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Pan G. Current status of dynamic musculoskeletal ultrasound for application to treatment of orthopedic diseases. Am J Transl Res 2024; 16:2180-2189. [PMID: 39006303 PMCID: PMC11236655 DOI: 10.62347/wher3512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/08/2024] [Indexed: 07/16/2024]
Abstract
In recent years, dynamic musculoskeletal ultrasound (DMUS) technology has demonstrated great potential in the diagnosis and treatment of orthopedic diseases. As a non-invasive, real-time imaging technique, it provides a dynamic view of joints and soft tissues, offering crucial insight for evaluating muscle injuries and bone damage caused by motion. This article comprehensively reviews the latest research in the field of DMUS, discussing its significant roles in managing orthopedic diseases and enhancing clinical practice. The application of DMUS is wide-ranging, including but not limited to the diagnosis of tendon injuries, ligament tears, arthritis, and soft tissue diseases. Additionally, DMUS has significant value in monitoring treatment progress and evaluating post-operative recovery. Furthermore, we discuss the use of DMUS for improving the accuracy and effectiveness of orthopedic surgeries. DMUS can provide high-quality diagnostic and therapeutic services for patients without a need for expensive equipment or complex procedures. Despite its promising outlook in orthopedics, broader clinical adoption remains limited by factors such as the steep learning curve associated with its use, the demand for specialized skills in interpreting high-quality images, and the need for extensive clinical validation. Future research should focus on standardizing operational procedures, improving the automation of image analysis, and validating its application in different orthopedic diseases through clinical trials.
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Affiliation(s)
- Guobin Pan
- Medical Equipment Department, Yantai Yantaishan Hospital Yantai 264003, Shandong, China
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Soliman SB. Challenges to address prior to considering performing musculoskeletal point-of-care ultrasound. J Osteopath Med 2024; 124:139-140. [PMID: 38073485 DOI: 10.1515/jom-2023-0146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 07/11/2023] [Indexed: 02/24/2024]
Affiliation(s)
- Steven B Soliman
- Clinical Associate Professor, Division of Musculoskeletal Radiology, Department of Radiology, University of Michigan, Ann Arbor, MI, USA
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Contreras ES, Virk MS, Kwon YW, Zuckerman JD. Shoulder prosthetic joint infections presenting as atypical sinus tracts - A case series. JSES Int 2024; 8:322-327. [PMID: 38464440 PMCID: PMC10920135 DOI: 10.1016/j.jseint.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024] Open
Affiliation(s)
| | - Mandeep S. Virk
- NYU Langone Department of Orthopedic Surgery, New York, NY, USA
| | - Young W. Kwon
- NYU Langone Department of Orthopedic Surgery, New York, NY, USA
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Jardon M, Fritz J, Samim M. Imaging approach to prosthetic joint infection. Skeletal Radiol 2023:10.1007/s00256-023-04546-7. [PMID: 38133670 DOI: 10.1007/s00256-023-04546-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/08/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
The diagnosis of prosthetic joint infection (PJI) remains challenging, despite multiple available laboratory tests for both serum and synovial fluid analysis. The clinical symptoms of PJI are not always characteristic, particularly in the chronic phase, and there is often significant overlap in symptoms with non-infectious forms of arthroplasty failure. Further exacerbating this challenge is lack of a universally accepted definition for PJI, with publications from multiple professional societies citing different diagnostic criteria. While not included in many of the major societies' guidelines for diagnosis of PJI, diagnostic imaging can play an important role in the workup of suspected PJI. In this article, we will review an approach to diagnostic imaging modalities (radiography, ultrasound, CT, MRI) in the workup of suspected PJI, with special attention to the limitations and benefits of each modality. We will also discuss the role that image-guided interventions play in the workup of these patients, through ultrasound and fluoroscopically guided joint aspirations. While there is no standard imaging algorithm that can universally applied to all patients with suspected PJI, we will discuss a general approach to diagnostic imaging and image-guided intervention in this clinical scenario.
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Affiliation(s)
- Meghan Jardon
- Department of Radiology, NYU Langone Medical Center, New York, NY, USA.
| | - Jan Fritz
- Department of Radiology, NYU Langone Medical Center, New York, NY, USA
| | - Mohammad Samim
- Department of Radiology, NYU Langone Medical Center, New York, NY, USA
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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.
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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
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Weaver JS, Omar IM, Chadwick NS, Shechtel JL, Elifritz JM, Shultz CL, Taljanovic MS. Update on Shoulder Arthroplasties with Emphasis on Imaging. J Clin Med 2023; 12:jcm12082946. [PMID: 37109282 PMCID: PMC10143235 DOI: 10.3390/jcm12082946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/03/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023] Open
Abstract
Shoulder pain and dysfunction may significantly impact quality of life. If conservative measures fail, advanced disease is frequently treated with shoulder arthroplasty, which is currently the third most common joint replacement surgery following the hip and knee. The main indications for shoulder arthroplasty include primary osteoarthritis, post-traumatic arthritis, inflammatory arthritis, osteonecrosis, proximal humeral fracture sequelae, severely dislocated proximal humeral fractures, and advanced rotator cuff disease. Several types of anatomic arthroplasties are available, such as humeral head resurfacing and hemiarthroplasties, as well as total anatomic arthroplasties. Reverse total shoulder arthroplasties, which reverse the normal ball-and-socket geometry of the shoulder, are also available. Each of these arthroplasty types has specific indications and unique complications in addition to general hardware-related or surgery-related complications. Imaging-including radiography, ultrasonography, computed tomography, magnetic resonance imaging, and, occasionally, nuclear medicine imaging-has a key role in the initial pre-operative evaluation for shoulder arthroplasty, as well as in post-surgical follow-up. This review paper aims to discuss important pre-operative imaging considerations, including rotator cuff evaluation, glenoid morphology, and glenoid version, as well as to review post-operative imaging of the various types of shoulder arthroplasties, to include normal post-operative appearances as well as imaging findings of complications.
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Affiliation(s)
- Jennifer S Weaver
- Department of Radiology and Radiologic Sciences, Vanderbilt University Medical Center, 1161 21st Ave. S, MCN CCC-1118, Nashville, TN 37232, USA
| | - Imran M Omar
- Department of Radiology, Northwestern Memorial Hospital, 676 N. Saint Clair Street, Suite 800, Chicago, IL 60611, USA
| | - Nicholson S Chadwick
- Department of Radiology and Radiologic Sciences, Vanderbilt University Medical Center, 1161 21st Ave. S, MCN CCC-1118, Nashville, TN 37232, USA
| | - Joanna L Shechtel
- Department of Radiology and Radiologic Sciences, Vanderbilt University Medical Center, 1161 21st Ave. S, MCN CCC-1118, Nashville, TN 37232, USA
| | - Jamie M Elifritz
- Department of Radiology, MSC08 4720, 1 University of New Mexico, Albuquerque, NM 87131, USA
- Department of Pathology, University of New Mexico, New Mexico Office of the Medical Investigator, MSC08 4720, 1 University of New Mexico, Albuquerque, NM 87131, USA
| | - Christopher L Shultz
- Department of Orthopaedics and Rehabilitation, University of New Mexico, MSC 10 5600, 1 University of New Mexico, Albuquerque, NM 87131, USA
| | - Mihra S Taljanovic
- Department of Radiology, MSC08 4720, 1 University of New Mexico, Albuquerque, NM 87131, USA
- Department of Medical Imaging, University of Arizona, 1501 N. Campbell, Tucson, AZ 85724, USA
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