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See detailUne infiltration de plasma riche en plaquettes (PRP) pour traiter les tendinopathies rotuliennes supérieures chroniques
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; Bruyère, Olivier ULg et al

in Annals of Physical and Rehabilitation Medicine (2013, October), 56(Sup 1),

Objective: Jumper’s knee is a frequent chronic overuse syndrome of the upper part of the patellar tendon. Platelets contain lots of growth factors which could enhance the healing process of tendons ... [more ▼]

Objective: Jumper’s knee is a frequent chronic overuse syndrome of the upper part of the patellar tendon. Platelets contain lots of growth factors which could enhance the healing process of tendons. Infiltration of platelet-rich plasma (PRP) could be a new therapy for such chronic tendinopathies. Materiel and methods: Twenty patients with chronic upper patellar tendinopathy were enrolled. Assessments were made before infiltration of PRP, and 6 weeks and 3 months after the infiltration, using a 10-point Visual Analogic Scale, clinical examinations with a pressure algometer, algofunctional scores (IKDC and VISA-P), functional assessments (isokinetic and optojump evaluations) and imagery (ultrasounds and MRI). The PRP was obtained with an apheresis system (COM.TEC, Fresenius). Six millilitres of PRP were injected without local anaesthetic. One week after infiltration, patients started a standardised sub-maximal eccentric reeducation. Results: Pain during daily activities significantly decreased with time (especially after 6 weeks and continued to a lesser extend up to 3 months). During functional evaluation, it decreased as well, but without significant functional improvement. No improvements in the imagery measurements were observed. Younger patients seemed to be more susceptible to have an improvement of pain by the PRP infiltration. Discussion: This study demonstrates that a local infiltration of PRP associated with a submaximal eccentric protocol is efficient to improve symptoms of chronic jumper’s knee in patients non-responsive to classical conservative treatments. [less ▲]

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See detailPlatelet-rich plasma (PRP) to treat chronic upper patellar tendinopathies
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; Bruyère, Olivier ULg et al

in British Journal of Sports Medicine (2013, July), 47(10 (e3)), 15

Background: Upper patellar tendinopathies remain often chronic and rebel to a thorough conservative treatment. Moreover, the option of a surgical treatment could be disappointing. New treatments are being ... [more ▼]

Background: Upper patellar tendinopathies remain often chronic and rebel to a thorough conservative treatment. Moreover, the option of a surgical treatment could be disappointing. New treatments are being developed. Injection of PRP is one of these. Platelets contain lot of growth factors which would have the potentiality to enhance the healing process of tendons. Even if in vitro and animal experiments have demonstrated this stimulation of tendon healing process1, clinical series are subject to controversy2. Methods: Twenty patients with chronic upper patellar tendinopathy were enrolled. Assessments [VAS, clinical examination with an algometer, algofunctional scores (IKDC and VISA-P), functional assessments (isokinetic and Optojump) and imagery (ultrasounds and MRI)]were made before infiltration of PRP, and 6 weeks and 3 months after. The PRP was obtained by an apheresis system (COM.TEC, Fresenius). Six millilitres of PRP were injected without local anaesthetic. One week after infiltration, patients started a 6-week standardised sub-maximal eccentric reeducation. Results: We observed a very significant improvement of the algofunctional status as soon as 6 weeks after the infiltration of PRP, and continued to a lesser extent up to 3 months. During functional evaluation, pain decreased as well, but without significant improvement of performances. No significant improvements in the imagery were observed. Interestingly, patients who had a VAS equal or below 1 after 3 months post-infiltration were younger (24.7 vs 32.2 y.o.). Moreover, these younger patients had a significant increase of the IKDC score (p=0.003), a significant improvement of pain during isokinetic evaluations (p<0.05), and during Optojump assessments (p=0.01). Seventy-five percent of subjects were able to return to sport, even if only half of these patients recovered the same level than before the tendinopathy. Discussion / Conclusions: This study demonstrates that a local infiltration of PRP associated with a submaximal eccentric protocol is efficient to improve symptoms of chronic upper patellar tendinopathies, non-responsive to classical conservative treatments. However, up to now, there is no consensus on the method to prepare the PRP. Indeed, each technique could provide a very different PRP (variations in the platelet concentrations and of the amount of red and white cells). [less ▲]

