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Calvisi SL, Olarte D, Meloni M, Bianchi S. Sonographic diagnosis of radiographically undetectable bennet fracture. J Ultrasound 2024:10.1007/s40477-024-00901-z. [PMID: 38691324 DOI: 10.1007/s40477-024-00901-z] [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: 02/24/2024] [Accepted: 03/29/2024] [Indexed: 05/03/2024] Open
Abstract
Intra-articular fractures of the base of the first metacarpal (Bennet fractures) are prone to dislocation and require surgical reduction and fixation to prevent secondary degenerative joint disease and chronic dysfunction. Therefore, a prompt diagnosis is necessary, mostly achieved by conventional roentgenograms. We report the case of a 62-year-old man in whom a Bennet fracture was highly suspected on ultrasound (US) examination realized after a fall. Standard radiographs, obtained after US to confirm the diagnosis, were interpreted as normal. A computed tomography was then performed showing a typical Bennet fracture. This case report demonstrates that a careful assessment of bones must be an integral part of any routine musculo-skeletal US examination, particularly in post-traumatic patients. US can detect bone fractures where radiograph is not discriminating.
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Affiliation(s)
- Stefania Laura Calvisi
- Casa di Cura Beato Palazzolo, Bergamo, Italy.
- CIM SA, Cabinet Imagerie Médicale, Géneva, Switzerland.
| | - Diana Olarte
- CIM SA, Cabinet Imagerie Médicale, Géneva, Switzerland
- Emergency Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Marco Meloni
- Ospedale Moriggia Pelascini, Gravedona e Uniti, Italy
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2
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Lee YH, Bae H, Chun YH, Lee JW, Kim HJ. Ultrasonographic examination of masticatory muscles in patients with TMJ arthralgia and headache attributed to temporomandibular disorders. Sci Rep 2024; 14:8967. [PMID: 38637633 PMCID: PMC11026518 DOI: 10.1038/s41598-024-59316-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/09/2024] [Indexed: 04/20/2024] Open
Abstract
This study used ultrasonography to compare the thickness and cross-sectional area of the masticatory muscles in patients with temporomandibular joint arthralgia and investigated the differences according to sex and the co-occurrence of headache attributed to temporomandibular disorders (HATMD). The observational study comprised 100 consecutive patients with TMJ arthralgia (71 females and 29 males; mean age, 40.01 ± 17.67 years) divided into two groups: Group 1, including 86 patients with arthralgia alone (60 females; 41.15 ± 17.65 years); and Group 2, including 14 patients with concurrent arthralgia and HATMD (11 females; 33.00 ± 16.72 years). The diagnosis of TMJ arthralgia was based on the diagnostic criteria for temporomandibular disorders. The parameters of the masticatory muscles examined by ultrasonography were subjected to statistical analysis. The pain area (2.23 ± 1.75 vs. 5.79 ± 2.39, p-value = 0.002) and visual analog scale (VAS) score (3.41 ± 1.82 vs. 5.57 ± 12.14, p-value = 0.002) were significantly higher in Group 2 than in Group 1. Muscle thickness (12.58 ± 4.24 mm) and cross-sectional area (4.46 ± 2.57 cm2) were larger in the masseter muscle than in the other three masticatory muscles (p-value < 0.001). When examining sex-based differences, the thickness and area of the masseter and lower temporalis muscles were significantly larger in males (all p-value < 0.05). The area of the masseter muscle (4.67 ± 2.69 vs. 3.18 ± 0.92, p-value = 0.004) and lower temporalis muscle (3.76 ± 0.95 vs. 3.21 ± 1.02, p-value = 0.049) was significantly smaller in Group 2 than in Group 1. An increase in VAS was significantly negatively correlated with the thickness of the masseter (r = - 0.268) and lower temporalis (r = - 0.215), and the cross-sectional area of the masseter (r = - 0.329) and lower temporalis (r = - 0.293). The masseter and lower temporalis muscles were significantly thinner in females than in males, and their volumes were smaller in patients with TMJ arthralgia and HATMD than in those with TMJ arthralgia alone. HATMD and decreased masseter and lower temporalis muscle volume were associated with increased pain intensity.
