Pub Date : 2024-02-07eCollection Date: 2024-02-01DOI: 10.15557/jou.2024.0003
Konstantinos Chlapoutakis, Maria Raissaki, Styliani Markatzinou, Nikolaos Skoulikaris, Antonios Galanos, Adam Hatzidakis, Panagiotis Prassopoulos
Aim: To investigate whether linear measurements or ratios on the Graf's "standard plane" ultrasound images of the neonatal/infantile hip, can support the clinically important differentiation between type I and type II hips.
Material and methods: A total of 60 Graf type II hips and 124 randomly selected Graf type I hips, matched to the gestational age at delivery, birth weight, delivery mode, and age at the time of the examination, were identified through our hip screening service, during a period of two years. The images were diagnostically suitable, following anatomical identification and usability check, according to Graf. Anatomical landmarks including the lower limb of the os ilium, the bony rim, the silhouette of the os ilium, the labrum and the femoral head's borders, were used to determine the measurements and ratios which quantified their inter-relationships.
Results: The indices which differed significantly between type I and type II hips included: (a) the width of the "bony roof" (cut-off value 5.91 mm, sensitivity: 75%, specificity: 70%), (b) the ratio of the width of the "bony roof" to the femoral head's width (cut-off value 0.40, sensitivity 83%, specificity 71%), and (c) the ratio of the cartilaginous acetabular roof's width (including the labrum), to the width of the femoral head (cut-off value 0.450, sensitivity 82%, specificity 67%).
Conclusions: Newly introduced measurements and calculated ratios on "standard plane" ultrasound images can be used as additional indices in the differentiation between Graf's types of "centered hips", thus increasing the diagnostic certainty of the examiner in borderline cases and limiting unnecessary re-examinations or treatment.
{"title":"Treat, follow-up, or discharge? An aid in sonographic decisions for the borderline centered neonatal/infantile hips.","authors":"Konstantinos Chlapoutakis, Maria Raissaki, Styliani Markatzinou, Nikolaos Skoulikaris, Antonios Galanos, Adam Hatzidakis, Panagiotis Prassopoulos","doi":"10.15557/jou.2024.0003","DOIUrl":"https://doi.org/10.15557/jou.2024.0003","url":null,"abstract":"<p><strong>Aim: </strong>To investigate whether linear measurements or ratios on the Graf's \"standard plane\" ultrasound images of the neonatal/infantile hip, can support the clinically important differentiation between type I and type II hips.</p><p><strong>Material and methods: </strong>A total of 60 Graf type II hips and 124 randomly selected Graf type I hips, matched to the gestational age at delivery, birth weight, delivery mode, and age at the time of the examination, were identified through our hip screening service, during a period of two years. The images were diagnostically suitable, following anatomical identification and usability check, according to Graf. Anatomical landmarks including the lower limb of the os ilium, the bony rim, the silhouette of the os ilium, the labrum and the femoral head's borders, were used to determine the measurements and ratios which quantified their inter-relationships.</p><p><strong>Results: </strong>The indices which differed significantly between type I and type II hips included: (a) the width of the \"bony roof\" (cut-off value 5.91 mm, sensitivity: 75%, specificity: 70%), (b) the ratio of the width of the \"bony roof\" to the femoral head's width (cut-off value 0.40, sensitivity 83%, specificity 71%), and (c) the ratio of the cartilaginous acetabular roof's width (including the labrum), to the width of the femoral head (cut-off value 0.450, sensitivity 82%, specificity 67%).</p><p><strong>Conclusions: </strong>Newly introduced measurements and calculated ratios on \"standard plane\" ultrasound images can be used as additional indices in the differentiation between Graf's types of \"centered hips\", thus increasing the diagnostic certainty of the examiner in borderline cases and limiting unnecessary re-examinations or treatment.</p>","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":"24 94","pages":"1-7"},"PeriodicalIF":1.1,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10850939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-23eCollection Date: 2023-10-01DOI: 10.15557/jou.2023.0041
Mihra S Taljanovic
