Brachial Plexus Birth Injury: US Screening for Glenohumeral Joint Instability
To prospectively evaluate the use and optimal timing of ultrasonographic (US) screening for posterior shoulder subluxation in infantswith brachial plexus birth injury (BPBI). Approval of the ethics committee and informed consent of guardians was obtained. This population-based prospective study incl...
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| Veröffentlicht in: | Radiology 2010, Vol.254 (1), p.253-260 |
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| creator | PÖYHIÄ, Tiina H LAMMINEN, Antti E PELTONEN, Jari I KIRJAVAINEN, Mikko O WILLAMO, Patrick J NIETOSVAARA, Yrjänä |
| description | To prospectively evaluate the use and optimal timing of ultrasonographic (US) screening for posterior shoulder subluxation in infantswith brachial plexus birth injury (BPBI).
Approval of the ethics committee and informed consent of guardians was obtained. This population-based prospective study included neonates with BPBI who were born in Helsinki from January 1, 2003 through December 31, 2006, and in whom BPBI was verified with sequential clinical examinations. US was performed at 1, 3, 6, and 12 months. Size (width and height) of the humeral head and its ossification center and congruency of the shoulder (alpha angle) were measured. Frequency of BPBI and permanent changes were evaluated. This study also included patients who were referred from the tertiary catchment area. For statistical analysis, 95% confidence intervals were calculated, and analysis of variance was performed.
BPBI was seen in 132 of 41980 neonates (3.1 per 1000). In 27 cases (0.64 per 1000), BPBI did not heal during the 1st year of life and was considered permanent. The humeral head and its ossification center were smaller on the affected side in permanent BPBI. Nine patients with permanent palsy had posterior subluxation of the humeral head depicted with US (alpha angle, >30 degrees ). In five patients, posterior subluxation [corrected] was detected at 3 months. Nineteen of 21 patients with BPBI from the tertiary catchment area had permanent palsy. Ten of 19 patients developed posterior subluxation of the shoulder, which was verified with US. Altogether, three of these cases were not detected by surgeons. Posterior subluxation of the humeral head developed during the 1st year of life in one-third of patients with permanent BPBI. In more than one-half (55% [five of nine]) of the patients, posterior subluxation [corrected] was detected with US at 3 months, and in 89% (eight of nine), it was detected at 6 months.
US is a fast and useful tool for diagnosis of posterior subluxation of the humeral head, and examination of the glenohumeral joint should be performed at 3 and 6 months of age in infants with BPBI if symptoms persist. |
| doi_str_mv | 10.1148/radiol.09090570 |
| format | Article |
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Approval of the ethics committee and informed consent of guardians was obtained. This population-based prospective study included neonates with BPBI who were born in Helsinki from January 1, 2003 through December 31, 2006, and in whom BPBI was verified with sequential clinical examinations. US was performed at 1, 3, 6, and 12 months. Size (width and height) of the humeral head and its ossification center and congruency of the shoulder (alpha angle) were measured. Frequency of BPBI and permanent changes were evaluated. This study also included patients who were referred from the tertiary catchment area. For statistical analysis, 95% confidence intervals were calculated, and analysis of variance was performed.
BPBI was seen in 132 of 41980 neonates (3.1 per 1000). In 27 cases (0.64 per 1000), BPBI did not heal during the 1st year of life and was considered permanent. The humeral head and its ossification center were smaller on the affected side in permanent BPBI. Nine patients with permanent palsy had posterior subluxation of the humeral head depicted with US (alpha angle, >30 degrees ). In five patients, posterior subluxation [corrected] was detected at 3 months. Nineteen of 21 patients with BPBI from the tertiary catchment area had permanent palsy. Ten of 19 patients developed posterior subluxation of the shoulder, which was verified with US. Altogether, three of these cases were not detected by surgeons. Posterior subluxation of the humeral head developed during the 1st year of life in one-third of patients with permanent BPBI. In more than one-half (55% [five of nine]) of the patients, posterior subluxation [corrected] was detected with US at 3 months, and in 89% (eight of nine), it was detected at 6 months.
