Der Orthopäde
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Subsequent to clinical and radiologic examination, ultrasonography is an important diagnostic method in knee and foot trauma, especially to assess pathologic conditions of the periarticular soft tissue. The main indications for ultrasonographic assessment of the knee region are fluid conglomerations, injuries of tendons, ligaments, and muscles, and vascular diagnosis. ⋯ Fractures involve the base of the fifth metatarsal, navicular and sesamoid bones, and epiphysiolysis. Rare indications are the search for free articular bodies and free air and the depiction of cartilaginous lesions and fractures of the knee region.
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A total of 329 children with hip pain were examined by ultrasound, which indicated transient synovitis (n = 161), rheumatoid arthritis (n = 16), tuberculoid arthritis (n = 3), septic arthritis (n = 16), Legg-Calvé-Perthes disease (n = 102), and slipped capital femoral epiphysis (n = 31). Using the standard planes described by DEGUM and DGOOC, it is possible to analyze the joint capsule, the surface of the femoral head, and the periarticular structures. ⋯ Because capsular distension exhibits no significant differences in the various diseases, differentiation is not possible with ultrasound in the absence of osseous abnormalities. In cases with both capsular distension and osseous abnormalities, ultrasound usually allows a differentiation between slipped capital femoral epiphysis and Perthes disease as well as septic and unspecific arthritis.