Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Imagerie du Tendon d'Achille

20,047 views

Published on

Published in: Health & Medicine
  • Was a little hesitant about using ⇒⇒⇒WRITE-MY-PAPER.net ⇐⇐⇐ at first, but am very happy that I did. The writer was able to write my paper by the deadline and it was very well written. So guys don’t hesitate to use it.
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • If you’re struggling with your assignments like me, check out ⇒ www.HelpWriting.net ⇐.
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Ich kann eine Website empfehlen. Er hat mir wirklich geholfen. ⇒ www.WritersHilfe.com ⇐ Zufrieden und beeindruckt.
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (Unlimited) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/qURD } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/qURD } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/qURD } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/qURD } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/qURD } ......................................................................................................................... Download doc Ebook here { https://soo.gd/qURD } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • DOWNLOAD THAT BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { http://shorturl.at/mzUV6 } ......................................................................................................................... Download Full EPUB Ebook here { http://shorturl.at/mzUV6 } ......................................................................................................................... Download Full doc Ebook here { http://shorturl.at/mzUV6 } ......................................................................................................................... Download PDF EBOOK here { http://shorturl.at/mzUV6 } ......................................................................................................................... Download EPUB Ebook here { http://shorturl.at/mzUV6 } ......................................................................................................................... Download doc Ebook here { http://shorturl.at/mzUV6 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book that can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer that is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story That Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money That the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths that Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here