US is a fast and useful tool for diagnosis of posterior subluxation of the humeral head, and examination of the glenohumeral joint should be performed at 3 and 6 months of age in infants with BPBI if symptoms persist.</description><identifier>ISSN: 0033-8419</identifier><identifier>EISSN: 1527-1315</identifier><identifier>DOI: 10.1148/radiol.09090570</identifier><identifier>PMID: 20032156</identifier><identifier>CODEN: RADLAX</identifier><language>eng</language><publisher>Oak Brook, IL: Radiological Society of North America</publisher><subject>Analysis of Variance ; Biological and medical sciences ; Brachial Plexus Neuropathies - complications ; Female ; Humans ; Infant ; Infant, Newborn ; Injuries of the limb. Injuries of the spine ; Injuries of the nervous system and the skull. Diseases due to physical agents ; Joint Instability - diagnostic imaging ; Joint Instability - physiopathology ; Male ; Medical sciences ; Prospective Studies ; Shoulder Dislocation - diagnostic imaging ; Shoulder Dislocation - physiopathology ; Shoulder Joint - diagnostic imaging ; Shoulder Joint - physiopathology ; Traumas. Diseases due to physical agents ; Ultrasonography</subject><ispartof>Radiology, 2010, Vol.254 (1), p.253-260</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c392t-7d5d94fb2ee1238c5a51ac58b86b3601f7d2f0caf6786673dd7e1d770a0560c43</citedby><cites>FETCH-LOGICAL-c392t-7d5d94fb2ee1238c5a51ac58b86b3601f7d2f0caf6786673dd7e1d770a0560c43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,4010,27902,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22379359$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20032156$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>PÖYHIÄ, Tiina H</creatorcontrib><creatorcontrib>LAMMINEN, Antti E</creatorcontrib><creatorcontrib>PELTONEN, Jari I</creatorcontrib><creatorcontrib>KIRJAVAINEN, Mikko O</creatorcontrib><creatorcontrib>WILLAMO, Patrick J</creatorcontrib><creatorcontrib>NIETOSVAARA, Yrjänä</creatorcontrib><title>Brachial Plexus Birth Injury: US Screening for Glenohumeral Joint Instability</title><title>Radiology</title><addtitle>Radiology</addtitle><description>To prospectively evaluate the use and optimal timing of ultrasonographic (US) screening for posterior shoulder subluxation in infantswith brachial plexus birth injury (BPBI).
Approval of the ethics committee and informed consent of guardians was obtained. This population-based prospective study included neonates with BPBI who were born in Helsinki from January 1, 2003 through December 31, 2006, and in whom BPBI was verified with sequential clinical examinations. US was performed at 1, 3, 6, and 12 months. Size (width and height) of the humeral head and its ossification center and congruency of the shoulder (alpha angle) were measured. Frequency of BPBI and permanent changes were evaluated. This study also included patients who were referred from the tertiary catchment area. For statistical analysis, 95% confidence intervals were calculated, and analysis of variance was performed.
BPBI was seen in 132 of 41980 neonates (3.1 per 1000). In 27 cases (0.64 per 1000), BPBI did not heal during the 1st year of life and was considered permanent. The humeral head and its ossification center were smaller on the affected side in permanent BPBI. Nine patients with permanent palsy had posterior subluxation of the humeral head depicted with US (alpha angle, >30 degrees ). In five patients, posterior subluxation [corrected] was detected at 3 months. Nineteen of 21 patients with BPBI from the tertiary catchment area had permanent palsy. Ten of 19 patients developed posterior subluxation of the shoulder, which was verified with US. Altogether, three of these cases were not detected by surgeons. Posterior subluxation of the humeral head developed during the 1st year of life in one-third of patients with permanent BPBI. In more than one-half (55% [five of nine]) of the patients, posterior subluxation [corrected] was detected with US at 3 months, and in 89% (eight of nine), it was detected at 6 months.
US is a fast and useful tool for diagnosis of posterior subluxation of the humeral head, and examination of the glenohumeral joint should be performed at 3 and 6 months of age in infants with BPBI if symptoms persist.</description><subject>Analysis of Variance</subject><subject>Biological and medical sciences</subject><subject>Brachial Plexus Neuropathies - complications</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Injuries of the limb. Injuries of the spine</subject><subject>Injuries of the nervous system and the skull. Diseases due to physical agents</subject><subject>Joint Instability - diagnostic imaging</subject><subject>Joint Instability - physiopathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Prospective Studies</subject><subject>Shoulder Dislocation - diagnostic imaging</subject><subject>Shoulder Dislocation - physiopathology</subject><subject>Shoulder Joint - diagnostic imaging</subject><subject>Shoulder Joint - physiopathology</subject><subject>Traumas. Diseases due to physical agents</subject><subject>Ultrasonography</subject><issn>0033-8419</issn><issn>1527-1315</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkM1PwjAYxhujEUTP3swuxtOgH-u6ehOiiMFogpyXrh9SUjZst0T-e2sAzXt4Du_veQ4_AK4RHCKUFSMvlG3cEPJ4lMET0EcUsxQRRE9BH0JC0iJDvAcuQlhDiDJasHPQw_GDEc374HXshVxZ4ZJ3p7-7kIytb1fJrF53fnefLBfJQnqta1t_JqbxydTpull1G-1j5aWxdRvZ0IrKOtvuLsGZES7oq0MOwPLp8WPynM7fprPJwzyVhOM2ZYoqnpkKa40wKSQVFAlJi6rIK5JDZJjCBkphclbkOSNKMY0UY1BAmkOZkQG42-9uffPV6dCWGxukdk7UuulCyQgpogjOIznak9I3IXhtyq23G-F3JYLlr8Jyr7A8KoyNm8N2V220-uOPziJwewBEkMIZL2ppwz-HCeOEcvIDGzx6GQ</recordid><startdate>2010</startdate><enddate>2010</enddate><creator>PÖYHIÄ, Tiina