Ultrasound Diagnosis and Guided Intervention of Musculoskeletal/Neuromuscular Pathology 2022

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 January 2023) | Viewed by 56985

Special Issue Editor


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Guest Editor
1. Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan
2. Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan
3. Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei, Taiwan
Interests: muscuoloskeletal ultrasound; pain management research; meta-analysis
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Special Issue Information

Dear Colleagues,

The use of clinical symptoms and physical findings for the diagnosis of musculoskeletal disorders is often unreliable. The advancement of ultrasound technology has enabled the delineation of the reciprocal anatomy of the regions, thereby enhancing identification of the underlying pathology. There are many advantages of using ultrasound to explore musculoskeletal pain, including the lack of radiation, real-time imaging, non-invasive evaluation of vascularity and allowance of dynamic studies. Recently, the development of elastography has improved the qualitative and quantitative evaluation of mechanical properties of tendons and muscles, providing better diagnostic accuracy and follow-up of musculoskeletal disorders. Furthermore, compared with magnetic resonance imaging, ultrasound is comparatively better for identifying origins of peripheral and axial musculoskeletal pain.

Once the cause of pain is correctly diagnosed, the intervention instrument can also be directed through ultrasound guidance, increasing the rate of treatment success. Several systematic reviews and meta-analyses have pointed out that ultrasound guidance leads to more effective treatment of musculoskeletal pain than landmark guidance. Since pain severely hampers quality of life and is treated as the fifth vital sign, the determination of how ultrasound can assist in the management of pain has emerged as one of the most important issues for pain physicians. Therefore, this Special Issue will provide a collection of narrative or systematic reviews, basic research and clinical studies which employ ultrasound to identify the origin and associations of musculoskeletal pain as well as to guide interventions. Since nerve entrapment is a common etiology of musculoskeletal pain, we also welcome articles investigating ultrasound-guided treatment for peripheral nerve entrapment syndrome.

Potential topics include, but are not limited to, the following:

  • Association of ultrasound diagnosed musculoskeletal painful disorders with pathologies obtained from other imaging modalities;
  • Accuracy of ultrasound imaging in the diagnosis of musculoskeletal pain compared with surgical and radiological findings;
  • Education/training of musculoskeletal ultrasound in the diagnosis of musculoskeletal painful syndrome;
  • Comparative effectiveness of ultrasound-guided treatments for musculoskeletal painful syndrome;
  • Use of ultrasound elastography for diagnosis and follow up of musculoskeletal pain.

Dr. Ke-Vin Chang
Guest Editor

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Keywords

  • diagnosis
  • ultrasound
  • pain
  • muscle
  • tendon
  • nerve
  • rehabiltation

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Published Papers (15 papers)

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Editorial

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3 pages, 196 KiB  
Editorial
Ultrasound Diagnosis and Guided Intervention of Musculoskeletal/Neuromuscular Pathology 2022
by Ke-Vin Chang
Diagnostics 2023, 13(11), 1945; https://doi.org/10.3390/diagnostics13111945 - 02 Jun 2023
Viewed by 1029
Abstract
The field of musculoskeletal medicine has been revolutionized by the introduction of ultrasound imaging [...] Full article

