Journal of Ultrasonography最新文献

{"title":"Ultrasound versus MRI in the evaluation of the thumb metacarpophalangeal joint","authors":"Beatrice Knisely, Shelley S. Noland, David M. Melville","doi":"10.15557/jou.2023.0030","DOIUrl":"https://doi.org/10.15557/jou.2023.0030","url":null,"abstract":"An intricate and unique combination of ligamentous, fibrocartilaginous, and osseous structures stabilize the thumb metacarpophalangeal joint. Both ultrasound and high-resolution magnetic resonance imaging are extremely useful in evaluating these critical structures. This article reviews common injuries of the thumb metacarpophalangeal joint, while highlighting the merits, limitations, and pitfalls of the two imag- ing modalities. A clear appreciation of each method, paired with anatomic knowledge, will lend greater confidence and accuracy to diagnosing impactful injuries and guiding intervention.","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136132775","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}

{"title":"High-resolution ultrasound and MRI in the evaluation of pectoralis major injuries","authors":"Nicholson Chadwick, Jennifer S. Weaver, Christopher Shultz, Yoav Morag, Arjun Patel, Mihra S. Taljanovic","doi":"10.15557/jou.2023.0029","DOIUrl":"https://doi.org/10.15557/jou.2023.0029","url":null,"abstract":"The pectoralis major muscle is the largest muscle of the anterior chest wall. The primary function of the muscle is to adduct and internally rotate the arm at the shoulder. The pectoralis major muscle is broken down into two main components or “heads” based upon muscle fiber origin: clavicular and sternal. Pectoralis major muscle injury results from direct trauma or indirect force overload. The inferior sternal head fibers are the most com- monly torn. The pectoralis major tendon most commonly is torn at the humeral insertion. Magnetic reso- nance imaging and high-resolution ultrasound have value in diagnosing pectoralis major muscle injury and help guide clinical and surgical management. Non-operative versus operative management of pectoralis major tears is dependent upon accurate diagnosis of tear location and severity on imaging. Operative management is recommended for tears at the humeral insertion and for musculotendinous junction tears with severe cos- metic/functional deformity. The indications for surgical intervention have been further expanded to complete intra-tendinous tears, defined as the mid-tendon substance between the myotendinous junction and humeral insertion, and those located at the sternal head/posterior lamina. This paper reviews normal pectoralis major anatomy and the spectrum of injury on magnetic resonance imaging and ultrasound. The importance of re- gional anatomical landmarks in assessing for pectoralis major muscle injury will be described. Other patholo- gies, such as tumor and infection, can also affect the pectoralis major muscle and key imaging features will be discussed to help differentiate these entities. Operative and non-operative management of pectoralis major muscle injury is described with examples of pectoralis major repair on post-operative imaging.","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136132779","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}

{"title":"Tips and tricks in ultrasound-guided musculoskeletal interventional procedures","authors":"William R. Walter, Christopher J. Burke, Ronald S. Adler","doi":"10.15557/jou.2023.0039","DOIUrl":"https://doi.org/10.15557/jou.2023.0039","url":null,"abstract":"Ultrasound visualization affords proceduralists versatile and accurate guidance for a variety of percutaneous, minimally invasive procedures in the musculoskeletal system including joint (intra-articular) injections or aspirations, intra-bursal injections, peritendinous, and perineural injections. A variety of percutaneous procedures are traditionally performed blindly, but may be more easily or more accurately performed with the real-time assistance of ultrasound guidance. Other procedures are only possible utilizing image-guidance, due to the required precision of the injection because of delicate local anatomy or depth of the injection; ultrasound is a safe, portable, and widespread modality that can be used to assist the proceduralist in localizing the needle tip in such cases, to ensure safe and accurate delivery of the medication, most frequently a solution of steroid and anesthetic. This review aims to provide a foundational approach to ultrasound-guided procedures in the musculoskeletal system, offering tips and tricks that can be employed in many different procedures including intra-articular, juxta-articular, and perineural injections for a multitude of clinical scenarios. Technical considerations regarding ultrasound transducer selection, sonographic technique, as well as common indications, contraindications, and complications of these procedures, are presented. Additionally, a variety of pharmacologic considerations for proceduralists contemplating ultrasound-guided injections are discussed.","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136132562","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}

