Examinando por Autor "Iruretagoiena Urbieta, Seber"

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    Case report: synovial chondromatosis in sport climbers fingers
    (Frontiers Media SA, 2025) Becker, Helmut; Iruretagoiena Urbieta, Seber; Schöffl, Volker
    Introduction: Sport Climbing is a rapidly developing sport with an increasing variety and number of injuries, especially now that it is an Olympic event. The objective of this study is to firstly report the presence of Finger Synovial Chondromatosis (FSC) found in the fingers of climbers. Synovial chondromatosis is a rare condition and particularly rare in the hands and fingers. Methods: We prospectively evaluated all climbers with finger injuries presenting in 2022 for the presence of FSC in the finger joints. 13 patients in this case series were included with complaints of finger pain for more than 6 weeks. The study was performed in our Sports Medical Centre in Bamberg, Germany. The diagnosis was made based on in person clinical assessment, ultrasound examination and additional radiological findings (e.g., x-ray, CT, MRI) as applicable. Results: We detected 13 male climbers with FSC with experience ranging from intermediate to elite level. 77% (10/13) of the patients did not complain of any symptoms of the FSC and presented with other diagnoses (e.g.pulley rupture, tenosynovitis) and the finding of FSC was just an additional finding. In 12 subjects FSC was found in the proximal interphalangeal (PIP) joint and one in the metacarpo-pahalangeal (MCP) joint and distributed as follows: right (R) side 69%, left (L) side 38%, considering 15% in both hands. The prevalence corresponded to the digits are as follows: D2 15%, D3 77%, and D4 15%. Discussion: With the rapid development in sport climbing there has been a rise in the intensity, volume and variety of training, which may be the key factors contributing to the spectrum of injuries associated with climbing. Hand and finger climbing related injuries are well documented, however the incidental discovery of this rare condition warrants its inclusion as another differential diagnosis in the spectrum of climbing related pathologies. At the moment, not enough is understood about FSC and its long-term consequences therefore further analysis is warranted for future studies
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    Reliability and validity of ultrasound in identifying anatomical landmarks for diagnosing A2 pulley ruptures: a cadaveric study
    (Multidisciplinary Digital Publishing Institute (MDPI), 2024-10) Iruretagoiena Urbieta, Seber; Schöffl, Volker; Balius Matas, Ramón; Blasi, Marc; Dávila, Fernando; Sala Blanch, Xavier; Dorronsoro, Asier; Fuente, Javier de la
    Background/Objectives: Rock climbing is becoming more popular, leading to an increased focus on diagnosing and treating related injuries. Finger pulley and flexor tendon injuries are common among climbers, with the A2 pulley being the most frequently affected. High-resolution ultrasound (US) is the preferred method for detecting pulley injuries. This study aimed to determine the reliability and validity of US in identifying anatomical landmarks for diagnosing A2 pulley ruptures. Methods: This study was cross-sectional, involving 36 fingers from 4 cadaver arms. A Canon Aplio i800 US machine was used to measure two anatomical landmarks: the midpoint of the proximal phalanx and the distal edge of the A2 pulley. For the first anatomical landmark, the length of the proximal phalanx (PP distance), and for the second landmark, the distance between the distal edges of the proximal phalanx and the A2 pulley (“A” distance), were measured. Measurements were performed by two sonographers and compared to a digital caliper measurement taken post-cadaver dissection. Observers were blinded during measurements to ensure unbiased results. Results: Overall PP distance measured by US (O1: 37.5 ± 5.3 mm, O2: 37.8 ± 5.4 mm) tended to be shorter than caliper measurements (O3: 39.5 ± 5.5 mm). The differences between sonographers were minimal, but larger when compared to caliper measurements. High reliability for PP distance measurement was observed, especially between sonographers, with an ICC average of 0.99 (0.98, 1.00). However, reliability was lower for the “A” distance, with significant differences between US and caliper measurements. Regarding validity, US measurements were valid when compared to caliper measurements for PP distance, but not as reliable for the “A” due to wider confidence intervals. While US can substitute caliper measurements for PP distance (LR, Y:O2, X:O3, −0.70 (−3.28–1.38), 0.98 (0.93 ± 1.04)), its validity for “A” distance is lower (LR, Y:O2, X:O3, −2.37 (−13.53–4.83), 1.02 (0.62–1.75)). Conclusions: US is a reliable and valid tool in identifying anatomical landmarks for diagnosing A2 pulley ruptures, particularly for detecting the midpoint of the proximal phalanx. This is important to differentiate between complete and partial A2 pulley tears. However, the measurement of the “A” distance requires further refinement. These findings support efforts to standardize US examination protocols and promote consensus in diagnostic methodology, though further research is needed to address the remaining challenges.