H</creator><creator>LAMMINEN, Antti E</creator><creator>PELTONEN, Jari I</creator><creator>KIRJAVAINEN, Mikko O</creator><creator>WILLAMO, Patrick J</creator><creator>NIETOSVAARA, Yrjänä</creator><general>Radiological Society of North America</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2010</creationdate><title>Brachial Plexus Birth Injury: US Screening for Glenohumeral Joint Instability</title><author>PÖYHIÄ, Tiina H ; LAMMINEN, Antti E ; PELTONEN, Jari I ; KIRJAVAINEN, Mikko O ; WILLAMO, Patrick J ; NIETOSVAARA, Yrjänä</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c392t-7d5d94fb2ee1238c5a51ac58b86b3601f7d2f0caf6786673dd7e1d770a0560c43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Analysis of Variance</topic><topic>Biological and medical sciences</topic><topic>Brachial Plexus Neuropathies - complications</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Injuries of the limb. Injuries of the spine</topic><topic>Injuries of the nervous system and the skull. Diseases due to physical agents</topic><topic>Joint Instability - diagnostic imaging</topic><topic>Joint Instability - physiopathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Prospective Studies</topic><topic>Shoulder Dislocation - diagnostic imaging</topic><topic>Shoulder Dislocation - physiopathology</topic><topic>Shoulder Joint - diagnostic imaging</topic><topic>Shoulder Joint - physiopathology</topic><topic>Traumas. Diseases due to physical agents</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>PÖYHIÄ, Tiina H</creatorcontrib><creatorcontrib>LAMMINEN, Antti E</creatorcontrib><creatorcontrib>PELTONEN, Jari I</creatorcontrib><creatorcontrib>KIRJAVAINEN, Mikko O</creatorcontrib><creatorcontrib>WILLAMO, Patrick J</creatorcontrib><creatorcontrib>NIETOSVAARA, Yrjänä</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>PÖYHIÄ, Tiina H</au><au>LAMMINEN, Antti E</au><au>PELTONEN, Jari I</au><au>KIRJAVAINEN, Mikko O</au><au>WILLAMO, Patrick J</au><au>NIETOSVAARA, Yrjänä</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Brachial Plexus Birth Injury: US Screening for Glenohumeral Joint Instability</atitle><jtitle>Radiology</jtitle><addtitle>Radiology</addtitle><date>2010</date><risdate>2010</risdate><volume>254</volume><issue>1</issue><spage>253</spage><epage>260</epage><pages>253-260</pages><issn>0033-8419</issn><eissn>1527-1315</eissn><coden>RADLAX</coden><abstract>To prospectively evaluate the use and optimal timing of ultrasonographic (US) screening for posterior shoulder subluxation in infantswith brachial plexus birth injury (BPBI).
Approval of the ethics committee and informed consent of guardians was obtained. This population-based prospective study included neonates with BPBI who were born in Helsinki from January 1, 2003 through December 31, 2006, and in whom BPBI was verified with sequential clinical examinations. US was performed at 1, 3, 6, and 12 months. Size (width and height) of the humeral head and its ossification center and congruency of the shoulder (alpha angle) were measured. Frequency of BPBI and permanent changes were evaluated. This study also included patients who were referred from the tertiary catchment area. For statistical analysis, 95% confidence intervals were calculated, and analysis of variance was performed.
BPBI was seen in 132 of 41980 neonates (3.1 per 1000). In 27 cases (0.64 per 1000), BPBI did not heal during the 1st year of life and was considered permanent. The humeral head and its ossification center were smaller on the affected side in permanent BPBI. Nine patients with permanent palsy had posterior subluxation of the humeral head depicted with US (alpha angle, >30 degrees ). In five patients, posterior subluxation [corrected] was detected at 3 months. Nineteen of 21 patients with BPBI from the tertiary catchment area had permanent palsy. Ten of 19 patients developed posterior subluxation of the shoulder, which was verified with US. Altogether, three of these cases were not detected by surgeons. Posterior subluxation of the humeral head developed during the 1st year of life in one-third of patients with permanent BPBI. In more than one-half (55% [five of nine]) of the patients, posterior subluxation [corrected] was detected with US at 3 months, and in 89% (eight of nine), it was detected at 6 months.
US is a fast and useful tool for diagnosis of posterior subluxation of the humeral head, and examination of the glenohumeral joint should be performed at 3 and 6 months of age in infants with BPBI if symptoms persist.</abstract><cop>Oak Brook, IL</cop><pub>Radiological Society of North America</pub><pmid>20032156</pmid><doi>10.1148/radiol.09090570</doi><tpages>8</tpages></addata></record> |
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| subjects | Analysis of Variance Biological and medical sciences Brachial Plexus Neuropathies - complications Female Humans Infant Infant, Newborn Injuries of the limb. Injuries of the spine Injuries of the nervous system and the skull. Diseases due to physical agents Joint Instability - diagnostic imaging Joint Instability - physiopathology Male Medical sciences Prospective Studies Shoulder Dislocation - diagnostic imaging Shoulder Dislocation - physiopathology Shoulder Joint - diagnostic imaging Shoulder Joint - physiopathology Traumas. Diseases due to physical agents Ultrasonography |
| title | Brachial Plexus Birth Injury: US Screening for Glenohumeral Joint Instability |
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