Josef Kramer - Academia.edu (original) (raw)
Papers by Josef Kramer
Journal of Computer Assisted Tomography, 1992
American Journal of Roentgenology, 1999
SUBJECTS AND METHODS. MR arthrography of the hip joint was pertbrmed in 40 patients and six cadav... more SUBJECTS AND METHODS. MR arthrography of the hip joint was pertbrmed in 40 patients and six cadavers. All patients underwent subsequent arthrotomy of the hip. MR arthrography consisted of a Il-weighted three-dimensional gradient-echo sequence in both the coronal oblique and sagittal oblique planes after intraarticular injection of a 2 mmol/l solution of gadopentetate dimeglumine. The normal and pathologic appearance of the capsular-labral complex was assessed, and the labra were evaluated on the basis of morphology, signal intensity, presence of a tear. and attachment to the acetabulum. MR arthrography findings were correlated with the surgical results in all patients and with the anatomic sections of the cadaveric hipjoint specimens. the accuracy, 88%. CONCLUSION. MR arthrography with TI-weighted three-dimensional gradient-echo sequences allows excellent assessment of the normal and pathologic acetabular capsular-labral complex.
Radiologie up2date
ZusammenfassungWegen ihres ausgezeichneten Weichteilkontrasts ist die MRT die Methode der Wahl, u... more ZusammenfassungWegen ihres ausgezeichneten Weichteilkontrasts ist die MRT die Methode der Wahl, um Gelenke und die sie umgebenden Strukturen zu beurteilen. Eine gute Diagnostik setzt dabei mindestens voraus, Anatomie, Pathologie, pathophysiologische Mechanismen und häufige Verletzungsmuster zu kennen. Aber auch die in diesem Beitrag vorgestellten weniger augenscheinlichen Diagnosen sind essenzieller Bestandteil der Diagnostik.
International Journal of Legal Medicine
In the past, numerous studies have documented the possibility of intraindividual differing appear... more In the past, numerous studies have documented the possibility of intraindividual differing appearances of the paired age-marker "medial clavicular ossification" in borderline adults. However, the extent of the divergences is rarely mentioned. Against that the article describes this phenomenon from a large sample of 2595 male persons by means of thin-slice CT imaging of the sternoclavicular regions. For determining the ossification stage of the medial clavicles, the two accepted classifications by Schmeling et al. (five main stages) and Kellinghaus et al. (six substages) were applied and buildings deviating from that labelled as atypical "norm variants". The longstanding observation could be confirmed that intraindividual stage discrepancies of this age indicator are generally moderate and do not exceed one main stage or two substages of the respective classifications. It is concluded that stage determination should be scrutinized, if a dissimilarity seems to show larger differences.
Data Revues 00305898 V35i3 S0030589804000380, Aug 24, 2011
The Radiologic Clinics of North America, Jan 9, 2002
MR arthrography by virtue of its ability accurately to demonstrate intra-articular structures and... more MR arthrography by virtue of its ability accurately to demonstrate intra-articular structures and abnormalities of these structures has become an important tool for the evaluation of a variety of articular disorders. Although not necessary in all patients, MR arthrography may facilitate the evaluation of patients with suspected intra-articular pathology in whom conventional MRI is not sufficient for an adequate therapy planning. MR arthrography combines the advantages of arthrography, like joint distention and delineation of intra-articular structures, with the superior spatial resolution of MRI. This technique improves diagnostic confidence, particularly in the assessment of subtle lesions and of complex anatomic structures. MR arthrography is of high value in the evaluation of osteochondral defects, loose bodies, previously operated menisci, and acetabular labral lesions.