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Affiliation(s)
- Yeon-Hee Lee
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University, Kyung Hee University Dental Hospital, #613 Hoegi-dong, Dongdaemun-gu, Seoul, 02447, South Korea.
| | - Hyungkyu Bae
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
| | - Yang-Hyun Chun
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University, Kyung Hee University Dental Hospital, #613 Hoegi-dong, Dongdaemun-gu, Seoul, 02447, South Korea
| | - Jung-Woo Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, 02447, South Korea.
| | - Hee-Jin Kim
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
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Choukri K, Haddad E, Al Khouri Salem H, Boutet C, Leveques V, Mteirek A, Philbois O, Scalabre A, Cantais A. Ultrasound as a Tool for Initial Diagnosis of Bone Lesions in Children Has Good Predictive Values: A Prospective Study From a University Hospital. Clin Pediatr (Phila) 2024:99228241241894. [PMID: 38554017 DOI: 10.1177/00099228241241894] [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] [Indexed: 04/01/2024]
Abstract
Pediatric bone injuries are traditionally diagnosed using radiography. However, ultrasonography is emerging as an alternative due to its speed and minimal invasiveness. This study assessed the diagnostic capabilities of ultrasound before radiography in a group of 186 children with suspected long bone fractures at Saint Etienne University Hospital (Saint-Priest-en-Jarez, France). Patients with open trauma and severe deformity were excluded. Ultrasonography demonstrated 88.2% sensitivity and 86.4% specificity, with better results for forearm injuries. Of the 186 cases, 162 were consistent with radiography and 24 varied. Factors influencing an accurate diagnosis included the presence of indirect signs, operator experience, and examination duration, while indirect signs often led to misinterpretation. Although ultrasound cannot completely replace radiography due to its limitations in identifying deeper fractures, this study revealed its substantial efficacy and ease, supporting its potential utility in pediatric trauma emergencies.
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Affiliation(s)
- Kaoutar Choukri
- Pediatric Emergency Department, Hospital University of Saint-Etienne, Jean Monnet University, Saint Etienne, France
| | - Elie Haddad
- Pediatric Surgery Department, Hospital University of Saint-Etienne, Jean Monnet University, Saint Etienne, France
| | - Hassan Al Khouri Salem
- Pediatric Surgery Department, Hospital University of Saint-Etienne, Jean Monnet University, Saint Etienne, France
| | - Claire Boutet
- Department of Radiology, Hospital University of Saint-Etienne, Jean Monnet University, Saint Etienne, France
| | - Virginie Leveques
- Pediatric Emergency Department, Hospital University of Saint-Etienne, Jean Monnet University, Saint Etienne, France
| | - Ahmad Mteirek
- Pediatric Emergency Department, Hospital University of Saint-Etienne, Jean Monnet University, Saint Etienne, France
| | - Olivier Philbois
- Pediatric Emergency Department, Hospital University of Saint-Etienne, Jean Monnet University, Saint Etienne, France
| | - Aurélien Scalabre
- Pediatric Surgery Department, Hospital University of Saint-Etienne, Jean Monnet University, Saint Etienne, France
| | - Aymeric Cantais
- Pediatric Emergency Department, Hospital University of Saint-Etienne, Jean Monnet University, Saint Etienne, France
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4
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Lee YH, Chun YH, Bae H, Lee JW, Kim HJ. Comparison of ultrasonography-based masticatory muscle thickness between temporomandibular disorders bruxers and temporomandibular disorders non-bruxers. Sci Rep 2024; 14:6923. [PMID: 38519584 PMCID: PMC10960048 DOI: 10.1038/s41598-024-57696-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/20/2024] [Indexed: 03/25/2024] Open
Abstract
To compare masticatory muscle thickness in patients with temporomandibular disorders (TMDs) during rest and clenching, and by body position, using ultrasonography. This prospective study included 96 patients with TMD (67 females, 29 males; mean age: 40.41 ± 17.88 years): group 1, comprising 66 patients with TMD without bruxism (TMD_nonbruxer), and group 2, comprising 30 patients with concurrent TMD and bruxism (TMD_bruxer). In patients with TMD, bruxism was correlated with the presence of tinnitus, muscle stiffness, sleep problems, psychological stress, and restricted mouth opening. The masseter muscle significantly thickened during clenching (11.16 ± 3.03 mm vs 14.04 ± 3.47 mm, p < 0.001), whereas the temporalis muscle showed no significant increase in thickness from resting to clenching in an upright position (7.91 ± 1.98 vs 8.39 ± 2.08, p = 0.103). Similarly, during clenching in the supine position, the masseter muscle was significantly thicker compared with rest (11.24 ± 2.42 vs 13.49 ± 3.09, p < 0.001), but no significant difference was observed in temporal muscle thickness (8.21 ± 2.16 vs 8.43 ± 