Trans-axillary sonography in the ABER (ABduction and External Rotation) position: a window to the subscapularis, teres major and latissimus dorsi.

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Journal of Ultrasound Pub Date : 2024-12-01 Epub Date: 2024-08-10 DOI:10.1007/s40477-024-00924-6
Logeswaran Selvarajah, Mark Cresswell, Romain David, Paul Winston, Timothy Murray
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引用次数: 0

Abstract

Shoulder ultrasound is a key tool used by musculoskeletal practitioners to diagnose and treat a variety of upper girdle diseases. While magnetic resonance imaging is the cornerstone of shoulder imaging, sonography is readily available, practical and superior in its ability for dynamic assessment of musculoskeletal pathologies. The subscapularis, teres major and latissimus dorsi muscles are commonly involved in a myriad of pathology including myofascial pain and spasticity. There is scarce literature on the assessment of these muscles for diagnostic and therapeutic purposes. Conventional approaches to shoulder ultrasound have not included a dedicated assessment of the subscapularis muscle due to its inherent anatomical location deep to the scapular blade which blocks sound wave penetration. We describe an approach to visualizing the subscapularis muscle as a short addition to the established shoulder sonography format, which also permits assessment of both the latissimus dorsi and teres major muscles, which are important muscles for shoulder spasticity. The patient is imaged in a semi-recumbent position with the arms elevated above and behind the head in the ABduction and External Rotation (ABER) position. The relative ease of positioning and sonographic access to the musculature coupled with the potential for assessment and intervention makes this approach extremely desirable to the musculoskeletal practitioner looking to diagnose or treat muscle belly pathologies of the subscapularis, teres major or latissimus dorsi.

ABER(ABduction and External Rotation,内收外旋)体位下的经腋窝超声造影:了解肩胛下肌、大圆肌和背阔肌的窗口。
肩部超声是肌肉骨骼医生诊断和治疗各种上腰椎疾病的重要工具。虽然磁共振成像是肩部成像的基石,但超声波成像技术在动态评估肌肉骨骼病变方面具有方便、实用和优越性。肩胛下肌、大圆肌和背阔肌常见于各种病症,包括肌筋膜疼痛和痉挛。对这些肌肉进行诊断和治疗评估的文献很少。由于肩胛下肌位于肩胛骨的深处,其固有的解剖位置阻碍了声波的穿透,因此传统的肩部超声检查方法并不包括对肩胛下肌的专门评估。我们介绍了一种肩胛下肌可视化方法,它是对现有肩部超声造影方法的一个简短补充,同时还能评估背阔肌和大圆肌,这两块肌肉是肩部痉挛的重要肌肉。患者以半卧位进行成像,双臂抬高至头顶上方和后方,呈内收外旋 (ABER) 位。由于定位和声像图检查肌肉组织相对容易,而且具有评估和干预的潜力,因此这种方法对于希望诊断或治疗肩胛下肌、大圆肌或背阔肌肌腹病变的肌肉骨骼医生来说非常理想。
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来源期刊
Journal of Ultrasound
Journal of Ultrasound RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
4.10
自引率
15.00%
发文量
133
期刊介绍: The Journal of Ultrasound is the official journal of the Italian Society for Ultrasound in Medicine and Biology (SIUMB). The journal publishes original contributions (research and review articles, case reports, technical reports and letters to the editor) on significant advances in clinical diagnostic, interventional and therapeutic applications, clinical techniques, the physics, engineering and technology of ultrasound in medicine and biology, and in cross-sectional diagnostic imaging. The official language of Journal of Ultrasound is English.
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