Radiology Intelligent Assistant, 2000
![Research paper thumbnail of [Imaging examinations of the patellofemoral joint]](https://attachments.academia-assets.com/74293987/thumbnails/1.jpg)
](Der Orthopäde, 2008
Lesions in the patellofemoral region can be caused by trauma, chronic overloading, and especially... more Lesions in the patellofemoral region can be caused by trauma, chronic overloading, and especially regarding cartilage alterations by normal aging or pathologic processes. Very commonly these lesions lead to early arthrosis. An accurate clinical evaluation in all these patients is recommended. The combination of clinical information and radiological examinations should end up with an exact diagnosis.As part of the radiological evaluation of complaints of the patellofemoral region MR imaging is of special value since this method allows direct visualization of all intra- and extra-articular structures and their alterations, ultimately aiding in planning sufficient therapy. Moreover, is it possible to exclude pathology by MR imaging, which helps to prevent useless treatment and surgical procedures.
![Research paper thumbnail of [MRI/CT arthrography: no superfluous examination]](https://attachments.academia-assets.com/74293982/thumbnails/1.jpg)
](
AJR. American journal of roentgenology, 2004
The purpose of this study was to describe a largely observer-independent computer-assisted method... more The purpose of this study was to describe a largely observer-independent computer-assisted method for accurate quantitative analysis of bone marrow edema. Ten patients with bone marrow edema of the knee were included in the study. Coronal STIR images of the affected knees were obtained using a 1.0-T MR scanner. Size and signal intensity of the bone marrow edema were assessed on the basis of gray-scale value analysis and calculation of a threshold value for differentiating normal and edematous bone marrow. All measurements were carried out three times for statistical analysis. The intraobserver coefficient of variation was 0.89% for the volume and 0.94% for the signal intensity of the bone marrow edema, showing the small impact of manual interference on results produced with this method. A computer-assisted method for quantification of bone marrow edema has been described. Intraobserver variation was very low, indicating excellent reproducibility of results. Although the method is to...
Medical Radiology, 2010
The most common injuries that occur during the course of winter sports are mainly due to downhill... more The most common injuries that occur during the course of winter sports are mainly due to downhill skiing and snowboarding. In recent years it has been observed an increase in the number of accidents due also to a greater number of practitioners, especially snowboarders. Although head and spine injuries are often fatal, they are less common; in fact, most accidents
Radiology Intelligent Assistant, 2000
International Journal of Legal Medicine, 2014
In order to establish identity of asylum seekers, part of which is age clarification, administrat... more In order to establish identity of asylum seekers, part of which is age clarification, administrative authorities are obliged to investigate the credibility of allegations based on the usual means of evidence to determine the applicable legal background. In case of serious doubts concerning age minority declaration, medical expert opinion builds the key proof bound by a complex framework consisting of EU regulations, domestic legal backgrounds and the scientific 'state of the art,' the latter being largely influenced by the pursuit of the German 'Study Group on Forensic Age Diagnostics.' Our application example demonstrates the exceptional value of its guidelines serving evidence-based understanding of the age issue in borderline adults within the asylum context. The results deriving from a substantial number of cases disclose an unequivocal inclination of age-disputed male refugees towards concluding somatic development despite a tendency of low lying age reports.
Medical Radiology, 2006
MR arthrography has become an important tool for the evaluation of a variety of articular disorde... more MR arthrography has become an important tool for the evaluation of a variety of articular disorders providing new insights into the lesions underlying mechanical hip pain. Although not necessary in all patients, MR arthrography may facilitate the evaluation of patients with suspected intra-articular pathology in whom conventional MR imaging is not sufficient for an adequate therapy planning. This technique combines arthrographic advantages, like joint distention and delineation of intra-articular structures, with the high quality of MR imaging. Diagnostic confidence can frequently be improved by MR arthrography, particularly in the assessment of subtle lesions and complex anatomic structures. MR arthrography has been proven especially useful in patients with suspected acetabular labral lesions, osteochondral defects or loose bodies.
