsal longitudinal scans in extension and flexion70 degrees along the CMC I, MCP, PIP and DIP joints to evaluate effusion and synovial proliferation, tenosynovitis or tendinitis, irregularities of the bone surface (osteophytes, erosions), and 4) dorsal transverse scans along the finger joints to evaluate these structures in an additional dimension. Optional 5) scans include the following: medial longitudinal scan along the MCP I, II, PIP and DIP joints, and 6) lateral longitudinal scan along the MCP V, PIP and DIP joints to evaluate the erosive bone process and joint instability. A linear transducer with a frequency of between 7.5 and 12 MHz is recommendable. The anterior distance between the bone and the joint-capsule of the wrist isor = 3 mm in probable andor = 4 mm in definite synovitis or effusions. Synovitis or effusions are probable if the difference between right and left wrist isor = 1 mm, and they are definite if the difference isor = 2 mm. A carpal tunnel syndrome is probable with a cross-sectional area of the median nerve ofor = 12 mm(2).
- Published
- 2002
4. [Technical aspects and value of arthrosonography in rheumatologic diagnosis. 4: Ultrasound of the elbow]
- Author
-
M, Backhaus, W A, Schmidt, H, Mellerowicz, M, Bohl-Bühler, D, Banzer, J, Braun, H, Sattler, and R W, Hauer
- Subjects
Arthritis, Rheumatoid ,Diagnosis, Differential ,Synovitis ,Bursitis ,Elbow Joint ,Humans ,Ultrasonography, Doppler, Color ,Sensitivity and Specificity - Abstract
Musculoskeletal ultrasonography is an important imaging technique in the diagnosis of rheumatic diseases especially for early manifestation. It allows sensitive detection of small joint fluid collections as well as differentiation of soft tissue lesions and bone lesions. The following standard scans are suggested for sonographic evaluation of the elbow: 1) anterior humeroradial longitudinal scan, 2) anterior humeroulnar longitudinal scan to detect effusions, synovial proliferation, loose joint bodies, bone lesions (osteoarthritis/arthritis), 3) anterior transverse scan over the trochlea to evaluate these structures in an additional dimension, 4) posterior longitudinal scan and 5) posterior transverse scan of the olecranon fossa with flexed/extended elbow to evaluate the same objectives as the above mentioned scans and additionally to detect olecranon bursitis, and optional 6) distal dorsal longitudinal scan to differentiate soft tissue lesions such as rheumatoid nodules or gout tophi, 7) anterior transverse scan over the radius head to evaluate lesions of the radius head, tendopathy, calcinosis, 8) lateral humeroradial longitudinal scan to evaluate epicondylitis, 9) medial humeroulnar longitudinal scan to evaluate calcinosis, epicondylitis, signs of compression of the ulnar nerve. A linear transducer with a frequency of about 5-7.5 MHz is recommendable. The anterior distance between trochlea and the capitulum of the humerus between the bone and the joint-capsule of the elbow isor = 2 mm in probable andor = 3 mm in definite synovitis or effusions. Synovitis or effusions are probable if the difference between the right and left elbow is 1 mm, and they are definite if the difference isor = 2 mm.
- Published
- 2002
5. [Technique and diagnostic value of musculoskelatal ultrasonography in rheumatology. Part 5: Ultrasonography of the shoulder]
- Author
-
H, Mellerowicz, R W, Hauer, W A, Schmidt, M, Bohl-Bühler, D, Banzer, H, Sattler, J, Braun, and M, Backhaus
- Subjects
Arthritis, Rheumatoid ,Tendons ,Rotator Cuff ,Acromioclavicular Joint ,Shoulder Joint ,Synovial Membrane ,Transducers ,Humans ,Bursa, Synovial ,Range of Motion, Articular ,Sensitivity and Specificity ,Sternoclavicular Joint ,Ultrasonography - Abstract
Shoulder-related symptoms are very common in rheumatic diseases. For the evaluation of the diagnosis as well as for therapy and prognosis, an anatomic assignment is essential. Clinical investigations alone are often not capable to do this. Ultrasonography is a method to delineate bony surfaces as well as the soft tissues around the shoulder joints statically and even dynamically. For the purpose of rheumatic diseases, ultrasound standard scans help to detect the lesions at the biceps tendon, the bursae, the rotator cuff, the humeral head as well as in the acromial and sternoclavicular joints. Considering the limitations of the method (obesity, frozen shoulder, no findings under bony structures) and knowing the pitfalls and errors of the method, ultrasonography is a reliable, quick and low cost method for the diagnosis of rheumatic shoulder joint pathology. Compared to computer tomography and magnetic resonance imaging, ultrasonography should be used as a screening method. The following standard scans are suggested for sonographic evaluation of the shoulder: 1) anterior transverse scan and 2) anterior longitudinal scan at the bicipal groove to detect synovitis and tenosynovitis, 3) anterior transverse scan at the coracoacromiale window in the neutral position, 4) at maximal external rotation and 5) at maximal internal rotation to evaluate the rotator cuff, bursitis, synovitis and erosions, 6) anterior longitudinal scan at 90 degrees to the coracoacomiale window at maximal internal rotation to describe these findings in an additional dimension, 7) anterior-lateral longitudinal scan at the anterior lateral acromion to tuberculum majus to evaluate the distal part of the supraspinatus muscle, 8) posterior transverse scan at the fossa infraspinata lateral under the spina scapulae, 9) axillary longitudinal scan to evaluate synovitis, synovial proliferation, erosions at the humeral head, lesions at the glenoidale labrum, 10) anterior transverse scan at the acromioclavicular joint and 11) anterior oblique scan at the sternoclavicular joint to detect synovitis, synovial proliferation, erosion, osteophytes.