{"title":"Practical approach to ultrasound of soft tissue tumors and the added value of MRI: how I do it","authors":"James Francis Griffith","doi":"10.15557/jou.2023.0036","DOIUrl":"https://doi.org/10.15557/jou.2023.0036","url":null,"abstract":"This review outlines a practical approach to the everyday assessment of both non-neoplastic and neoplastic soft tissue tumors, focusing on ultrasound examination, though emphasizing the added benefit of magnetic resonance imaging in certain instances. Ultrasound approach and assessment, practical scenarios, report- ing, biopsy, and follow-up are covered, as well as the criteria used to distinguish benign from malignant tumors. The potential benefits and current limitations of elastography and contrast-enhanced ultrasound in assessment are also addressed. Examples of commonly encountered soft tissue tumors are shown. Ul- trasound can characterize most soft tissue masses based on their ultrasound appearance alone. Following ultrasound examination, three potential scenarios usually exist in clinical practice: (a) confident regarding diagnosis, (b) indeterminate mass with no evidence of malignancy, and (c) indeterminate mass with pos- sibility of malignancy. A diagnostic pathway for each of these scenarios is provided. Magnetic resonance imaging is generally not helpful in further characterizing masses which are indeterminate on ultrasound assessment, though it is helpful in addressing other issues such as exact tumor location and neurovascular bundle involvement that may not be fully resolved on ultrasound examination. In these situations, mag- netic resonance imaging examination can be tailored to address those specific questions that have not been adequately addressed on ultrasound examination. In this sense, both examinations are highly complemen- tary. Tips for undertaking magnetic resonance imaging examinations are provided.","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136132565","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}

{"title":"Role of high-resolution ultrasound and magnetic resonance neurography in the evaluation of peripheral nerves in the upper extremity","authors":"Ali Serhal, Steven Kyungho Lee, Julia Michalek, Muhamad Serhal, Imran Muhammad Omar","doi":"10.15557/jou.2023.0037","DOIUrl":"https://doi.org/10.15557/jou.2023.0037","url":null,"abstract":"Upper extremity entrapment neuropathies are common conditions in which peripheral nerves are prone to injury at specific anatomical locations, particularly superficial regions or within fibro-osseous tunnels, resulting in pain and potential disability. Although neuropathy is primarily diagnosed clinically by physical examination and electrophysiology, imaging evaluation with ultrasound and magnetic resonance neurogra- phy are valuable complementary non-invasive and accurate tools for evaluation and can help define the site and cause of nerve dysfunction which ultimately leads to precise and timely treatment. Ultrasound, which has higher spatial resolution, can quickly and comfortably characterize the peripheral nerves in real time and can evaluate for denervation related muscle atrophy. Magnetic resonance imaging on the other hand provides excellent contrast resolution between the nerves and adjacent tissues, also between pathologic and normal segments of peripheral nerves. It can also assess the degree of muscle denervation and atrophy. As a prerequisite for nerve imaging, radiologists and sonographers should have a thorough knowledge of anat- omy of the peripheral nerves and their superficial and deep branches, including variant anatomy, and the motor and sensory territories innervated by each nerve. The purpose of this illustrative article is to review the common neuropathy and nerve entrapment syndromes in the upper extremities focusing on ultrasound and magnetic resonance neurography imaging.","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136132777","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}