Seminars in Musculoskeletal Radiology, 2014
The spine, in athletes is a relatively frequent origin of problems. Chronic spine problems are mu... more The spine, in athletes is a relatively frequent origin of problems. Chronic spine problems are much more common compared to acute injuries. Chronic injuries to the spine most often occur in low-contact sports like gymnastics and are most commonly the result of overuse. Acute injuries are more common in high-speed and full contact sports and are traumatic in origin. Injuries to the spinal cord can be devastating but are fortunately very uncommon. Although imaging of the spine appears to be straightforward, any radiologist will acknowledge that the optimal imaging strategy is often unclear due to several reasons. For the cervical spine much has improved since the NEXUS and CCR studies appeared in which clear rules were defined when to image the C-spine in acute trauma situations. For the thoracic and lumbar spines such rules are not defined. Although conventional imaging has long been the primary imaging modality of choice there is ample evidence that this should be abandoned in favor of multidetector CT for the C-spine. This is reflected in the ACR criteria in which conventional imaging of tile C-spine in trauma is rated as the least appropriate imaging method. However, this is not true in children and adolescents although a strict age criterion is not defined. It is also not true for injuries to the thoracic and lumbar spine in which conventional imaging still plays a large role as primary imaging modality followed by evaluation by CT in trauma situations. The role for MRI in acute situations is increasing especially with the increasing use of the TLICS system to classify injuries of the thoracic and lumbar spine in which the evaluation of the integrity of the posterior ligamentous structures is included. For the evaluation of chronic complaints, the roles of CT and MRI are basically reversed in which MRI will become the prime imaging modality of choice after conventional imaging after which CT can be reserved for a selected patient group. The merit of the different imaging modalities will be discussed together with a spectrum of acute and chronic injuries often encountered in the spine in athletes.
Seminars in musculoskeletal radiology, 2009
Seminars in musculoskeletal radiology, 2009
Sports injuries of the knee involving the extensor mechanism are common. Specific conditions addi... more Sports injuries of the knee involving the extensor mechanism are common. Specific conditions additionally affect the extensor mechanism in adolescents during growth and maturation, and in older patients as a result of degeneration. Prior to the advent of magnetic resonance (MR) imaging, the specific anatomical-pathological cause of anterior knee pain was often uncertain, with diagnosis limited to clinical examination and conventional radiographic assessment. MR imaging allows for the accurate and specific diagnosis of pathology of the extensor mechanism, impacting on decision making and clinical treatment of such conditions. In this article the anatomy, normal MR appearance, and common pathological conditions of the extensor mechanism of the knee are described.
Journal of Computer Assisted Tomography, 1992
American Journal of Roentgenology, 1999
SUBJECTS AND METHODS. MR arthrography of the hip joint was pertbrmed in 40 patients and six cadav... more SUBJECTS AND METHODS. MR arthrography of the hip joint was pertbrmed in 40 patients and six cadavers. All patients underwent subsequent arthrotomy of the hip. MR arthrography consisted of a Il-weighted three-dimensional gradient-echo sequence in both the coronal oblique and sagittal oblique planes after intraarticular injection of a 2 mmol/l solution of gadopentetate dimeglumine. The normal and pathologic appearance of the capsular-labral complex was assessed, and the labra were evaluated on the basis of morphology, signal intensity, presence of a tear. and attachment to the acetabulum. MR arthrography findings were correlated with the surgical results in all patients and with the anatomic sections of the cadaveric hipjoint specimens. the accuracy, 88%. CONCLUSION. MR arthrography with TI-weighted three-dimensional gradient-echo sequences allows excellent assessment of the normal and pathologic acetabular capsular-labral complex.
Radiologie up2date
ZusammenfassungWegen ihres ausgezeichneten Weichteilkontrasts ist die MRT die Methode der Wahl, u... more ZusammenfassungWegen ihres ausgezeichneten Weichteilkontrasts ist die MRT die Methode der Wahl, um Gelenke und die sie umgebenden Strukturen zu beurteilen. Eine gute Diagnostik setzt dabei mindestens voraus, Anatomie, Pathologie, pathophysiologische Mechanismen und häufige Verletzungsmuster zu kennen. Aber auch die in diesem Beitrag vorgestellten weniger augenscheinlichen Diagnosen sind essenzieller Bestandteil der Diagnostik.
