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Abdulsalam AJ, Kara M, Özçakar L. Ultrasound Guidance for Filler and Botulinum Toxin Injections: A Transformative Approach Avoiding Complications. Dermatol Surg 2024:00042728-990000000-00941. [PMID: 39230044 DOI: 10.1097/dss.0000000000004390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Affiliation(s)
- Ahmad J Abdulsalam
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
- Department of Physical Medicine and Rehabilitation, Mubarak Alkabeer Hospital, Jabriya, Kuwait
| | - Murat Kara
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
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Kandil NM, Hashem AMB, Toukhy MME, Yousef NMAA, Al-Feeshawy ASH, Havwana MAR. Ultrasound imaging and shear wave elastography for the differential diagnosis of heel pain: a comparative cross-sectional study. J Ultrasound 2024; 27:621-634. [PMID: 38879835 PMCID: PMC11333687 DOI: 10.1007/s40477-024-00906-8] [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: 02/01/2024] [Accepted: 04/16/2024] [Indexed: 08/21/2024] Open
Abstract
PURPOSE In correlation with magnetic resonance imaging (MRI), this study attempts to assess the effectiveness of the diagnostic of ultrasonography (US) features and shear wave elastography (SWE) in determining the different causes of heel pain. MATERIALS AND METHODS 55 heels with a mean age of 38.33 ± 10.8 were included in the study (10 control cases and 41 cases, 4 of which had bilateral heel pain). There were 23 female cases (56.1%) and 18 male cases (43.95%). Examinations using shear wave elastography (SWE) and ultrasound (US) were done in different positions. MRI and the obtained data were correlated. RESULTS When used to diagnose different heel pain causes, ultrasound demonstrated great sensitivity and specificity. SWE demonstrated a good correlation with MRI findings and enhanced the ultrasound's diagnostic precision in identifying plantar fasciitis early on (increased accuracy from 88.9 to 93.33% with 100% sensitivity and 83.3% specificity) and Achilles tendinopathy (increased accuracy from 88.9 to 97.8 with 94.7% sensitivity and 100% specificity). CONCLUSION In summary, we concluded that heel pain can be efficiently examined by both ultrasound (US) and shear wave elastography (SWE) with the former being used as the primary effective tool and the latter being done to increase diagnostic accuracy. We also concluded that SWE improved the ultrasound's diagnostic precision in identifying patients with early plantar fasciitis and Achilles tendinopathy and showed a robust relationship with clinical outcomes, enhancing patient evaluation and follow-up.
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Affiliation(s)
- Nour Mohamed Kandil
- Diagnostic and Interventional Radiology Department, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Aya Mohamed Bassam Hashem
- Diagnostic and Interventional Radiology Department, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Marwan Mohamed El Toukhy
- Diagnostic and Interventional Radiology Department, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | | | - Maged Abdel Rahman Havwana
- Diagnostic and Interventional Radiology Department, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt
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Štěpánková T, Quittková A, Čech Z, Machač S. Sonographic measurement of deep fascia parameters - Interrater reliability. Surg Radiol Anat 2024; 46:1481-1489. [PMID: 39014213 DOI: 10.1007/s00276-024-03423-9] [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: 02/04/2024] [Accepted: 06/17/2024] [Indexed: 07/18/2024]
Abstract
PURPOSE The deep fascia has recently been a current topic in many medical fields, including rehabilitation. Some research has already focused on assessing deep fascia, however results of individual authors differ in certain aspects. This study focuses on the inter-rater reliability of ultrasound (US) measurement of the thickness of deep fascia and loose connective tissue (LCT). The aim was to define the causes of any discrepancies in measurement that could contribute to the unification of management of evaluating fascia. METHODS An observational study was performed including 20 healthy individuals in whom fascia lata of the anterior thigh was examined by US imaging and then measured in Image J software. Three raters participated in this study: the first with 6 years of US imaging experience, other two were newly trained. The measurement of fascial parameters was conducted in two phases with special consultation between them resulting in an agreement of the research team on the more precise way of measurement. RESULTS Results revealed the value of inter-rater reliability ICC3,1 = 0.454 for deep fascia thickness and ICC3,1 = 0.265 for LCT thickness in the first phase and any significant difference in the second phase. This poor inter-rater reliability led to a search for possible causes of discrepancies, which authors subsequently highlighted. CONCLUSION The findings of the study show the main pitfalls of deep fascia measurement that should contribute to the unification of evaluation.