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See detailPlatelet-rich plasma (PRP) to treat upper patellar tendinopathies
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; SIMONI, Paolo ULg et al

in Book of abstracts of 18th Annual Congress of the ECSS (2013, June)

Introduction: Tendinopathies, especially upper patellar tendinopathy also known as jumper’s knee, often remain rebel to conservative treatments. Several experimental studies have shown the healing ... [more ▼]

Introduction: Tendinopathies, especially upper patellar tendinopathy also known as jumper’s knee, often remain rebel to conservative treatments. Several experimental studies have shown the healing properties of platelet and their growth factors. These factors have the potentiality to improve healing of different tissues: bones, muscles, tendons... Researches have specifically demonstrated the platelets action as mediator and/or enhancer of tissue healing. On the other hand, such treatment has been totally removed of list of doping treatments. The aim of our study was to investigate the effect of 1 injection of PRP in patients suffering from chronic jumper’s knee. Methods: Patients performed imaging (US and MRI) and functional assessments, and a clinical examination using an algometer, before treatment and 6 weeks after PRP treatment. They were also invited to answer to questionnaire relative to pain and functional status. PRP was obtained from autologous blood using an apheresis system (COM.TEC, Fresenius). The injection of 6mL of PRP was realised without local anaesthesia into the proximal insertion of the patellar tendon. A 48h rest-time was recommended after infiltration. Afterwards, a submaximal eccentric reeducation was initiated 1 week after infiltration 3 times a week during 5 weeks. In case of pain, anti-inflammatory drugs were prohibited and patient were encouraged to take class I or II painbrakers. Our protocol was approved by Ethic Committee of University and University Hospital of Liège. Results: Eighteen patients with jumper’s knee were included in our study. Pre-injection tests revealed pain of the upper part of the patellar tendon just below the patella, associated with loss of function. Imaging exams confirmed diagnosis. Six weeks post-injection, the clinical status was improved for the majority of the patients, with a significant decrease of algo-functional scores. The pain reported during functional assessments was decreased (in particular for the eccentric actions), yet no significant improvement of physical performances was observed. We found no significant differences between imaging exams before and 6 weeks after PRP injection. Conclusion: One in situ injection of PRP clinically improved patients with jumper’s knee 6 weeks after treatment. Most patients reported a decrease of pain during day-life and through physical activities. However nor functional performances neither imaging were improved. A followup at 3 months is actually in process to evaluate more long term efficacy of PRP treatment. [less ▲]

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See detailFATAL ALVEOLAR ECHINOCOCCOSIS OF THE LUMBAR SPINE
KEUTGENS, Aurore ULg; SIMONI, Paolo ULg; DETREMBLEUR, Nancy ULg et al

in Journal of Clinical Microbiology (2013), 51(2), 688-91

For the last ten years, the southern part of Belgium has been recognized as a low-risk endemic area for alveolar echinococcosis. This infection, caused by Echinococcus multilocularis, usually induces a ... [more ▼]

For the last ten years, the southern part of Belgium has been recognized as a low-risk endemic area for alveolar echinococcosis. This infection, caused by Echinococcus multilocularis, usually induces a severe liver condition, and can sometimes spread to other organs. However, alveolar echinococcosis involving bones has been described only very rarely. Here, a fatal case of spondylodiscitis due to E. multilocularis contracted in southern Belgium is reported. [less ▲]