- Published
- 2002
6. [Technique and value of arthrosonography in rheumatologic diagnosis--3: Ultrasound diagnosis of the ankle joint, foot and toes]
- Author
-
W A, Schmidt, R W, Hauer, D, Banzer, M, Bohl-Bühler, J, Braun, H, Mellerowicz, H, Sattler, and M, Backhaus
- Subjects
Arthritis, Rheumatoid ,Foot Diseases ,Fasciitis, Plantar ,Polymyalgia Rheumatica ,Foot Joints ,Practice Guidelines as Topic ,Transducers ,Humans ,Tenosynovitis ,Toe Joint ,Sensitivity and Specificity ,Ankle Joint ,Ultrasonography - Abstract
The clinical investigation of ankles, feet, and toes is frequently equivocal in rheumatology. Sonography can distinguish between underlying pathologies. We suggest following standard scans: 1) anterior longitudinal scan to diagnose effusions in the ankle and talonavicular joints, to display erosive and osteoarthrotic pathologies, and to diagnose tenosynovitis of the extensor tendons; 2) anterior transverse scan to document the findings in an additional dimension; 3) lateral transverse scan and 4) lateral longitudinal scan to diagnose tenosynovitis of the peroneus tendons; 5) medial transverse scan and 6) medial longitudinal scan to diagnose tenosynovitis of the flexor tendons; 7) posterior longitudinal scan and 8) posterior transverse scan to evaluate the Achilles tendon, the retrocalcaneal bursa, and the posterior recess of the ankle joint. Additionally we suggest optional scans: 9) plantar longitudinal scan for the plantar fascia and the plantar calcaneal surface; 10) distal anterior longitudinal scan to evaluate the midtalar joints; 11) distal anterior longitudinal scan to evaluate the toes; and 12) plantar, distal transverse scan to evaluate the flexor tendons of the toes. Additionally, the correlating longitudinal and transverse scans can be used to confirm the findings. The frequency of the transducer should be about 7.5 MHz for ankles and the peroneus, flexor, and extensor tendons. Ten to over 20 MHz are possible for more superficially located structures. Using modern equipment with higher resolution a hypoechoic border may be normal up to 3 mm in the ankle joints, the MTP joints, and around the peroneus tendons, and up to 4 mm around the tibialis posterior tendons.
- Published
- 2002
7. [Technique and value of arthrosonography in rheumatologic diagnosis. 2: Ultrasound diagnosis of the hip area]
- Author
-
W A, Schmidt, R W, Hauer, D, Banzer, M, Bohl-Bühler, J, Braun, H, Mellerowicz, H, Sattler, and M, Backhaus
- Subjects
Arthritis, Rheumatoid ,Diagnosis, Differential ,Synovitis ,Quality Assurance, Health Care ,Bursitis ,Femur Head Necrosis ,Practice Guidelines as Topic ,Humans ,Hip Joint ,Sensitivity and Specificity ,Osteoarthritis, Hip ,Ultrasonography - Abstract
The clinical investigation of the hips in patients with rheumatic diseases is often equivocal. Thus, ultrasonography of this region is very relevant for rheumatologists. We suggest following standard scans: 1) anterior longitudinal scan to detect synovitis of the hip joint, iliopectineal bursitis, irregularities of the bone surface in osteoarthritis, Perthes' disease, and erosions due to inflammatory disease, 2) anterior transverse scan to evaluate these structures in an additional dimension, 3) lateral longitudinal scan of the hip joint with the same objective as the above mentioned scans; 4) lateral longitudinal scan, and 5) lateral transverse scan of the greater trochanter to diagnose trochanteric bursitis and bone irregularities due to enthesiopathy, and 6) dorsal oblique scan (optional) to diagnose hip joint effusions and pannus that localize in the dorsal region. Rotation of the joint is necessary to detect small effusions. The transducers should have a medium frequency of 5 to 7.5 MHz. In obese or muscular patients, 3.5 MHz transducers may be necessary to increase penetration. The anterior distance between the bone and the joint capsule of the hip joint isor = 7 mm in probable andor = 8 mm in definite synovitis or effusions. Synovitis or effusions are probable if the difference between right and left hip isor = 2 mm, and they are definite if the difference isor = 3 mm.
- Published
- 2002
8. [Ultrasound diagnosis of hand and finger joints. Changes in arthritis]
- Author
-
H, Sattler
- Subjects
Arthritis, Rheumatoid ,Metacarpophalangeal Joint ,Finger Joint ,Humans ,Carpal Tunnel Syndrome ,Sensitivity and Specificity ,Carpal Bones ,Ultrasonography - Abstract
Arthritis of the hand and finger joints is seen with unspecific and specific signs, as known from the hip and knee joints. The examination has to be done with special applicators (small sized with 7-13 MHz). Especially signs such as erosions and surrounding synovitis ensure the diagnosis of rheumatoid arthritis.
- Published
- 2002
9. [Ultrasound diagnosis in rheumatoid omarthritis]
- Author
-
H, Sattler
- Subjects
Arthritis, Rheumatoid ,Diagnosis, Differential ,Shoulder Joint ,Humans ,Sensitivity and Specificity ,Ultrasonography - Abstract
There are specific and unspecific signs of omarthritis. The more specific the signs seen together in connection with laboratory and clinical findings are, the more certain the result becomes. A complete scanning is necessary including axillary as well as static and dynamic examinations.
- Published
- 2002
10. [Ultrasonography in inflammatory rheumatic diseases]
- Author
-
H, Sattler
- Subjects
Diagnosis, Differential ,Arthroscopy ,Knee Joint ,Arthritis ,Humans ,Hip Joint ,Joints ,Joint Diseases ,Arthrography ,Algorithms ,Ultrasonography - Abstract
In addition to clinical and laboratory findings, ultrasound is a very useful imaging procedure for the diagnosis of all rheumatic diseases. This method is able to monitor their development and dynamics. All joints that can be reached by the ultrasound beam are examined (from large ones such as the shoulder and knee to small ones such as fingers and toes) with various techniques and different frequencies.