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Affiliation(s)
- Tereza Štěpánková
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
| | - Adéla Quittková
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Zdeněk Čech
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Stanislav Machač
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
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Abdulsalam AJ, Ricci V, Cocco G, Aksakal MF, Kara M, Özçakar L. Demystifying the Forehead With Ultrasonography. Aesthet Surg J 2024; 44:NP523-NP524. [PMID: 38506161 DOI: 10.1093/asj/sjae065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 03/21/2024] Open
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Ricci V, Chang KV, Naňka O, Özçakar L. Superficial retrocalcaneal bursae and nerves: From anatomy to ultrasound-guided procedures. Clin Anat 2024. [PMID: 38860583 DOI: 10.1002/ca.24193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 05/28/2024] [Accepted: 06/02/2024] [Indexed: 06/12/2024]
Abstract
The pertinent literature widely describes ultrasound-guided procedures targeting the retrocalcaneal bursa and the tendon tissue to manage insertional Achilles tendinopathy. Synovial bursae and cutaneous nerves of the superficial retrocalcaneal pad are often overlooked pain generators and are poorly considered by clinicians and surgeons. A layer-by-layer dissection of the superficial soft tissues in the retrocalcaneal region of two fresh frozen cadavers was matched with historical anatomical tables of the textbook Traite d'Anatomie Topographique Avec Applications Médico-Chirurgicales (1909 by Testut and Jacob). An accurate and detailed description of the superficial retrocalcaneal pad with its synovial bursae and cutaneous nerves was provided. Cadaveric dissections confirmed the compartmentalized architecture of the superficial retrocalcaneal fat pad and its histological continuum with the superficial lamina of the crural fascia. Superficial synovial tissue islands have been demonstrated on the posterior aspect of the Achilles tendon in one cadaver and on the posterolateral surface of the tendon in the other one. Digitalization of the original anatomical tables of the textbook Traite d'Anatomie Topographique Avec Applications Médico-Chirurgicales (1909 by Testut and Jacob) showed five potential locations of the superficial calcaneal bursa and a superficial retrocalcaneal nerve plexus within the Achilles tendon-fat pad interface. In clinical practice, in addition to the previously described interventions regarding the retrocalcaneal bursa and the tendon tissue, ultrasound-guided procedures targeting the synovial and neural tissues of the superficial retrocalcaneal pad should be considered to optimize the management of insertional Achilles tendinopathy.
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Affiliation(s)
- Vincenzo Ricci
- Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Ke-Vin Chang
- Department of Physical Medicine and Rehabilitation and Community and Geriatric Research Center, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan
| | - Ondřej Naňka
- Institute of Anatomy, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
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Ricci V, Tamborrini G, Zunica F, Chang KV, Kara M, Farì G, Naňka O, Özçakar L. High-resolution ultrasound imaging of elementary lesions in dactylitis. J Ultrasound 2024; 27:281-290. [PMID: 38006512 PMCID: PMC11178685 DOI: 10.1007/s40477-023-00834-z] [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: 07/22/2023] [Accepted: 10/02/2023] [Indexed: 11/27/2023] Open
Abstract
OBJECTIVE The aim of the present study was to illustrate the (potential) diagnostic role of high resolution US images in assessing the elementary lesions of dactylitis. METHODS Using high-frequency US machines/probes, we matched the micro-anatomical cadaveric architecture of the digit with multiple sonographic findings of dactylitis. High-sensitive color/power Doppler assessments have also been performed to evaluate the digital microvasculature. DISCUSSION Modern US equipment/features guarantee prompt and in-depth B-mode and color/power Doppler imaging of tiny anatomical structures of the digit which are usually not properly visible with standard US machines. More specifically, hypervascularization of the digital subcutaneous tissue, fibrous pulleys of flexor tendons, dorsal synovial pads as well as pathological changes of the distal entheseal anchorage network can be accurately detected. CONCLUSION In clinical practice, high-end US equipment can be used to accurately assess the digits in patients with dactylitis. This way, simple and convenient sonographic diagnosis of different elementary lesions can be timely established.
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Affiliation(s)
- Vincenzo Ricci
- Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy.
| | - Giorgio Tamborrini
- UZR, Ultraschallzentrum und Institut für Rheumatologie, Basel, Switzerland
- Rheumatology Clinic, University Hospital of Basel, Basel, Switzerland
| | - Fiammetta Zunica
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, 20154, Milan, Italy
| | - Ke-Vin Chang
- Department of Physical Medicine and Rehabilitation and Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Huy Branch, Taipei, Taiwan
| | - Murat Kara
- Department of Physical and Rehabilitation Medicine Ankara, Hacettepe University Medical School, Ankara, Turkey
| | - Giacomo Farì
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, Aldo Moro University of Bari, Bari, Italy
- Department of Biological and Environmental Science and Technologies (Di.S.Te.B.A.), University of Salento, Lecce, Italy
| | - Ondřej Naňka
- Institute of Anatomy, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine Ankara, Hacettepe University Medical School, Ankara, Turkey
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Zhao L, Huang J, Bell MAL, Raghavan P. Measuring myofascial shear strain in chronic shoulder pain with ultrasound shear strain imaging: a case report. BMC Musculoskelet Disord 2024; 25:412. [PMID: 38802774 PMCID: PMC11129449 DOI: 10.1186/s12891-024-07514-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 05/11/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Dysfunctional gliding of deep fascia and muscle layers forms the basis of myofascial pain and dysfunction, which can cause chronic shoulder pain. Ultrasound shear strain imaging may offer a non-invasive tool to quantitatively evaluate the extent of muscular dysfunctional gliding and its correlation with pain. This case study is the first to use ultrasound shear strain imaging to report the shear strain between the pectoralis major and minor muscles in shoulders with and without chronic pain. CASE PRESENTATION The shear strain between the pectoralis major and minor muscles during shoulder rotation in a volunteer with chronic shoulder pain was measured with ultrasound shear strain imaging. The results show that the mean ± standard deviation shear strain was 0.40 ± 0.09 on the affected side, compared to 1.09 ± 0.18 on the unaffected side (p<0.05). The results suggest that myofascial dysfunction may cause the muscles to adhere together thereby reducing shear strain on the affected side. CONCLUSION Our findings elucidate a potential pathophysiology of myofascial dysfunction in chronic shoulder pain and reveal the potential utility of ultrasound imaging to provide a useful biomarker for shear strain evaluation between the pectoralis major and minor muscles.