Imagerie du Tendon d'Achille

  1. 1. LOCALISATION ANATOMIQUE DES PATHOLOGIES Aux extrémités*Jonction myo-tendineuse (rupture traumatique, tennis leg)*Partie basse corps tendon mal vascularisée (tendinite corporéale dégénérative/nodules, rupture partielle/fente ou totale)*Insertion calcanéenne/enthèse (frottement, bursite pré/rétro achilléenne, conflit osseux, Haglund)*Péritendinite (pas de ténosynovite)
  2. 2. LES MUSCLES DU MOLLET : soléaire, jumeaux, plantaire grêle
  3. 3. Le système suro-achilléo-calcanéo-plantaire
  4. 4. ANATOMIE RADIOLOGIQUE ACHILLE
  5. 5. RADIOGRAPHIE STANDARD (épines mécaniques, Sever)
  6. 6. RADIOGRAPHIE STANDARD (Malformation de HAGLUND)
  7. 7. TECHNIQUE ECHOGRAPHIQUE*Pied en flexion dorsale *Doppler couleur pour(tendon tendu) bursites et Δ≠ enthésopathie mécanique/inflammatoire*Sonde perpendiculaire *Regarder autour :(artefact anisotropie) Soléaire accessoire Tennis leg, désinsertion JI*Comparative +++ *Dynamique (dorsiflexion,*Du soléaire au calcanéus ruptures)*Coupes Axiales et sagittales
  8. 8. ECHOGRAPHIE ACHILLE NORMALE (structure fibrillaire)corps tendon et insertion calcaneus jonction myo tendineuse a tibia soléaire c h i l graisse l Kager e
  9. 9. ECHOGRAPHIE : TENDINOPATHIE FUSIFORME (CORPORÉALE)
  10. 10. Tendinopathie (fusiforme, nodules, fente, bursite) Normal Fusiforme Bursite pré-achilléenne FenteNodules Bursite pré-achilléenne
  11. 11. CONFLIT HAGLUND : TENDINOBURSITE ÉROSIVE
  12. 12. ECHOGRAPHIE ACHILLE RUPTURE (CAVITÉ LIQUIDIENNE HYPOÉCHOGÈNE) Rupture totale Rupture partielle
  13. 13. ECHOGRAPHIE RUPTURE (HÉMATOME HYPERÉCHOGÈNE)
  14. 14. SOLÉAIRE ACCESSOIRE (TUMÉFACTION POSTÉRIEURE)
  15. 15. TECHNIQUE IRM Achille*Antenne cheminée *Sagittal T1, T2*, rhô fatdédiée cheville sat*Coupes Axiales et *Axial Rhô fat satsagittales (coronal ?) *Sagittal T1 fat sat gadolinium (SPGR)
  16. 16. Tendinopathie corporéale (nodules, cavitation,PRISE DE CONTRASTE)
  17. 17. Tendinobursite : MALFORMATION DE haglund
  18. 18. ENTHÉSOPATHIE CALCANÉENNE
  19. 19. RUPTURE TOTALE TENDON
  20. 20. TENDON ACHILLE OPÉRÉ (DOULEUR TALON, ŒDÈME, CALCIFICATION)
  21. 21. Δ≠ACHILLE Syndrome du Carrefour Postérieur *Flexion plantaire répétée*Effet de pince sur la « queue » du talus (fracture, sclérose, œdème) et cartilage *Lésions des parties molles postérieures (synoviale, LFH)
  22. 22. Fracture de stress du calcaneus (TALALGIES)
  23. 23. IRM et echographie de l’APS (TALALGIES)
  24. 24. IRM de l’APSMyo-aponévrosite/rupture/pathologie chronique
  25. 25. IRM de l’APS et des muscles plantaires (Pathologie aigue traumatique)
  26. 26. RADIOLOGIE INTERVENTIONNELLE PAS DE CORTICOIDES DANS TENDON ACHILLE INFILTRATION BURSITES ET ENTHÉSITES INFILTRATION CARREFOUR POSTÉRIEUR
  27. 27. INFILTRATION DIRECTE CARREFOUR POSTÉRIEUR Infiltration/scanner
  28. 28. Ténoscanner/téno-infiltration LFH
  29. 29. Traitement destendinopathies chroniques par INJECTION de PRP
  30. 30. Principes d’action du PRPIntervient aux 3 étapes de la réparation tissulaire : *phase inflammatoire : plaquettes s’agrègent et libèrent les facteurs de croissance (granules alpha) *phase proliférative : fibroblastes / Σ collagène cellules endothéliales / angiogénèse *épithélialisation puis remodelage
  31. 31. *But : Appor ter in situ dans les zones peuvasculariséesles « principes actifs » autologues sanguinspour accélérer la cicatrisation : tendons,muscles, os, car tilage*1 ère indication historique : traitement destendinopathies rebelles*Ce n’est pas du dopage (injection intramusculairede facteurs plaquettaires retirées de la liste des produitsdopants en janvier 2011)*Pas de risque de rupture tendineuse commeavec cor ticoides
  32. 32. Facteurs de croissance IGF-1 : prolifération et migration fibroblastes, production collagène HGF : prolifération cellules endothéliales, angiogénèse FGF : fibroblast growth factorBone Morphogenic Proteins (BMPs) : consolidation osseuse après fracture
  33. 33. 1/le prélèvementPlasma Riche en Plaquettes 5 fois + que sang complet
  34. 34. 2/le traitement/technique*Désinfection, champs, gants stériles, anesthésie locale (?)*Injection selon les cas de 3 ou 6 cc de PRP selon la taille de lacavitation (tendon, ménisque) ou du décollement (muscle,bourse…) ou la voie d’injection (intra et péri tendineux,articulation)*Repérage par échographie (voire scopie, scanner) :profondeur, cible, articulation, espace bursal…
  35. 35. *si gros épanchement (muscle, morel lavallée…) vidange etinjection de PRP, contrôle après vidange*pansement compressif si muscle (élasto)*repos 48 heures, pas d’anti inflammatoires (inhibition PRPpar ralentissement inflammation)*autres sessions selon résultats : contrôle échographique à 8 jourset seconde injection +/- 3ème à 8 jours (2 semaines en tout)
  36. 36. Traitement d’une fente intra tendineuse/Achille
  37. 37. CHOIX DE L’IMAGERIE ECHOGRAPHIE :  IRM :+++Simple, rapide, rentable +++PolyvalenteStructure tendon (nodules), « Mou et dur » dynamique, comparatif Voisinage rapide, bursite, mollet en Séquences multiples (fat sat) même temps, APS Contraste (gadolinium)Interventionnel+++ Plus précis pour rupture siCalcifications+++ bilan pré et post op- Os en profondeur Carrefour postérieur (spongieux) - Comparatif = 2 examens,Pas vue d’ensemble (conflits) calcifications, dynamiqueRupture partielle pas toujours facile, post op
  38. 38. http://www.radiologie-toulouse-garonne.com/

×