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Orthopaedic Proceedings
Vol. 84-B, Issue SUPP_I | Pages 22 - 22
1 Mar 2002
Wallny T Schild R Fimmers R Wagner U Hansmann M
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The vertebral canal reaches maturity early in life. The size of the lumbar spinal canal was evaluated to determine normal values for vertebral canal size.

For our prospective cross-sectional study 95 women with a singleton pregnancy between 16 and 41 weeks of gestation were recruited during their routine anomaly scan. After defining the region of interest on the 2D ultrasound image, volume scanning was performed and the rendered volume was displayed in three orthogonal planes on the screen. Area and volume of the vertebral canal in L1, L3 and L5 were calculated.

Area and volume of the vertebral canal showed a close correlation to gestational age. Advancing gestational age was characterised by a statistically significant increase in all volumetric and conventional 2D measurements. No major differences regarding area and volume measurements could be found between upper and lower spine.

Sonographic evaluation of the fetal spine plays an important role in obstetric anomaly scans. Prenatal diagnosis may also lead to interesting aspects concerning back pain in adults. A small vertebral canal is considered to be one of the causes for back pain in later life but these syndromes are multi-factorial. Since interpedicular diameter of the spinal canal at the level of L1-L4 at birth is approximately 70 % of the adult size, any kind of intrauterine growth impairment will affect further development. Further data will show if our normal values will have significance in the early detection of disorders of the vertebral canal.


Orthopaedic Proceedings
Vol. 84-B, Issue SUPP_I | Pages - 22
1 Mar 2002
Wallny T Bertelsbeck DS Schild R Theuerkauf I
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Two dimensional ultrasound of the shoulder joint has become a well established diagnostic tool. Difficult interpretation of ultrasonographic findings, however, suggests that ultrasound appears not to be an always reliable method, especially in partial thickness tears. The present study was performed to determine whether the use of three dimensional (3D) sonography further increases the diagnostic yield of ultrasound.

On a total of 22 externally intact appearing rotator cuffs of cadaveric shoulder joints 7 full thickness and 15 partial thickness incisions were carried out on the M. supraspinatus, subscapularis and infraspinatus tendon. The specimens included the humeral head, the glenoid, the joint capsule and periarticular tendons.

Ultrasound was performed on the shoulder specimens in a water basin with a 8.5 MHz curved array transducer (Combison 530D, Kretztechnik, Zipf, Austria).

With three dimensional ultrasound rotator cuff lesions were more often correctly diagnosed (sensitivity of 77 %) than with conventional 2D sonography (sensitivity of 64 %). Specificity was 85 % and 69 %, respectively. In partial thickness tears in particular, 3D imaging was the superior method reaching a sensitivity and specifity of 73% and 77%, respectively compared to 53% and 61%, respectively with 2D ultrasound.

The use of three dimensional ultrasound appears to have a higher diagnostic yield in partial thickness tears. One advantage is that the examiner must not move the transducer to obtain other planes. Changes in echogenicity can be observed in the complete volume and in any plane. In the diagnosis of partial tears these changes enabled the examiner to distinguish intact from ruptured tissue.