{"title":"Update on current concepts and advances in musculoskeletal ultrasound: Honoring my Teacher Dr. Ronald Adler.","authors":"Mihra S Taljanovic","doi":"10.15557/jou.2023.0041","DOIUrl":"https://doi.org/10.15557/jou.2023.0041","url":null,"abstract":"","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":"23 95","pages":"e170-e171"},"PeriodicalIF":1.1,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10668927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Radiography is the appropriate initial imaging modality to assess for midfoot and forefoot pathology before turning to advanced imaging techniques. While most lesions of the mid- and forefoot can be diagnosed clinically, the exact nature and severity of the pathology is often unclear. This review addresses the use of the ultrasound, as well as the added value of magnetic resonance imaging, in diagnosing conditions of the mid- foot and forefoot. Ultrasound allows a dynamic assessment as well as enabling imaging-guided interven- tions for diagnostic and therapeutic purposes. Practical tips for optimal examination of this area with ultra- sound and magnetic resonance imaging are provided. Metatarsal stress fracture, Chopart’s injury, Lisfranc injury, as well as the 1st metatarsophalangeal joint injury and lesser metatarsophalangeal plantar plate injury are injuries unique to the mid- and forefoot. The imaging anatomy of the 1st and lesser metatarsophalan- geal joints is reviewed, as such knowledge is key to correctly assessing injury of these joints. Characteristic imaging features of masses commonly encountered in the mid- and forefoot, such as ganglion cyst, Morton neuroma, gouty tophus, plantar fibroma, foreign body granuloma, and leiomyoma are reviewed. The use of ultrasound and magnetic resonance imaging in assessing degenerative and inflammatory joint disorders, and in particular rheumatoid arthritis, of the mid- and forefoot region is also reviewed. In summary, when necessary, most lesions of the mid-and forefoot can be adequately assessed with ultrasound, supplemented on occasion with radiographs, computed tomography, or magnetic resonance imaging.
{"title":"High-resolution ultrasound and MRI in the evaluation of the forefoot and midfoot","authors":"Monique Reijnierse, James F. Griffith","doi":"10.15557/jou.2023.0033","DOIUrl":"https://doi.org/10.15557/jou.2023.0033","url":null,"abstract":"Radiography is the appropriate initial imaging modality to assess for midfoot and forefoot pathology before turning to advanced imaging techniques. While most lesions of the mid- and forefoot can be diagnosed clinically, the exact nature and severity of the pathology is often unclear. This review addresses the use of the ultrasound, as well as the added value of magnetic resonance imaging, in diagnosing conditions of the mid- foot and forefoot. Ultrasound allows a dynamic assessment as well as enabling imaging-guided interven- tions for diagnostic and therapeutic purposes. Practical tips for optimal examination of this area with ultra- sound and magnetic resonance imaging are provided. Metatarsal stress fracture, Chopart’s injury, Lisfranc injury, as well as the 1st metatarsophalangeal joint injury and lesser metatarsophalangeal plantar plate injury are injuries unique to the mid- and forefoot. The imaging anatomy of the 1st and lesser metatarsophalan- geal joints is reviewed, as such knowledge is key to correctly assessing injury of these joints. Characteristic imaging features of masses commonly encountered in the mid- and forefoot, such as ganglion cyst, Morton neuroma, gouty tophus, plantar fibroma, foreign body granuloma, and leiomyoma are reviewed. The use of ultrasound and magnetic resonance imaging in assessing degenerative and inflammatory joint disorders, and in particular rheumatoid arthritis, of the mid- and forefoot region is also reviewed. In summary, when necessary, most lesions of the mid-and forefoot can be adequately assessed with ultrasound, supplemented on occasion with radiographs, computed tomography, or magnetic resonance imaging.","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":"125 26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136132771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The knee joint relies on a combination of deep and superficial structures for stability and function. Both ultrasound and high-resolution magnetic resonance imaging are extremely useful in evaluating these struc- tures and associated pathology. This article reviews a combination of critical anatomic structures, joint abnormalities, and pathologic conditions at the knee joint, while highlighting the merits, limitations, and pitfalls of the two imaging modalities. A clear appreciation of each method paired with its relative strengths will aid in expediting diagnosis and appropriate treatment for a wide range of knee joint conditions.
