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[Computed tomography of the musculoskeletal system].

Computed tomography (CT) is an important diagnostic modality in the work-up of musculoskeletal diseases. Just as projection radiography and magnetic resonance imaging, it has specific possible uses. As a tool to guide interventional and surgical procedures, it is a significant imaging technique. The technical development of multislice spiral CT in recent years has contributed considerably to increasing the diagnostic quality of CT. In particular, the possibilities for depicting the findings with methods for secondary image reconstruction have been decidedly improved.

Bone Diseases↗

Magnetic resonance imaging of the musculoskeletal system.

MRI is a complementary technique to CT in the examination of the spine, the hip, and musculoskeletal tumors. In some cases, it provides diagnostic information not available with any other modality, including CT. MRI has the potential to be very useful in the assessment of various marrow-based disorders and may someday obviate the need for contrast-aided studies of ligaments, tendons, and cartilage.

Aged↗

Field hospital treatment of blast wounds of the musculoskeletal system during the Yugoslav civil war.

The spectrum of wounding and treatment of forty-one patients with musculoskeletal blast injuries at a U.S. military field hospital in the former Yugoslavia was reviewed. Patients underwent wound exploration, irrigation, debridement, broad-spectrum antibiotic therapy, early fracture stabilization, and appropriate reconstructive surgery. Four patients developed wound infections. Two patients died as a result of their injuries (overall mortality 5 percent). There were three below-knee amputations and five other amputations (above-knee, ankle, midtarsal, partial forefoot, and finger). Three patients sustained lumbar burst fractures from mines that exploded under their vehicles, resulting in paraplegia in one case. Our patients underwent 112 surgical procedures, an average of 2.1 per patient. Twenty-two patients (54 percent) had other injuries or conditions in addition to their orthopaedic wounds. There were wide variations in the bone and soft tissue injuries caused by detonating ordnance, and the tissue damage was qualitatively different from that caused by gunshot wounds. Early debridement, leaving wounds open, and treatment with broad-spectrum antibiotics were important factors in wound healing to allow subsequent successful reconstructive surgery in an austere field setting.

Adult↗

[The musculoskeletal system in diabetic patients].

In this review, musculoskeletal manifestations in diabetic patients are presented. Late complications of diabetes mellitus (neuropathic arthropathy and diabetic muscle infarction), consequences of metabolic derangement inherent to diabetes (diffuse idiopathic skeletal hyperostosis, osteopenia, and osteoporosis), syndromes that may share etiologic mechanisms with changes of collagen and microvascular disease (limited joint mobility syndrome (cheiroarthropathy), palmar flexor tenosynovitis (trigger finger), Dupuytren's disease, adhesive capsulitis of the shoulder, and reflex sympathetic dystrophy) are described. Moreover, carpal tunnel syndrome, gout, osteoarthritis and their probable association with diabetes mellitus are discussed.

Bone Diseases, Metabolic↗