Publications by authors named "Robin Westerbeek"

Background:  The diagnosis of recurrent ipsilateral deep vein thrombosis (DVT) with compression ultrasonography (CUS) may be hindered by residual intravascular obstruction after previous DVT. A reference CUS, an additional ultrasound performed at anticoagulant discontinuation, may improve the diagnostic work-up of suspected recurrent ipsilateral DVT by providing baseline images for future comparison.

Objectives:  To evaluate the cost-effectiveness of routinely performing reference CUS in DVT patients.

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The diagnostic workup of recurrent ipsilateral deep vein thrombosis (DVT) using compression ultrasonography (CUS) can be complicated by persistent intravascular abnormalities after a previous DVT. We showed that magnetic resonance direct thrombus imaging (MRDTI) can exclude recurrent ipsilateral DVT. However, it is unknown whether the application of MRDTI in daily clinical practice is cost effective.

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Article Synopsis
  • The study aimed to assess the effectiveness of using the Wells score and D-dimer test to rule out acute recurrent deep vein thrombosis (DVT) in patients suspected of having it.
  • In a group of 231 patients, those with an unlikely Wells score and a normal D-dimer showed only a 6.1% chance of having recurrent DVT, indicating high sensitivity but low specificity for this method.
  • While the approach could potentially reduce the need for radiological imaging in 21% of patients, the significant failure rate (6.1%) suggests that this strategy isn't advisable in everyday clinical practice.
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Article Synopsis
  • Diagnosing recurrent ipsilateral deep vein thrombosis (DVT) is difficult because past DVT can cause lasting changes that complicate ultrasound diagnosis.
  • Magnetic resonance direct thrombus imaging (MRDTI) is a promising, quick, and contrast-free method that can differentiate between new DVT and old thrombus.
  • In a study involving 305 patients, MRDTI showed a low rate of new venous thromboembolism (1.1%) after negative results, indicating it is a reliable diagnostic tool.
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Introduction: Total knee replacement (TKR) for osteoarthritis results in a satisfactory outcome in the majority of patients, although up to one in five patients may be dissatisfied with the outcome. Persistent pain is a main contributor to patient dissatisfaction, and femoral and tibial component malrotation have been identified as a potential cause for both persistent pain and patellofemoral problems. Based on the assumption that component malrotation is the causative factor for persistent pain, early revision for patients with symptomatic malrotated components has been advocated in the literature.

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Background: Clinical outcomes in patellofemoral joint replacement may be related to femoral component rotation. Assessment of rotational alignment is however difficult as patients with isolated patellofemoral osteoarthritis often have trochlear dysplasia. The use of the medial malleolus as a landmark to guide rotation has been suggested.

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Background: A magnetic resonance imaging (MRI) scan of the shoulder can have added value in diagnosing symptomatic osteoarthritis of the acromioclavicular (AC) joint. Specific MRI signs have been recognized but not analyzed extensively before. This study aims to identify predictive MRI signs in patients with symptomatic AC osteoarthritis.

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. FMF (Familial Mediterranean Fever) is characterized by recurrent attacks of fever and articular pain. Enthesitis is the hallmark of pain in spondyloarthropathy.

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Background: Good clinical results have been reported for both surgical and conservative treatment of rotator cuff tears. The primary aim of this randomized controlled trial was to compare functional and radiologic improvement after surgical and conservative treatment of degenerative rotator cuff tears.

Methods: We conducted a randomized controlled trial that included 56 patients with a degenerative full-thickness rotator cuff tear between January 2009 and December 2012; 31 patients were treated conservatively, and rotator cuff repair was performed in 25 patients.

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Aim: The primary aim of this study is to analyse the long-term results of the third generation of the "Zweymüller" total hip arthroplasty (THA) comprising the SL-Plus Stem and the Bicon-Plus cup.

Methods: We evaluated 208 patients with a SL/Bicon-Plus primary THA (218 hips). Survival analysis was performed with a follow-up of 13 to 15 years.

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Patellofemoral joint replacement is a successful treatment option for isolated patellofemoral osteoarthritis. The short and mid-term outcomes are related to malposition and unexplained pain. Whether external rotation of the femoral component in isolated patellofemoral joint replacement is required is unclear.

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Accurate diagnostic assessment of suspected ipsilateral recurrent deep vein thrombosis (DVT) is a major clinical challenge because differentiating between acute recurrent thrombosis and residual thrombosis is difficult with compression ultrasonography (CUS). We evaluated noninvasive magnetic resonance direct thrombus imaging (MRDTI) in a prospective study of 39 patients with symptomatic recurrent ipsilateral DVT (incompressibility of a different proximal venous segment than at the prior DVT) and 42 asymptomatic patients with at least 6-month-old chronic residual thrombi and normal D-dimer levels. All patients were subjected to MRDTI.

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A 11-year-old female gymnast presented with long-standing bilateral wrist pain. Radiographs showed physeal widening and irregularity of the left distal radial and ulnar metaphyses, and irregularity of the right distal radial and ulnar metaphyses without physeal widening. 'Gymnast wrist' was diagnosed and cessation of strenuous activities was advised.

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Deep vein thrombosis (DVT) is a common disease that may lead to potentially fatal complications, such as pulmonary embolism. In the past decades several diagnostic tools and algorithms for DVT have been studied. Currently the combination of a clinical decision rule, D-dimer testing and compression ultrasonography has proved to be safe and effective for the diagnosis of DVT in the lower extremities.

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