G. Gruber's research while affiliated with Deutsche Gesellschaft für Orthopädie und Unfallchirurgie e.V. and other places

Publications (74)

Article
Purpose Femoroacetabular impingement (FAI) is a known risk factor for hip osteoarthritis. The gold standard for diagnostics is X-ray and MRI. The accuracy of hip joint alpha angle measurements obtained using sonography is equal to measurements in MRI for patients with cam impingement of the hip joint. Materials and Methods Patients with hip pain an...
Chapter
Das Kapitel zeigt die Sonografie des Kniegelenks. Alle Standardschnittebenen der DEGUM werden mit der Lage des Schallkopfes und einem Ultraschallbild mit erklärendem Piktogramm dargestellt.
Chapter
Das Kapitel zeigt die Sonografie des Schultergelenkes. Alle Standardschnittebenen der DEGUM werden mit der Lage des Schallkopfes und einem Ultraschallbild mit erklärendem Piktogramm dargestellt.
Chapter
Das Kapitel zeigt die Sonografie des Ellenbogengelenks. Alle Standardschnittebenen der DEGUM werden mit der Lage des Schallkopfes und einem Ultraschallbild mit erklärendem Piktogramm dargestellt.
Chapter
Das Kapitel zeigt die Sonografie des Handgelenks. Alle Standardschnittebenen der DEGUM werden mit der Lage des Schallkopfes und einem Ultraschallbild mit erklärendem Piktogramm dargestellt.
Chapter
Das Kapitel zeigt die Sonografie des Hüftgelenks. Alle Standardschnittebenen der DEGUM werden mit der Lage des Schallkopfes und einem Ultraschallbild mit erklärendem Piktogramm dargestellt.
Chapter
Das Kapitel zeigt die Sonografie des Sprunggelenks. Alle Standardschnittebenen der DEGUM werden mit der Lage des Schallkopfes und einem Ultraschallbild mit erklärendem Piktogramm dargestellt.
Chapter
Das Kapitel zeigt die Sonografie von Wirbelsäule, Iliosakralgelenk und Os sacrum. Alle Standardschnittebenen der DEGUM werden mit der Lage des Schallkopfes und einem Ultraschallbild mit erklärendem Piktogramm dargestellt.
Book
Für die Kitteltasche: Sonografie in Orthopädie, Unfallchirurgie und Rheumatologie Dieses Buch beschreibt das How-to-do der sonografischen Diagnostik der Bewegungsorgane und gibt einen vollständigen Überblick über die im Jahr 2017 überarbeiteten Standardschnittebenen des Arbeitskreises „Bewegungsorgane“ der DEGUM. Die Schallkopfposition und die Ziel...
Chapter
Das Kapitel zeigt die Sonografie von Hand und Fingern. Alle Standardschnittebenen der DEGUM werden mit der Lage des Schallkopfes und einem Ultraschallbild mit erklärendem Piktogramm dargestellt.
Article
A diagnostic method is presented for measuring the leg length and the difference in leg lengths with ultrasound. A special device for holding and moving the ultrasound transducer was constructed. The measuring points on the hip, knee, and upper ankle can be visualized with a 5- or 7.5-MHz linear scanner. The measuring device gives the distance of t...
Article
Imaging guidelines have been proposed by the German Society of Ultrasonography (DEGUM, 1996) for the locomotor apparatus using five standardized sections of the elbow that allow a reproducible presentation of the surrounding soft tissues and cortical landmarks of this joint. Intra-articular fractures form a variable amount of hematoma, which is eas...
Article
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...
Article
Ultrasound is a noninvasive, immediately available procedure without radiation, which should be performed after exploration and clinical examination. It cannot, however, replace radiographic examination because the cortical substance represents a barrier for the ultrasound waves so that bony lesions (i.e., intraosseous tumors or osteomyelitis) cann...
Article
Sonographic examination can yield additional information free of radiation in the course of corticotomy/callus distraction. The echogenic structures of the cortical structure and the callus between can be scanned at the area of the callus distraction by ultrasound examination. Individual sectional planes are focussed. They are different from the st...