1.94, p = 0.464). In comparison between two groups, the average thickness of the masseter muscle was greater among TMD_bruxers than among TMD_nonbruxers in both the upright and supine positions (all p < 0.05). In the generalized lineal model, female sex (B = - 1.018, 95% confidence interval [CI] - 1.855 to - 0.181, p = 0.017) and bruxism (B = 0.868, 95% CI 0.567 to 1.169, p = 0.048) significantly predicted changes in masseter muscle thickness. Female sex (B = - 0.201, 95% CI - 0.299 to - 0.103, p = 0.011), increased age (B = - 0.003, 95% CI - 0.005 to 0.000, p = 0.038), and muscle stiffness (B = - 1.373, 95% CI - 2.369 to - 0.376, p = 0.007) were linked to decreased temporal muscle thickness. Comparing TMD nonbruxer and bruxer muscle thicknesses in upright and supine positions revealed significant increased thickness in the masseter muscle during clenching but not in the temporalis muscle. Masseter muscle thickness varied significantly by sex, body position, and resting/clenching, notably influenced by bruxism. These findings emphasize the relevance of these factors in clinical examinations of patients with TMD.
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Affiliation(s)
- Yeon-Hee Lee
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University, Kyung Hee University Dental Hospital, #613 Hoegi-dong, Dongdaemun-gu, Seoul, 02447, South Korea.
| | - Yang-Hyun Chun
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University, Kyung Hee University Dental Hospital, #613 Hoegi-dong, Dongdaemun-gu, Seoul, 02447, South Korea
| | - Hyungkyu Bae
- Division in Anatomy and Developmental Biology, Department of Oral Biology, BK21 FOUR Project, Human Identification Research Institute, Yonsei University College of Dentistry, Seoul, South Korea
| | - Jung-Woo Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, 02447, South Korea
| | - Hee-Jin Kim
- Division in Anatomy and Developmental Biology, Department of Oral Biology, BK21 FOUR Project, Human Identification Research Institute, Yonsei University College of Dentistry, Seoul, South Korea
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Silva A, Fontes T, Fonseca JE, Saraiva F. Ultrasound ability in early diagnosis of metatarsal stress fractures. ARP RHEUMATOLOGY 2024; 3:53-55. [PMID: 38558065 DOI: 10.63032/zfct7949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
Stress fractures are common in young and active individuals, associated with aggressive or repetitive physical activity and their early detection is fundamental to optimise patient care, decrease complications and avoid unnecessary exams. Currently, magnetic resonance imaging is the standard of care for detecting these lesions. Recently, ultrasound has been getting an increasing interest for the detection of stress fractures. In this article, we describe a clinical case that involved a second metatarsal stress fracture diagnosed by ultrasound and review the literature regarding the use of ultrasound in the diagnosis of stress fractures, particularly of the metatarsals.
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Affiliation(s)
- Augusto Silva
- Departamento de Reumatologia, Centro Hospitalar Universitário Lisboa Norte
| | - Tomás Fontes
- Departamento de Reumatologia, Hospital do Divino Espírito Santo
| | | | - Fernando Saraiva
- Departamento de Reumatologia, Centro Hospitalar Universitário Lisboa Norte
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Machado PAB, Bartolomeu GFP, Handeri AM, Wainstein AJA, Drummond-Lage AP. Assessment of Medical Students' Knowledge of Imaging Methods for Bone Sarcomas. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:1571-1576. [PMID: 37185942 DOI: 10.1007/s13187-023-02301-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/17/2023] [Indexed: 05/17/2023]
Abstract
Cancer is a leading cause of death in Brazil and worldwide. However, Brazilian medical education fails to include oncology as an essential topic. This creates a gap between the health status of the population and medical education. Bone sarcomas fall into both the group of malignant neoplasms and rare diseases and are thus doubly influenced by misinformation. To assess medical students' knowledge of imaging diagnostic methods for bone sarcomas. A cross-sectional, quantitative study was undertaken by obtaining the responses of medical students to a questionnaire containing radiographic images and questions about the radiological aspects of bone sarcomas. The categorical variables were compared using the chi-square test. The level of significance was 5% for all the tests. SPSS software version 25.0 was used for the analysis. A total of 325 responses were collected, with 72% of the participants having no interest in oncology and 55.6-63.9% not knowing how to diagnose a periosteal reaction on bone radiography. Only 11.1-17.1% of the students correctly interpreted the radiographic image of osteosarcoma. Medical students fail to correctly interpret images of bone sarcomas. It is important to promote oncology undergraduate education in general and to include the approach to bone sarcomas in this context.