{"title":"Anatomical considerations of US-guided carpal tunnel release in daily clinical practice.","authors":"Hanne-Rose Honis,&nbsp;Hannes Gruber,&nbsp;Sarah Honold,&nbsp;Marko Konschake,&nbsp;Bernhard Moriggl,&nbsp;Erich Brenner,&nbsp;Elisabeth Skalla-Oberherber,&nbsp;Alexander Loizides","doi":"10.15557/jou.2023.0022","DOIUrl":"https://doi.org/10.15557/jou.2023.0022","url":null,"abstract":"<p><p>Carpal tunnel syndrome is the most frequent compression neuropathy with an incidence of one to three subjects per thousand. As specific anatomical variations might lead to unintended damage during surgical interventions, we present a review to elucidate the anatomical variability of the carpal tunnel region with important considerations for daily clinical practice: several variants of the median nerve branches in and around the transverse carpal ligament are typical and must - similarly to the variant courses of the median artery, which may be found eccentric ulnar to the median nerve - be taken into account in any interventional therapy at the carpal tunnel. Unintended interference in these structures might lead to heavy arterial bleeding and, in consequence, even underperfusion of segments of the median nerve or, if neural structures such as variant nerve branches are impaired or even cut, severe pain-syndromes with a profound impact on the quality of life. This knowledge is thus crucial for outcome- and safety-optimization of different surgical procedures at the volar aspect of the wrist and surgical therapy of the carpal tunnel syndrome e.g., US-guided carpal tunnel release, as injury might result in dysfunction and/or pain on wrist motion or direct impact in the region concerned. For most variations, anatomical and surgical descriptions vary, as official classifications are still lacking.</p>","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e0/f1/jou-23-94-jou.2023.0022.PMC10508271.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41153789","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}

{"title":"Median nerve versus flexor tendons: visualization of median nerve level changes in the proximal carpal tunnel during wrist movement with dynamic high-resolution ultrasound.","authors":"Suren Armeni Jengojan,&nbsp;Lisa Lechner,&nbsp;Gregor Kasprian,&nbsp;Elena Drakonaki,&nbsp;Veith Moser,&nbsp;Žiga Snoj,&nbsp;Gerd Bodner","doi":"10.15557/jou.2023.0020","DOIUrl":"https://doi.org/10.15557/jou.2023.0020","url":null,"abstract":"<p><strong>Aim: </strong>The purpose of this prospective ultrasound study was to document dorso-palmar (vertical) displacement of the median nerve in relation to the superficial flexor tendons at the level of the carpal tunnel. Furthermore, the gliding patterns of the median nerve were characterized. The presence of vertical gliding was intended to serve as an additional bio-kinematic parameter of median nerve movement, and will be referred to as a 'level change'.</p><p><strong>Material and methods: </strong>In this study, a total of 32 healthy young individuals underwent dynamic high-resolution ultrasound examinations of both wrists. The neutral position, and maximum flexion and extension of the wrist had to be reached in active and passive movement. The gliding patterns were determined in relation to the superficial flexor tendons. When no vertical nerve gliding was observed, it was characterized as 'no level change'.</p><p><strong>Results: </strong>The presence of a level change prevailed in the healthy young cohort and was observed in 84% (27/32) of individuals during wrist flexion. The following gliding pattern was distinctively the most common: gliding of the entire nerve in between the flexor tendons in active but not in passive movement of the right and left wrists (13/27; 48%). The extent of vertical displacement was found to be associated with the gliding pattern (Kruskal-Wallis test).</p><p><strong>Conclusions: </strong>Movement in the carpal tunnel allows the median nerve to adapt to biomechanical stress. Dynamic ultrasound can demonstrate median nerve level changes in response to wrist movements. Furthermore, a typical gliding pattern was characterized. The presence of level change and gliding patterns were proposed as additional movement parameters during wrist flexion in healthy individuals.</p>","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e0/27/jou-23-94-jou.2023.0020.PMC10508267.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41137420","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}

{"title":"A rare case of an intraneural ganglion cyst of the median nerve.","authors":"Sisith Ariyaratne,&nbsp;Gora Pathak,&nbsp;Karthikeyan Iyengar,&nbsp;Rajesh Botchu,&nbsp;Amit Shah","doi":"10.15557/jou.2023.0025","DOIUrl":"10.15557/jou.2023.0025","url":null,"abstract":"<p><strong>Aim of the study: </strong>Intraneural ganglion cysts are a relatively uncommon type of ganglion cyst that can affect peripheral nerves. They are particularly rare in the upper limb, and even more so in the median nerve, with the vast majority of them occurring in the peroneal nerves. This paper aims to make the reader aware of this relatively uncommon condition.</p><p><strong>Case description: </strong>We report a case of a 41-year-old male who presented with a gradually progressing mass on the volar aspect of the wrist extending to the index finger. The nonspecific presentation as well as the rarity of the condition may make diagnosis challenging. The patient was referred for surgical management under a specialist peripheral nerve hand surgeon.</p><p><strong>Conclusions: </strong>Ultrasound and magnetic resonance imaging as well as awareness of the typical imaging features of this entity are crucial in making the correct diagnosis as well as excluding other potential considerations such as neoplasm.</p>","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/79/08/jou-23-94-jou.2023.0025.PMC10494806.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10228381","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}