International Journal of Legal Medicine
In the past, numerous studies have documented the possibility of intraindividual differing appear... more In the past, numerous studies have documented the possibility of intraindividual differing appearances of the paired age-marker "medial clavicular ossification" in borderline adults. However, the extent of the divergences is rarely mentioned. Against that the article describes this phenomenon from a large sample of 2595 male persons by means of thin-slice CT imaging of the sternoclavicular regions. For determining the ossification stage of the medial clavicles, the two accepted classifications by Schmeling et al. (five main stages) and Kellinghaus et al. (six substages) were applied and buildings deviating from that labelled as atypical "norm variants". The longstanding observation could be confirmed that intraindividual stage discrepancies of this age indicator are generally moderate and do not exceed one main stage or two substages of the respective classifications. It is concluded that stage determination should be scrutinized, if a dissimilarity seems to show larger differences.
Data Revues 00305898 V35i3 S0030589804000380, Aug 24, 2011
The Radiologic Clinics of North America, Jan 9, 2002
MR arthrography by virtue of its ability accurately to demonstrate intra-articular structures and... more MR arthrography by virtue of its ability accurately to demonstrate intra-articular structures and abnormalities of these structures has become an important tool for the evaluation of a variety of articular disorders. Although not necessary in all patients, MR arthrography may facilitate the evaluation of patients with suspected intra-articular pathology in whom conventional MRI is not sufficient for an adequate therapy planning. MR arthrography combines the advantages of arthrography, like joint distention and delineation of intra-articular structures, with the superior spatial resolution of MRI. This technique improves diagnostic confidence, particularly in the assessment of subtle lesions and of complex anatomic structures. MR arthrography is of high value in the evaluation of osteochondral defects, loose bodies, previously operated menisci, and acetabular labral lesions.
Radiology Intelligent Assistant, 2000
Der Orthopäde, 2008
Lesions in the patellofemoral region can be caused by trauma, chronic overloading, and especially... more Lesions in the patellofemoral region can be caused by trauma, chronic overloading, and especially regarding cartilage alterations by normal aging or pathologic processes. Very commonly these lesions lead to early arthrosis. An accurate clinical evaluation in all these patients is recommended. The combination of clinical information and radiological examinations should end up with an exact diagnosis.As part of the radiological evaluation of complaints of the patellofemoral region MR imaging is of special value since this method allows direct visualization of all intra- and extra-articular structures and their alterations, ultimately aiding in planning sufficient therapy. Moreover, is it possible to exclude pathology by MR imaging, which helps to prevent useless treatment and surgical procedures.
AJR. American journal of roentgenology, 2004
The purpose of this study was to describe a largely observer-independent computer-assisted method... more The purpose of this study was to describe a largely observer-independent computer-assisted method for accurate quantitative analysis of bone marrow edema. Ten patients with bone marrow edema of the knee were included in the study. Coronal STIR images of the affected knees were obtained using a 1.0-T MR scanner. Size and signal intensity of the bone marrow edema were assessed on the basis of gray-scale value analysis and calculation of a threshold value for differentiating normal and edematous bone marrow. All measurements were carried out three times for statistical analysis. The intraobserver coefficient of variation was 0.89% for the volume and 0.94% for the signal intensity of the bone marrow edema, showing the small impact of manual interference on results produced with this method. A computer-assisted method for quantification of bone marrow edema has been described. Intraobserver variation was very low, indicating excellent reproducibility of results. Although the method is to...