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Affiliation(s)
- Pedro Alcântara Botelho Machado
- Department of Post-Graduation, Faculty of Medical Sciences of Minas Gerais, Alameda Ezequiel Dias 275/3º - Centro, Belo Horizonte, MG, Brazil
| | | | | | | | - Ana Paula Drummond-Lage
- Department of Post-Graduation, Faculty of Medical Sciences of Minas Gerais, Alameda Ezequiel Dias 275/3º - Centro, Belo Horizonte, MG, Brazil.
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7
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Movaghar S, Roostayi MM, Naimi SS, Daryabor A, Jahantigh Akbari N, Mehreganfar B. Comparison of 4 weeks of cupping and Kinesio-taping on clinical and ultrasound outcomes of carpal tunnel syndrome during pregnancy. J Bodyw Mov Ther 2023; 35:57-63. [PMID: 37330803 DOI: 10.1016/j.jbmt.2023.04.048] [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: 12/20/2021] [Revised: 01/16/2023] [Accepted: 04/12/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE To explore effect of cupping and Kinesio-taping techniques on clinical and ultrasound outcomes of carpal tunnel syndrome (CTS) during pregnancy. METHODS Thirty pregnant women suffering from CTS were randomly assigned into Kinesio-taping (n = 15) and cupping (n = 15) groups. In Kinesio-taping group, individuals underwent Kinesio-taping for three days, one day with no treatment, and three days with Kinesio-taping, continuing this procedure for four weeks. In cupping group, cupping was moved for 5 min with pressure of 50 mm-Hg on the carpal tunnel area. This procedure continued longitudinally in forearm area for 2 min. The therapeutic intervention of cupping group continued with eight sessions, two days a week for 4 weeks. Ultrasound outcomes including median nerve cross-sectional area through ultrasonography, and clinical outcomes including pain through visual analog scale and severity of symptoms and functional status through Boston questionnaire were measured in both groups before and after therapeutic program. RESULTS In both groups, a significant reduction was observed in all variables after treatment compared to pre-treatment (P < 0.001). In inter-group comparison, a significant improvement was found in outcomes of Boston questionnaire and ultrasound results about median nerve cross-sectional area at pisiform and hook of hamate in cupping group compared to Kinesio-taping at end of four weeks (P < 0.001). CONCLUSION Both cupping and Kinesio-taping improved clinical and ultrasound outcomes of CTS. However, efficacy of cupping compared to Kinesio-taping was better in improvement of median nerve cross-sectional area at hamate hook and pisiform levels, symptoms severity scale, and functional status scale, which makes the results clinically more applicable.
