Simulation of personalised haemodynamics by various mounting positions of a prosthetic valve using computational fluid dynamics.

Diseases of the cardiovascular system account for nearly 42% of all deaths in the European Union. In Germany, approximately 12,000 patients receive surgical replacement of the aortic valve due to heart valve disease alone each year. A three-dimensional (3D) numerical model based on patient-specific anatomy derived from four-dimensional (4D) magnetic resonance imaging (MRI) data was developed to investigate preoperatively the flow-induced impact of mounting positions of aortic prosthetic valves to select the best orientation for individual patients.

Comparison of muscle and joint pressure-pain thresholds in patients with complex regional pain syndrome and upper limb pain of other origin.

Pain localized in the deep tissues occurs frequently in complex regional pain syndrome (CRPS). In addition, hyperalgesia to blunt pressure over muscles is common in CRPS, but it often appears in limb pain of other origin as well. Considering that 3-phase bone scintigraphy (TPBS) reveals periarticular enhanced bone metabolism in CRPS, joint-associated hyperalgesia to blunt pressure might be a more specific finding than hyperalgesia over muscles.

Permanent lesion of the lateral femoral cutaneous nerve after low-volume ethanol 96%application on the lumbar sympathetic chain.

Lumbar sympathetic blocks and chemical sympathectomies are used for the pain treatment of peripheral arterial occlusive disease or sympathetically maintained pain syndrome after nerve injury or complex regional pain syndrome (CRPS). A 30-year-old patient was referred to the pain department with all the clinical signs and symptoms of a CRPS of the right foot one and a half years after being surgically treated for rupture of the achilles tendon. An inpatient admission was necessary due to insufficient pain reduction upon the current treatment, strong allodynia in the medial distal right lower leg and decreased load-bearing capacity of the right foot.

[Degenerative alterations of the spinal column: rational imaging].

Unspecific back pain is a common phenomenon. Imaging often shows no clear cause for the genesis of back pain and generally has no impact on the therapeutic procedure. In contrast specific back pain, where a morphological cause is present is more infrequent.

Acute ventricular fibrillation during primary HIV infection.

Primary HIV infection normally shows an asymptomatic presentation or symptoms resembling infectious mononucleosis. However, severe unusual presentations have been reported. We report a case of acute ventricular fibrillation during primary HIV infection.

Different underlying pain mechanisms despite identical pain characteristics: a case report of a patient with spinal cord injury.

Pain following spinal cord injury has been classified as nociceptive (musculoskeletal, visceral) or neuropathic (above, at, below level). There is no clear relation between the etiology and reported symptoms. Thus, due to different underlying mechanisms, the treatment is often ineffective.

Determination of flow profiles of different mechanical aortic valve prostheses using phase-contrast MRI.

Aim: After heart valve replacement in aortic position turbulences may occur in the aortic outflow tract. Valve-induced turbulences and retrograde flow represent a loss of efficiency of cardiac output in respect to antegrade kinetic energy of blood flow. Aim of this study is the evaluation of the flow profiles of monoleaflet and bileaflet valves after aortic valve replacement.

Intra-individual, randomised comparison of the MRI contrast agents gadobutrol and gadoterate in imaging the distal lower limb of patients with known or suspected osteomyelitis, evaluated in an off-site blinded read.

Objective: To prove that 1.0 M gadobutrol provides superior contrast enhancement in suspicion of osteomyelitis of the feet compared with 0.5 M gadoterate.

Sensitivity and specificity of 3-phase bone scintigraphy in the diagnosis of complex regional pain syndrome of the upper extremity.

Objectives: Joint and bone alterations are seldom mentioned in the diagnostic criteria for complex regional pain syndrome (CRPS) even though they are important for long-term outcome. Altered periarticular bone metabolism can be detected by 3-phase bone scintigraphy (TPBS). Although frequently examining the diagnostic efficacy of TPBS is debatable.

Sternal osteomyelitis: long-term results after pectoralis muscle flap reconstruction.

Background: Reports regarding long-term follow-up including quality-of-life assessment, pulmonary function, and donor-site morbidity after operative treatment for sternal osteomyelitis are rare.