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See detailImaging osteoarthritis using (18F)FPRGD2 PET/CT : observation and potential application.
WITHOFS, Nadia ULg; ALVAREZ MIEZENTSEVA, Victoria ULg; SIMONI, Paolo ULg et al

in Journal of Nuclear Medicine (The) (2013), 54(SUPPL), 250

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See detailBone mass of the calvarium
SIMONI, Paolo ULg; STULKO, Jennifer ULg; BEN MUSTAPHA, Selma ULg et al

in Skeletal Radiology (2013), 42

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See detailUne infiltration de plasma riche en plaquettes (PRP) améliore les symptômes des tendinopathies patellaires supérieures
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; Rodriguez de la Cruz, Carlos ULg et al

in 5ème Congrès Commun SFMES & SFTS (2012, October)

Introduction : Le plasma riche en plaquettes (PRP) aurait des effets bénéfiques sur les symptômes des tendinopathies grâce à la libération locale de leurs nombreux facteurs de croissance. Le but de cette ... [more ▼]

Introduction : Le plasma riche en plaquettes (PRP) aurait des effets bénéfiques sur les symptômes des tendinopathies grâce à la libération locale de leurs nombreux facteurs de croissance. Le but de cette étude est d’évaluer les résultats d’une injection de PRP sur la symptomatologie des patients présentant une tendinopathie patellaire supérieure. Matériels et Méthodes : Vingt patients atteints d’une tendinopathie patellaire supérieure, rebelle aux traitements conservateurs classiques depuis au moins 3 mois, ont bénéficié d’une évaluation du statut algo-fonctionnel (EVA, algomètre de pression, VISA-P et IKDC) et des performances physqiues (isocinétique et optojump), ainsi que d’un bilan d’imagerie (échographie et IRM). Ces analyses ont été réalisées en pré-injection ainsi qu’aux 6èmeet 12èmesemaines post-injection. Le test isocinétique évaluait la force des quadriceps et des ischios-jambiers des deux membres suivant différentes modalités (C60°/sec, C240°/sec et E30°/sec). Le test Optojump évaluait la détente et la puissance musculaire par la mesure de la hauteur de saut via deux modalités («Counter Movement Jump » et « Drop Jump »). Le PRP est obtenue à l’aide d’une machine d’aphérèse (COM.TEC, Fresenius-Kabi), permettant d’obtenir une concentration plaquettaire reproductible d’un patient à l’autre, en l’absence quasi totale de globules rouges et blancs. L’infiltration intratendineuse de PRP (6mL) est réalisé à la pointe de la rotule in loco dolenti sans anesthésie locale. Résultats : Les résultats de notre expérimentation démontrent qu’une seule injection locale de PRP accompagnée d’un programme de rééducation excentrique améliore significativement la cicatrisation du tendon patellaire au niveau du score EVA, de l’algomètre de pression, des scores VISA-P et IKDC. Lors du test isocinétique, seuls l’augmentation du MFM des ischios jambiers en C240°/sec, de la différence bilatérale des ischios jambiers en C60°/sec ainsi que de l’EVA en E30°/sec était significative. Les résultats optojump en terme de détente et puissance musculaire ne montrent pas d’amélioration des performances. Néanmoins, l’EVA du « Counter Movement Jump » se voit significativement diminuée après l’infiltration. Enfin, les résultats de l’imagerie (échographie et IRM) ne démontrent pas de modification significative du tendon. Conclusions : L’injection locale de PRP dans le cadre de tendinopathies patellaires supérieure permet une diminution de la symptomatologie douloureuse à 6 semaines, se poursuivant à 12 semaines. La performance fonctionnelle et l’imageries, quant à elles, ne sont pas modifiées. [less ▲]

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See detailPlatelet-rich plasma (PRP) to treat patellar tendinopathy: preliminary results
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; SIMONI, Paolo ULg et al

in Regional Anesthesia & Pain Medicine (2012, September), 37(5 - Suppl 1), 216

Introduction: Patellar tendinopathy, often remain rebel to conservative treatments. Researches have specifically demonstrated the platelets action as mediator and/or enhancer of tissue healing. The aim of ... [more ▼]