Research

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10 pages, 2344 KiB  
Article
Validation of the Measuring Protocol for the Infraspinatus Muscle with M-Mode Ultrasound in Asymptomatic Subjects. Intra- and Inter-examiner Reliability Study
by Marina Ortega-Santamaría, María-Eugenia Torralbo-Álvarez-Novoa, Juan-Nicolás Cuenca-Zaldívar, Fermin Naranjo-Cinto, Samuel Fernández-Carnero and Daniel Pecos-Martín
Diagnostics 2023, 13(4), 582; https://doi.org/10.3390/diagnostics13040582 - 04 Feb 2023
Cited by 1 | Viewed by 1383
Abstract
M-mode ultrasound is a reliable and valid instrument for assessing muscle activity. However, it has not been studied in any of the muscles belonging to the shoulder joint complex, particularly in the infraspinatus muscle. The aim of this study is the validation of [...] Read more.
M-mode ultrasound is a reliable and valid instrument for assessing muscle activity. However, it has not been studied in any of the muscles belonging to the shoulder joint complex, particularly in the infraspinatus muscle. The aim of this study is the validation of the infraspinatus muscle activity measurement protocol with the M-mode ultrasound in asymptomatic subjects. Sixty asymptomatic volunteers were evaluated by two physiotherapists who were blinded; each of them carried out three measurements with the M-mode ultrasound in infraspinatus muscle and analysed the muscle thickness at rest and contraction, velocity of muscle activation and relaxation and Maximum Voluntary Isometric Contraction (MVIC). Intra-observer reliability was significant in both observers, showing good thickness at rest (ICC = 0.833–0.889), thickness in contraction (ICC = 0.861–0.933) and MVIC (ICC = 0.875–0.813); moderate in the activation velocity (ICC = 0.499–0.547) and relaxation velocity (ICC = 0.457–0.606). The inter-observer reliability also had good thickness at rest (ICC = 0.797), thickness in contraction (ICC = 0.89) and MVIC (ICC = 0.84); poor in relaxation time variable (ICC = 0.474) and not significant at the activation velocity (ICC = 0). The muscle activity measurement protocol of the infraspinatus muscle measured with M-mode ultrasound has been found to be reliable in asymptomatic subjects, for both the intra-examiner and inter-examiner. Full article
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9 pages, 1738 KiB  
Article
Ultrasonography Assessment Based on Muscle Thickness and Echo Intensity in Post-Polio Patients
by Álvaro Mateos-Angulo, José Andrés Salazar-Agulló, Cristina Roldán-Jiménez, Manuel Trinidad-Fernández and Antonio Ignacio Cuesta-Vargas
Diagnostics 2022, 12(11), 2743; https://doi.org/10.3390/diagnostics12112743 - 09 Nov 2022
Cited by 2 | Viewed by 1552
Abstract
There is no specific designed diagnostic test for post-poliomyelitis syndrome. The most important symptoms of this syndrome are new loss of muscle strength and more fatigue. Previous studies have investigated muscle ultrasound parameters to distinguish neuromuscular disease patients from healthy controls. The aim [...] Read more.
There is no specific designed diagnostic test for post-poliomyelitis syndrome. The most important symptoms of this syndrome are new loss of muscle strength and more fatigue. Previous studies have investigated muscle ultrasound parameters to distinguish neuromuscular disease patients from healthy controls. The aim of this study was to investigate if muscle thickness and echo intensity measured by ultrasound can discriminate post-poliomyelitis syndrome patients from healthy controls. A total of 29 post-polio patients and 27 healthy controls participated in this cross-sectional study. Anthropometric measures, muscle thickness, echo intensity using B-mode ultrasound in rectus femoris and biceps brachii muscles, and muscle strength test data were collected. Muscle thickness in rectus femoris was significantly lower in post-poliomyelitis patients than in healthy controls, but not in biceps brachii. Echo intensity in rectus femoris and biceps brachii was higher in post-poliomyelitis syndrome patients than in healthy controls. Correlations were found between muscle thickness and strength in the upper and lower limbs. The results of the present study showed that muscle thickness in rectus femoris and echo intensity in rectus femoris and biceps brachii can discriminate post-poliomyelitis syndrome patients from healthy controls. A better assessment is possible because it can observe differences and relevant parameters in this clinical population. Full article
