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Vigny S, Rubinstenn E, Michelin P, Sabatier T, Dhellemmes O, Duparc F, Auquit-Aukbur I, Lalevee M. Ultrasound identification of hand and wrist anatomical structures by hand surgeons new to ultrasonographic techniques. Surg Radiol Anat 2024; 46:795-804. [PMID: 38597950 DOI: 10.1007/s00276-024-03355-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 03/21/2024] [Indexed: 04/11/2024]
Abstract
PURPOSE Ultrasound is becoming an essential tool for hand surgeons, but most of them are trained on the job, without any diploma or dedicated training. The aim of this study was to assess the ability of hand surgeons new to ultrasound to identify hand and wrist anatomical structures. METHODS A monocentric study was conducted from January 2022 to April 2022. Ten residents and five attending hand surgeons, ultrasound novices, were involved in this study. The participants underwent two tests, wherein they were required to identify 17 anatomical structures using ultrasound, on the same subject. The second test was similar and carried out 2 to 6 weeks later by all participants. The number of structures successfully identified and if it was the case, the detection time per structure, were recorded. The correlations between participants age, years of surgical experience, surgical background (orthopedic or plastic) and the ability to perform immediately during the first test or to progress between the two tests were also assessed. RESULTS The average number of structures identified during the first test (T1) was 14.1+/-2.1 (82.9%), versus 16.2+/-0.8 (95.3%) structures during the second test (T2) (p = 0.001). The mean detection time per structure was 53.4 +/- 18.9 s during T1 versus 27.7 +/- 7.2 s during T2 (p < 0.0001). A moderate negative correlation between the progression in the number of anatomical structures identified between the two tests and the years of surgical experience (ρ=-0.56; p = 0.029) was found. The other parameters were neither correlated with the ability to perform at the first test nor with the progression between the two tests. CONCLUSION Hand surgeons new to ultrasound are most of the time able to identify hand and wrist anatomical structures. Comparison of their first and second tests showed significant potential for improvement in anatomical structure identification and detection time of those, especially in surgeons with limited surgical experience.
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Affiliation(s)
- Solène Vigny
- Department of Orthopedic Surgery, Rouen University Hospital, Rouen, 76000, France
- Laboratory of Anatomy, Faculty of Medicine, Rouen Normandy University, Rouen, 76000, France
| | - Eva Rubinstenn
- Department of Orthopedic Surgery, Rouen University Hospital, Rouen, 76000, France
| | - Paul Michelin
- Department of Radiology, Rouen University Hospital, Rouen, 76000, France
- Rouen Normandy University, CETAPS, Mont Saint Aignan, UR 3832, 79821, France
| | - Thibaut Sabatier
- Department of Epidemiology and Health Promotion, Rouen University Hospital, Rouen, 1073, F 76000, France
| | - Octave Dhellemmes
- Department of Plastic and Hand Surgery, Rouen University Hospital, Rouen, 76000, France
| | - Fabrice Duparc
- Department of Orthopedic Surgery, Rouen University Hospital, Rouen, 76000, France
- Laboratory of Anatomy, Faculty of Medicine, Rouen Normandy University, Rouen, 76000, France
- Rouen Normandy University, CETAPS, Mont Saint Aignan, UR 3832, 79821, France
| | | | - Matthieu Lalevee
- Department of Orthopedic Surgery, Rouen University Hospital, Rouen, 76000, France.
- Rouen Normandy University, CETAPS, Mont Saint Aignan, UR 3832, 79821, France.
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Babaei-Ghazani A, Boudier-Revéret M, Michaud J. Zebras in the Shoulder: a Review Article on Advanced Diagnostic Ultrasound of the Shoulder. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2021. [DOI: 10.1007/s40141-021-00331-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mattox R, Trager RJ, Kettner NW. Effort Thrombosis in 2 Athletes Suspected of Musculoskeletal Injury. J Chiropr Med 2020; 18:213-218. [PMID: 32874161 DOI: 10.1016/j.jcm.2019.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 11/22/2018] [Accepted: 01/16/2019] [Indexed: 11/24/2022] Open
Abstract
Objective This case series describes the clinical presentation of effort thrombosis and the utility of sonography in its diagnosis. Clinical Features Two young male athletes presented to separate chiropractic clinics with suspected musculoskeletal shoulder injury. The first complained of dull shoulder pain after pitching in a baseball game and had no other signs or symptoms. The second presented after performing a weighted plank exercise and had prominent edema and discoloration of the affected extremity. Intervention and Outcome In the first patient, who had no physical signs to suggest thrombosis, a normal sonographic musculoskeletal shoulder exam prompted imaging in the abduction-external rotation position. This provided visualization of a thrombus in the axillosubclavian vein. Emergent referral followed, and treatment was initiated with thrombolysis and surgery, which resolved his condition. The second patient had physical signs consistent with effort thrombosis and was also referred to the emergency department, where sonography was performed and revealed thrombosis of the axillary and basilic veins. He responded to anticoagulants and thrombolysis and avoided surgery. Conclusion Effort thrombosis has a variable presentation that can mimic common musculoskeletal disorders and has a poorly defined diagnostic pathway. Acute shoulder pain in an athlete, especially with extremity edema after repetitive exertion, warrants urgent imaging such as sonography and emergent referral. Clinicians should understand the importance of a timely evaluation and diagnosis of effort thrombosis and that imaging may include sonography as a first-line imaging tool.
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Affiliation(s)
- Ross Mattox
- Department of Radiology, Logan University, Chesterfield, Missouri
| | | | - Norman W Kettner
- Department of Radiology, Logan University, Chesterfield, Missouri
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