{"title":"Evaluation of the knee joint with ultrasound and magnetic resonance imaging","authors":"Siddharth Pandya, David M. Melville","doi":"10.15557/jou.2023.0032","DOIUrl":"https://doi.org/10.15557/jou.2023.0032","url":null,"abstract":"The knee joint relies on a combination of deep and superficial structures for stability and function. Both ultrasound and high-resolution magnetic resonance imaging are extremely useful in evaluating these struc- tures and associated pathology. This article reviews a combination of critical anatomic structures, joint abnormalities, and pathologic conditions at the knee joint, while highlighting the merits, limitations, and pitfalls of the two imaging modalities. A clear appreciation of each method paired with its relative strengths will aid in expediting diagnosis and appropriate treatment for a wide range of knee joint conditions.","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":"35 31","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136132778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Linda Probyn, Dyan Flores, Emma Rowbotham, Mark Cresswell, Angela Atinga
This paper reviews ultrasound of the hip, which is a commonly requested examination for symptomatic hip issues. This includes both intra-articular and extra-articular causes of hip pain. Ultrasound is easily acces- sible, lacks radiation exposure, and allows for evaluation of the contralateral hip as well as assessment of dy- namic maneuvers. Ultrasound can be used to guide interventional procedures. Ultrasound of the hip can be challenging due to the deep location of structures and complex anatomy. Typically, high-frequency trans- ducers are used to examine the hip, however the choice of ultrasound transducer depends on the patient’s body habitus, with lower frequency transducers required to penetrate deep structures in obese patients. It is important to have an approach to ultrasound of the hip which includes assessment of the anterior, lateral, posterior, and medial aspects of the hip. The technique and relevant anatomy of each of these compart- ments are discussed as well as the use of Doppler examination of the hip. Several dynamic maneuvers can be performed to help determine the cause of hip pathology in various locations, and these are described and illustrated. Ultrasound is useful for guided procedures about the hip, and these indications will be reviewed.
{"title":"High-resolution ultrasound in the evaluation of the adult hip","authors":"Linda Probyn, Dyan Flores, Emma Rowbotham, Mark Cresswell, Angela Atinga","doi":"10.15557/jou.2023.0031","DOIUrl":"https://doi.org/10.15557/jou.2023.0031","url":null,"abstract":"This paper reviews ultrasound of the hip, which is a commonly requested examination for symptomatic hip issues. This includes both intra-articular and extra-articular causes of hip pain. Ultrasound is easily acces- sible, lacks radiation exposure, and allows for evaluation of the contralateral hip as well as assessment of dy- namic maneuvers. Ultrasound can be used to guide interventional procedures. Ultrasound of the hip can be challenging due to the deep location of structures and complex anatomy. Typically, high-frequency trans- ducers are used to examine the hip, however the choice of ultrasound transducer depends on the patient’s body habitus, with lower frequency transducers required to penetrate deep structures in obese patients. It is important to have an approach to ultrasound of the hip which includes assessment of the anterior, lateral, posterior, and medial aspects of the hip. The technique and relevant anatomy of each of these compart- ments are discussed as well as the use of Doppler examination of the hip. Several dynamic maneuvers can be performed to help determine the cause of hip pathology in various locations, and these are described and illustrated. Ultrasound is useful for guided procedures about the hip, and these indications will be reviewed.","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":"35 27","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136132563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Steven Kyungho Lee, Ali Mostafa Serhal, Muhamad Serhal, Julia Michalek, Imran Muhammad Omar