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11 pages, 1013 KiB  
Article
Abdominal and Pelvic Floor Activity Related to Respiratory Diaphragmatic Activity in Subjects with and without Non-Specific Low Back Pain
by Cristina Sicilia-Gomez, Samuel Fernández-Carnero, Alicia Martin-Perez, Nicolas Cuenca-Zaldívar, Fermin Naranjo-Cinto, Daniel Pecos-Martín, Maria Cervera-Cano and Susana Nunez-Nagy
Diagnostics 2022, 12(10), 2530; https://doi.org/10.3390/diagnostics12102530 - 18 Oct 2022
Cited by 6 | Viewed by 2212
Abstract
One of the advances in physiotherapy in recent years is the exploration and treatment by ultrasound imaging. This technique makes it possible to study the relationship between the musculature of the anterolateral wall of the abdomino-pelvic cavity, the pelvic floor muscles and the [...] Read more.
One of the advances in physiotherapy in recent years is the exploration and treatment by ultrasound imaging. This technique makes it possible to study the relationship between the musculature of the anterolateral wall of the abdomino-pelvic cavity, the pelvic floor muscles and the diaphragm muscle, among others, and thus understand their implication in non-specific low back pain (LBP) in pathological subjects regarding healthy subjects. Objective: To evaluate by RUSI (rehabilitative ultrasound imaging) the muscular thickness at rest of the abdominal wall, the excursion of the pelvic floor and the respiratory diaphragm, as well as to study their activity. Methodology: Two groups of 46 subjects each were established. The variables studied were: non-specific low back pain, thickness and excursion after tidal and forced breathing, pelvic floor (PF) excursion in a contraction and thickness of the external oblique (EO), internal oblique (IO) and transverse (TA) at rest. Design: Cross-sectional observational study. Results: Good-to-excellent reliability for measurements of diaphragm thickness at both tidal volume (TV) (inspiration: 0.763, expiration: 0.788) and expiration at forced volume (FV) (0.763), and good reliability for inspiration at FV (0.631). A correlation was found between the EO muscle and PF musculature with respect to diaphragmatic thickness at TV, inspiration and expiration, and inspiration at FV, in addition to finding significant differences in all these variables in subjects with LBP. Conclusion: Subjects with LBP have less thickness at rest in the OE muscle, less excursion of the pelvic diaphragm, less diaphragmatic thickness at TV, in inspiration and expiration, and in inspiration to FV. Full article
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11 pages, 1770 KiB  
Article
Sequential Ultrasound Assessment of Peri-Articular Soft Tissue in Adhesive Capsulitis of the Shoulder: Correlations with Clinical Impairments—Sequential Ultrasound in Adhesive Capsulitis
by Byung Chan Lee, Seung Mi Yeo, Jong Geol Do and Ji Hye Hwang
Diagnostics 2022, 12(9), 2231; https://doi.org/10.3390/diagnostics12092231 - 15 Sep 2022
Cited by 4 | Viewed by 2758
Abstract
Recently, ultrasound measurements of the shoulder such as thickening of the rotator interval (RI) and the axillary recess (AR) are suggested as specific indicators of adhesive capsulitis. Herein, we evaluated the sequential changes in ultrasound parameters and clinical impairments and the correlation between [...] Read more.
Recently, ultrasound measurements of the shoulder such as thickening of the rotator interval (RI) and the axillary recess (AR) are suggested as specific indicators of adhesive capsulitis. Herein, we evaluated the sequential changes in ultrasound parameters and clinical impairments and the correlation between the two in the case of adhesive capsulitis through a prospective observational study of 56 patients with adhesive capsulitis. Clinical assessments and ultrasound parameters, including the thicknesses of the RI and AR, were surveyed at baseline and after 1, 3, and 6 months. In 56 patients with adhesive capsulitis, the thickness of the AR significantly decreased at each follow-up evaluation, but the thickness of the RI showed a significant decrease only between the baseline and 1-month evaluation. In repeated analyses of correlation, the thickness of the AR was strongly correlated with all clinical impairments except the pain at rest and range of internal rotation in the affected shoulder. The thickness of AR was correlated with clinical impairments in patients with adhesive capsulitis during the 6 months follow up and could be useful as a surrogate marker in patients with adhesive capsulitis. Full article