Article
Ultrasound is a noninvasive, immediately available procedure without radiation, which should be performed after exploration and clinical examination. It cannot, however, replace radiographic examination because the cortical substance represents a barrier for the ultrasound waves so that bony lesions (i.e., intraosseous tumors or osteomyelitis) cann...
Article
Imaging guidelines have been proposed by the German Society of Ultrasonography (DEGUM, 1996) for the locomotor apparatus using five standardized sections of the elbow that allow a reproducible presentation of the surrounding soft tissues and cortical landmarks of this joint. Intra-articular fractures form a variable amount of hematoma, which is eas...
Article
Comparable to the standardized ultrasound screening of newborns and infants according to Graf's method, the standardized ultrasound examination of the locomotor apparatus has become an important feature in the evaluation of many acute and chronic diseases. The standardized ultrasound examination technique according to the guidelines of DEGUM and DG...
Article
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...
Article
Zusammenfassung Aufgrund der Vorzüge der sonographischen Untersuchung als nichtinvasives, strahlungsfreies und sofort verfügbares, kostengünstiges Verfahren sollte die Sonographie grundsätzlich nach Anamneseerhebung und klinischer Untersuchung angewendet werden. Da die knöcherne Kortikalis jedoch eine für die Schallwellen unüberwindbare Barriere d...
Article
Zusammenfassung Eine von den Autoren entwickelte Messapparatur zur sonographischen Beinlängen- und Beinlängendifferenzmessung wird dargestellt. Die Messpunkte im Bereich des Hüft-, Knie- und oberen Sprunggelenks werden sonographisch mit einem 5- oder 7,5-MHz-Schallkopf abgebildet. Der ventrale Pfannenrand, der Hüftkopfscheitelpunkt sowie der later...
Article
Sonographic examination can yield additional information free of radiation in the course of corticotomy/callus distraction. The echogenic structures of the cortical structure and the callus between can be scanned at the area of the callus distraction by ultrasound examination. Individual sectional planes are focussed. They are different from the st...
Article
Ähnlich wie die standardisierte sonographische Untersuchung der Neugeborenen- und Säuglingshüfte in der Methode nach Graf ist die standardisierte sonographische Untersuchung am Stütz- und Bewegungsorgan fest integrierter Bestandteil im diagnostischen Algorithmus in der Abklärung vieler akuter und chronischer Erkrankungen. Die standardisierte sonogr...
Article
In diesem Beitrag werden die Richtlinien der Kassenärztlichen Vereinigung sowie die Richtlinien des Arbeitskreises “Bildgebende Verfahren” der DGOOC für den/die “Ausbildungsleiter/in und Seminarleiter/in Sonographie” der Allianz der Orthopädie vorgestellt. Die Richtlinien des Arbeitskreises “Stütz- und Bewegungsorgane” der DEGUM (Deutsche Gesellsch...
Chapter
Failure of the bone to unite six months after fracture or after osteosynthetic stabilization of fracture.
Chapter
A typical ESWT system is comprised of Shock wave source with controls and coupling cushion, water circulation unit Shock wave source positioning system Rack for power supply, shock wave generator and controls Localization device(s) or localization aids Markings indicating the direction of shock wave propagation Laser pointer Localization device(s)...
Chapter
Tangential shock wave direction should be selected whenever possible. This allows optimal positioning of the shock wave focus with respect to its longitudinal and lateral dimensions precise localization of the insertion plane at the point of bone/ligament insertion positioning of transducer directly above the ROI when using ultrasound localization...
Chapter
In the early 1970s engineers at Dornier GmbH, one of the leading aircraft and space industries of Germany, were studying material damage at the site of impact of rain drops on the surface of airplanes flying at supersonic speed. The damage was caused by generation of shock waves and their interaction with the surface of the airplane. The observatio...
Chapter
Periarticular soft tissue changes and intraarticular changes can be detected by ultrasound. In this context inflammatory changes similar to those seen in rheumatoid patients are of most importance. Table 9.1 lists common and rare indications for ultrasound examination of the elbow.