Lower extremity peripheral neuropathy is a commonly encountered neurologic disorder, which can lead to chronic pain, functional disability, and decreased quality of life for a patient. As diagnostic imaging modalities have improved, imaging has started to play an integral role in the detection and characterization of peripheral nerve abnormalities by non-invasively and accurately identifying abnormal nerves as well as potential causes of neuropathy, which ultimately leads to precise and timely treatment. Ultrasound, which has high spatial resolution and can quickly and comfortably characterize peripheral nerves in real time along with associated denervation muscle atrophy, and magnetic resonance neurography, which provides excellent contrast resolution between nerves and other tissues and between pathologic and normal seg- ments of peripheral nerves, in addition to assessing reversible and irreversible muscle denervation changes, are the two mainstay imaging modalities used in peripheral nerve assessment. These two modalities are complimentary, and one may be more useful than the other depending on the nerve and location of pathol- ogy. Imaging must be interpreted in the context of available clinical information and other diagnostic stud- ies, such as electrodiagnostic tests. Here, we offer a comprehensive overview of the role of high-resolution ultrasound and magnetic resonance neurography in the evaluation of the peripheral nerves of the lower extremity and their associated neuropathies.
{"title":"The role of high-resolution ultrasound and MRI in the evaluation of peripheral nerves in the lower extremity","authors":"Steven Kyungho Lee, Ali Mostafa Serhal, Muhamad Serhal, Julia Michalek, Imran Muhammad Omar","doi":"10.15557/jou.2023.0038","DOIUrl":"https://doi.org/10.15557/jou.2023.0038","url":null,"abstract":"Lower extremity peripheral neuropathy is a commonly encountered neurologic disorder, which can lead to chronic pain, functional disability, and decreased quality of life for a patient. As diagnostic imaging modalities have improved, imaging has started to play an integral role in the detection and characterization of peripheral nerve abnormalities by non-invasively and accurately identifying abnormal nerves as well as potential causes of neuropathy, which ultimately leads to precise and timely treatment. Ultrasound, which has high spatial resolution and can quickly and comfortably characterize peripheral nerves in real time along with associated denervation muscle atrophy, and magnetic resonance neurography, which provides excellent contrast resolution between nerves and other tissues and between pathologic and normal seg- ments of peripheral nerves, in addition to assessing reversible and irreversible muscle denervation changes, are the two mainstay imaging modalities used in peripheral nerve assessment. These two modalities are complimentary, and one may be more useful than the other depending on the nerve and location of pathol- ogy. Imaging must be interpreted in the context of available clinical information and other diagnostic stud- ies, such as electrodiagnostic tests. Here, we offer a comprehensive overview of the role of high-resolution ultrasound and magnetic resonance neurography in the evaluation of the peripheral nerves of the lower extremity and their associated neuropathies.","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":"35 36","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136132773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
During the past four decades, musculoskeletal ultrasound has become popular as an imaging modality due to its low cost, accessibility, and lack of ionizing radiation. The development of ultrasound technology was possible in large part due to concomitant advances in both solid-state electronics and signal processing. The invention of the transistor and digital computer in the late 1940s was integral in its development. Moore’s prediction that the number of microprocessors on a chip would grow exponentially, resulting in progressive miniaturization in chip design and therefore increased computational power, added to these capabilities. The development of musculoskeletal ultrasound has paralleled technical advances in diagnostic ultrasound. The appearance of a large variety of transducer capabilities and rapid image processing along with the abil- ity to assess vascularity and tissue properties has expanded and continues to expand the role of musculo- skeletal ultrasound. It should also be noted that these developments have in large part been due to a number of individuals who had the insight to see the potential applications of this developing technology to a host of relevant clinical musculoskeletal problems. Exquisite high-resolution images of both deep and small super- ficial musculoskeletal anatomy, assessment of vascularity on a capillary level and tissue mechanical proper- ties can be obtained. Ultrasound has also been recognized as the method of choice to perform a large variety of interventional procedures. A brief review of these technical developments, the timeline over which these improvements occurred, and the impact on musculoskeletal ultrasound is presented below.