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Affiliation(s)
- Lingyi Zhao
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, 21218, MD, USA
| | - Jonny Huang
- Department of Physical Medicine and Rehabilitation and Neurology, Johns Hopkins Medicine, Baltimore, MD, 21287, USA
| | - Muyinatu A Lediju Bell
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, 21218, MD, USA.
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, 21218, MD, USA.
- Department of Computer Science, Johns Hopkins University, Baltimore, 21218, MD, USA.
| | - Preeti Raghavan
- Department of Physical Medicine and Rehabilitation and Neurology, Johns Hopkins Medicine, Baltimore, MD, 21287, USA.
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Ricci V, Cocco G, Donati D, Farì G, Chang KV, Özçakar L. From Histopathology to High-Resolution Ultrasound Imaging of Skin Scars. Diagnostics (Basel) 2023; 13:3629. [PMID: 38132213 PMCID: PMC10742690 DOI: 10.3390/diagnostics13243629] [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: 11/09/2023] [Revised: 12/02/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
Nowadays, modern ultrasound machines and high-frequency transducers allow us to accurately assess the superficial soft tissues of the human body. In this sense, sonographic evaluation of the skin and related pathologies is progressively growing in the pertinent literature. To the best of our knowledge, a standardized sonographic protocol focused on the assessment of pathological skin scars is still lacking. As such, the main purpose of the present study was to propose a technical guide to sonographically assess skin scars in the daily practice of clinicians-starting from knowledge on their histopathological features. In order to standardize the ultrasound examination, a superficial-to-deep, layer-by-layer approach has been proposed to optimize its reproducibility and to promote a common language among the different healthcare providers.
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Affiliation(s)
- Vincenzo Ricci
- Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, 20157 Milan, Italy
| | - Giulio Cocco
- Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy;
| | - Danilo Donati
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy;
| | - Giacomo Farì
- Department of Biological and Environmental Sciences and Technologies (DiSTeBA), Università del Salento, 73100 Lecce, Italy;
| | - Ke-Vin Chang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10617, Taiwan;
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, 06100 Ankara, Turkey;
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Li D, Yang F, Zhao Y, Wang Q, Ren W, Sun L, Shan D, Qin C. High-Frequency Ultrasound Imaging to Distinguish High-Risk and Low-Risk Dermatofibromas. Diagnostics (Basel) 2023; 13:3305. [PMID: 37958200 PMCID: PMC10650765 DOI: 10.3390/diagnostics13213305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/19/2023] [Accepted: 10/21/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Dermatofibroma has various pathological classifications, some of which pose a risk of recurrence and metastasis. Distinguishing these high-risk dermatofibromas based on appearance alone can be challenging. Therefore, high-frequency ultrasound may provide additional internal information on these lesions, helping to identify high-risk and low-risk dermatofibroma early. METHODS In this retrospective study, 50 lesions were analyzed to explore the correlation between clinical and high-frequency ultrasound features and dermatofibroma risk level. Based on their pathological features, the lesions were divided into high-risk (n = 17) and low-risk (n = 33) groups. Subsequently, an identification model based on significant high-frequency ultrasound features was developed. RESULTS Significant differences were observed in the thickness, shape, internal echogenicity, stratum basal, and Doppler vascular patterns between the high-risk and low-risk groups. The median lesion thickness for the high-risk dermatofibroma group was 4.1 mm (IQR: 3.2-6.1 mm), while it was 3.1 mm (IQR: 1.3-4.2 mm) for the low-risk dermatofibroma group. In the high-risk dermatofibroma group, irregular morphology was predominant (70.6%, 12/17), the most common being dermis-to-subcutaneous soft tissue penetration (64.7%, 11/17), and heterogenous internal echogenicity was observed in the majority of cases (76.5%, 13/17). On the other hand, regular morphology was more prevalent in the low-risk dermatofibroma group (78.8%, 26/33), primarily limited to the dermis layer (78.8%, 26/33), with homogeneous internal echogenicity also being prevalent in the majority of cases (81.8%, 27/33). Regarding the Doppler vascularity pattern, 69.7% (23/33) of low-risk dermatofibromas had no blood flow, while 64.7% (11/17) of high-risk dermatofibromas had blood flow. CONCLUSION High-frequency ultrasound is crucial in distinguishing high-risk and low-risk dermatofibromas, making it invaluable for clinical management.