Methods: Data for 69 consecutive patients were acquired from patients' charts and contact with patients and general practitioners, with special reference to treatment and clinical course. Twenty-four patients were interviewed and physically examined (mean follow-up, 4 years; range, 1 to 9 years).

[Radiological differential diagnosis of chronic back pain].

Back pain is a frequent phenomenon. Published guidelines should be used to avoid unnecessary diagnostic imaging ("European guidelines for the management of chronic non-specific low back pain" - www.backpaineurope.

Aneurysmal bone cyst of the cervical spine (2008:7b).

Aneurysmal bone cysts (ABC) are rare, benign, but locally destructive bone tumors. They occur in the spine in 14% of cases, but only 2% are found in the cervical spine. This case report presents a 16-year-old female with an expansive aneurysmatic bone cyst with extensive bone destruction and instability in the cervical segments C1 and C2.

[Aneurysmal bone cysts. First description of the extensive destruction of the upper cervical spine].

Aneurysmal bone cysts are not counted among the classic malignant tumors, although they are destructive locally as blood filled reactive bone lesions. Typically, they are found in the metaphysis of the long bones, while localizations on the spine are rare. A 16-year-old female patient presented with unspecific, progressive neck pain which had been present for half a year.

Elastofibroma dorsi--differential diagnosis in chest wall tumours.

Background: Elastofibromas are benign soft tissue tumours mostly of the infrascapular region between the thoracic wall, the serratus anterior and the latissimus dorsi muscle with a prevalence of up to 24% in the elderly. The pathogenesis of the lesion is still unclear, but repetitive microtrauma by friction between the scapula and the thoracic wall may cause the reactive hyperproliferation of fibroelastic tissue.

Methods: We present a series of seven cases with elastofibroma dorsi with reference to clinical findings, further clinical course and functional results after resection, as well as recurrence.

MRI Findings Do not Correlate with Outcome in Athletes with Chronic Groin Pain.

This trial aimed to assess the value of MRI in the differential diagnosis of chronic groin pain in athletes, a condition caused by various pathologies, the most common being posterior abdominal wall deficiency, osteitis pubis and muscular imbalance. Nineteen subjects with clinically ruled-out hernia and recurrent episodes of exercise-triggered groin pain were assessed. Dynamic MRI was performed under Valsalva manoeuver and at rest within a training- free period and after training activity.

[Immobilization in external rotation after primary shoulder dislocation].

Introduction: The standard method of treating acute primary dislocation of the glenohumeral joint is immobilization of the arm in adduction and internal rotation with a sling. The recurrence rate for anterior instability after nonoperative treatment in young active patients is extremely high (up to 90%) and well reported. A new method of immobilization with the arm in external rotation improves the position of the displaced labrum on the glenoid rim.

[Initial results of shoulder MRI in external rotation after primary shoulder dislocation and after immobilization in external rotation].

Purpose: A change in the strategy for treating primary anterior traumatic dislocation of the shoulder has occurred. To date, brief fixation of internal rotation via a Gilchrist bandage has been used. Depending on the patient's age, a redislocation is seen in up to 90 % of cases.

[Feasibilities and bounds of diagnostic radiology in case of back pain].

Chronic monotone back pain is no pressing indication for radiographic procedures, but chronic progressive or symptomatic back pain should be investigated by radiographic means. Beneath conventional radiology and computed tomography (CT) magnetic resonance imaging (MRI) has become a more method of standard in these cases. The radiographic investigation of back pain is shown in cases of discal and vertebral degeneration and spondylitis.

[Lumbar intraspinal juxtafacet cysts: MR imaging and CT-arthrography].

Purpose: To present data on the MR imaging appearance of lumbar intraspinal juxtafacet cysts (JFC) and to assess the importance of additional CT arthrography.

Material And Methods: Twenty-eight patients (16 women, 12 men) with a mean age of 64 years (range: 43 - 82), who underwent MR imaging because of radicular pain or spinal claudication, were found to have an intraspinal cyst associated with the facet joint. In 14 patients, additional CT-arthrography was performed to determine whether a communication exists between the cyst and the facet joint and to try to rupture the cyst.