{"title":"Musculoskeletal ultrasound: a technical and historical perspective","authors":"Ronald Steven Adler","doi":"10.15557/jou.2023.0027","DOIUrl":"https://doi.org/10.15557/jou.2023.0027","url":null,"abstract":"During the past four decades, musculoskeletal ultrasound has become popular as an imaging modality due to its low cost, accessibility, and lack of ionizing radiation. The development of ultrasound technology was possible in large part due to concomitant advances in both solid-state electronics and signal processing. The invention of the transistor and digital computer in the late 1940s was integral in its development. Moore’s prediction that the number of microprocessors on a chip would grow exponentially, resulting in progressive miniaturization in chip design and therefore increased computational power, added to these capabilities. The development of musculoskeletal ultrasound has paralleled technical advances in diagnostic ultrasound. The appearance of a large variety of transducer capabilities and rapid image processing along with the abil- ity to assess vascularity and tissue properties has expanded and continues to expand the role of musculo- skeletal ultrasound. It should also be noted that these developments have in large part been due to a number of individuals who had the insight to see the potential applications of this developing technology to a host of relevant clinical musculoskeletal problems. Exquisite high-resolution images of both deep and small super- ficial musculoskeletal anatomy, assessment of vascularity on a capillary level and tissue mechanical proper- ties can be obtained. Ultrasound has also been recognized as the method of choice to perform a large variety of interventional procedures. A brief review of these technical developments, the timeline over which these improvements occurred, and the impact on musculoskeletal ultrasound is presented below.","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136132561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laurens Koonen, Martin van Amerongen, Katrijn Smulders, Stephanie Mangesius, Gabriella Cerna, Andrea Klauser, Erich Mur, Marina Obradov
Aim of the study: There is no consensus on the most suitable non-surgical treatment of chronic lateral elbow tendinopathy. The aim of this pilot randomized controlled trial was to evaluate the size of effect of ultrasound-guided percutaneous needle tenotomy. Material and methods: Three intervention arms were formed: 1) percutaneous needle tenotomy, hydrodissection, and physiotherapy; 2) hydrodissection and physiotherapy; and 3) physiotherapy alone. Patients with chronic lateral elbow tendinopathy were randomized. Clinical endpoints included multiple questionnaires after three months: Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), Numeric Rating Scale (NRS) pain at rest and during activity, and EuroQol 5D-5L (EQ-5D-5L). Results: Thirty patients were included of 128 screened. The QuickDASH score improved in the percutaneous needle tenotomy and physiotherapy group, but not in the hydrodissection group. The NRS pain at rest and during activity improved more in the percutaneous needle tenotomy (resp. –2 and –2) and hydrodissection (resp. –3 and –3) groups than in the physiotherapy (resp. +1 and –1) group. The EQ-5D-5L improved similarly in all groups. Conclusions: Patients receiv- ing percutaneous needle tenotomy and/or hydrodissection may show better results in terms of pain but not in their functional outcomes compared to those who received physiotherapy alone. The size of effect, however, is small, so a large sample size is needed for a future randomized controlled trial to further in- vestigate these results.