Introduction: Patellar tendinopathy, often remain rebel to conservative treatments. Researches have specifically demonstrated the platelets action as mediator and/or enhancer of tissue healing. The aim of our study was to investigate the effect of 1 injection of PRP in patients suffering from chronic patellar tendinopathy. Methods: Patients performed imaging (US and MRI) and functional assessments, and a clinical examination using an algometer, before treatment and 6 weeks after PRP treatment. They were also invited to answer to questionnaire relative to pain and functional status. PRP was obtained from autologous blood using an apheresis system (COM.TEC, Fresenius). The injection of 6mL of PRP was realised without local anaesthesia into the proximal insertion of the patellar tendon. A 48h rest-time was recommended after infiltration. Afterwards, a submaximal eccentric reeducation was initiated 1 week after infiltration 3 times a week during 5 weeks. In case of pain, anti-inflammatory drugs were prohibited and patient were encouraged to take class I or II painkillers. Results: At this time, 10 patients with patellar tendinopathy were included in our study. Pre-injection tests revealed pain of the upper part of the patellar tendon just below the patella, associated with loss of function. Imaging exams confirmed diagnosis. Six weeks post-injection, the clinical status was improved in all patients, with a significant decrease of algo-functional scores. The pain reported during functional assessments was decreased (in particular for the eccentric actions), yet no significant improvement of physical performances was observed. We found no significant differences between imaging exams before and 6 weeks after PRP injection. Conclusion: One in situ injection of PRP clinically improved patients with patellar tendinopathy 6 weeks after treatment. All the 10 patients reported a decrease of pain during day-life and through physical activities. However nor functional performances neither imaging were improved. [less ▲]

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See detailEvaluation of DCE-MRI postprocessing techniques to assess metastatic bone marrow in patients with prostate cancer
Michoux, Nicolas; SIMONI, Paolo ULg; Tombal, Bertrand et al

in Clinical Imaging (2012)

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See detailPlatelet-rich plasma (PRP) to treat upper patellar tendinopathies
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; SIMONI, Paolo ULg et al

in Meeusen, R; Duchateau, J; Roelands, B (Eds.) et al Book of Abstracts of the 17th annual Congress of the ECSS (2012, July)

Introduction: Tendinopathies, especially upper patellar tendinopathy also known as jumper’s knee, often remain rebel to conservative treatments. Several experimental studies have shown the healing ... [more ▼]

Introduction: Tendinopathies, especially upper patellar tendinopathy also known as jumper’s knee, often remain rebel to conservative treatments. Several experimental studies have shown the healing properties of platelet and their growth factors. These factors have the potentiality to improve healing of different tissues: bones, muscles, tendons... Researches have specifically demonstrated the platelets action as mediator and/or enhancer of tissue healing. On the other hand, such treatment has been totally removed of list of doping treatments. The aim of our study was to investigate the effect of 1 injection of PRP in patients suffering from chronic jumper’s knee. Methods: Patients performed imaging (US and MRI) and functional assessments, and a clinical examination using an algometer, before treatment and 6 weeks after PRP treatment. They were also invited to answer to questionnaire relative to pain and functional status. PRP was obtained from autologous blood using an apheresis system (COM.TEC, Fresenius). The injection of 6mL of PRP was realised without local anaesthesia into the proximal insertion of the patellar tendon. A 48h rest-time was recommended after infiltration. Afterwards, a submaximal eccentric reeducation was initiated 1 week after infiltration 3 times a week during 5 weeks. In case of pain, anti-inflammatory drugs were prohibited and patient were encouraged to take class I or II painbrakers. Our protocol was approved by Ethic Committee of University and University Hospital of Liège. Results: Eighteen patients with jumper’s knee were included in our study. Pre-injection tests revealed pain of the upper part of the patellar tendon just below the patella, associated with loss of function. Imaging exams confirmed diagnosis. Six weeks post-injection, the clinical status was improved for the majority of the patients, with a significant decrease of algo-functional scores. The pain reported during functional assessments was decreased (in particular for the eccentric actions), yet no significant improvement of physical performances was observed. We found no significant differences between imaging exams before and 6 weeks after PRP injection. Conclusion: One in situ injection of PRP clinically improved patients with jumper’s knee 6 weeks after treatment. Most patients reported a decrease of pain during day-life and through physical activities. However nor functional performances neither imaging were improved. A followup at 3 months is actually in process to evaluate more long term efficacy of PRP treatment. [less ▲]