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9 pages, 524 KiB  
Article
Assessment of the Elastographic and Electromyographic of Pelvic Floor Muscles in Postmenopausal Women with Stress Urinary Incontinence Symptoms
by Kuba Ptaszkowski, Bartosz Małkiewicz, Romuald Zdrojowy, Malgorzata Paprocka-Borowicz and Lucyna Ptaszkowska
Diagnostics 2021, 11(11), 2051; https://doi.org/10.3390/diagnostics11112051 - 05 Nov 2021
Cited by 9 | Viewed by 1997
Abstract
Background. Shear wave elastography is an effective method for studying the condition of various musculoskeletal soft tissues. The primary aim of this study was the objective elastographic and electromyographic assessment of the pelvic floor during the rest and contraction of the pelvic floor [...] Read more.
Background. Shear wave elastography is an effective method for studying the condition of various musculoskeletal soft tissues. The primary aim of this study was the objective elastographic and electromyographic assessment of the pelvic floor during the rest and contraction of the pelvic floor muscles (PFM) in postmenopausal women. Methods. This was a prospective observational study that was carried out at the University Hospital in Wroclaw, Poland, between January 2017 and December 2019. Patients. The target group of the study included postmenopausal women with stress urinary incontinence. The primary outcomes were the features of the elastographic assessment of the pelvic floor during rest and contraction of the PFM obtained using shear wave elastography. Results. Based on the inclusion and exclusion criteria for the study, 14 patients took part in the measurements. There was a significant difference between the elastographic assessment of the pelvic floor during rest and contraction of the PFM at all locations in front of the urethra. No statistically significant correlation was found between the results of elastography and the bioelectrical activity of PFM. Conclusion. The elasticity of the periurethral structures is higher during active pelvic floor muscle contraction than at rest, it seems that shear wave elastography is an effective test that objectively assesses the strength of PFM contraction. Full article
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10 pages, 1149 KiB  
Article
Muscle Thickness and Echo Intensity by Ultrasonography and Cognitive and Physical Dimensions in Older Adults
by Alvaro Mateos-Angulo, Alejandro Galán-Mercant and Antonio Ignacio Cuesta-Vargas
Diagnostics 2021, 11(8), 1471; https://doi.org/10.3390/diagnostics11081471 - 13 Aug 2021
Cited by 7 | Viewed by 2271
Abstract
The purpose of the present study was to investigate the associations between muscle thickness and echo intensity with cognitive and physical dimensions like functional capacity measured in older people. This cross-sectional study involved 20 older adults (15 women and 5 men, mean age [...] Read more.
The purpose of the present study was to investigate the associations between muscle thickness and echo intensity with cognitive and physical dimensions like functional capacity measured in older people. This cross-sectional study involved 20 older adults (15 women and 5 men, mean age ± SD: 85 ± 7 years, body mass index: 25 ± 3 kg/m2) from a geriatric centre in Malaga (Spain). Anthropometric measurements, cognitive assessment with Pfeiffer Short Portable Mental Status Questionnaire and Motor Memory test, Physical Performance with Short Physical Performance Battery, and muscle strength were tested. Additionally, using B-mode ultrasonography, images of wrist flexors, biceps brachii, rectus femoris, vastus lateralis, medial gastrocnemius, and tibialis anterior were captured, and muscle thickness and echo intensity variables were extracted. An association between muscle parameters assessed by ultrasonography and cognitive and physical dimensions were found in older people. Echo intensity was the best predictor in a set of regression models with different muscle parameters and a battery of cognitive and physical tests in older people. Echo intensity adjusted by handgrip strength could be a low cost and ambulatory index and an indirect and reversible indicator of functional capacity. Full article
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12 pages, 1547 KiB  
Article
The Morphological and Dynamic Changes of Ultrasound in the Evaluation of Effects of Oral Steroids Treatment for Patients with Carpal Tunnel Syndrome