- Published
- 2002
11. [Technique and value of arthrosonography in rheumatologic diagnosis. 1: Ultrasound diagnosis of the knee joint]
- Author
-
R W, Hauer, W A, Schmidt, M, Bohl-Bühler, D, Banzer, H, Mellerowicz, H, Sattler, J, Braun, and M, Backhaus
- Subjects
Arthritis, Rheumatoid ,Knee Joint ,Quality Assurance, Health Care ,Humans ,Osteoarthritis, Knee ,Sensitivity and Specificity ,Ultrasonography - Abstract
Within the last few years, ultrasonography (US) of joints has attained a firm position for the diagnosis of joint diseases. Degenerative as well as inflammatory changes can be recognized using this method. With new, higher resolution techniques even bone surfaces and tendon textures can be visualized in greater detail. The advantages of sonography are general availability and low costs. When used properly, as a non-invasive procedure US has no detrimental effects on patients. The disadvantages of this technique result from its physical limitations, such as high reflection of US on bone and the negative correlation between resolution and penetration which makes US imaging difficult in deeper regions. The current technical development of probes and imaging processing, however, promises better deep structure imaging in the future. The quality of ultrasound examination always depends on the technical equipment, as well as on the patients' individual tissue constitution and the experience of the physician. It is possible to avoid misinterpretation and to increase the diagnostic value of US by using a standardized technique and professional knowledge of the specific aspects of the method. The significance of qualified education and sufficient training of sonographers is to be stressed. The aim of this article is to deliver a basic contribution to the standardization and quality assurance of joint US and to indicate the value of this method. In addition to the overview the authors propose guidelines for performance and interpretation of joint US. Due to the major significance of the knee joint in rheumatology it was decided to begin the work in this area.
- Published
- 2001
12. [Current value of arthrosonography in diagnosis of rheumatic diseases]
- Author
-
H, Sattler
- Subjects
Arthritis, Rheumatoid ,Cartilage, Articular ,Diagnosis, Differential ,Synovitis ,Bursitis ,Osteoarthritis ,Humans ,Joints ,Ultrasonography - Abstract
Arthrosonography is now firmly established in the diagnosis of rheumatic diseases. Apart from revealing disorders of soft tissue it can also demonstrate bone defects. Arthrosonography is one of the very few imaging methods that enable observation of joint motions to complete the examination. Only a widespread technique like arthrosonography can improve the diagnostics of joint disorders from which millions of people suffer.
- Published
- 1994
13. [Sonographic criteria of omarthritis]
- Author
-
H, Sattler
- Subjects
Adult ,Male ,Synovitis ,Shoulder Joint ,Middle Aged ,Arthritis, Rheumatoid ,Rotator Cuff ,Bursitis ,Osteoarthritis ,Tendinopathy ,Humans ,Female ,Periarthritis ,Spondylitis, Ankylosing ,Aged ,Ultrasonography - Abstract
The sonographic examination of the shoulder has established itself in the diagnostic variety of imaging methods. Especially the results of the rotator cuff have contributed to the fact that arthrosonography is now indispensable for the shoulder examination. In this paper, another scan--the examination of the fossa axillaris--is added to the standard ones to find the early changes in the shoulder capsule in order to obtain efficient results in discovering the omarthritis.
- Published
- 1993
14. [Value of arthrosonography of the shoulder in rheumatologic diagnosis. Examination technique, findings and their interpretation]
- Author
-
H, Sattler
- Subjects
Arthritis, Rheumatoid ,Joint Instability ,Scapula ,Acromioclavicular Joint ,Bursitis ,Shoulder Joint ,Shoulder Dislocation ,Humans ,Periarthritis ,Humerus ,Ultrasonography - Abstract
The sonographic examination of the shoulder has established itself in the diagnostic spectrum of the imaging methods. Especially the results of the rotator cuff have contributed to the fact, that arthrosonography is now indisputable for the shoulder examination. In this paper another scan--the examination through the fossa axillaris--is added to the standard ones, to find the early changes of the shoulder capsule in order to receive efficient results in discovering the omarthritis.
- Published
- 1993
15. [Status of arthrosonography in rheumatologic diagnosis: examination technic, findings and their interpretation. I. The elbow joint]
- Author
-
H, Sattler and K L, Schmidt
- Subjects
Arthritis, Rheumatoid ,Diagnosis, Differential ,Gout ,Bursitis ,Rheumatoid Factor ,Elbow Joint ,Synovial Cyst ,Humans ,Rheumatoid Nodule ,Ultrasonography - Abstract
Between July 1984 and October 1985 the elbow joints of 135 patients were examined by arthrosonography. Of these 97 patients suffered from rheumatoid arthritis, 4 from psoriatic arthritis, 2 from suspected ankylosing spondylitis, 1 from gout, and 27 patients were found to be normal. The equipment used was a Kretz sector scanner Combison 320 and a Siemens Sonoline SL linear scanner. The examination was divided into three parts: longitudinal and transversal scans of the fossa olecrani, the fossa coronoidea and fossa radii. We found, that inflammation of the elbow joint has to be evaluated separately for each part of the joint. The more intense the inflammation, the more certain diagnosis becomes. Bursitis and rheumatoid nodules could be separated sonographically. Also synovialitic complications such as of the bone and the development of synovial cysts could easily be recognized. These arthrosonographical findings are a valuable help in the diagnostics of rheumatic diseases. Their interpretation, however, requires the input of all clinical data.