Chapter
Ultrasound examination of the joints of the musculoskeletal system can supply important additional information for treating a number of clinical conditions and injuries. This can apply to both intraarticular structures, such as hyaline cartilage and periarticular soft tissue structures seen in calcific tendinitis, or rotator cuff defects. Especiall...
Chapter
When locating the ROI (region of interest) with the help of patient feedback, the point of maximum pain is palpated and marked (X) on the skin. Using the marking of the shock wave path on the coupling cushion, the therapeutic focus is placed either directly (OPM = one point method) or tangentially (TPM = two point method) at the ROI.
Chapter
The shoulder region is composed of the following five functional units: Glenohumeral joint Acromioclavicular joint Sternoclavicular joint Scapulo-thoracic space Subacromial space.
Chapter
Ultrasound of the ankle joint can detect intraarticular volume increases in the presence of effusion or synovialitis, as well as periarticular soft tissue changes. The most frequent indications for ultrasound examination of this joint are injuries and disorders of the Achilles tendon. Ultrasound can offer decisive additional information for the con...
Article
In 65 patients an ultrasonographically guided needle biopsy was performed for histologic diagnosis of benign and malignant soft tissue and bone tumors. On the basis of the histopathologic findings, a final diagnosis could be made in 54 cases after sonographically guided needle biopsy of the soft tissue tumor component. In addition, tumor grouping w...
Article
We demonstrate a technique for examining the hip joint sonographically in a standardised way using sectional planes corresponding to the guidelines provided by the work group "Sonography of the Musculo-Skeletal System" of the German Society of Ultrasound (DEGUM). MRT-scans were used as a comparative standard. The ultrasound examination was performe...
Chapter
Anfang der 80er Jahre beobachteten Ingenieure der Dornier Flugzeugbau Gesellschaft an Flugzeugen, die Überschallgeschwindigkeit flogen, Korrosionsschäden an den Stellen, an denen sich Wassertropfen auf dem Flugzeug befanden. Dieses Phänomen war auf die Entstehung einer Stoßwelle zurückzuführen, die bei gleichzeitigem Vorhandensein von Wasser (als Ü...
Chapter
Es handelt sich um eine ausbleibende Knochenheilung 6 Monate nach aufge­tretenem Knochenbruch oder osteosynthetischer Versorgung einer Fraktur.
Chapter
Die sonographische Untersuchung der großen Gelenke der Stütz- und Bewegungsorgane kann bei vielen Erkrankungen und Verletzungen wichtige Zusatzinformationen liefern. Dies kann sowohl intraartikuläre Strukturen wie z. B. den hyalinen Knorpelbelag als auch periartikuläre Weichteilstrukturen wie z. B. die Tendinosis calcarea oder einen Rotatorenmansch...
Chapter
Die Schulterregion setzt sich aus 4 Gelenken zusammen: Glenohumeralgelenk. Acromioclaviculargelenk Sternoclaviculargelenk Scapulo-thorakales Gelenk
Chapter
Bei der Lokalisation der ROI (Region of Interest) durch Patienten-Feedback wird der maximale Schmerzpunkt palpiert und auf der Haut markiert (X). Mit Hilfe der Markierung des Stoßwellenverlaufes auf dem Koppelbalgs wird der Therapiefokus entweder direkt (OPM = One Point Method) oder tangential (TPM=Two Point Method) in die ROI plaziert.
Chapter
Am Sprunggelenk können intraartikuläre Volumenzunahmen bei Gelenkerguß oder Synovialitis sowie periartikuläre Weichteilveränderungen sonographisch erfaßt werden. Die häufigsten Indikationen für die Ultraschalluntersuchung dieses Gelenkes betreffen jedoch Verletzungen und Erkrankungen der Achillessehne. Die Ultraschalluntersuchung kann in der Indika...
Chapter
Ein typisches System für die ESWT besteht aus folgenden Komponenten: Schallquelle mit Ansteuerung und Ankoppelkissen (Wasserkreislauf) Schallquellenpositionierung Gehäuse mit Netzteilen, Steuerung, Stoßgeneratoren, etc. Ortungseinrichtung (en) und/oder Ortungshilfen Markierung des Stoßwellenverlaufes Laserpointer Bildgebende Verfahren: ideal sind i...