Medical Radiology, 2010
The most common injuries that occur during the course of winter sports are mainly due to downhill... more The most common injuries that occur during the course of winter sports are mainly due to downhill skiing and snowboarding. In recent years it has been observed an increase in the number of accidents due also to a greater number of practitioners, especially snowboarders. Although head and spine injuries are often fatal, they are less common; in fact, most accidents
Radiology Intelligent Assistant, 2000
International Journal of Legal Medicine, 2014
In order to establish identity of asylum seekers, part of which is age clarification, administrat... more In order to establish identity of asylum seekers, part of which is age clarification, administrative authorities are obliged to investigate the credibility of allegations based on the usual means of evidence to determine the applicable legal background. In case of serious doubts concerning age minority declaration, medical expert opinion builds the key proof bound by a complex framework consisting of EU regulations, domestic legal backgrounds and the scientific 'state of the art,' the latter being largely influenced by the pursuit of the German 'Study Group on Forensic Age Diagnostics.' Our application example demonstrates the exceptional value of its guidelines serving evidence-based understanding of the age issue in borderline adults within the asylum context. The results deriving from a substantial number of cases disclose an unequivocal inclination of age-disputed male refugees towards concluding somatic development despite a tendency of low lying age reports.
Medical Radiology, 2006
MR arthrography has become an important tool for the evaluation of a variety of articular disorde... more MR arthrography has become an important tool for the evaluation of a variety of articular disorders providing new insights into the lesions underlying mechanical hip pain. Although not necessary in all patients, MR arthrography may facilitate the evaluation of patients with suspected intra-articular pathology in whom conventional MR imaging is not sufficient for an adequate therapy planning. This technique combines arthrographic advantages, like joint distention and delineation of intra-articular structures, with the high quality of MR imaging. Diagnostic confidence can frequently be improved by MR arthrography, particularly in the assessment of subtle lesions and complex anatomic structures. MR arthrography has been proven especially useful in patients with suspected acetabular labral lesions, osteochondral defects or loose bodies.
Seminars in Musculoskeletal Radiology, 2014
The spine, in athletes is a relatively frequent origin of problems. Chronic spine problems are mu... more The spine, in athletes is a relatively frequent origin of problems. Chronic spine problems are much more common compared to acute injuries. Chronic injuries to the spine most often occur in low-contact sports like gymnastics and are most commonly the result of overuse. Acute injuries are more common in high-speed and full contact sports and are traumatic in origin. Injuries to the spinal cord can be devastating but are fortunately very uncommon. Although imaging of the spine appears to be straightforward, any radiologist will acknowledge that the optimal imaging strategy is often unclear due to several reasons. For the cervical spine much has improved since the NEXUS and CCR studies appeared in which clear rules were defined when to image the C-spine in acute trauma situations. For the thoracic and lumbar spines such rules are not defined. Although conventional imaging has long been the primary imaging modality of choice there is ample evidence that this should be abandoned in favor of multidetector CT for the C-spine. This is reflected in the ACR criteria in which conventional imaging of tile C-spine in trauma is rated as the least appropriate imaging method. However, this is not true in children and adolescents although a strict age criterion is not defined. It is also not true for injuries to the thoracic and lumbar spine in which conventional imaging still plays a large role as primary imaging modality followed by evaluation by CT in trauma situations. The role for MRI in acute situations is increasing especially with the increasing use of the TLICS system to classify injuries of the thoracic and lumbar spine in which the evaluation of the integrity of the posterior ligamentous structures is included. For the evaluation of chronic complaints, the roles of CT and MRI are basically reversed in which MRI will become the prime imaging modality of choice after conventional imaging after which CT can be reserved for a selected patient group. The merit of the different imaging modalities will be discussed together with a spectrum of acute and chronic injuries often encountered in the spine in athletes.
Seminars in musculoskeletal radiology, 2009
Seminars in musculoskeletal radiology, 2009
Sports injuries of the knee involving the extensor mechanism are common. Specific conditions addi... more Sports injuries of the knee involving the extensor mechanism are common. Specific conditions additionally affect the extensor mechanism in adolescents during growth and maturation, and in older patients as a result of degeneration. Prior to the advent of magnetic resonance (MR) imaging, the specific anatomical-pathological cause of anterior knee pain was often uncertain, with diagnosis limited to clinical examination and conventional radiographic assessment. MR imaging allows for the accurate and specific diagnosis of pathology of the extensor mechanism, impacting on decision making and clinical treatment of such conditions. In this article the anatomy, normal MR appearance, and common pathological conditions of the extensor mechanism of the knee are described.