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Affiliation(s)
- Sara Movaghar
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Mohsen Roostayi
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sedigheh Sadat Naimi
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Aliyeh Daryabor
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Narges Jahantigh Akbari
- Student Research Committee, Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahare Mehreganfar
- Student Research Committee, Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Quarato CMI, Lacedonia D, Salvemini M, Tuccari G, Mastrodonato G, Villani R, Fiore LA, Scioscia G, Mirijello A, Saponara A, Sperandeo M. A Review on Biological Effects of Ultrasounds: Key Messages for Clinicians. Diagnostics (Basel) 2023; 13:855. [PMID: 36899998 PMCID: PMC10001275 DOI: 10.3390/diagnostics13050855] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
Ultrasound (US) is acoustic energy that interacts with human tissues, thus, producing bioeffects that may be hazardous, especially in sensitive organs (i.e., brain, eye, heart, lung, and digestive tract) and embryos/fetuses. Two basic mechanisms of US interaction with biological systems have been identified: thermal and non-thermal. As a result, thermal and mechanical indexes have been developed to provide a means of assessing the potential for biological effects from exposure to diagnostic US. The main aims of this paper were to describe the models and assumptions used to estimate the "safety" of acoustic outputs and indices and to summarize the current state of knowledge about US-induced effects on living systems deriving from in vitro models and in vivo experiments on animals. This review work has made it possible to highlight the limits associated with the use of the estimated safety values of thermal and mechanical indices relating above all to the use of new US technologies, such as contrast-enhanced ultrasound (CEUS) and acoustic radiation force impulse (ARFI) shear wave elastography (SWE). US for diagnostic and research purposes has been officially declared safe, and no harmful biological effects in humans have yet been demonstrated with new imaging modalities; however, physicians should be adequately informed on the potential risks of biological effects. US exposure, according to the ALARA (As Low As Reasonably Achievable) principle, should be as low as reasonably possible.
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Affiliation(s)
- Carla Maria Irene Quarato
- Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Universitario “Riuniti” di Foggia, University of Foggia, 71122 Foggia, Italy
| | - Donato Lacedonia
- Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Universitario “Riuniti” di Foggia, University of Foggia, 71122 Foggia, Italy
| | - Michela Salvemini
- Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Universitario “Riuniti” di Foggia, University of Foggia, 71122 Foggia, Italy
| | - Giulia Tuccari
- Department of Medical and Surgical Sciences, Institute of Geriatric, Policlinico Universitario “Riuniti” di Foggia, University of Foggia, 71122 Foggia, Italy
| | - Grazia Mastrodonato
- Department of Basic Medical Science, Neuroscience and Sensory Organs, Institute of Sports Medicine, University “Aldo Moro” of Bari, 70122 Bari, Italy
| | - Rosanna Villani
- Department of Medical and Surgical Sciences, Institute of Internal Medicine, Liver Unit, Policlinico Universitario “Riuniti” di Foggia, University of Foggia, 71122 Foggia, Italy
| | - Lucia Angela Fiore
- Department of Medical and Surgical Sciences, Institute of Geriatric, Policlinico Universitario “Riuniti” di Foggia, University of Foggia, 71122 Foggia, Italy
| | - Giulia Scioscia
- Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Universitario “Riuniti” di Foggia, University of Foggia, 71122 Foggia, Italy
| | - Antonio Mirijello
- Department of Internal of Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
| | | | - Marco Sperandeo
- Unit of Interventional and Diagnostic Ultrasound of Internal Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy
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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.
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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
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10
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Ren Q, Tang D, Xiong Z, Zhao H, Zhang S. Traumatic bone marrow lesions in dual-energy computed tomography. Insights Imaging 2022; 13:174. [PMID: 36308637 PMCID: PMC9617981 DOI: 10.1186/s13244-022-01312-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 10/11/2022] [Indexed: 11/26/2022] Open
Abstract
Traumatic bone marrow lesions (TBMLs) are considered to represent a range of concealed bone injuries, including haemorrhage, infarction, and localised oedema caused by trabecular microfracture occurring in the cancellous bone. If TBMLs are not managed timeously, they potentially cause a series of complications that can lead to irreversible morbidity and prolonged recovery time. This article reviews interesting image findings of bone marrow lesions in dual-energy computed tomography (DECT). In addition to combining the benefits of traditional CT imaging, DECT also reveals and identifies various structures using diverse attenuation characteristics of different radiographic spectra. Therefore, DECT has the capacity to detect TBMLs, which have traditionally been diagnosed using MRI. Through evaluating DECT virtual non-calcium maps, the detection of TBMLs is rendered easier and more efficient in some acute accidents.
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Affiliation(s)
- Qiuping Ren
- Department of Radiology, The First Affiliated Hospital of Jinan University, No. 613, Huangpu West Road, Tianhe District, Guangzhou, 510627, Guangdong, People's Republic of China
| | - Deqiu Tang
- Department of Radiology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Chuanshan Road No. 69, Hengyang, Hunan, People's Republic of China
| | - Zhiyuan Xiong
- Department of Radiology, The First Affiliated Hospital of Jinan University, No. 613, Huangpu West Road, Tianhe District, Guangzhou, 510627, Guangdong, People's Republic of China
| | - Heng Zhao
- Department of Radiology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Chuanshan Road No. 69, Hengyang, Hunan, People's Republic of China.
| | - Shuixing Zhang
- Department of Radiology, The First Affiliated Hospital of Jinan University, No. 613, Huangpu West Road, Tianhe District, Guangzhou, 510627, Guangdong, People's Republic of China.