- Published
- 1986
16. [Arthrosonography--a new additional image-producing procedure in the detection of diseases of the knee joint]
- Author
-
H, Sattler and H, Gerhold
- Subjects
Arthritis, Rheumatoid ,Diagnosis, Differential ,Knee Joint ,Humans ,Joint Diseases ,Ultrasonography - Abstract
Ultrasonic examination of the knee joint is a non invasive reliable technique without disadvantages to the patients. It should be used supplementary to usual X-ray pictures of the popliteal space. Ultrasonography is a fast and accurate method to detect a wide variety of disorders, describing their exact location and calculating their volume. It produces supplementary diagnosis of extraarticular findings like popliteal cysts (Baker's cysts), aneurysms of popliteal artery, soft-tissue lesions, abscesses, hematomas, bursitis and varicosis, and of intra-articular disorders like effusion and synovial edema.
- Published
- 1984
17. [Dimensions of the concept of emotions. A reanalysis based on a random sample of emotional concepts]
- Author
-
W, Marx, A, Enzinger, C, Paszyna, R, Rauh, H, Sattler, and E, Schröger
- Subjects
Free Association ,Concept Formation ,Emotions ,Humans ,Semantics - Published
- 1987
18. Einfluß von verschiedenen Zellstoffen auf die Hydratation von Tonerdezement
- Author
-
H. Sattler, K. Lempfer, E. Roffael, and Publica
- Subjects
Hydratation ,Tonerdezement ,General Materials Science ,Forestry ,Zellstoff ,Extraktstoff - Abstract
Die wäßrigen Extrakte von Baumwoll-Linters verzögern die Zementhydratation praktisch nicht. Auch von den wäßrigen Extrakten des Fichtensulfitzellstoffes, des Buchensulfitzellstoffes und des Altpapiers geht vergleichsweise nur ein unbedeutender verzögernder Einfluß auf die Zementhärtung aus. Demgegenüber ist die Verlängerung der Hydratationsdauer durch den Extrakt des Strohzellstoffes erheblich.
- Published
- 1989
19. [Hand disinfection]
- Author
-
H, Sattler and E, Rohr
- Subjects
Sterilization ,Nursing ,Hand - Published
- 1966
20. [Studies on the effect of orthostatically caused blood and water shifts on the course of the blood alcohol curve]
- Author
-
O, GRUNER and H, SATTLER
- Subjects
Ethanol ,Posture ,Humans ,Water - Published
- 1958
21. [Arthrosonography].
- Author
-
Sattler H
- Subjects
- Diagnosis, Differential, Evidence-Based Medicine, Humans, Image Enhancement methods, Endoscopic Ultrasound-Guided Fine Needle Aspiration methods, Joints diagnostic imaging, Joints pathology, Rheumatic Diseases diagnostic imaging, Rheumatic Diseases pathology, Ultrasonography methods
- Published
- 2016
- Full Text
- View/download PDF
22. [Imaging techniques in rheumatology: sonography in rheumatoid arthritis].
- Author
-
Schmidt WA, Backhaus M, Sattler H, and Kellner H
- Subjects
- Germany, Humans, Joints diagnostic imaging, Practice Guidelines as Topic, Sensitivity and Specificity, Synovitis diagnostic imaging, Tenosynovitis diagnostic imaging, Ultrasonography, Doppler, Color instrumentation, Arthritis, Rheumatoid diagnostic imaging, Image Enhancement instrumentation, Image Processing, Computer-Assisted instrumentation, Transducers, Ultrasonography instrumentation
- Abstract
Musculoskeletal ultrasonography has become an important diagnostic tool in rheumatoid arthritis. In Germany it is part of the rheumatology training, and many ultrasound courses provide further education. Only in the last five years the international importance of ultrasound in rheumatology has increased dramatically. Sonography can be performed as a bedside procedure and as an extension of the clinical investigation. It is easily tolerated by the patients, and it can be repeated any time. Sonography can have a great impact on therapeutic decisions. A > or = 5 MHz linear transducer is needed. Most transducers that are used for musculoskeletal ultrasound have about 7.5 MHz. Modern transducers with higher frequencies (>7.5 MHz) and high resolution improve the diagnostic value of the investigation. Sonography is superior to plain radiography to detect erosions as far as the region is accessible by ultrasound. It is more sensitive than the clinical investigation for the detection of synovitis, tenosynovitis, tendinitis, and bursitis as well as for the differentiation of these lesions. Color Doppler sonography aids in evaluating the activity of inflammation and in differentiating intraarticular structures. Carpal- and ulnar neuropathy occur secondary to rheumatoid arthritis and may lead to characteristic nerve swelling. Ultrasound-guided injections into joints and tendon sheets can be performed.
- Published
- 2003
- Full Text
- View/download PDF
23. [Technique and diagnostic value of musculoskeletal ultrasonography in rheumatology. Part 6: ultrasonography of the wrist/hand].