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See detailPlatelet-rich plasma to treat jumper’s knee: preliminary results
Kaux, Jean-François ULg; CROISIER, Jean-Louis ULg; SIMONI, Paolo ULg et al

in Biomedica 2012 (2012, April)

Introduction: Tendinopathies, especially jumper’s knee, often remain rebel to conservative treatments. Several experimental studies have shown the healing properties of platelet and their growth factors ... [more ▼]

Introduction: Tendinopathies, especially jumper’s knee, often remain rebel to conservative treatments. Several experimental studies have shown the healing properties of platelet and their growth factors. Researches have specifically demonstrated the platelets action as mediator and/or enhancer of tissue healing. The aim of our study was to investigate the effect of 1 injection of PRP in patients suffering from chronic jumper’s knee. Our protocol was approved by Ethic Committee of University and University Hospital of Liège. Methods: Patients performed imaging (US and MRI) and functional assessments, and a clinical examination using an algometer, before treatment and 6 weeks after PRP treatment. They were also invited to answer to questionnaire relative to pain and functional status. PRP was obtained from autologous blood using an apheresis system (COM.TEC, Fresenius). The injection of 6mL of PRP was realised without local anaesthesia into the proximal insertion of the patellar tendon. A 48h rest-time was recommended after infiltration. Afterwards, a submaximal eccentric reeducation was initiated 1 week after infiltration 3 times a week during 5 weeks. In case of pain, anti-inflammatory drugs were prohibited and patient were encouraged to take class I or II painbrakers. Results: At this time, 10 patients with jumper’s knee were included in our study. Pre-injection tests revealed pain of the upper part of the patellar tendon just below the patella, associated with loss of function. Imaging exams confirmed diagnosis. Six weeks post-injection, the clinical status was improved in all patients, with a significant decrease of algo-functional scores. The pain reported during functional assessments was decreased (in particular for the eccentric actions), yet no significant improvement of physical performances was observed. We found no significant differences between imaging exams before and 6 weeks after PRP injection. Conclusion: One in situ injection of PRP clinically improved patients with jumper’s knee 6 weeks after treatment. All the 10 patients reported a decrease of pain during day-life and through physical activities. However nor functional performances neither imaging were improved. [less ▲]

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See detailMécanisme et imagerie des fractures de la cheville
MEUNIER, Benoît ULg; JOSKIN, Julien ULg; GILLET, Philippe ULg et al

in Revue Médicale de Liège (2011), 66(9), 491-497

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See detailInfiltration de concentré plaquettaire dans le traitement des tendinopathies rotuliennes : résultats préliminaires
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; SIMONI, Paolo ULg et al

in 4ème Congrès commun SFMS & SFTS (2011, September)

Introduction : L’évolution de certaines tendinopathies, et plus particulièrement, les tendinopathies rotuliennes aussi appelées Jumper’s knee demeurent relativement rebelles aux traitements ... [more ▼]

