Bridging function and structure of the neuromuscular system.
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Electric Impedance↗
Biomedical subjects
Sigrid Pillen
Publications and source records attributed to Sigrid Pillen.
Eosinophilic fasciitis in a child mimicking a myopathy.
A 14-year-old boy was suspected of having a myopathy with joint contractures. He presented with progressive painless joint contractures of his right wrist and fingers, and reduced muscle strength of his right arm, without obvious skin changes. Laboratory investigation showed a normal CK, hypergammaglobulinemia and eosinophilia. Ultrasonography revealed thickened fasciae in the forearm. A full thickness biopsy confirmed the diagnosis of eosinophilic fasciitis. The contractures diminished quickly with prednisolone and methotrexate. The ultrasound scans 2 years after diagnosis showed improvement, although some thickening of the fasciae was still present, indicating residual changes. In conclusion, eosinophilic fasciitis has to be regarded as a differential diagnosis of painless joint contractures in children. Ultrasonography can be helpful to suspect the diagnosis.
Adolescent↗
Skeletal muscle ultrasonography: Visual versus quantitative evaluation.
In this study, we compared the sensitivity and specificity of visual versus quantitative evaluation of skeletal muscle ultrasound in children suspected of having a neuromuscular disorder (NMD). Ultrasonography (US) scans of four muscles (biceps brachii, forearm flexors, quadriceps femoris, anterior tibial muscle) were made in 76 children. All images were visually evaluated using the Heckmatt criteria and quantitatively evaluated with computer-assisted grey-scale analysis of muscle echo intensity. Visual evaluation could achieve a sensitivity up to 71%, with a specificity of 92%. With quantification, a sensitivity of 87% accompanied by a specificity of 67% was found, but other diagnostic values could be achieved, depending on the cut-off point. Quantification resulted in a higher interobserver agreement (kappa 0.86) compared with visual evaluation (kappa 0.53). We conclude that quantification of echo intensity is a more objective and accurate method. Because it can achieve higher sensitivities, it is better-suited for the screening task in the diagnostic phase of children with a NMD.
Adolescent↗