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Affiliation(s)
- Danhua Li
- Department of Medical Ultrasound, Jinshan Hospital, Fudan University, Shanghai 201508, China; (D.L.); (Y.Z.)
| | - Feiyue Yang
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Tongji University, Shanghai 200072, China; (F.Y.); (Q.W.); (W.R.); (L.S.)
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China
| | - Yang Zhao
- Department of Medical Ultrasound, Jinshan Hospital, Fudan University, Shanghai 201508, China; (D.L.); (Y.Z.)
| | - Qiao Wang
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Tongji University, Shanghai 200072, China; (F.Y.); (Q.W.); (W.R.); (L.S.)
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai 200443, China
| | - Weiwei Ren
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Tongji University, Shanghai 200072, China; (F.Y.); (Q.W.); (W.R.); (L.S.)
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai 200443, China
| | - Liping Sun
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Tongji University, Shanghai 200072, China; (F.Y.); (Q.W.); (W.R.); (L.S.)
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China
| | - Dandan Shan
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Tongji University, Shanghai 200072, China; (F.Y.); (Q.W.); (W.R.); (L.S.)
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China
| | - Chuan Qin
- Department of Medical Ultrasound, Jinshan Hospital, Fudan University, Shanghai 201508, China; (D.L.); (Y.Z.)
- Department of Ultrasound, Karamay Central Hospital, Karamay 834000, China
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Ricci V, Özçakar L. Ultrasound examination for fascial pathologies: The surfacing truth. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:1376-1377. [PMID: 37671657 DOI: 10.1002/jcu.23548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 08/14/2023] [Indexed: 09/07/2023]
Affiliation(s)
- Vincenzo Ricci
- Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
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Zhuang N, Lyu H, Zhao C, Zhang Y, Dong L, Luo H, Tian Y, Xie L, Wu W, Liu L, Sun D, Xie H. Ultrasound features and differential diagnosis for superficial nodular fasciitis. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:1370-1375. [PMID: 37602559 DOI: 10.1002/jcu.23542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Nodular fasciitis (NF) has nonspecific clinical manifestations and is often misdiagnosed as sarcoma. The investigations of imaging methods for NF were limited. OBJECTIVE To analyze the ultrasound (US) features of NF, and to evaluate the diagnostic value of US for NF. MATERIALS AND METHODS A total of 61 NF patients were recruited retrospectively, and 551 lesions in the subcutaneous fat layer were included for comparison. We evaluated the ultrasound features of the patients and divided the NF cases into three types. Chi-square test or Fisher exact test were conducted to detect the potential difference in the distributions of three types in the two groups. RESULTS Among the 61 NF cases, 65.6% were in the upper extremities (n = 40). The proportion of type 1, 2, and 3 were 57.4%, 24.6%, and 18.0%, respectively. NF were significantly more likely locating in the upper extremities than the other soft tissue tumors (p < 0.001). Type 1 and type 2 of sonographic features were significantly more commonly observed in NF than other soft tissue tumors among the three types (p < 0.001). CONCLUSION The type 1 and type 2 of US features can help to distinguish NF from other lesions. US has great potential to improve the diagnostic accuracy and reduce the unnecessary surgery.
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Affiliation(s)
- Nan Zhuang
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, China
| | - Heng Lyu
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, China
| | - Chenyang Zhao
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, China
| | - Yusen Zhang
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, China
| | - Licong Dong
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, China
| | - Haiyu Luo
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, China
| | - Yun Tian
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, China
| | - Lu Xie
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, China
| | - Wangjie Wu
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, China
| | - Li Liu
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, China
| | - Desheng Sun
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, China
| | - HaiQin Xie
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen, China
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Cocco G, Ricci V, Corvino A, Pacini P, Boccatonda A, Naňka O, Sensi SL, Caulo M, Delli Pizzi A. Ultrasound Imaging of the Sciatic Nerve. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2023; 44:e263-e273. [PMID: 37832532 DOI: 10.1055/a-2095-2842] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
Abstract
The sciatic nerve (SN) is the biggest nerve in the human body and innervates a large skin surface of the lower limb and several muscles of the thigh, leg, and foot. It originates from the ventral rami of spinal nerves L4 through S3 and contains fibers from both the posterior and anterior divisions of the lumbosacral plexus. After leaving the neural foramina, the nerve roots merge with each other forming a single peripheral nerve that travels within the pelvis and thigh. Non-discogenic pathologies of the SN are largely underdiagnosed entities due to nonspecific clinical tests and poorly described imaging findings. Likewise, to the best of our knowledge, a step-by-step ultrasound protocol to assess the SN is lacking in the pertinent literature. In this sense, the aim of the present manuscript is to describe the normal sono-anatomy of the SN from the greater sciatic foramen to the proximal thigh proposing a standardized and simple sonographic protocol. Then, based on the clinical experience of the authors, a few tips and tricks have been reported to avoid misinterpretation of confounding sonographic findings. Last but not least, we report some common pathological conditions encountered in daily practice with the main purpose of making physicians more confident regarding the sonographic "navigation" of a complex anatomical site and optimizing the diagnosis and management of non-discogenic neuropathies of the SN.
