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Jones JC, Schultz C, Podvin C, Mikhail D, Radel LC. Point-of-Care Ultrasound (POCUS) for Sideline Youth Sports Coverage. Curr Rev Musculoskelet Med 2023; 16:493-500. [PMID: 37566361 PMCID: PMC10587036 DOI: 10.1007/s12178-023-09859-7] [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] [Accepted: 07/20/2023] [Indexed: 08/12/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to discuss the use of point-of-care ultrasound for sideline youth sports coverage. RECENT FINDINGS Participation in youth sports has been increasing, with trends that athletes are specializing earlier and competing at higher levels at younger ages (NSCH 2019, Fabricant 2013). Point-of-care ultrasound (POCUS) utilizes non-invasive imaging to diagnose and manage various musculoskeletal conditions ranging from traumatic injuries, such as fractures and intramuscular hematomas, to early screening for conditions such as asymptomatic knee lesions. Since it is well-tolerated by children and adolescents and allows for easy accessibility for sideline care, POCUS could provide a strong alternative to other imaging modalities such as x-ray and magnetic resonance imaging (MRI) as both have their limitations. Youth sideline sports coverage could be enhanced with immediate medical attention from ultrasound-trained medical professionals. On the sidelines of a traumatic injury, POCUS expedites patient care with immediate examination of acute injuries. In low resource and hard-to-reach locations such as a rural youth sporting event, it can be key in the triaging of injuries. As a supplement to a physical exam, the risk of a misdiagnosis is reduced, and a long, expensive trip to the hospital for unnecessary imaging studies may be avoided. Ultrasound is a versatile, non-invasive, radiation-free imaging modality that serves as an accessible option for sideline coverage at youth sporting events. Ultrasound is well-tolerated by children and adolescents. It can be used to evaluate, diagnose, and manage a range of musculoskeletal conditions at the sidelines of youth sports.
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Affiliation(s)
- Jacob C. Jones
- Scottish Rite for Children, 5700 Dallas Pkwy Frisco, Dallas, TX 75034 USA
- University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Cassidy Schultz
- Scottish Rite for Children, 5700 Dallas Pkwy Frisco, Dallas, TX 75034 USA
| | - Caroline Podvin
- Scottish Rite for Children, 5700 Dallas Pkwy Frisco, Dallas, TX 75034 USA
| | - David Mikhail
- University of Texas Southwestern Medical Center, Dallas, TX USA
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Bilger R, Laumonerie P, Barret H, Lapègue F, Mansat P, Sans N, Faruch-Bilfeld M. Ultrasonography: an interesting imaging method for ligament assessment during the acute phase of closed elbow injuries. J Med Ultrason (2001) 2022; 49:739-746. [PMID: 35943621 DOI: 10.1007/s10396-022-01246-y] [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: 01/19/2022] [Accepted: 07/02/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate whether ultrasonography can be used to explore the medial and lateral ligament structures during the acute phase of a closed elbow injury. METHODS A single-center, prospective study performed between December 2019 and June 2020, including patients who suffered a radial head fracture or elbow dislocation. Two radiologists did a blinded analysis using ultrasonography of visibility, injury grade, and presence of bone avulsion for the radial collateral ligament (RCL), lateral ulnar collateral ligament (LUCL), annular ligament (AL), and anterior (MCLant) and posterior bundles (MCLpost) of the medial collateral ligament. The inter-rater agreement was calculated. The ultrasonography findings were compared with the intraoperative findings in the patients who subsequently underwent surgery. RESULTS Forty patients were included (28 radial head fractures and 12 elbow dislocations). The inter-rater agreement was strong for all the study parameters (kappa between 0.65 and 1), except for the visibility of the LUCL (kappa 0.52) and the visibility and appearance of the MCLpost (kappa 0.54 and 0.47, respectively). The injured ligaments were thicker than their contralateral counterparts (p < 0.05). In the 10 patients who underwent surgery, the radiological-surgical correlation was 100% for the RCL and medial ligaments and 70% for the LUCL. CONCLUSION Ultrasonography is a reproducible examination that can be used to assess the damage to elbow ligaments during the acute phase following an injury. This examination could be incorporated into the exploration protocol for elbow injuries during the preoperative assessment and to adapt the treatment.
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Affiliation(s)
- Romain Bilger
- Service d'Imagerie Ostéoarticulaire, Centre Hospitalier Universitaire de Toulouse, Allée Jean Dausset, 31300, Toulouse, France.