Book
Dieses Buch stellt in übersichtlicher Weise den heutigen Stand der Frühdiagnostik der Hüftreifungsstörung (sog. Hüftdysplasie und -luxation) mittels der generellen sonographischen Vorsorgeuntersuchung dar und beleuchtet alle Aspekte der sich daraus ergebenden therapeutischen Konsequenzen. Folgende Fragen sind von zentralem wissenschaftlichen und pr...
Chapter
Am Ellenbogengelenk können periartikuläre Weichteilveränderungen und intraartikuläre Veränderungen sonographisch erfaßt werden. Hierbei stehen entzündliche Veränderungen wie sie z. B. bei Erkrankungen aus dem rheumatischen Formenkreis auftreten im Vordergrund. Nachfolgend sind in Tabelle 9.1 sowohl typische als auch seltene Indikationen für die son...
Chapter
Nach Möglichkeit sollte eine tangential verlaufende Stoßwellenrichtung gewählt werden. Hierdurch kann der Fokus optimal in seinem Längs- und Querdurchmesser ausgenutzt werden die Insertionsebene am Übergang Knochen/Sehne genau lokalisiert undeingestellt werden bei Ultraschallortung der Schallkopf direkt über dem zu therapierenden anatomischen Punkt...
Article
Die Exkorporale Stoßwellentherapie (ESWT) stellt eine neue Behandlungsmethode bei verschiedenen Erkrankungen im Bereich der Stütz- und Bewegungsorgane dar: - Tendinosis calcarea des Schultergelenkes - Epicondylopathien des Ellenbogengelenkes - Fasziitis plantaris - Pseudarthrosen Weitere Indikationen für Krankheitbilder wie Ligamentosen und Tendopa...
Article
Fragestellung: In der vorliegenden prospektiven klinischen Studie soll der Stellenwert der sonographischen Untersuchung bei Verletzungen des medialen Knie-Seitenbandes überprüft werden. Methode: Die Untersuchung wurde mit einem Ultraschallgerät der Firma Dornier, Typ AI 3200 mit einem Linearschallkopf mit einer Frequenz von 7,5 Mhz im B-Bild-Verfah...
Article
The sonographic examination of the shoulder and elbow joint is demonstrated in standardized sectional planes providing a reproducible representation of anatomical structures. In ultrasound examination of the shoulder joint the following standardized planes are employed transverse and longitudinal planes in the dorsal, superior/lateral and ventral r...
Article
Ziel: Die standardisierten sonographischen Schnittebenen am Schulter- und Ellenbogengelenk werden vorgestellt und sollen eine reproduzierbare Darstellung der anatomischen Strukturen ermöglichen. Methode: Das Schultergelenk wird in der dorsalen, superior/lateralen und ventralen Region jeweils in einer Transversal- und einer Longitudinalschnittebene...
Article
Studienziel: Die sonographische Untersuchung des Sprunggelenkes in standardisierten Schnittebenen wird vorgestellt. Die sonographischen Schnittebenen werden anhand von MRT-Abbildungen erläutert. Methode: Die Untersuchungen wurden mit einem Ultraschallgerät der Marke Siemens (Erlangen) mit einem 7,5 MHz-Linear-Schallkopf im Real-time-Verfahren durch...
Article
The present prospective clinical study investigates the value of ultrasonic examination of injuries of the medial collateral ligament of the knee. The sonographical examination was done in a real-time method with an ultrasound unit Type AI 3200 (Dornier, Neufahrn, Germany) and with a linear transducer (frequency 7.5 Mhz). This functional measuremen...
Article
The efficiency of ultrasound was tested in septic arthritis. A total of 259 children with hip pain, septic arthritis (n = 14), transient synovitis (n = 120), juvenile rheumatoid arthritis (n = 12), Legg-Calvé-Perthes disease (n = 92) and slipped capital femoral epiphysis (n = 21) were examined by ultrasound. By using the standard planes described b...