{"title":"Added value of ultrasound-guided percutaneous needle tenotomy over hydrodissection and physiotherapy in chronic lateral elbow tendinopathy: a pilot randomized controlled trial","authors":"Laurens Koonen, Martin van Amerongen, Katrijn Smulders, Stephanie Mangesius, Gabriella Cerna, Andrea Klauser, Erich Mur, Marina Obradov","doi":"10.15557/jou.2023.0040","DOIUrl":"https://doi.org/10.15557/jou.2023.0040","url":null,"abstract":"Aim of the study: There is no consensus on the most suitable non-surgical treatment of chronic lateral elbow tendinopathy. The aim of this pilot randomized controlled trial was to evaluate the size of effect of ultrasound-guided percutaneous needle tenotomy. Material and methods: Three intervention arms were formed: 1) percutaneous needle tenotomy, hydrodissection, and physiotherapy; 2) hydrodissection and physiotherapy; and 3) physiotherapy alone. Patients with chronic lateral elbow tendinopathy were randomized. Clinical endpoints included multiple questionnaires after three months: Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), Numeric Rating Scale (NRS) pain at rest and during activity, and EuroQol 5D-5L (EQ-5D-5L). Results: Thirty patients were included of 128 screened. The QuickDASH score improved in the percutaneous needle tenotomy and physiotherapy group, but not in the hydrodissection group. The NRS pain at rest and during activity improved more in the percutaneous needle tenotomy (resp. –2 and –2) and hydrodissection (resp. –3 and –3) groups than in the physiotherapy (resp. +1 and –1) group. The EQ-5D-5L improved similarly in all groups. Conclusions: Patients receiv- ing percutaneous needle tenotomy and/or hydrodissection may show better results in terms of pain but not in their functional outcomes compared to those who received physiotherapy alone. The size of effect, however, is small, so a large sample size is needed for a future randomized controlled trial to further in- vestigate these results.","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":"35 35","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136132774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennifer S. Weaver, Imran Omar, Katherine Epstein, Alana Brown, Nicholson Chadwick, Mihra S. Taljanovic
Soft tissue and osseous musculoskeletal infections are common but can be difficult to diagnose clinically. Signs, symptoms, and physical examination findings may be nonspecific, and laboratory values can be in- conclusive. The extent of disease may also be underestimated on physical examination. Soft tissue infections most commonly occur secondary to direct inoculation from broken skin and less frequently due to the seed- ing of the soft tissues from hematogenous spread, while osseous infections are more commonly due to he- matogenous seeding. Infections may also be iatrogenic, following surgery or other procedural interventions. High-resolution ultrasound is an extremely useful imaging modality in the evaluation of musculoskeletal soft tissue and joint infections, and can occasionally be used to evaluate osseous infections as well. Ultrasound can aid in the early diagnosis of musculoskeletal infections, allowing for prompt treatment, decreased risk of complications, and treatment optimization. Ultrasound is sensitive and specific in evaluating soft tissue edema and hyperemia; soft tissue abscesses; joint, bursal and tendon sheath effusions/synovitis; and subperi- osteal abscesses. This article describes the typical high-resolution grayscale as well as color and power Dop- pler ultrasound imaging findings of soft tissue infections including cellulitis, fasciitis, necrotizing deep soft tissue infection, pyomyositis, soft tissue abscess, infectious bursitis, and infectious tenosynovitis. Ultrasound findings of septic arthritis as well as osteomyelitis, such as subperiosteal spread of infection (subperiosteal abscess). are also reviewed. In addition, the use of ultrasound to guide fluid and tissue sampling is discussed.