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11
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Ricci V, Güvener O, Chang KV, Wu WT, Mezian K, Kara M, Leblebicioğlu G, Pirri C, Ata AM, Dughbaj M, Jain NB, Stecco C, Özçakar L. EURO-MUSCULUS/USPRM Dynamic Ultrasound Protocols for Elbow. Am J Phys Med Rehabil 2022; 101:e83-e92. [PMID: 34930863 DOI: 10.1097/phm.0000000000001915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT In this dynamic protocol, ultrasound examination of the elbow using different maneuvers is described for several/relevant elbow problems. Scanning videos are coupled with real-time patient examination videos for better understanding. The authors believe that this practical guide-prepared by an international consensus of several experts (EURO-MUSCULUS: European Musculoskeletal Ultrasound Study Group and USPRM: Ultrasound Study Group of ISPRM [International Society of Physical and Rehabilitation Medicine])-will help musculoskeletal physicians perform a better and uniform/standard approach.
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Affiliation(s)
- Vincenzo Ricci
- From the Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy (VR); Department of Physical and Rehabilitation Medicine, Mersin University Medical School, Mersin, Turkey (OG); Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan (K-VC, W-TW); National Taiwan University College of Medicine, Taipei, Taiwan (K-VC); Department of Rehabilitation Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic (KM); Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey (MK, LÖ); The Hand Clinic, Ankara, Turkey (GL); Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy (CP, CS); Ankara City Hospital, Physical Medicine and Rehabilitation Hospital, Ankara, Turkey (AMA); Physical Medicine and Rehabilitation Hospital, Ministry of Health, Kuwait City, Kuwait (MD); and Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Population and Data Sciences, University of Texas Southwestern, Dallas, Texas (NBJ)
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Puccetti M, Beccati F, Denoix JM. Bone stress injuries and fatigue fractures of the pelvis in endurance horses. Equine Vet J 2021; 54:1064-1075. [PMID: 34738269 DOI: 10.1111/evj.13536] [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: 02/25/2021] [Accepted: 10/29/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Bone stress injuries and fatigue fractures of the pelvis are reported in only a small number of endurance horses. OBJECTIVES To describe bone stress injuries and fatigue fracture of the pelvis in endurance horses trained and competing on the deep sand surfaces. STUDY DESIGN Retrospective case series. METHODS Medical records of horses used for endurance and diagnosed with bone stress injuries and/or fatigue fractures of the pelvis by ultrasound were reviewed. The bone stress injuries and fatigue fractures were classified as affecting the iliac wing, the iliac shaft, the tuber ischiadicum, the rest of the ischium or the pubis and subdivided into four fracture configurations: isolated iliac fracture, isolated fracture of the floor of the pelvis, isolated tuber ischiadicum fracture and multiple fractures. Descriptive statistics were performed overall and on fracture configurations for age, sex, breed, level of activity, affected limbs, previous injuries, development of the injury, seasons in the UAE, physical and dynamic findings and outcome. For each fracture configuration and the outcome, multivariable logistic regression models were developed after univariable logistic regression and collinearity analyses. Significance was set at P ≤ .05. RESULTS Sixty endurance horses were included; 48% (95% CI: 36%-61%) had isolated iliac fracture, 17% (7%-26%) isolated fracture of the floor of the pelvis, 15% (6%-24%) isolated tuber ischiadicum fracture and 20% (10%-30%) had multiple fractures. Breed (OR, 4.42; 95%CI, 1.02-19.57) was significantly associated with isolated iliac fracture and asymmetry of bone landmarks (OR, 7.42; 95% CI, 1.47-37.45) with isolated tuber ischiadicum fracture. Degree of lameness (OR, 3.08; 95% CI, 1.07-8.9) and trotting on three tracks (OR, 8.62; 95% CI, 1.43-51.9) were significantly associated with the diagnosis of isolated fracture of the floor of the pelvis. MAIN LIMITATIONS Data acquired in a single country. CONCLUSIONS Bone stress injuries and fatigue fractures of the pelvis can affect endurance horses trained and competing on deep sand. Isolated bone stress injuries and/or fatigue fractures of the ileum were the commonest followed by multiple pelvic bones involvement. The presence of lameness and trotting on three tracks suggest the presence of bone stress injuries and/or fatigue fractures of the floor of the pelvis; asymmetry of bony landmarks is more commonly detected in horses with bone stress injuries and/or fatigue fractures of the tuber ischiadicum.