{"title":"Ultrasound-guided median nerve hydrodissection of pronator teres syndrome: a case report and a literature review.","authors":"Parham Shojaie,&nbsp;Rajesh Botchu,&nbsp;Karthikeyan Iyengar,&nbsp;Elena Drakonaki,&nbsp;Gaurav Kant Sharma","doi":"10.15557/jou.2023.0026","DOIUrl":"10.15557/jou.2023.0026","url":null,"abstract":"<p><strong>Aim of the study: </strong>To describe the sonographic appearance of pronator teres syndrome and the role of ultrasound-guided hydrodissection for its management.</p><p><strong>Case description: </strong>Pronator teres syndrome is a well-known compressive neuropathy of the median nerve between the two heads of pronator teres. However, the clinical presentation of this syndrome can be indolent with vague pain at the proximal volar forearm leading to a delay in diagnosis. We describe our experience in the management of pronator teres syndrome in a healthy young badminton player with ultrasound-guided median nerve hydrodissection. We highlight the clinical presentation, the role of dynamic Ultrasound scan (USS) in the diagnosis and effective treatment of pronator teres syndrome.</p><p><strong>Conclusions: </strong>In conclusion, managing PTS can be challenging, and this case highlights the importance of ultrasound-guided hydrodissection, when conservative measures have failed to improve the symptoms. Further studies are required to assess and compare the long-term outcomes of these interventions.</p>","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ee/6c/jou-23-94-jou.2023.0026.PMC10494808.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10228376","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}

{"title":"Ultrasound of the plantar foot: a guide for the assessment of plantar intrinsic muscles.","authors":"Federico Zaottini,&nbsp;Riccardo Picasso,&nbsp;Federico Pistoia,&nbsp;Maribel Miguel Perez,&nbsp;Deborah Bianco,&nbsp;Rinaldi Simone,&nbsp;Gabriele Rossi,&nbsp;Marta Macciò,&nbsp;Michelle Pansecchi,&nbsp;Luca Tovt,&nbsp;Carlo Martinoli","doi":"10.15557/jou.2023.0024","DOIUrl":"https://doi.org/10.15557/jou.2023.0024","url":null,"abstract":"<p><p>Plantar intrinsic muscles play a pivotal role in posture control and gait dynamics. They help maintain the longitudinal and transverse arches of the foot, and they regulate the degree and velocity of arch deformation during walking or running. Consequently, pathologies affecting the plantar intrinsic muscles (for instance, acquired and inherited neuropathies) lead to foot deformity, gait disorders, and painful syndromes. Intrinsic muscle malfunctioning is also associated with multifactorial overuse or degenerative conditions such as pes planus, hallux valgus, and plantar fasciitis. As the clinical examination of each intrinsic muscle is challenging, ultrasound is gaining a growing interest as an imaging tool to investigate the trophism of these muscular structures and the pattern of their alterations, and potentially to follow up on the effects of dedicated rehabilitation protocols. The ten plantar intrinsic muscles can be dived into three groups (medial, central and lateral) and four layers. Here, we propose a regional and landmark-based approach to the complex sonoanatomy of the plantar intrinsic muscles in order to facilitate the correct identification of each muscle from the superficial to the deepest layer. We also summarize the pathological ultrasound findings that can be encountered when scanning the plantar muscles, pointing out the patterns of alterations specific to certain conditions, such as plantar nerves mononeuropathies.</p>","PeriodicalId":45612,"journal":{"name":"Journal of Ultrasonography","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b0/67/jou-23-94-jou.2023.0024.PMC10508328.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41151799","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}