- Author
-
Backhaus M, Schmidt WA, Mellerowicz H, Bohl-Bühler M, Banzer D, Braun J, Sattler H, and Hauer RW
- Subjects
- Carpal Tunnel Syndrome diagnostic imaging, Humans, Joint Capsule diagnostic imaging, Sensitivity and Specificity, Synovitis diagnostic imaging, Tenosynovitis diagnostic imaging, Ultrasonography, Arthritis, Rheumatoid diagnostic imaging, Critical Pathways, Finger Joint diagnostic imaging, Osteoarthritis diagnostic imaging, Quality Assurance, Health Care, Wrist Joint diagnostic imaging
- Abstract
Sonography of the hands is especially helpful in the diagnosis of early arthritis. Sonography allows for a very sensitive detection of small joint-effusion, tenosynovitis and small erosive bone lesions earlier than conventional radiography. Musculoskeletal sonography is also helpful in morphological analysis of changes of the median nerve in patients with carpal tunnel syndrome. The following standard scans are suggested for the sonographic evaluation of the wrist: 1. dorsal longitudinal scan along the radio-carpal joint, 2) along the ulno-carpal joint, and 3) dorsal transverse scan along the wrist to detect joint fluid collection, synovitis, tenosynovitis, ganglia, irregularities of the bone surface in osteoarthritis, and erosions due to inflammatory disease, 4) volar longitudinal scan along the radio-carpal joint, and 5) along the ulno-carpal joint, and 6) volar transverse scan along the wrist to diagnose the same objective as the above mentioned scans and to evaluate the median nerve in cases of carpal tunnel syndrome. Optional scans are the following: 7) ulnar longitudinal 8) transverse scan along the ulnar joint space and the extensor carpi ulnaris muscle to detect tenosynovitis and caput ulnae syndrome, 9) radial longitudinal, and 10). transverse scan along the joint space to diagnose synovitis and tenosynovitis. The following standard scans are suggested for the sonographic evaluation of the fingers: 1) volar longitudinal, 2) volar transverse scan in extension along the finger joints to detect effusion and synovial proliferation, tenosynovitis, irregularities of the bone surface (osteophytes, erosions), 3) dorsal longitudinal scans in extension and flexion >70 degrees along the CMC I, MCP, PIP and DIP joints to evaluate effusion and synovial proliferation, tenosynovitis or tendinitis, irregularities of the bone surface (osteophytes, erosions), and 4) dorsal transverse scans along the finger joints to evaluate these structures in an additional dimension. Optional 5) scans include the following: medial longitudinal scan along the MCP I, II, PIP and DIP joints, and 6) lateral longitudinal scan along the MCP V, PIP and DIP joints to evaluate the erosive bone process and joint instability. A linear transducer with a frequency of between 7.5 and 12 MHz is recommendable. The anterior distance between the bone and the joint-capsule of the wrist is > or = 3 mm in probable and > or = 4 mm in definite synovitis or effusions. Synovitis or effusions are probable if the difference between right and left wrist is > or = 1 mm, and they are definite if the difference is > or = 2 mm. A carpal tunnel syndrome is probable with a cross-sectional area of the median nerve of > or = 12 mm(2).
- Published
- 2002
- Full Text
- View/download PDF
24. [Technique and diagnostic value of musculoskelatal ultrasonography in rheumatology. Part 5: Ultrasonography of the shoulder].
- Author
-
Mellerowicz H, Hauer RW, Schmidt WA, Bohl-Bühler M, Banzer D, Sattler H, Braun J, and Backhaus M
- Subjects
- Acromioclavicular Joint diagnostic imaging, Bursa, Synovial, Humans, Sensitivity and Specificity, Sternoclavicular Joint diagnostic imaging, Synovial Membrane diagnostic imaging, Transducers, Ultrasonography, Arthritis, Rheumatoid diagnostic imaging, Range of Motion, Articular physiology, Rotator Cuff diagnostic imaging, Shoulder Joint diagnostic imaging, Tendons diagnostic imaging
- Abstract
Shoulder-related symptoms are very common in rheumatic diseases. For the evaluation of the diagnosis as well as for therapy and prognosis, an anatomic assignment is essential. Clinical investigations alone are often not capable to do this. Ultrasonography is a method to delineate bony surfaces as well as the soft tissues around the shoulder joints statically and even dynamically. For the purpose of rheumatic diseases, ultrasound standard scans help to detect the lesions at the biceps tendon, the bursae, the rotator cuff, the humeral head as well as in the acromial and sternoclavicular joints. Considering the limitations of the method (obesity, frozen shoulder, no findings under bony structures) and knowing the pitfalls and errors of the method, ultrasonography is a reliable, quick and low cost method for the diagnosis of rheumatic shoulder joint pathology. Compared to computer tomography and magnetic resonance imaging, ultrasonography should be used as a screening method. The following standard scans are suggested for sonographic evaluation of the shoulder: 1) anterior transverse scan and 2) anterior longitudinal scan at the bicipal groove to detect synovitis and tenosynovitis, 3) anterior transverse scan at the coracoacromiale window in the neutral position, 4) at maximal external rotation and 5) at maximal internal rotation to evaluate the rotator cuff, bursitis, synovitis and erosions, 6) anterior longitudinal scan at 90 degrees to the coracoacomiale window at maximal internal rotation to describe these findings in an additional dimension, 7) anterior-lateral longitudinal scan at the anterior lateral acromion to tuberculum majus to evaluate the distal part of the supraspinatus muscle, 8) posterior transverse scan at the fossa infraspinata lateral under the spina scapulae, 9) axillary longitudinal scan to evaluate synovitis, synovial proliferation, erosions at the humeral head, lesions at the glenoidale labrum, 10) anterior transverse scan at the acromioclavicular joint and 11) anterior oblique scan at the sternoclavicular joint to detect synovitis, synovial proliferation, erosion, osteophytes.
- Published
- 2002
- Full Text
- View/download PDF
25. [Technical aspects and value of arthrosonography in rheumatologic diagnosis. 4: Ultrasound of the elbow].