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Affiliation(s)
- Giulio Cocco
- Department of Neuroscience, Imaging and Clinical Sciences, Gabriele d'Annunzio University of Chieti and Pescara, Chieti, Italy
- Unit of Ultrasound in Internal Medicine, Department of Medicine and Science of Aging, Gabriele d'Annunzio University of Chieti and Pescara, Chieti, Italy
| | - Vincenzo Ricci
- Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, Milano, Italy
| | - Antonio Corvino
- Movement Sciences and Wellbeing Department, University of Naples Parthenope, Napoli, Italy
| | - Patrizia Pacini
- Department of Radiological, Oncological and Anatomopathological Sciences, Umberto I Polyclinic of Rome, Roma, Italy
| | | | - Ondřej Naňka
- Institute of Anatomy, First Faculty of Medicine, Charles University, Praha, Czech Republic
| | - Stefano L Sensi
- Advanced Computing Core, Center of Advanced Studies and Technology (CAST), Gabriele d'Annunzio University of Chieti and Pescara, Chieti, Italy
- Department of Neuroscience, Imaging and Clinical Sciences, Gabriele d'Annunzio University of Chieti and Pescara, Chieti, Italy
| | - Massimo Caulo
- Department of Neuroscience, Imaging and Clinical Sciences, Gabriele d'Annunzio University of Chieti and Pescara, Chieti, Italy
| | - Andrea Delli Pizzi
- Department of Innovative Technologies in Medicine and Dentistry, Gabriele d'Annunzio University of Chieti and Pescara, Chieti, Italy
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Ricci V, Cocco G, Özçakar L. Pitfalls in ultrasound imaging of superficial tissues. J Ultrasound 2023; 26:745-746. [PMID: 37294379 PMCID: PMC10469137 DOI: 10.1007/s40477-023-00791-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 04/17/2023] [Indexed: 06/10/2023] Open
Affiliation(s)
- Vincenzo Ricci
- Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy.
| | - Giulio Cocco
- Unit of Ultrasound in Internal Medicine, Department of Medicine and Science of Aging, University G. d'Annunzio, 66100, Chieti, Italy
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
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Tanyeri A, Çildağ MB. Assessment of the skin with 2D-shear wave elastography in the systemic scleroderma and its correlation with pulmonary involvement. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:1205-1211. [PMID: 37199062 DOI: 10.1002/jcu.23488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 04/26/2023] [Accepted: 05/08/2023] [Indexed: 05/19/2023]
Abstract
PURPOSE The purpose of this study was to assess the skin involvement in systemic scleroderma patients (SSc) with 2D-Shear Wave Elastography (2D-SWE) and to review the corelation between skin elasticity and pulmonary involvement. METHODS Thirty SSc patients and 30 controls were examined using 2D-SWE. The demographics matched both groups. B-mode ultrasound (US) and 2D-SWE assessed skin thickness and elastography from the ventral side of the right forearm in each subjective. ROC analysis determined optimal group separation cut-off values. A rheumatologist applied mRSS for SSc patients. US, mRSS, and pulmonary involvement correlations were reviewed. RESULTS US parameter values (skin thickness, median kPa, median m/s) were higher in the SSc patient group (1.78 ± 0.36 mm, 22.15 ± 16.26, 2.60 ± 0.82, respectively) compared to the control group (1.55 ± 0.2 mm, 7.45 ± 1.84, 1.56 ± 0.2, respectively, p < 0.05). When the optimal cut-off SWE values for separating groups was determined as 10.5 kPa and 1.87 m/s, the sensitivity was 93% and the specificity was 97%. Pearson's correlation analysis showed a strong positive correlation between mRSS and median SWE values (kPa, r = 0.626, p = 0.001; m/s, r = 0.638, p < 0.001). There was no correlation between pulmonary involvement of SSc patients with mRSS and US parameters. CONCLUSION 2D-SWE is a promising non-invasive method to evaluate skin involvement in SSc patient group. For pulmonary involvement we need more data with bigger patient groups.