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Affiliation(s)
| | - Francesca Beccati
- Department of Veterinary Medicine, Sport Horse Research Centre, University of Perugia, Perugia, Italy
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Wu WT, Chang KV, Hsu YC, Hsu PC, Ricci V, Özçakar L. Artifacts in Musculoskeletal Ultrasonography: From Physics to Clinics. Diagnostics (Basel) 2020; 10:diagnostics10090645. [PMID: 32867385 DOI: 10.3390/diagnostics10090645.pmid:32867385;pmcid:pmc7555047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 08/21/2020] [Accepted: 08/24/2020] [Indexed: 05/26/2023] Open
Abstract
Ultrasound appears to be the most useful imaging tool in the diagnosis and guided treatment of musculoskeletal disorders. However, ultrasonography has been criticized for being user dependent. Therefore, medical professionals should be familiar with the basic principles of ultrasound imaging (e.g., physics and technical skills) to diminish artifacts and avoid misinterpretation. In this review, we focused on the physics of common artifacts, their clinical significance, and the ways to tackle them in daily practice during musculoskeletal imaging. In particular, artifacts pertaining to the focal zone, beam attenuation, path and side lobe of the beam, speed of the sound, and range ambiguity were described.
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Affiliation(s)
- Wei-Ting Wu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei 10048, Taiwan
| | - Ke-Vin Chang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei 10048, Taiwan
| | - Yu-Chun Hsu
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei 11221, Taiwan
| | - Po-Cheng Hsu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, Taiwan
| | - Vincenzo Ricci
- Department of Biomedical and Neuromotor Science, Physical and Rehabilitation Medicine Unit, Istituto di Ricovero e Cura a Carattere Scientifico Rizzoli Orthopedic Institute, 40136 Bologna, Italy
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara 06100, Turkey
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Wu WT, Chang KV, Hsu YC, Hsu PC, Ricci V, Özçakar L. Artifacts in Musculoskeletal Ultrasonography: From Physics to Clinics. Diagnostics (Basel) 2020; 10:diagnostics10090645. [PMID: 32867385 PMCID: PMC7555047 DOI: 10.3390/diagnostics10090645] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 08/21/2020] [Accepted: 08/24/2020] [Indexed: 12/11/2022] Open
Abstract
Ultrasound appears to be the most useful imaging tool in the diagnosis and guided treatment of musculoskeletal disorders. However, ultrasonography has been criticized for being user dependent. Therefore, medical professionals should be familiar with the basic principles of ultrasound imaging (e.g., physics and technical skills) to diminish artifacts and avoid misinterpretation. In this review, we focused on the physics of common artifacts, their clinical significance, and the ways to tackle them in daily practice during musculoskeletal imaging. In particular, artifacts pertaining to the focal zone, beam attenuation, path and side lobe of the beam, speed of the sound, and range ambiguity were described.
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Affiliation(s)
- Wei-Ting Wu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, Taiwan; (W.-T.W.); (P.-C.H.)
- Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei 10048, Taiwan
| | - Ke-Vin Chang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, Taiwan; (W.-T.W.); (P.-C.H.)
- Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei 10048, Taiwan
- Correspondence:
| | - Yu-Chun Hsu
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei 11221, Taiwan;
| | - Po-Cheng Hsu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, Taiwan; (W.-T.W.); (P.-C.H.)
| | - Vincenzo Ricci
- Department of Biomedical and Neuromotor Science, Physical and Rehabilitation Medicine Unit, Istituto di Ricovero e Cura a Carattere Scientifico Rizzoli Orthopedic Institute, 40136 Bologna, Italy;
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara 06100, Turkey;
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