by Yun-Chain Yau, Chun-Pai Yang, Ching-Po Lin, I-Ju Tsai, Ching-Mao Chang, Cheng-Chia Yang, Po-Hsuan Shih and Yin-Yin Liao
Diagnostics 2021, 11(8), 1336; https://doi.org/10.3390/diagnostics11081336 - 26 Jul 2021
Cited by 2 | Viewed by 1988
Abstract
The role of oral steroids in carpal tunnel syndrome (CTS) remains elusive. This study aims to depict the ultrasound findings and conceivable mechanisms in relation to the efficacy of oral steroids for patients with CTS by measuring the morphological and motion changes in [...] Read more.
The role of oral steroids in carpal tunnel syndrome (CTS) remains elusive. This study aims to depict the ultrasound findings and conceivable mechanisms in relation to the efficacy of oral steroids for patients with CTS by measuring the morphological and motion changes in the median nerve. In this study, CTS patients were randomized to the oral steroid group (14 participants and 22 wrists) or nicergoline group (22 participants and 35 wrists) for 4 weeks. Both treatment arms were given global symptom score (GSS) measurements and completed an ultra-sound at baseline and at 2- and 4-weeks post-treatment. In the nerve conduction study (NCS), distal motor latency (DML) was used to assess the treatment response at baseline and 4 weeks post-treatment. The cross-sectional area (CSA) and amplitude (AMP) evaluated by the maximum lateral sliding displacement represented the morphological and dynamic changes in the median nerve, respectively. The results showed that AMP, CSA, GSS, and DML were significantly im-proved in the steroid group, as compared to the nicergoline group at weeks 2 and 4 (p < 0.05). The mean improvement in ultrasound parameters CSA (15.03% reduction) and AMP (466.09% increase) was better than the DML (7.88% reduction) parameter of NCS, and ultrasound changes were detectable as early as 2 weeks after oral steroid administration. Ultrasounds can serve as a tool for the quantitative measurement of treatment effects and can potentially elucidate the pathogenesis of CTS in a non-invasive and more effective manner. Full article
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12 pages, 1307 KiB  
Article
Reliability of Sonography Measures of the Lumbar Multifidus and Transversus Abdominis during Static and Dynamic Activities in Subjects with Non-Specific Chronic Low Back Pain
by Eleuterio A. Sánchez Romero, José Luis Alonso Pérez, Alberto Carlos Muñoz Fernández, Andrea Battaglino, Matteo Castaldo, Joshua A. Cleland and Jorge Hugo Villafañe
Diagnostics 2021, 11(4), 632; https://doi.org/10.3390/diagnostics11040632 - 01 Apr 2021
Cited by 21 | Viewed by 3320
Abstract
Purpose: The purpose of this study was to investigate the test-retest reliability of ultrasound (US) thickness measurements and the muscle contraction ratio (CR) of lumbar multifidus (LM) and transversus abdominis (TA) muscles in participants with and without nonspecific chronic low back pain (NCLBP). [...] Read more.
Purpose: The purpose of this study was to investigate the test-retest reliability of ultrasound (US) thickness measurements and the muscle contraction ratio (CR) of lumbar multifidus (LM) and transversus abdominis (TA) muscles in participants with and without nonspecific chronic low back pain (NCLBP). Methods: A total of 62 participants (37 with NCLBP, 25 without NCLBP) with participated in the study. The within-day and between-day reliability of US thickness measurements and CR in a lying (supine for TA and prone for LM) and sitting positions for both muscles (sitting on a gym ball with both feet on the ground or lifting one foot off the floor) were assessed. Reliability analysis was performed with intraclass correlations (ICCs) for these two static and dynamic positions. Results: Test-retest reliability was calculated to be good to high for the static position (ICC = 0.72–0.95) and the dynamic position (ICC = 0.74–0.94) sonographic measurements in both group of TA measurement. Test-retest reliability of LM measurements was good to high for the static position (ICC = 0.82–0.95) and the dynamic position (ICC = 0.85–0.97) sonographic measurements in both groups. Conclusions: US imaging is a highly reliable method for the assessment of TA and LM thickness muscles in the dynamic position in participants with and without NCLBP. The CR measures may be adequately reliable in assessing the function of the TA and LM muscles in participants with NCLBP and healthy ones. Full article
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Review