Introduction : L’évolution de certaines tendinopathies, et plus particulièrement, les tendinopathies rotuliennes aussi appelées Jumper’s knee demeurent relativement rebelles aux traitements «conservateurs». Divers travaux expérimentaux ont souligné les propriétés réparatrices des plaquettes et de divers facteurs de croissances libérés localement. Ceux-ci peuvent effectivement accélérer la cicatrisation de certains tissus : os, muscles et tendons. Ces recherches ont permis de comprendre l’action plaquettaire en qualité de médiateur et/ou activateur de la cicatrisation tissulaire. Depuis janvier 2010, ce traitement des lésions tendineuses n’est plus repris sur la liste des méthodes dopantes. Matériel et méthodes : Le but de l’étude est de réaliser une injection locale de concentré plaquettaire (PRP) chez des patients présentant une tendinopathie rotulienne supérieure rebelle, évoluant depuis plus de 3 mois, n’ayant plus bénéficié de traitement physique (programme excentrique, ondes de choc) depuis 4 semaines. Les patients bénéficient d’un bilan d’imagerie (échographie et IRM), un bilan fonctionnel ainsi qu’un test clinique algique palpatoire à l’aide d’un algomètre avant le traitement et à 6 semaines. Ils sont également invités à répondre à un questionnaire relatif à l’importance de la douleur et de la situation médico-sportive et fonctionnelle. Le PRP est prélevé à partir de sang autologue par l’intermédiaire d’un système d’aphérèse. L’injection de PRP (± 6 mL) est réalisée, sans anesthésie locale, de manière stérile au niveau de l’insertion proximale du tendon rotulien. Un repos relatif 48 heures après l’infiltration est préconisé. Une rééducation excentrique complémentaire est initiée 1 semaine après l’injection. Un repos sportif spécifique de 6 semaines est maintenu. En cas de douleur, le patient ne peut pas prendre d’anti-inflammatoire mais bien un antidouleur de classe I ou II. Notre protocole a été examiné et approuvé par le Comité d’Ethique Hospitalo-Facultaire Universitaire de Liège. Résultats et discussion : Dix patients présentant une tendinopathie rotulienne supérieure chronique sont actuellement inclus dans l’étude. Les tests et évaluation pré-injection révèlent une douleur persistante à la pointe de la rotule associée généralement à une perte de fonction. L’imagerie permet de confirmer le diagnostic. A 6 semaines de l’injection de PRP, l’évolution clinique est globalement favorable, avec une diminution significative des scores algo-fonctionnels (questionnaires et EVA lors des tests fonctionnels), mais sans amélioration significative des performances physiques. Il n’y a pas non plus de différence significative quant aux explorations d’imagerie médicale 6 semaines après l’injection de PRP. Conclusion: Une injection de PRP in situ semble améliorer cliniquement les patients atteints d’une tendinopathie rotulienne supérieure, à 6 semaines post-infiltration. Cependant, celle-ci ne semble pas avoir de répercussion sur les performances fonctionnelles ni sur l’imagerie médicale après 6 semaines. Un suivi sur une période plus importante est nécessaire pour en apprécier les effets à long terme. [less ▲]

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See detail36-year-old man with sudden severe headache.
SIMONI, Paolo ULg; MEUNIER, Benoît ULg; Deprez, Manuel ULg et al

in Skeletal Radiology (2011), 40(10), 1361-21387-8

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See detailLe syndrome d'oedeme medullaire de la tete femorale.
Vande Berg, B.; Lecouvet, F.; Koutaissoff, S. et al

in Journal de Radiologie (2011), 92(6), 557-66

Transient bone marrow edema of the hip is characterized by moderate homogeneous low MR signal intensity with ill-defined margins that involves at least a portion of the femoral head. Spin echo T1-weighted ... [more ▼]

Transient bone marrow edema of the hip is characterized by moderate homogeneous low MR signal intensity with ill-defined margins that involves at least a portion of the femoral head. Spin echo T1-weighted images are helpful to exclude other underlying diseases (tumor, infection, necrosis from systemic origin...), for which marrow edema is secondary or no epiphyseal in location. High-resolution fat-suppressed T2-weighted or proton density images allow evaluation of the articular cartilage, subchondral bone and subchondal marrow: if the articular cartilage is abnormal, the lesion is irreversible (arthrosis or necrosis); if the subchondral bone is focally interrupted and/or if the femoral is no longer spherical, the lesion is irreversible (necrosis); if a focal linear fluid collection is present under the subchondral bone, the lesion is irreversible (necrosis). Finally, subchondral changes may provide useful prognostic information: the absence of any abnormality other than marrow edema typically indicates that complete resolution is likely; the presence of a focal T2-weighted hypointense lesion immediately next to the subchondral bone suggests an irreversible lesion, especially if it is equal to or thicker than 4mm or the joint space. In some instances, prognosis cannot be reliably determined requiring the need for follow-up imaging. [less ▲]

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