{"title":"High-resolution ultrasound in the evaluation of musculoskeletal infections","authors":"Jennifer S. Weaver, Imran Omar, Katherine Epstein, Alana Brown, Nicholson Chadwick, Mihra S. Taljanovic","doi":"10.15557/jou.2023.0034","DOIUrl":"https://doi.org/10.15557/jou.2023.0034","url":null,"abstract":"Soft tissue and osseous musculoskeletal infections are common but can be difficult to diagnose clinically. Signs, symptoms, and physical examination findings may be nonspecific, and laboratory values can be in- conclusive. The extent of disease may also be underestimated on physical examination. Soft tissue infections most commonly occur secondary to direct inoculation from broken skin and less frequently due to the seed- ing of the soft tissues from hematogenous spread, while osseous infections are more commonly due to he- matogenous seeding. Infections may also be iatrogenic, following surgery or other procedural interventions. High-resolution ultrasound is an extremely useful imaging modality in the evaluation of musculoskeletal soft tissue and joint infections, and can occasionally be used to evaluate osseous infections as well. Ultrasound can aid in the early diagnosis of musculoskeletal infections, allowing for prompt treatment, decreased risk of complications, and treatment optimization. Ultrasound is sensitive and specific in evaluating soft tissue edema and hyperemia; soft tissue abscesses; joint, bursal and tendon sheath effusions/synovitis; and subperi- osteal abscesses. This article describes the typical high-resolution grayscale as well as color and power Dop- pler ultrasound imaging findings of soft tissue infections including cellulitis, fasciitis, necrotizing deep soft tissue infection, pyomyositis, soft tissue abscess, infectious bursitis, and infectious tenosynovitis. Ultrasound findings of septic arthritis as well as osteomyelitis, such as subperiosteal spread of infection (subperiosteal abscess). are also reviewed. In addition, the use of ultrasound to guide fluid and tissue sampling is discussed.","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":"35 26","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136132564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rheumatologic diseases are a widespread group of disorders affecting the joints, bones, and connective tissue, and leading to significant disability. Imaging is an indispensable component in diagnosing, assess- ing, monitoring, and managing these disorders, providing information about the structural and functional alterations occurring within the affected joints and tissues. This review article aims to compare the utility, specific clinical applications, advantages, and limitations of high-resolution ultrasound and magnetic reso- nance imaging in the context of rheumatologic diseases. It also provides insights into the imaging features of various types of inflammatory arthritis with clinical relevance and a focus on high-resolution ultrasound and magnetic resonance imaging. By understanding the comparative aspects of high-resolution ultrasound and magnetic resonance imaging, it is easier for the treating physicians to make informed decisions when selecting the optimal imaging modality for specific diagnostic purposes, effective treatment planning, and improve patient outcomes. The patterns of soft tissue and joint involvement; bony erosion and synovitis help in differentiating between various type of arthritis. Involvement of various small joints of the hands also gives an insight into the type of arthritis. We also briefly discuss the potential applications of emerging techniques, such as ultrasound elastography, contrast-enhanced ultrasound, and dual-energy CT, in the field of rheumatology.
{"title":"Added value of high-resolution ultrasound and MRI in the evaluation of rheumatologic diseases","authors":"Amit Kumar Sahu, Shweta Kataria, Girish Gandikota","doi":"10.15557/jou.2023.0035","DOIUrl":"https://doi.org/10.15557/jou.2023.0035","url":null,"abstract":"Rheumatologic diseases are a widespread group of disorders affecting the joints, bones, and connective tissue, and leading to significant disability. Imaging is an indispensable component in diagnosing, assess- ing, monitoring, and managing these disorders, providing information about the structural and functional alterations occurring within the affected joints and tissues. This review article aims to compare the utility, specific clinical applications, advantages, and limitations of high-resolution ultrasound and magnetic reso- nance imaging in the context of rheumatologic diseases. It also provides insights into the imaging features of various types of inflammatory arthritis with clinical relevance and a focus on high-resolution ultrasound and magnetic resonance imaging. By understanding the comparative aspects of high-resolution ultrasound and magnetic resonance imaging, it is easier for the treating physicians to make informed decisions when selecting the optimal imaging modality for specific diagnostic purposes, effective treatment planning, and improve patient outcomes. The patterns of soft tissue and joint involvement; bony erosion and synovitis help in differentiating between various type of arthritis. Involvement of various small joints of the hands also gives an insight into the type of arthritis. We also briefly discuss the potential applications of emerging techniques, such as ultrasound elastography, contrast-enhanced ultrasound, and dual-energy CT, in the field of rheumatology.","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":"35 37","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136132772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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