| | - Pierre Laumonerie
- Service de Chirurgie Orthopédique, Centre Hospitalier Universitaire de Toulouse, Allée Jean Dausset, 31300, Toulouse, France.,Service de Chirurgie Orthopédique, Hôpital Pellegrin, 33000, Bordeaux, France
| | - Hugo Barret
- Service de Chirurgie Orthopédique, Centre Hospitalier Universitaire de Toulouse, Allée Jean Dausset, 31300, Toulouse, France
| | - Franck Lapègue
- Service d'Imagerie Ostéoarticulaire, Centre Hospitalier Universitaire de Toulouse, Allée Jean Dausset, 31300, Toulouse, France
| | - Pierre Mansat
- Service de Chirurgie Orthopédique, Centre Hospitalier Universitaire de Toulouse, Allée Jean Dausset, 31300, Toulouse, France
| | - Nicolas Sans
- Service d'Imagerie Ostéoarticulaire, Centre Hospitalier Universitaire de Toulouse, Allée Jean Dausset, 31300, Toulouse, France
| | - Marie Faruch-Bilfeld
- Service d'Imagerie Ostéoarticulaire, Centre Hospitalier Universitaire de Toulouse, Allée Jean Dausset, 31300, Toulouse, France
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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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Lin CY, Ooi CC, Chan E, Chew KT. Emerging Technological Advances in Musculoskeletal Ultrasound. PM R 2018; 10:112-119. [PMID: 29413117 DOI: 10.1016/j.pmrj.2017.08.444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 08/21/2017] [Accepted: 08/27/2017] [Indexed: 12/11/2022]
Affiliation(s)
- Cindy Y Lin
- Sports and Spine Division, Department of Rehabilitation Medicine, University of Washington Medical Center, Seattle, WA; Sports, Spine, and Orthopaedic Health, University of Washington Husky Stadium Sports Medicine Center, 3800 Montlake Blvd NE, Seattle, WA 98195.,Department of Radiology, Singapore General Hospital, Singapore.,Singhealth Family Medicine, Singapore.,Department of Sports Medicine, Changi General Hospital, Singapore
| | - Chin Chin Ooi
- Sports and Spine Division, Department of Rehabilitation Medicine, University of Washington Medical Center, Seattle, WA; Sports, Spine, and Orthopaedic Health, University of Washington Husky Stadium Sports Medicine Center, 3800 Montlake Blvd NE, Seattle, WA 98195.,Department of Radiology, Singapore General Hospital, Singapore.,Singhealth Family Medicine, Singapore.,Department of Sports Medicine, Changi General Hospital, Singapore
| | - Eric Chan
- Sports and Spine Division, Department of Rehabilitation Medicine, University of Washington Medical Center, Seattle, WA; Sports, Spine, and Orthopaedic Health, University of Washington Husky Stadium Sports Medicine Center, 3800 Montlake Blvd NE, Seattle, WA 98195.,Department of Radiology, Singapore General Hospital, Singapore.,Singhealth Family Medicine, Singapore.,Department of Sports Medicine, Changi General Hospital, Singapore
| | - Kelvin T Chew
- Sports and Spine Division, Department of Rehabilitation Medicine, University of Washington Medical Center, Seattle, WA; Sports, Spine, and Orthopaedic Health, University of Washington Husky Stadium Sports Medicine Center, 3800 Montlake Blvd NE, Seattle, WA 98195.,Department of Radiology, Singapore General Hospital, Singapore.,Singhealth Family Medicine, Singapore.,Department of Sports Medicine, Changi General Hospital, Singapore
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Yoshida M, Goto H, Takenaga T, Tsuchiya A, Sugimoto K, Musahl V, Fu F, Otsuka T. Anterior and posterior bands of the anterior bundle in the elbow ulnar collateral ligament: ultrasound anatomy. J Shoulder Elbow Surg 2017; 26:1803-1809. [PMID: 28735845 DOI: 10.1016/j.jse.2017.05.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 05/11/2017] [Accepted: 05/21/2017] [Indexed: 02/01/2023]
Abstract
BACKGROUND The anterior oblique bundle (AOL) of the ulnar collateral ligament (UCL) is composed of anterior and posterior bands. This study evaluated the anatomy of the anterior and posterior bands in the AOL of the UCL for their separate visualization with ultrasound (US). METHODS We dissected 18 cadaveric elbow joints and recorded the direction of each band from the lateral view to determine the proper position for the US transducer. To determine the proper inclination of the transducer, we measured the inclinations of each band at the proximal and distal insertions from the transverse view. A paired t test was used for comparisons between both bands. Values of P < .05 were considered statistically significant. RESULTS The mean angles of the directions in the anterior and posterior bands were 10° ± 4° and 24° ± 9°, respectively. At the medial epicondyle, the mean inclination angles of both bands were 61° ± 5° and 67° ± 5°, respectively. At the sublime tubercle, the mean inclination angles of both bands were 14° ± 7° and 44° ± 9°, respectively. The inclination angles at the proximal ulna and the directions in both bands were significantly different (P < .001). CONCLUSIONS This study shows that the directions of both bands and inclination angles of the bony attachments in both bands can assist with correct placement of the US transducer and allow for separate visualization of each band.
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Affiliation(s)
- Masahito Yoshida
- Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Hideyuki Goto
- Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | - Tetsuya Takenaga
- Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Atsushi Tsuchiya
- Department of Orthopedic Surgery, Meitetsu Hospital, Nagoya, Japan
| | | | - Volker Musahl
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Freddie Fu
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Takanobu Otsuka
- Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan
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