Koxarthrose – ein Update

Degenerative osteoarthritis of the hip joint (coxarthrosis) is the most common disease of the hip joint in adults. The diagnosis is based on a combination of radiographic findings and characteristic clinical symptoms. The lack of a radiographic consensus definition has seemingly resulted in a variation of the published incidences and prevalence of degenerative osteoarthritis of the hip joint. The chronological sequence of degeneration includes the following basic symptoms on conventional radiographs and CT: joint space narrowing, development of osteophytes, subchondral demineralisation/sclerosis and cyst formation, as well as loose bodies, joint malalignment and deformity. MR imaging allows additional visualization of early symptoms and/or activity signs such as cartilage edema, cartilage tears and defects, subchondral bone marrow edema, synovial edema and thickening, joint effusion and muscle atrophy. The scientific dispute concerns the significance of (minimal) joint malalignment (e.g. impingement, dysplasia etc.) and forms of malpositioning which as possible prearthrosis have a high probability of leading to degenerative osteoarthritis. Moreover, without any question, the preservation of joint containment and gender differences are important additional basic diagnostic principles, which have gained great interest in recent years. In research different MR procedures such as Na and H spectroscopy, T2*-mapping etc. with ultrahigh field MR allow cartilage metabolism and its changes in early degenerative osteoarthritis (“biochemical imaging”) to be studied. There is no doubt that even in a few years new profound knowledge is to be expected in this field.     

Arthrose – Update 2012

Osteoarthritis is the most common joint disease in adults. With higher life expectancy and a growing proportion of elderly people in society, the relevance of osteoarthritis is becoming higher, especially in terms of socioeconomic effects and burdens for the healthcare system. In this review the pathogenesis and risk factors of the disease are presented with the focus on the knee, hip and shoulder, clinical symptoms, diagnosis and especially radiological imaging and therapy options.     

Teleradiologie – Segen oder Fluch? Vier Jahre Routine im Teleradiologischen Datennetz Nordhessen

Several hospitals in northern Hessen, not having their own radiology departments, want to run CT-scanners with the goal of improving medical quality. They requested co-operation from the Radiological Institute in the Hardtwaldklinik I in Bad Zwesten. Therefore a teleradiological network was developed, which enables the exchange of radiological-images and -reports between 19 hospitals today. An elementary requirement for this co-operation is an efficient and functional computer infrastructure and verified co-operation contracts. The conception, structure and development of the program, as well as associated difficulties are presented and discussed from different perspectives in the light of the controversy among experts. The results, experiences and benefits gained in four years, in which the teleradiological network of northern Hessen has been in place, demonstrate the importance and possibilities of teleradiology as an element of telemedicine. Teleradiology/telediagnostics improves the quality of patient care in smaller hospitals located in less-populated areas and present possibilities to optimize and integrate health care structures, taking economic considerations into account.     

Qualitätssicherung mit Teleradiologie

Teleradiology offers many applications for quality assurance in medicine. The spectrum reaches from electronic consultations in emergency or special cases and double reading--along with new models of cooperative work and medical networks--to technical quality assurance and integration into interinstitutional and patient controlled health records. Regional teleradiology networks based on server concepts can fulfill the developing technical and organisational requirements. The increasing mobility arising from smaller radiological equipment and improved accessibility to experts with minimized visualisation and reporting systems will change the radiological world of tomorrow, especially in combination with the usage of knowledge based systems in reference data bases and computer assisted diagnosis (CAD). Teleradiology by itself must be liable to quality assurance measurements to prevent unnecessary radiation exposure or danger to the doctor patient relation.     

Teleradiologie und PACS — das Konzept des Universitätsklinikums Innsbruck

Zusammenfassung Die Systeme zum digitalen Bilddatenmanagement haben große Bedeutung und weite Verbreitung an der Universitätsklinik Innsbruck und sind zentraler Bestandteil der IT-Strategie der Krankenhausbetreibergesellschaft TILAK (Tiroler Landeskrankenanstalten). Ziel dabei ist es insbesondere, sämtliche Bilddaten in die elektronische Krankengeschichte zu integrieren und von jedem der ca. 2500 klinischen Arbeitsplätze aus online zugreifbar zu machen sowie den elektronischen Datenaustausch mit anderen Gesundheitsdiensteanbietern zu gewährleisten. Seit 1995 bestehen Teleradiologieverbindungen der Universitätsklinik für Radiologie; diese wurden laufend ausgebaut und die Einbindung in das zentrale PACS hergestellt. Zur Kommunikation von Bild- und Befunddaten aus den Krankenhäusern der TILAK an andere Gesundheitseinrichtungen wurde kürzlich ein eHealth WebPortal geschaffen, über das sämtliche radiologischen Bilddaten durch zeitbefristete Freigaben für registrierte Benutzer zugänglich gemacht werden können.     

Late Effects Surveillance System After Childhood Cancer in Germany,Austria and Parts of Switzerland – Update 2009

Strahlentherapie und Onkologie -