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41 pages, 3921 KiB  
Review
Ultrasound-Guided Interventions for Carpal Tunnel Syndrome: A Systematic Review and Meta-Analyses
by King Hei Stanley Lam, Yung-Tsan Wu, Kenneth Dean Reeves, Felice Galluccio, Abdallah El-Sayed Allam and Philip W. H. Peng
Diagnostics 2023, 13(6), 1138; https://doi.org/10.3390/diagnostics13061138 - 16 Mar 2023
Cited by 6 | Viewed by 4879
Abstract
Carpal tunnel syndrome (CTS) is the most common peripheral entrapment, and recently, ultrasound-guided perineural injection (UPIT) and percutaneous flexor retinaculum release (UPCTR) have been utilized to treat CTS. However, no systematic review or meta-analysis has included both intervention types of ultrasound-guided interventions for [...] Read more.
Carpal tunnel syndrome (CTS) is the most common peripheral entrapment, and recently, ultrasound-guided perineural injection (UPIT) and percutaneous flexor retinaculum release (UPCTR) have been utilized to treat CTS. However, no systematic review or meta-analysis has included both intervention types of ultrasound-guided interventions for CTS. Therefore, we performed this review using four databases (i.e., PubMed, EMBASE, Scopus, and Cochrane) to evaluate the quality of evidence, effectiveness, and safety of the published studies on ultrasound-guided interventions in CTS. Among sixty studies selected for systemic review, 20 randomized treatment comparison or controlled studies were included in six meta-analyses. Steroid UPIT with ultrasound guidance outperformed that with landmark guidance. UPIT with higher-dose steroids outperformed that with lower-dose steroids. UPIT with 5% dextrose in water (D5W) outperformed control injection and hydrodissection with high-volume D5W was superior to that with low-volume D5W. UPIT with platelet-rich plasma outperformed various control treatments. UPCTR outperformed open surgery in terms of symptom improvement but not functional improvement. No serious adverse events were reported in the studies reviewed. The findings suggest that both UPIT and UPCTR may provide clinically important benefits and appear safe. Further treatment comparison studies are required to determine comparative therapeutic efficacy. Full article
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18 pages, 10241 KiB  
Review
Ultrasound Imaging of Facial Vascular Neural Structures and Relevance to Aesthetic Injections: A Pictorial Essay
by Wei-Ting Wu, Ke-Vin Chang, Hsiang-Chi Chang, Chen-Hsiang Kuan, Lan-Rong Chen, Kamal Mezian, Vincenzo Ricci and Levent Özçakar
Diagnostics 2022, 12(7), 1766; https://doi.org/10.3390/diagnostics12071766 - 21 Jul 2022
Cited by 3 | Viewed by 10639
Abstract
The facial and submental regions are supplied by complicated neurovascular networks; therefore, facial aesthetic injections may be associated with serious adverse events such as skin necrosis and blindness. Pre-injection localization of neurovascular structures using high-resolution ultrasound can theoretically prevent unexpected complications. Therefore, a [...] Read more.
The facial and submental regions are supplied by complicated neurovascular networks; therefore, facial aesthetic injections may be associated with serious adverse events such as skin necrosis and blindness. Pre-injection localization of neurovascular structures using high-resolution ultrasound can theoretically prevent unexpected complications. Therefore, a systematic protocol that focuses on these facial neurovascular structures is warranted. In this pictorial essay, we discuss the sonoanatomy of facial and submental neurovascular structures and its relevance to aesthetic injections. Moreover, we have highlighted the mechanisms underlying potential neurovascular injuries during aesthetic injections. Full article
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19 pages, 28314 KiB  
Review
High-Resolution Ultrasound of the Forefoot and Common Pathologies
by Xiangmei Chen, Guangjin Zhou, Heng Xue, Run Wang, Stephen Bird, Desheng Sun and Ligang Cui
Diagnostics 2022, 12(7), 1541; https://doi.org/10.3390/diagnostics12071541 - 24 Jun 2022
Cited by 4 | Viewed by 6872
Abstract
Forefoot pain is common in clinical practice. Careful history taking and routine physical examination are initially performed for diagnosis, but imaging can confirm the clinical suspicion and play a key role in management. Ultrasound (US) can provide a visualization of the fine anatomy [...] Read more.
Forefoot pain is common in clinical practice. Careful history taking and routine physical examination are initially performed for diagnosis, but imaging can confirm the clinical suspicion and play a key role in management. Ultrasound (US) can provide a visualization of the fine anatomy of the forefoot and is a useful method for evaluating various lesions causing forefoot pain. In this review, we provide the detailed anatomical structures of the forefoot and their normal appearances on US. We also focus on the most common pathologies affecting the forefoot, including plantar plate tear, sesamoiditis, bone fracture, synovitis, tenosynovitis, bursitis, Morton’s neuromas, and foreign bodies. Full article
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Other