- Author
-
Backhaus M, Schmidt WA, Mellerowicz H, Bohl-Bühler M, Banzer D, Braun J, Sattler H, and Hauer RW
- Subjects
- Bursitis diagnostic imaging, Diagnosis, Differential, Humans, Sensitivity and Specificity, Synovitis diagnostic imaging, Ultrasonography, Doppler, Color, Arthritis, Rheumatoid diagnostic imaging, Elbow Joint diagnostic imaging
- Abstract
Musculoskeletal ultrasonography is an important imaging technique in the diagnosis of rheumatic diseases especially for early manifestation. It allows sensitive detection of small joint fluid collections as well as differentiation of soft tissue lesions and bone lesions. The following standard scans are suggested for sonographic evaluation of the elbow: 1) anterior humeroradial longitudinal scan, 2) anterior humeroulnar longitudinal scan to detect effusions, synovial proliferation, loose joint bodies, bone lesions (osteoarthritis/arthritis), 3) anterior transverse scan over the trochlea to evaluate these structures in an additional dimension, 4) posterior longitudinal scan and 5) posterior transverse scan of the olecranon fossa with flexed/extended elbow to evaluate the same objectives as the above mentioned scans and additionally to detect olecranon bursitis, and optional 6) distal dorsal longitudinal scan to differentiate soft tissue lesions such as rheumatoid nodules or gout tophi, 7) anterior transverse scan over the radius head to evaluate lesions of the radius head, tendopathy, calcinosis, 8) lateral humeroradial longitudinal scan to evaluate epicondylitis, 9) medial humeroulnar longitudinal scan to evaluate calcinosis, epicondylitis, signs of compression of the ulnar nerve. A linear transducer with a frequency of about 5-7.5 MHz is recommendable. The anterior distance between trochlea and the capitulum of the humerus between the bone and the joint-capsule of the elbow is > or = 2 mm in probable and > or = 3 mm in definite synovitis or effusions. Synovitis or effusions are probable if the difference between the right and left elbow is 1 mm, and they are definite if the difference is > or = 2 mm.
- Published
- 2002
- Full Text
- View/download PDF
26. [Technique and value of arthrosonography in rheumatologic diagnosis--3: Ultrasound diagnosis of the ankle joint, foot and toes].
- Author
-
Schmidt WA, Hauer RW, Banzer D, Bohl-Bühler M, Braun J, Mellerowicz H, Sattler H, and Backhaus M
- Subjects
- Fasciitis, Plantar diagnostic imaging, Humans, Practice Guidelines as Topic, Sensitivity and Specificity, Tenosynovitis diagnostic imaging, Transducers, Ultrasonography, Ankle Joint diagnostic imaging, Arthritis, Rheumatoid diagnostic imaging, Foot Diseases diagnostic imaging, Foot Joints diagnostic imaging, Polymyalgia Rheumatica diagnostic imaging, Toe Joint diagnostic imaging
- Abstract
The clinical investigation of ankles, feet, and toes is frequently equivocal in rheumatology. Sonography can distinguish between underlying pathologies. We suggest following standard scans: 1) anterior longitudinal scan to diagnose effusions in the ankle and talonavicular joints, to display erosive and osteoarthrotic pathologies, and to diagnose tenosynovitis of the extensor tendons; 2) anterior transverse scan to document the findings in an additional dimension; 3) lateral transverse scan and 4) lateral longitudinal scan to diagnose tenosynovitis of the peroneus tendons; 5) medial transverse scan and 6) medial longitudinal scan to diagnose tenosynovitis of the flexor tendons; 7) posterior longitudinal scan and 8) posterior transverse scan to evaluate the Achilles tendon, the retrocalcaneal bursa, and the posterior recess of the ankle joint. Additionally we suggest optional scans: 9) plantar longitudinal scan for the plantar fascia and the plantar calcaneal surface; 10) distal anterior longitudinal scan to evaluate the midtalar joints; 11) distal anterior longitudinal scan to evaluate the toes; and 12) plantar, distal transverse scan to evaluate the flexor tendons of the toes. Additionally, the correlating longitudinal and transverse scans can be used to confirm the findings. The frequency of the transducer should be about 7.5 MHz for ankles and the peroneus, flexor, and extensor tendons. Ten to over 20 MHz are possible for more superficially located structures. Using modern equipment with higher resolution a hypoechoic border may be normal up to 3 mm in the ankle joints, the MTP joints, and around the peroneus tendons, and up to 4 mm around the tibialis posterior tendons.
- Published
- 2002
- Full Text
- View/download PDF
27. [Technique and value of arthrosonography in rheumatologic diagnosis. 2: Ultrasound diagnosis of the hip area].
- Author
-
Schmidt WA, Hauer RW, Banzer D, Bohl-Bühler M, Braun J, Mellerowicz H, Sattler H, and Backhaus M
- Subjects
- Bursitis diagnostic imaging, Diagnosis, Differential, Femur Head Necrosis diagnostic imaging, Humans, Osteoarthritis, Hip diagnostic imaging, Practice Guidelines as Topic, Sensitivity and Specificity, Synovitis diagnostic imaging, Ultrasonography, Arthritis, Rheumatoid diagnostic imaging, Hip Joint diagnostic imaging, Quality Assurance, Health Care
- Abstract
The clinical investigation of the hips in patients with rheumatic diseases is often equivocal. Thus, ultrasonography of this region is very relevant for rheumatologists. We suggest following standard scans: 1) anterior longitudinal scan to detect synovitis of the hip joint, iliopectineal bursitis, irregularities of the bone surface in osteoarthritis, Perthes' disease, and erosions due to inflammatory disease, 2) anterior transverse scan to evaluate these structures in an additional dimension, 3) lateral longitudinal scan of the hip joint with the same objective as the above mentioned scans; 4) lateral longitudinal scan, and 5) lateral transverse scan of the greater trochanter to diagnose trochanteric bursitis and bone irregularities due to enthesiopathy, and 6) dorsal oblique scan (optional) to diagnose hip joint effusions and pannus that localize in the dorsal region. Rotation of the joint is necessary to detect small effusions. The transducers should have a medium frequency of 5 to 7.5 MHz. In obese or muscular patients, 3.5 MHz transducers may be necessary to increase penetration. The anterior distance between the bone and the joint capsule of the hip joint is > or = 7 mm in probable and > or = 8 mm in definite synovitis or effusions. Synovitis or effusions are probable if the difference between right and left hip is > or = 2 mm, and they are definite if the difference is > or = 3 mm.