Article
The efficiency of ultrasound was tested in septic arthritis. A total of 259 children with hip pain, septic arthritis (n = 14), transient synovitis (n = 120), juvenile rheumatoid arthritis (n = 12), Legg-Calve-Perthes disease (n = 92) and slipped capital femoral epiphysis (n = 21) were examined by ultrasound. By using the standard planes described b...
Article
Die sonographische Kniegelenksuntersuchung kann bei vielen pathologischen Kniegelenksveränderun-gen Zusatzinformationen liefern. Bei der standardisierten Ultraschall-Untersuchung des Kniegelenkes werden ventrale, seitliche und dorsale Schnittebenen eingestellt Spezielle Untersuchungen (Einstellung des vorderen und hinteren Kreuzbandes, Meniskussono...
Article
Allogenous versus xenogenous bone: The analysis of total costs that arise in producing of homologous bone transplant in the setting of our clinic's bone bank shows that the laboratory costs make up more than 50% (Katthagen 1992) of the total. The material for bone donation is made available by elective hip prothesis. Due to the increased use of aut...
Article
Eine neu entwickelte Meßeinheit zur sonographischen Beinlängen- und Beinlängendifferenzmessung wird dargestellt. Die Meßpunkte im Bereich des Hüft-. Knie- und oberen Sprunggelenkes werden sonographisch mit einem 5- oder 7.5-MHz Schallkopf abgebildet. Die ventrale Acetabulumkante. der Hüftkopfscheitelpunkt sowie der laterale Knie- und ventrale obere...
Article
Sonographic examination can yield additional information in the course of corticotomy-callus distraction. Hence, we focus on individual slices--which are different from the standardised ultrasound examination of the skeleton system--in the area of the corticotomy-callus distraction. In ultrasound examination the structure of corticalis in the field...
Article
We inform about 20 patients (19 men, 1 woman) with acute acromioclavicular striking, type Tossy III, which were operated. By usual preoperative diagnostic and physical examination, x-ray standard pictures of the shoulder in two planes and x-ray panoramic picture (loaded with 10 kp and unloaded) in ap-axis we made an additional sonographic examinati...
Article
We inform about 20 patients (19 men, 1 woman) with acute acromioclavicular striking, type Tossy III, which were operated. By usual preoperative diagnostic and physical examination, x-ray standard pictures of the shoulder in two planes and x-ray panoramic picture (loaded with 10 kp and unloaded) in ap-axis we made an additional sonographic examinati...
Article
The sonographic examination of the knee-joint can, in many pathological alterations of the knee-joint, supply additional informations. In the standardized ultrasound examination of the knee-joint ventral and dorsal sectional planes will be adjusted (4, 7, 14, 17). For the examination of the lesions of the anterior cruciate ligament direct adjustmen...
Article
In patients with habitual dislocation of the shoulder and post-fracture malrotation the measurement of humeral torsion is important in preoperative diagnostics. An easy method of ultrasonic measurement of humeral torsion is proposed. The correlation with anthropometric, radiological and CT-measurement is good, what could be shown in 20 macerated hu...
Article
Bei Patienten mit rezidivierenden Schulterluxationen oder posttraumatischen Rotationsfehlern des Humerus kann die Bestimmung der Retrotorsion für die Planung der operativen Behandlung von Interesse sein. Eine Methode zur sonographischen Bestimmung des Humerusretrotorsionswinkels wird vorgestellt. An 20 mazerierten Humeri werden die Ergebnisse der a...
Article
A new diagnostic method for measuring the leg length and the leg length difference by means of ultrasound is presented. A special device for holding and moving the ultrasound transducer was constructed. The measuring points on the hip, knee and upper ankle can be visualised by means of a 5- or 7.5-MHz linear scanner. The measuring device gives the...

Citations

... Femoroacetabular impingement syndrome (FAI) is a common pathology in the clinical setting of orthopedics [1][2][3]. Femoroacetabular impingement refers to the abnormal morphology of the hip joint characterized by pathological contact between the anterior upper femoral neck and the acetabulum [4]. It can be classified into two types: cam impingement, where there is a pathological transition of the femoral head and neck, and pincer impingement, where the femoral head is excessively covered by the acetabulum. ...