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Affiliation(s)
- Ahmet Tanyeri
- Department of Radiology, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkey
| | - Mehmet Burak Çildağ
- Department of Radiology, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkey
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15
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Cocco G, Ricci V, Ricci C, Naňka O, Catalano O, Corvino A, Boccatonda A, Serafini FL, Izzi J, Vallone G, Cantisani V, Iannetti G, Caulo M, Ucciferri C, Vecchiet J, Pizzi AD. Ultrasound imaging of the axilla. Insights Imaging 2023; 14:78. [PMID: 37166516 PMCID: PMC10175532 DOI: 10.1186/s13244-023-01430-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 04/14/2023] [Indexed: 05/12/2023] Open
Abstract
Axilla is a pyramidal-in-shape "virtual cavity" housing multiple anatomical structures and connecting the upper limb with the trunk. To the best of our knowledge, in the pertinent literature, a detailed sonographic protocol to comprehensively assess the axillary region in daily practice is lacking. In this sense, the authors have briefly described the anatomical architecture of the axilla-also using cadaveric specimens-to propose a layer-by-layer sonographic approach to this challenging district. The most common sonographic pathological findings-for each and every anatomical compartment of the axilla-have been accurately reported and compared with the corresponding histopathological features. This ultrasound approach could be considered a ready-to-use educational guidance for the assessment of the axillary region. CRITICAL RELEVANCE STATEMENT: Axilla is a pyramidal-in-shape "virtual cavity" housing multiple anatomical structures and connecting the upper limb with the trunk. The aim of this review article was to describe the anatomical architecture of the axilla, also using cadaveric specimens, in order to propose a layer-by-layer sonographic approach to this challenging district.
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Affiliation(s)
- Giulio Cocco
- Department of Neuroscience, Imaging and Clinical Sciences, G. d'Annunzio University, Chieti, Italy
- Unit of Ultrasound in Internal Medicine, Department of Medicine and Science of Aging, G. d'Annunzio University, Chieti, Italy
| | - Vincenzo Ricci
- Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Costantino Ricci
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Ondřej Naňka
- First Faculty of Medicine, Institute of Anatomy, Charles University, Prague, Czech Republic
| | - Orlando Catalano
- Department of Radiology, Istituto Diagnostico Varelli, Naples, Italy
| | - Antonio Corvino
- Movement Sciences and Wellbeing Department, University of Naples Parthenope, Naples, Italy.
| | - Andrea Boccatonda
- Internal Medicine, Bentivoglio Hospital, AUSL Bologna, Bentivoglio, Italy
| | - Francesco Lorenzo Serafini
- Department of Neuroscience, Imaging and Clinical Sciences, G. d'Annunzio University, Chieti, Italy
- Unit of Radiology, Santissima Annunziata Hospital, Chieti, Italy
| | - Jacopo Izzi
- Unit of Radiology, Santissima Annunziata Hospital, Chieti, Italy
| | - Gianfranco Vallone
- Department Life and Health V. Tiberio, Università Degli Studi del Molise, Campobasso, Italy
| | - Vito Cantisani
- Department of Radiology, Oncology, Anatomo-Pathology, Sapienza-University of Rome, Rome, Italy
| | - Giovanni Iannetti
- Ospedale S. Spirito, Università Degli Studi Chieti-Pescara, Chieti, Italy
| | - Massimo Caulo
- Department of Neuroscience, Imaging and Clinical Sciences, G. d'Annunzio University, Chieti, Italy
| | - Claudio Ucciferri
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, G. d'Annunzio University, Chieti, Italy
| | - Jacopo Vecchiet
- Clinic of Infectious Diseases, Department of Medicine and Science of Aging, G. d'Annunzio University, Chieti, Italy
| | - Andrea Delli Pizzi
- Unit of Radiology, Santissima Annunziata Hospital, Chieti, Italy
- Department of Innovative Technologies in Medicine and Dentistry, University G. d'Annunzio, Chieti, Italy
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Ricci V, Güvener O, Özçakar L. Injections for Myofascial Pain: From Whodunit to an Ultrasound-Guided Technique. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:1165-1166. [PMID: 36334270 DOI: 10.1002/jum.16118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 10/15/2022] [Indexed: 06/16/2023]
Affiliation(s)
- Vincenzo Ricci
- Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Orhan Güvener
- Department of Physical and Rehabilitation Medicine, Mersin University Medical School, Mersin, Turkey
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
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17
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Bellinato F, Gisondi P, Filippucci E, Tozzi F, Fassio A, Adami G, Idolazzi L. Systematic study on nail plate assessment: differences in nail plate shape, thickness, power Doppler signal and scanning approach. Arch Dermatol Res 2023; 315:593-600. [PMID: 36271200 PMCID: PMC10020276 DOI: 10.1007/s00403-022-02404-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/27/2022] [Accepted: 10/11/2022] [Indexed: 11/02/2022]
