Extracorporeal Shock Wave Therapy (ESWT) is a new method for the treatment of numerous chronic disorders of the musculos- keletal system: Calcific tendinitis of the shoulder joint - Lateral epicondylitis - Medial epicondylitis - Plantar fas- ciitis - Pseudarthrosis. Other indications are being investigated either in clinical studies or as empirical therapeutic possibilities of ESWT. This book gives a clear overview of the present status of ESWT and ultrasound imaging in the management of musculoske- letal disorders.
Indice testuale
1 Introduction.- 1.1 ESWT in Orthopedics.- 2 Introduction to Physical Principles of Shock Waves.- 2.1 Discovery of Shock Wave Applications in Medicine.- 2.2 Wave Patterns.- 2.3 Shock Wave Generation Systems.- 2.4 Technology of Shock Wave Generation.- 2.5 Dornier Electromagnetic Shock Wave Emitter (EMSE).- 2.6 Properties of Shock Waves.- 2.7 Shock Wave Focus.- 2.8 Pressure Field.- 2.9 Energy Flux Density and Effective Focal Energy.- 2.10 Aperture Angle.- 2.11 Cavitation.- 2.12 Measuring Methods.- 2.13 Biological Effects of ESWT.- 3 Extracorporeal Shock Wave Therapy Systems.- 3.1 Components of a Typical ESWT System.- 3.2 Targeting Aids for Localization using Patient Feedback.- 3.3 Localization Systems.- 3.3.1 Ultrasound.- 3.3.2 Isocentric X-ray System.- 3.3.3 Dual Imaging.- 3.3.4 Comparison Ultrasound / X-ray Systems.- 4 Orthopedic Shock Wave Therapy.- 4.1 Energy Levels.- 4.2 Action Mechanism of Shock Wave Therapy.- 4.2.1 Structural Damage.- 4.2.2 Analgesic Effect.- 4.2.3 Stimulation of Metabolic Reactions.- 4.2.4 Effects of Shock Waves on the Musculoskeletal System.- 4.3 Orthopedic Indications for Shock Wave Therapy.- 4.3.1 Standard Indications.- 4.3.2 Clinical Trials.- 4.4 Contraindications.- 4.5 Patient Information.- 5 Localization Techniques.- 5.1 Patient Feedback.- 5.2 Ultrasound.- 5.3 X-ray.- 5.4 Dual Imaging.- 5.5 Comparison of Imaging Procedures.- 6 Application Techniques.- 6.1 Tangential Coupling.- 6.1.1 Two Point Method (TPM).- 6.2 Direct Coupling.- 6.2.1 One Point Method (OPM).- 7 Ultrasound Examination - Standard Ultrasound Cross Sectional Planes (DEGUM Recommendations).- 7.1 Introduction.- 7.2 Safety Aspects, Advantages and Disadvantages of Ultrasound Examinations.- 7.3 Technical and Physical Principles of Ultrasound Examinations.- 7.4 Configuration of Ultrasound Systems.- 7.5 Transducers, Imaging.- 7.6 Stand-offs.- 7.7 Artifacts and Phenomena.- 7.8 Important Basic Ultrasound Terms.- 7.9 Special System Adjustments and Problems of Ultrasound Examinations of the Musculoskeletal System.- 7.10 DEGUM Guidelines for Documentation and Evaluation.- 7.11 Typical Ultrasound Presentation of Selected Tissue Structures.- 8 Shoulder.- 8.1 Anatomy and Pathology of the Periarticular Structures of the Shoulder.- 8.2 Standard Ultrasound Examination of the Shoulder.- 8.2.1 Typical Indications and Findings.- 8.2.2 Examination.- 8.2.3 Standard Sectional Planes.- 1) Dorsal Region - Transverse Sectional Plane.- 2) Dorsal Region - Longitudinal Sectional Plane.- 3) Lateral Superior Region - Transverse Sectional Plane.- 4) Lateral Superior Region - Longitudinal Plane.- 5) Ventral Region - Transverse Sectional Plane.- 6) Ventral Region - Longitudinal Sectional Plane.- 8.3 Calcific Tendinitis.- 8.3.1 Definition.- 8.3.2 Pathology.- 8.3.3 Clinical Diagnosis.- 8.3.4 X-ray.- 8.3.5 Ultrasound.- 8.3.6 Conservative and Surgical Therapy.- 8.3.7 ESWT.- 1) Prerequisites.- 2) Anesthesia.- 3) Positioning and Localization.- 4) Coupling.- 5) Treatment Regimen.- 8.4 Results.- 9 Elbow.- 9.1 Standard Ultrasound Examinations of the Elbow.- 9.1.1 Indications and Findings.- 9.1.2 Examination.- 9.1.3 Standard Sectional Planes.- 1) Ventral Region - Transverse Sectional Plane.- 2) Ventral Region - Humero Radial Longitudinal Plane.- 3) Ventral Region - Humero Ulnar Longitudinal Plane.- 4) Dorsal Region - Transverse Sectional Plane.- 5) Dorsal Region - Longitudinal Sectional Plane.- 9.2 Lateral Epicondylitis (Tennis elbow).- 9.2.1 Definition.- 9.2.2 Pathology.- 9.2.3 Clinical Diagnosis.- 9.2.4 Conservative and Surgical Therapy.- 9.2.5 ESWT.- 1) Prerequisites.- 2) Anesthesia.- 3) Positioning and Localization.- 4) Coupling.- 5) Treatment Regimen.- 9.3 Medial Epicondylitis (Golfer's Elbow).- 9.3.1 Definition.- 9.3.2 Pathology.- 9.3.3 Clinical Diagnosis.- 9.3.4 Conservative and Surgical Therapy.- 9.3.5 ESWT.- 1) Prerequisites.- 2) Anesthesia.- 3) Positioning and Localization.- 4) Coupling.- 5) Treatment Regimen.- 9.4 Results.- 10 Foot and Ankle Joint.- 10.1 Standard Ultrasound Sectional Planes of the Ankle Joint and Foot.- 10.1.1 Standard Indications and Findings.- 10.1.2 Examination.- 10.1.3 Standard Sectional Planes.- 1) Ventral Region - Transverse Sectional Plane.- 2) Ventral Region - Longitudinal Sectional Plane.- 3) Lateral Region - Diagonal Sectional Plane.- 4) Dorsal Region - Transverse Sectional Plane.- 5) Dorsal Region - Longitudinal Sectional Plane.- 6) Plantar Region - Transverse Sectional Plane.- 7) Plantar Region - Longitudinal Sectional Plane.- 10.2 Plantar Fasciitis (Plantar Heel Spur).- 10.2.1 Definition.- 10.2.2 Pathology.- 10.2.3 Clinical Diagnosis.- 10.2.4 Conservative Therapy and Surgical Treatment.- 10.2.5 ESWT.- 1) Prerequisites.- 2) Anesthesia.- 3) Positioning and Localization.- 4) Coupling.- 5) Treatment Regimen.- 10.3 Results.- 11 Pseudarthrosis.- 11.1 Definition.- 11.2 Pathology.- 11.3 Clinical Diagnosis.- 11.4 Conservative and Surgical Therapy.- 11.5 ESWT.- 1) Prerequisites.- 2) Anesthesia.- 3) Positioning and Localization.- 4) Coupling.- 5) Treatment Regimen.- 11.6 Results.- 12 Additional Literature on ESWT of the Musculoskeletal System.- 13 Additional Literature, Video Tapes and CD-ROMs on Ultrasound Examination of the Musculoskeletal System.
