Structured image diagnosis of vertebral body degeneration and disc damage – Binary image criteria and comparison for systematic image analysis in occupational diseases 2108/2110

Rainer Braunschweig; Daniela Kildal; Michael Meyer-Clement; Rolf Janka; Andreas Tiemann

doi:10.1055/a-2168-7399

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, Table of Contents

Rofo 2024; 196(04): 347-353
DOI: 10.1055/a-2168-7399

Review

Structured image diagnosis of vertebral body degeneration and disc damage – Binary image criteria and comparison for systematic image analysis in occupational diseases 2108/2110

Part 1: Legal background, imaging diagnosis, assessment Article in several languages: English | deutsch

Rainer Braunschweig

¹Institute of Radiology, Erlangen University Hospital, Erlangen, Germany

,

Daniela Kildal

²Radiology, Valais Hospital, Visp, Switzerland

³Radiology, University Hospital Ulm, Germany

,

Michael Meyer-Clement

⁴Institut for Clinical Assessments M. Meyer-Clement, Hamburg, Germany

,

Rolf Janka

¹Institute of Radiology, Erlangen University Hospital, Erlangen, Germany

,

Andreas Tiemann

⁵Institut for Clinical Assessments A.Tiemann, Leipzig, Germany

› Author Affiliations

Abstract

Background Occupationally related limitations of earning capacity can be recognized under social legislation and may be subject to compensation (“reduction in earning capacity”). For this purpose, legislators have defined a list of occupational diseases (“BK list”). Recognition of an occupational disease requires a legal assessment procedure based on a medical appraisal. The aim of the assessment is to prove the “causality” and the “causality giving rise to liability”.

Method In addition to clinical findings and workplace analyses, imaging methods (projection radiography, MRI) are primarily used to substantiate liability. These methods enable proof of load-conforming damage patterns for occupational diseases 2108/2110 (damage to intervertebral discs).

Results and Conclusion In addition to the legal background, the following review article primarily presents the image criteria for load-conforming damage patterns of the spine. On the basis of the consensus paper on the “Assessment of occupational disc diseases of the lumbar spine”, image criteria are assigned to age-atypical grades of findings, and “typical constellations of findings” are defined for vibration (BK 2108) or lifting (BK 2110) loads. The aim of Part 1 is to explain the image criteria of the comparative images presented as image plates in Part 2 and thus to present a reference catalog of findings.

Key statements

Occupational diseases are defined by legislators in the “List of Occupational Diseases”.
For occupational intervertebral disc diseases (BK 2108/2110), constellations of findings are defined.
In the context of imaging diagnostics, a large number of image criteria are used.
Part 1 explains the basics.
Part 2 provides the image criteria on the basis of “comparative images” as a reference catalog.

Citation Format

Braunschweig R, Kildal D, Meyer-Clement M et al. Structured image diagnosis of vertebral body degeneration and disc damage – Binary image criteria and comparison for systematic image analysis in occupational diseases 2108/2110. Fortschr Röntgenstr 2024; 196: 347 – 353

Keywords

occupational diseases - degenerative spine conditions - structured image diagnosis - intervertebral disc degeneration - systematic medical image analysis

Full Text

References

References
1 Bundesgesetzblatt I, S. 2245, Anlage 1 zur Berufskrankheiten-Verordnung (BKV) in der Fassung der Fünften Verordnung zur Änderung der Berufskrankheiten-Verordnung vom 29. Juni 2021.
2 Kaiser V, Zober A. Hinweise zur Begutachtung von Berufskrankheiten. 5. Auflage. Keppner-Druck Eppingen; 2005
3 Braunschweig R. Radiologische Begutachtung. Berlin: De Gruyter; 2017
4 Bolm-Audorff U. et al. Medizinische Beurteilungskriterien zu bandscheibenbedingten Berufskrankheiten der Lendenwirbelsäule Teil I und II. Trauma Berufskrankh 2005; 7: 211-252
5 S2k-Leitlinie AWMF-Nr: 020/010/ILO-Klassifikation: „Richtlinien für die Anwendung der internationalen Klassifikation des IAA von Pneumokoniose-Röntgenfilmen.“ Occupational safety and health series. 22. Genf: Internationales Arbeitsamt. 2012
6 Schönberger A, Mehrtens G, Valentin H. Arbeitsunfall und Berufskrankheit. 9. Aufl.. Berlin: Erich Schmidt; 2017
7 § 823, Absatz 1, BGB.
8 Heuck W. Radiologische Fachgutachten. Berlin: Springer; 1999
9 § 7, Abs. 1, SGB VII.
10 § 9, Abs. 2, SGB VII.
11 Merkblätter zu Berufskrankheiten: Bek. des Bundesministeriums für Arbeit und Soziales vom 01. September 2006 – IV a 4-45222-2108; Bundesarbeitsblatt 10-2006, S. 30 ff.
12 Klemm H-T. Ärztliche Begutachtung: Praxistipps und Stolperfallen. BVOU-Infobrief 2021; 4: 6-7
13 Dihlmann W. Gelenke – Wirbelverbindungen. 3. Aufl.. Stuttgart: Thieme; 1987
14 Pfirrmann CW, Metzdorf A, Zanetti M. et al. Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine 2002; 26: 1873-1878
15 Vahlensieck M, Reiser M. MRT des Bewegungsapparates. 4. Aufl.. Stuttgart: Thieme; 2015
16 Ludolph E, Meyer-Clement M. Begutachtung chirurgisch-orthopädischer Berufskrankheiten. Landsberg: ecomed Medizin; 2019
17 Leitlinie der Bundesärztekammer zur Qualitätssicherung in der Röntgendiagnostik. 2007
18 Hackländer T. Strukturierte Befundung in der Radiologie. Radiologe 2013; 188: 346-352
19 § 83, Abs. 3, StrlSchGesetz.
20 § 119, StrlSchV.
21 Meyer-Clement M. Begutachtung der BK 2108 – bandscheibenbedingte Erkrankungen der Lendenwirbelsäule. BVOU-Infobrief 2021; 4: 20-25
22 Roberts N, Gratin C, Whitehouse GH. MRI analysis of lumbar intervertebral disc height in young and older population. J Magn Reson Imaging 1997; 7: 880-887
23 Spahn G, Ramadani M, Günther S. et al. Messung der Bandscheibenhöhen in der Lendenwirbelsäule. Vergleich von Projektionsradiographie und Kernspintomografie, Messmethode und Bestimmung der Inter-Observer-Reliabilität. Zeitschrift für Orthopädie und Unfallchirurgie. Stuttgart: Thieme; 2022.
24 Verloh C. Regeln für die Beschriftung und Kennzeichnung von Röntgenaufnahmen. Röntgenpraxis 2011; 4 (02) 103-116
25 Leitfaden Skelettradiologie. Berlin: Kassenärztliche Vereinigung; 2016
26 § 85, Absatz 4, StrlSchGesetz.
27 § 30, StrlSchV.
28 Hurxthal LM. Measurment of anterior vertebral compressions and biconcave vertebrae. J Am Radiol 1968; 103: 635-644
29 Williams AL. et al. Lumbar disc nomenclature: version 2.0. American journal of neuroradiology 2014; 35 (11) 2029
30 BT-Drucksache 19/17586, S. 134, Deutscher Bundestag.
31 BSG, 2007, B 2 U 4/06 R.