4 pages, 1419 KiB  
Interesting Images
Dynamic Ultrasonography for Imaging Pediatric Fat Pad Herniation through the Lateral Patellar Retinaculum
by Wei-Ting Wu, Ke-Vin Chang, Kuan-Wen Wu, Kamal Mezian, Vincenzo Ricci and Levent Özçakar
Diagnostics 2022, 12(10), 2523; https://doi.org/10.3390/diagnostics12102523 - 17 Oct 2022
Cited by 2 | Viewed by 2902
Abstract
A 3-year-old boy was found to have a painless mass over his right anterior lateral knee for the previous 6 months. The mass was hardly identified during knee extension and became visible upon squatting. There was no specific finding on ultrasound imaging over [...] Read more.
A 3-year-old boy was found to have a painless mass over his right anterior lateral knee for the previous 6 months. The mass was hardly identified during knee extension and became visible upon squatting. There was no specific finding on ultrasound imaging over his right knee at the supine extended position. During squatting, ultrasound imaging showed an ill-demarcated hyperechoic mass protruding next to the cartilage overlying the distal femur towards the subcutaneous layer through a slit over the lateral patellar retinaculum. Herniation of the fat pad through a defect in the lateral patellar retinaculum was diagnosed. Our case highlights the usefulness of ultrasound examination as regards the lateral patellar retinaculum defect in pediatric knees, as well as its capability for dynamic scanning to capture the exact “pathological moment”. Full article
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18 pages, 75837 KiB  
Essay
Sonoanatomy and Stepwise/Systematic Ultrasound Examination of the Extrinsic/Intrinsic Wrist Ligaments
by Jia-Chi Wang, Wei-Ting Wu, Ke-Vin Chang, Lan-Rong Chen, Yuko Nakashima and Levent Özçakar
Diagnostics 2021, 11(10), 1834; https://doi.org/10.3390/diagnostics11101834 - 04 Oct 2021
Cited by 7 | Viewed by 9136
Abstract
Ultrasound has emerged as the most useful imaging tool for investigating wrist and hand disorders, with several published ultrasound protocols having demonstrated their practicality in scanning the wrist tendons and nerves. However, ligaments of the wrist are networked in a complex manner, deterring [...] Read more.
Ultrasound has emerged as the most useful imaging tool for investigating wrist and hand disorders, with several published ultrasound protocols having demonstrated their practicality in scanning the wrist tendons and nerves. However, ligaments of the wrist are networked in a complex manner, deterring sonographers from examining them with an organized strategy. Furthermore, because of the non-parallel alignment between the radiocarpal, mid-carpal, and carpal–metacarpal joints, precise recognition of the carpal bones is challenging, although ultrasound is paramount for visualizing the wrist ligaments. In this regard, the current article for point of view aims to elaborate sonoanatomy of the carpal bones and to present a stepwise systematic approach for navigating the extrinsic and intrinsic wrist ligaments. Full article
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5 pages, 3435 KiB  
Case Report
Ultrasound Examination and Navigation for Repeat/Delayed Reconstruction of the Ankle Extensor Tendons
by Kamal Mezian, Karolína Sobotová, David Zámečník and Levent Özçakar
Diagnostics 2021, 11(8), 1408; https://doi.org/10.3390/diagnostics11081408 - 04 Aug 2021
Cited by 1 | Viewed by 2051
Abstract
Herein, we describe a 46-year-old woman with persistent pain and weakness in her left ankle/foot one year after surgical repair of all three ankle extensor tendons following a penetrating injury. This report presents a unique case whereby US imaging played a paramount role [...] Read more.
Herein, we describe a 46-year-old woman with persistent pain and weakness in her left ankle/foot one year after surgical repair of all three ankle extensor tendons following a penetrating injury. This report presents a unique case whereby US imaging played a paramount role in the diagnosis and surgical management of a previous nonanatomic repair of the ankle extensor tendons after a penetrating injury one year prior. The above-quoted findings were subsequently corrected with end-to-end sutures. On the third postoperative month follow-up, the patient was free of any complaints or complications. Full article
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