Abstract
Ultrasonography (US) of the nail is raising interest in the last years and its feasibility, quickness and amount of descriptive data may provide valuable information. Different authors presented several scanning approaches to nail complex in different pathological conditions, such as psoriasis, but no scanning protocol was ever proposed using healthy subjects as population of reference. The aim of the study was to establish a protocol for the US of nail plate and to assess whether the measurement of the nail plate is influenced by longitudinal vs transverse scan, sex, digit and hand dominance. Using high frequency probe and a Canon Aplio i800 machine, ultrasonographers took scans of nail plates of the hands from healthy subjects. Nail plate shape, thickness and power Doppler signal (PDUS) were evaluated and scans were taken both on longitudinal and transverse axis, at distal, middle and proximal portion of the nail plate or at a fixed angles of - 45°, 0° or + 45°. All the images were then revised and scored using a DICOM software, in order to allow good standards of accuracy and reproducibility. A total of 27 subjects (14 females and 13 males) were assessed. The measures did not result to differ in different portions or angles. Furthermore, no difference appears in sex or dominant vs not dominant hand. A decreasing and significant trend for nail plate thickness was found from the first to the fifth finger. Doppler signal was found in all but one subjects, with a range from almost absent to very evident. No difference was found between groups regarding PDUS. The data provided suggest that a proper scan protocol should include all the nails and evaluation should be done both on longitudinal and transverse axis. Since Doppler signal is highly variable in healthy subjects, its presence should be carefully considered as pathological finding. Observations provided by this study clarify important points of the scanning technique and solve doubts related to which nails should be scanned and where to evaluate quantitative parameters.
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Affiliation(s)
- Francesco Bellinato
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy.
| | - Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Emilio Filippucci
- Clinica Reumatologica, Università Politecnica Delle Marche, Ospedale "Carlo Urbani", Jesi, Ancona, Italy
| | - Francesca Tozzi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Angelo Fassio
- Section of Rheumatology, Department of Medicine, University of Verona, Verona, Italy
| | - Giovanni Adami
- Section of Rheumatology, Department of Medicine, University of Verona, Verona, Italy
| | - Luca Idolazzi
- Section of Rheumatology, Department of Medicine, University of Verona, Verona, Italy
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Ricci V, Ricci C, Mezian K, Naňka O, Özçakar L. Trapezius Muscle and the Cutaneous Branches of Spinal Nerves: Sonographic/Anatomic Discussion of Myofascial Pain and Superficial Injections. PAIN MEDICINE 2023; 24:221-225. [PMID: 35980166 DOI: 10.1093/pm/pnac125] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/24/2022] [Accepted: 08/12/2022] [Indexed: 11/13/2022]
Affiliation(s)
- Vincenzo Ricci
- Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Costantino Ricci
- Unit of Pathology, Maggiore Hospital, Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Kamal Mezian
- Department of Rehabilitation Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Ondřej Naňka
- Institute of Anatomy, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
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19
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Ricci V, Mezian K, Chang KV, Tarantino D, Güvener O, Gervasoni F, Naňka O, Özçakar L. Ultrasound Imaging and Guidance for Cervical Myofascial Pain: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3838. [PMID: 36900848 PMCID: PMC10001397 DOI: 10.3390/ijerph20053838] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 02/07/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
Cervical myofascial pain is a very common clinical condition in the daily practice of musculoskeletal physicians. Physical examination is currently the cornerstone for evaluating the cervical muscles and identifying the eventual presence of myofascial trigger points. Herein, the role of ultrasound assessment in precisely localizing them is progressively mounting in the pertinent literature. Moreover, using ultrasound, not only the muscle tissue but also the fascial and neural elements can be accurately located/evaluated. Indeed, several potential pain generators, in addition to paraspinal muscles, can be involved in the clinical scenario of cervical myofascial pain syndrome. In this article, the authors extensively reviewed the sonographic approach for cervical myofascial pain in order to better diagnose or guide different procedures that can be performed in the clinical practice of musculoskeletal physicians.