- Published
- 2002
- Full Text
- View/download PDF
28. [Coxarthritis].
- Author
-
Sattler H
- Subjects
- Aged, Aged, 80 and over, Arthritis etiology, Arthritis, Rheumatoid diagnostic imaging, Bursitis diagnostic imaging, Bursitis etiology, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Synovitis diagnostic imaging, Synovitis etiology, Ultrasonography, Arthritis diagnostic imaging, Hip Joint diagnostic imaging
- Abstract
Coxarthritis is seen with specific and unspecific signs. The more specific signs are available in connection with clinical and laboratory findings, all the more certain is the result. Static and dynamic examinations are as necessary as a complete scanning of the dorsal side of the femoral head.
- Published
- 2002
- Full Text
- View/download PDF
29. [Ultrasound diagnosis of hand and finger joints. Changes in arthritis].
- Author
-
Sattler H
- Subjects
- Carpal Tunnel Syndrome diagnostic imaging, Humans, Sensitivity and Specificity, Ultrasonography, Arthritis, Rheumatoid diagnostic imaging, Carpal Bones diagnostic imaging, Finger Joint diagnostic imaging, Metacarpophalangeal Joint diagnostic imaging
- Abstract
Arthritis of the hand and finger joints is seen with unspecific and specific signs, as known from the hip and knee joints. The examination has to be done with special applicators (small sized with 7-13 MHz). Especially signs such as erosions and surrounding synovitis ensure the diagnosis of rheumatoid arthritis.
- Published
- 2002
- Full Text
- View/download PDF
30. [Ultrasound of the knee joint in gonarthritis].
- Author
-
Sattler H
- Subjects
- Artifacts, Bursitis diagnostic imaging, Humans, Patella diagnostic imaging, Sensitivity and Specificity, Synovial Cyst diagnostic imaging, Ultrasonography, Arthritis, Rheumatoid diagnostic imaging, Knee Joint diagnostic imaging
- Abstract
Ultrasound examination of the knee joint to detect early signs of inflammation is a useful diagnostic tool. The more specific the signs seen in connection with clinical and laboratory findings are, the more certain the diagnosis becomes. Static and dynamic examinations are necessary.
- Published
- 2002
- Full Text
- View/download PDF
31. [Ultrasound diagnosis in rheumatoid omarthritis].
- Author
-
Sattler H
- Subjects
- Diagnosis, Differential, Humans, Sensitivity and Specificity, Ultrasonography, Arthritis, Rheumatoid diagnostic imaging, Shoulder Joint diagnostic imaging
- Abstract
There are specific and unspecific signs of omarthritis. The more specific the signs seen together in connection with laboratory and clinical findings are, the more certain the result becomes. A complete scanning is necessary including axillary as well as static and dynamic examinations.
- Published
- 2002
- Full Text
- View/download PDF
32. [Ultrasonography in inflammatory rheumatic diseases].
- Author
-
Sattler H
- Subjects
- Algorithms, Arthritis diagnosis, Arthrography, Arthroscopy, Diagnosis, Differential, Hip Joint diagnostic imaging, Humans, Joint Diseases diagnosis, Knee Joint diagnostic imaging, Ultrasonography, Arthritis diagnostic imaging, Joint Diseases diagnostic imaging, Joints diagnostic imaging
- Abstract
In addition to clinical and laboratory findings, ultrasound is a very useful imaging procedure for the diagnosis of all rheumatic diseases. This method is able to monitor their development and dynamics. All joints that can be reached by the ultrasound beam are examined (from large ones such as the shoulder and knee to small ones such as fingers and toes) with various techniques and different frequencies.
- Published
- 2002
- Full Text
- View/download PDF
33. [Technique and value of arthrosonography in rheumatologic diagnosis. 1: Ultrasound diagnosis of the knee joint].
- Author
-
Hauer RW, Schmidt WA, Bohl-Bühler M, Banzer D, Mellerowicz H, Sattler H, Braun J, and Backhaus M
- Subjects
- Humans, Quality Assurance, Health Care, Sensitivity and Specificity, Ultrasonography, Arthritis, Rheumatoid diagnostic imaging, Knee Joint diagnostic imaging, Osteoarthritis, Knee diagnostic imaging
- Abstract
Within the last few years, ultrasonography (US) of joints has attained a firm position for the diagnosis of joint diseases. Degenerative as well as inflammatory changes can be recognized using this method. With new, higher resolution techniques even bone surfaces and tendon textures can be visualized in greater detail. The advantages of sonography are general availability and low costs. When used properly, as a non-invasive procedure US has no detrimental effects on patients. The disadvantages of this technique result from its physical limitations, such as high reflection of US on bone and the negative correlation between resolution and penetration which makes US imaging difficult in deeper regions. The current technical development of probes and imaging processing, however, promises better deep structure imaging in the future. The quality of ultrasound examination always depends on the technical equipment, as well as on the patients' individual tissue constitution and the experience of the physician. It is possible to avoid misinterpretation and to increase the diagnostic value of US by using a standardized technique and professional knowledge of the specific aspects of the method. The significance of qualified education and sufficient training of sonographers is to be stressed. The aim of this article is to deliver a basic contribution to the standardization and quality assurance of joint US and to indicate the value of this method. In addition to the overview the authors propose guidelines for performance and interpretation of joint US. Due to the major significance of the knee joint in rheumatology it was decided to begin the work in this area.
- Published
- 2001
- Full Text
- View/download PDF
34. [Current value of arthrosonography in diagnosis of rheumatic diseases].