... In summary, ultrasound examination demonstrates great potential as a valuable tool for successful and sufficient arthrocentesis of the glenohumeral joint due to its cost effectiveness, avoidance of ionizing radiation, and capability for dynamic imaging [19,20]. However, further research and validation studies are needed to establish ultrasound-assisted puncture of the shoulder as a safe and practicable method, especially for inexperienced physicians. ...
... An established method for the treatment of developmental dysplasia of the hip (DDH) is the use of an abduction splint [1,2], even in walking children [3]. To achieve a favourable outcome in treating DDH, the abduction splint [4] has to position the leg in such a degree of abduction, which would allow concentric distribution of pressure [5] of the femoral head [6] inside the dysplastic acetabulum [7] and induce acetabular remodeling [8,9] of the acetabulum [10] until it reaches normal levels. One drawback of the abduction splint in children is the long duration that it must be worn, usually more than a year. ...
... The characterization of the applied sound fields is often incomplete, and the used parameters are restricted to the technical settings of the applicators [17,19]. This is particularly problematic as the requirements for approval of medical shockwave devices by regulatory agencies are based on dated standards derived from ultrasound devices and applications [20]. There, one of the main safety aspects for patients is the time-averaged energy deposition within the tissue. ...
... Suitable FSW devices are commercially available and thus no complicated HIPU devices are needed for CNS applications. Similar to HIPU, FSW is well known to produce cavitation (Bachmann et al., 2001), which is believed to be the major mechanism responsible for BBB opening caused by negative pressureinduced cavitation (Wu, 2016;Hsu et al., 2018). However, BBB opening requires high FSW pressure levels required, and its safety has yet to be clarified. ...
... Epin calcanei is an intramembranous ossification which occurs predominantly in the plantar fascia [1]. Continuous and extreme loading of small foot muscles [2] infectious diseases and trauma [3], age, and weight [4] are factors that increase the generation of epin calcanei. Previous studies found that the epin calcanei line is vertical [5] and that epin calcanei acts as a stressor because it is located deep within the ligament. ...
... After providing consent to participate in the study, participants completed a digital evaluation form (E1) at station 1; subsequently they watched a total of two teaching videos, each lasting approximately four minutes, describing the palpatory and sonographic marking of soft spots/access points for knee and shoulder arthroscopy -each video was watched twice (see ▶Fig. 2). Certified ultrasound experts and experienced shoulder and knee surgeons demonstrated the method in the videos according to the current literature [4,[17][18][19][20][21]. ...
... More and higher intensity shockwave treatment induced more and larger areas of bubbles in the phantoms, implying more cavitation activity leading to larger areas of BBB opening and tissue injury (i.e., red blood cells extravasation, apoptosis and glia cell infiltration). The extensive red blood cell extravasation produced by the addition of UCA is probably due to the high peak negative pressure of the shockwaves and strong cavitation effect in the rat brains (see Table 1 for detailed parameters) [24][25][26] . ...
... MHz, Maximum Field of View: 153 mm, Maximum Display Depth: 160 mm), placed in a longitudinal direction over the medial aspect of the knee. Subjects were positioned supine with extended leg in 0° with and without reproducible applied valgus stress (loaded condition) through a fixation device (TELOS, Wölfersheim-Berstadt, Germany) with 15 dekanewton (daN), and in a second step with a 30° bended knee with and without valgus stress [11,20]. For standardized measurements, the medial epicondyle was palpated and the transducer was placed in the longitudinal direction. ...
... Both nonoperative and operative treatments of proximal humerus fractures (PHF) and humeral shaft fractures can result in torsional side differences. Several anatomical, radiological, and sonographic measurement methods are known to determine torsional malalignment [1][2][3][4][5]. While the determination of humeral torsion with the aid of conventional X-ray diagnostics or computed tomography would entail additional radiation exposure for the patient, and while magnetic resonance imaging might be associated with higher costs and is not suitable in cases of surgically treated fractures due to metal-induced artifacts, the sonographic measurement of humeral torsion represents a readily available and quickly performable measurement method without radiation exposure. ...