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Affiliation(s)
- Vincenzo Ricci
- Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, 20157 Milan, Italy
| | - Kamal Mezian
- Department of Rehabilitation Medicine, First Faculty of Medicine and General University Hospital, Charles University, 12800 Prague, Czech Republic
| | - Ke-Vin Chang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei Hu Branch, Taipei 10845, Taiwan
| | - Domiziano Tarantino
- Department of Public Health, Rehabilitation Unit, University Federico II of Naples, 80131 Naples, Italy
| | - Orhan Güvener
- Department of Physical and Rehabilitation Medicine, Mersin University Medical School, 33000 Mersin, Turkey
| | - Fabrizio Gervasoni
- Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, 20157 Milan, Italy
| | - Ondřej Naňka
- Institute of Anatomy, First Faculty of Medicine, Charles University, 12800 Prague, Czech Republic
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, 06100 Ankara, Turkey
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Ricci V, Mezian K, Cocco G, Tamborrini G, Fari G, Zunica F, Chang KV, Kara M, Özçakar L. Ultrasonography for Injecting (Around) the Lateral Epicondyle: EURO-MUSCULUS/USPRM Perspective. Diagnostics (Basel) 2023; 13:diagnostics13040717. [PMID: 36832216 PMCID: PMC9955720 DOI: 10.3390/diagnostics13040717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023] Open
Abstract
Lateral epicondylitis (LE) is a very common and painful condition seen in the daily practice of musculoskeletal physicians. Ultrasound-guided (USG) injections are commonly performed to manage the pain, promote the healing phase, and plan a tailored rehabilitation treatment. In this aspect, several techniques were described to target specific pain generators i the lateral elbow. Likewise, the aim of this manuscript was to extensively review those USG techniques together with the patients' pertinent clinical/sonographic features. The authors believe that this literature summary could also be refined as a practical, ready-to-use guide for planning the USG interventions of the lateral elbow in clinical practice.
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Affiliation(s)
- Vincenzo Ricci
- Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, 20157 Milan, Italy
- Correspondence: ; Tel.: +39-3381137042
| | - Kamal Mezian
- Department of Rehabilitation Medicine, First Faculty of Medicine and General University Hospital, Charles University, 12800 Prague, Czech Republic
| | - Giulio Cocco
- Unit of Ultrasound in Internal Medicine, Department of Medicine and Science of Aging, University “G. d’Annunzio”, 66100 Chieti, Italy
| | - Giorgio Tamborrini
- UZR, Ultraschallzentrum und Institut für Rheumatologie, 4051 Basel, Switzerland
- Rheumatology Clinic, University Hospital of Basel, 4001 Basel, Switzerland
| | - Giacomo Fari
- Department of Translational Biomedicine and Neuroscience (DiBraiN), Aldo Moro University, 70121 Bari, Italy
- Department of Biological and Environmental Science and Technologies (Di.S.Te.B.A.), University of Salento, 73100 Lecce, Italy
| | - Fiammetta Zunica
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, University of Milan, 20154 Milan, Italy
| | - Ke-Vin Chang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei 10845, Taiwan
| | - Murat Kara
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, 06100 Ankara, Turkey
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, 06100 Ankara, Turkey
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21
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Ricci V, Ricci C, Tamborrini G, Chang KV, Mezian K, Zunica F, Naňka O, Kara M, Özçakar L. From histology to sonography in synovitis: EURO-MUSCULUS/USPRM approach. Pathol Res Pract 2023; 241:154273. [PMID: 36563558 DOI: 10.1016/j.prp.2022.154273] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The aim of the present study was to propose a methodologically innovative sonographic approach for optimal evaluation of synovial tissues (starting from histopathology). METHODS Using high-frequency ultrasound probes and high-level ultrasound machines, we matched the histological microarchitecture of synovial tissues with multiple sonographic patterns in physiological and pathological conditions. Likewise, high-sensitive color/power Doppler assessments have also been performed to evaluate the microcirculation. RESULTS Modern equipment allows for a macroscopic classification of synovial pathologies recognizing different morphological patterns; however, intimal and subintimal layers of the synovium cannot be distinguished from each other on ultrasound. High-sensitive Doppler imaging clearly defines the microvascular pattern, especially in patients with hypertrophic synovial pathologies. CONCLUSIONS In clinical practice, using adequate technological equipment i.e. high-frequency B-mode and high-sensitive Doppler imaging, detailed sonographic assessment of synovial tissues can be performed - defining the main sono-histological patterns.
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Affiliation(s)
- Vincenzo Ricci
- Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy.
| | - Costantino Ricci
- Pathology Unit, Maggiore Hospital, Bologna, Italy; Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Giorgio Tamborrini
- UZR, Ultraschallzentrum und Institut für Rheumatologie, Basel, Switzerland; Rheumatology Clinic, University Hospital of Basel, Basel, Switzerland
| | - Ke-Vin Chang
- Department of Physical Medicine and Rehabilitation and Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Hu Branch, Taiwan
| | - Kamal Mezian
- Department of Rehabilitation Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Fiammetta Zunica
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Ondřej Naňka
- Institute of Anatomy, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Murat Kara
- Hacettepe University Medical School, Department of Physical and Rehabilitation Medicine Ankara, Turkey
| | - Levent Özçakar
- Hacettepe University Medical School, Department of Physical and Rehabilitation Medicine Ankara, Turkey
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Sono-histological Protocols of Superficial Tissues: A ‘Statuesque’ Approach for Plastic Surgeons. J Plast Reconstr Aesthet Surg 2022; 75:3877-3903. [DOI: 10.1016/j.bjps.2022.08.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/16/2022] [Indexed: 11/22/2022]
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