- Author
-
Sattler H
- Subjects
- Bursitis diagnostic imaging, Cartilage, Articular diagnostic imaging, Diagnosis, Differential, Humans, Joints diagnostic imaging, Synovitis diagnostic imaging, Ultrasonography, Arthritis, Rheumatoid diagnostic imaging, Osteoarthritis diagnostic imaging
- Abstract
Arthrosonography is now firmly established in the diagnosis of rheumatic diseases. Apart from revealing disorders of soft tissue it can also demonstrate bone defects. Arthrosonography is one of the very few imaging methods that enable observation of joint motions to complete the examination. Only a widespread technique like arthrosonography can improve the diagnostics of joint disorders from which millions of people suffer.
- Published
- 1994
- Full Text
- View/download PDF
35. [Sonographic criteria of omarthritis].
- Author
-
Sattler H
- Subjects
- Adult, Aged, Bursitis diagnostic imaging, Female, Humans, Male, Middle Aged, Rotator Cuff diagnostic imaging, Spondylitis, Ankylosing diagnostic imaging, Synovitis diagnostic imaging, Tendinopathy diagnostic imaging, Ultrasonography, Arthritis, Rheumatoid diagnostic imaging, Osteoarthritis diagnostic imaging, Periarthritis diagnostic imaging, Shoulder Joint diagnostic imaging
- Abstract
The sonographic examination of the shoulder has established itself in the diagnostic variety of imaging methods. Especially the results of the rotator cuff have contributed to the fact that arthrosonography is now indispensable for the shoulder examination. In this paper, another scan--the examination of the fossa axillaris--is added to the standard ones to find the early changes in the shoulder capsule in order to obtain efficient results in discovering the omarthritis.
- Published
- 1993
36. [Value of arthrosonography of the shoulder in rheumatologic diagnosis. Examination technique, findings and their interpretation].
- Author
-
Sattler H
- Subjects
- Humans, Humerus diagnostic imaging, Joint Instability diagnostic imaging, Scapula diagnostic imaging, Shoulder Dislocation diagnostic imaging, Ultrasonography, Acromioclavicular Joint diagnostic imaging, Arthritis, Rheumatoid diagnostic imaging, Bursitis diagnostic imaging, Periarthritis diagnostic imaging, Shoulder Joint diagnostic imaging
- Abstract
The sonographic examination of the shoulder has established itself in the diagnostic spectrum of the imaging methods. Especially the results of the rotator cuff have contributed to the fact, that arthrosonography is now indisputable for the shoulder examination. In this paper another scan--the examination through the fossa axillaris--is added to the standard ones, to find the early changes of the shoulder capsule in order to receive efficient results in discovering the omarthritis.
- Published
- 1993
37. [Status of arthrosonography in rheumatologic diagnosis: examination technic, findings and their interpretation. I. The elbow joint].
- Author
-
Sattler H and Schmidt KL
- Subjects
- Arthritis, Rheumatoid pathology, Bursitis diagnosis, Diagnosis, Differential, Gout diagnosis, Humans, Rheumatoid Factor analysis, Rheumatoid Nodule diagnosis, Synovial Cyst diagnosis, Arthritis, Rheumatoid diagnosis, Elbow Joint pathology, Ultrasonography methods
- Abstract
Between July 1984 and October 1985 the elbow joints of 135 patients were examined by arthrosonography. Of these 97 patients suffered from rheumatoid arthritis, 4 from psoriatic arthritis, 2 from suspected ankylosing spondylitis, 1 from gout, and 27 patients were found to be normal. The equipment used was a Kretz sector scanner Combison 320 and a Siemens Sonoline SL linear scanner. The examination was divided into three parts: longitudinal and transversal scans of the fossa olecrani, the fossa coronoidea and fossa radii. We found, that inflammation of the elbow joint has to be evaluated separately for each part of the joint. The more intense the inflammation, the more certain diagnosis becomes. Bursitis and rheumatoid nodules could be separated sonographically. Also synovialitic complications such as of the bone and the development of synovial cysts could easily be recognized. These arthrosonographical findings are a valuable help in the diagnostics of rheumatic diseases. Their interpretation, however, requires the input of all clinical data.
- Published
- 1986
38. [Arthrosonography--a new additional image-producing procedure in the detection of diseases of the knee joint].
- Author
-
Sattler H and Gerhold H
- Subjects
- Arthritis, Rheumatoid diagnosis, Diagnosis, Differential, Humans, Joint Diseases diagnosis, Knee Joint, Ultrasonography methods
- Abstract
Ultrasonic examination of the knee joint is a non invasive reliable technique without disadvantages to the patients. It should be used supplementary to usual X-ray pictures of the popliteal space. Ultrasonography is a fast and accurate method to detect a wide variety of disorders, describing their exact location and calculating their volume. It produces supplementary diagnosis of extraarticular findings like popliteal cysts (Baker's cysts), aneurysms of popliteal artery, soft-tissue lesions, abscesses, hematomas, bursitis and varicosis, and of intra-articular disorders like effusion and synovial edema.
- Published
- 1984
39. [Dimensions of the concept of emotions. A reanalysis based on a random sample of emotional concepts].
- Author
-
Marx W, Enzinger A, Paszyna C, Rauh R, Sattler H, and Schröger E
- Subjects
- Free Association, Humans, Semantics, Concept Formation, Emotions
- Published
- 1987
40. [Studies on the effect of orthostatically caused blood and water shifts on the course of the blood alcohol curve].
- Author
-
GRUNER O and SATTLER H
- Subjects
- Humans, Ethanol blood, Posture, Water
- Published
- 1958
41. [Hand disinfection].
- Author
-
Sattler H and Rohr E
- Subjects
- Hand, Nursing, Sterilization
- Published
- 1966
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