1
|
Weaver JS, Omar I, Epstein K, Brown A, Chadwick N, Taljanovic MS. High-resolution ultrasound in the evaluation of musculoskeletal infections. J Ultrason 2023; 23:e272-e284. [PMID: 38020512 PMCID: PMC10668941 DOI: 10.15557/jou.2023.0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 07/31/2023] [Indexed: 12/01/2023] Open
Abstract
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 inconclusive. 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 seeding of the soft tissues from hematogenous spread, while osseous infections are more commonly due to hematogenous 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 subperiosteal abscesses. This article describes the typical high-resolution grayscale as well as color and power Doppler 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.
Collapse
Affiliation(s)
- Jennifer S. Weaver
- Department of Radiology, University of Texas Health San Antonio, San Antonio, USA
| | - Imran Omar
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Katherine Epstein
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, USA
| | | | - Nicholson Chadwick
- Department of Radiology, Vanderbilt University Medical Center, Nashville, USA
| | - Mihra S. Taljanovic
- Department of Radiology, University of New Mexico, Albuquerque, New Mexico, USA
- Departments of Medical Imaging and Orthopedic Surgery, Banner University Medical Center, Tucson, Arizona, USA
| |
Collapse
|
2
|
Cocco G, Ricci V, Villani M, Delli Pizzi A, Izzi J, Mastandrea M, Boccatonda A, Naňka O, Corvino A, Caulo M, Vecchiet J. Ultrasound imaging of bone fractures. Insights Imaging 2022; 13:189. [PMID: 36512142 PMCID: PMC9748005 DOI: 10.1186/s13244-022-01335-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/20/2022] [Indexed: 12/15/2022] Open
Abstract
Ultrasound imaging is widely used to evaluate the neuromusculoskeletal system, and recently, a particular interest is mounting in assessing the bone tissue and fractures. Ultrasound can be considered a valuable diagnostic tool to perform a first-line evaluation of bone tissue, especially in particular settings without direct access to X-ray imaging and/or in emergency conditions. Moreover, different healing phases of bone fractures can be accurately assessed by combining the B-mode modality and (high-sensitive) color/power Doppler optimizing the management of patients-e.g., planning of progressive loads and rehabilitation procedures. In this review, we summarized the role of ultrasound imaging in the management of bone fractures and described the most common sonographic signs encountered in the daily practice by assessing different types of bone fractures and the progressive phases of the healing process.
Collapse
Affiliation(s)
- Giulio Cocco
- grid.412451.70000 0001 2181 4941Unit of Ultrasound in Internal Medicine, Department of Medicine and Science of Aging, G. D’Annunzio University, Chieti, Italy
| | - Vincenzo Ricci
- grid.507997.50000 0004 5984 6051Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Michela Villani
- Unit of Radiology, “Santissima Annunziata” Hospital, Chieti, Italy
| | - Andrea Delli Pizzi
- Unit of Radiology, “Santissima Annunziata” Hospital, Chieti, Italy ,grid.412451.70000 0001 2181 4941Department of Innovative Technologies in Medicine and Dentistry, G. D’Annunzio University, Chieti, Italy
| | - Jacopo Izzi
- Unit of Radiology, “Santissima Annunziata” Hospital, Chieti, Italy
| | - Marco Mastandrea
- Unit of Radiology, “Santissima Annunziata” Hospital, Chieti, Italy
| | - Andrea Boccatonda
- grid.414090.80000 0004 1763 4974Internal Medicine, Bentivoglio Hospital, AUSL Bologna, Bologna, Italy
| | - Ondřej Naňka
- grid.4491.80000 0004 1937 116XFirst Faculty of Medicine, Institute of Anatomy, Charles University, Prague, Czech Republic
| | - Antonio Corvino
- grid.17682.3a0000 0001 0111 3566Motor Science and Wellness Department, Parthenope University, Naples, Italy
| | - Massimo Caulo
- Unit of Radiology, “Santissima Annunziata” Hospital, Chieti, Italy ,grid.412451.70000 0001 2181 4941Department of Innovative Technologies in Medicine and Dentistry, G. D’Annunzio University, Chieti, Italy ,grid.414090.80000 0004 1763 4974Internal Medicine, Bentivoglio Hospital, AUSL Bologna, Bologna, Italy ,grid.4491.80000 0004 1937 116XFirst Faculty of Medicine, Institute of Anatomy, Charles University, Prague, Czech Republic ,grid.17682.3a0000 0001 0111 3566Motor Science and Wellness Department, Parthenope University, Naples, Italy ,grid.412451.70000 0001 2181 4941Department of Neuroscience Imaging and Clinical Sciences, G. D’Annunzio University, Chieti, Italy
| | - Jacopo Vecchiet
- grid.412451.70000 0001 2181 4941Clinic of Infectious Diseases, Department of Medicine and Science of Aging, G. D’Annunzio University, Chieti, Italy
| |
Collapse
|
3
|
Application of Nano-Inspired Scaffolds-Based Biopolymer Hydrogel for Bone and Periodontal Tissue Regeneration. Polymers (Basel) 2022; 14:polym14183791. [PMID: 36145936 PMCID: PMC9504130 DOI: 10.3390/polym14183791] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/28/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
This review’s objectives are to provide an overview of the various kinds of biopolymer hydrogels that are currently used for bone tissue and periodontal tissue regeneration, to list the advantages and disadvantages of using them, to assess how well they might be used for nanoscale fabrication and biofunctionalization, and to describe their production processes and processes for functionalization with active biomolecules. They are applied in conjunction with other materials (such as microparticles (MPs) and nanoparticles (NPs)) and other novel techniques to replicate physiological bone generation more faithfully. Enhancing the biocompatibility of hydrogels created from blends of natural and synthetic biopolymers can result in the creation of the best scaffold match to the extracellular matrix (ECM) for bone and periodontal tissue regeneration. Additionally, adding various nanoparticles can increase the scaffold hydrogel stability and provide a number of biological effects. In this review, the research study of polysaccharide hydrogel as a scaffold will be critical in creating valuable materials for effective bone tissue regeneration, with a future impact predicted in repairing bone defects.
Collapse
|