高分辨率超声在肌肉骨骼感染评估中的应用

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Journal of Ultrasonography Pub Date : 2023-10-30 DOI:10.15557/jou.2023.0034
Jennifer S. Weaver, Imran Omar, Katherine Epstein, Alana Brown, Nicholson Chadwick, Mihra S. Taljanovic
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引用次数: 0

摘要

软组织和骨骼肌骨骼感染是常见的,但临床上很难诊断。体征、症状和体格检查结果可能是非特异性的,实验室值可能是结论性的。体格检查也可能低估疾病的严重程度。软组织感染最常见的是继发于破损皮肤的直接接种,较少的是由于血液传播的软组织种子,而骨性感染更常见的是由于原生种子。感染也可能是医源性的,在手术或其他程序干预之后。高分辨率超声在评估肌肉骨骼软组织和关节感染方面是一种非常有用的成像方式,偶尔也可以用于评估骨骼感染。超声可以帮助肌肉骨骼感染的早期诊断,允许及时治疗,降低并发症的风险,并优化治疗。超声在评价软组织水肿和充血方面具有敏感性和特异性;软组织脓肿;关节、法氏囊和肌腱鞘积液/滑膜炎;骨周下脓肿。本文介绍了蜂窝织炎、筋膜炎、坏死性深部软组织感染、化脓炎、软组织脓肿、感染性滑囊炎和感染性腱鞘炎等软组织感染的典型高分辨率灰度、彩色和功率多普勒超声成像结果。超声检查发现脓毒性关节炎以及骨髓炎,如骨膜下扩散感染(骨膜下脓肿)。也进行了审查。此外,还讨论了利用超声引导液体和组织取样的方法。
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High-resolution ultrasound in the evaluation of musculoskeletal infections
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.
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来源期刊
Journal of Ultrasonography
Journal of Ultrasonography RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
2.30
自引率
0.00%
发文量
58
审稿时长
20 weeks
期刊最新文献
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