ULTRASONOGRAPHY OF THE MUSCULOSKELETAL SYSTEM

Long Term Treatment of Corticostreroids May Cause Hepatotoxicity and Oxidative Damage: A Case Controlled Study

Arthritis is a clinical condition, which mainly affects the structure and function joints. During this condition the joints gets swelled and stiffed resulting into development of pain and morbidity. Corticosteroids are frequently prescribed to manage various clinical conditions including the chronic inflammatory diseases such as arthritis. The steroidal drug also causes certain adverse effects depending on the dose, the route of administration and duration of treatment. However, a systematic investigation on the biochemical consequences of steroids as a therapeutic has not been carried out. In the present study we analyzed certain parameters associated to oxidative stress, liver function and energy metabolism has been done in the blood plasma of the arthritis patients who were using steroidal drugs (methylprednisolone and deflazacort) up to 168 days for the treatment of the disease. The results indicated increase in level of MDA and decrease in the activities of SOD, CAT and LDH. The activities of AST and ALT were found to be significantly enhanced over the increase in the treatment period. These results suggested that corticosteroids may induce lipid peroxidation, oxidative stress and liver toxicity in the arthritis patients in the dose and duration dependent manner. The use of antioxidants as supplements to the anti-arthritis agents could play a role in suppressing the oxidative stress mediated adverse effects. However, extensive research is required to explore for safer medication devoid of steroids to cure arthritis.

Graphical Abstract

Evaluation of the applicability of musculoskeletal ultrasonography of the thoracolumbar and lumbar spine segment of healthy dogs

ABSTRACT: Changes in the spine of dogs are usually detected in clinical and in surgical practice. Few studies exist on musculoskeletal ultrasound anatomy of the thoracolumbar and lumbar segments of the normal spine of dogs. This study aimed to compare the normal musculoskeletal ultrasound anatomy of the T10-S1 vertebral segments with images obtained with magnetic resonance imaging (MRI), computed tomography (CT), and anatomical structures, and to establish the ability to identify structures using these modalities. Ultrasound scans allowed visualization of the muscles of the region, articular processes, spinous process, interspinous ligament, and yellow ligament in the lumbosacral window. Computed tomography images provided better bone details, compared to ultrasound images. Low-field MRI allowed the identification of the same structures identified with ultrasound imaging, and allowed the identification of cerebrospinal fluid, transverse processes, and provided improved detail of the intervertebral discs and spinal cord. Knowledge of ultrasound anatomy of the region may allow the the identification of muscle and ligament injuries. Thus, in cities where CT and MRI are inaccessible, ultrasonography of the region could be a good alternative to identify possible changes not observable with radiographic examination or to complement radiographic examination.

Differential sonographic features of the extensor pollicis longus tendon rupture and other finger tendons rupture in the setting of hand and wrist trauma

PURPOSE

To investigate the difference between sonographic findings in extensor pollicis longus tendons rupture and other finger tendons rupture in patients sustaining hand and wrist trauma.

METHODS

Twenty-four patients who presented with signs and symptoms clinically suspicious for tendon injury and surgically confirmed tendon rupture were included in this study. We analyzed 6 sonographic features: discontinuity of the tendon, pseudomass formation, decreased echogenicity of the tendon, retraction of the ruptured tendon, fluid collection within the tendon sheath, and the motion of the tendon. We compared the sonographic features of ruptured extensor pollicis longus tendons with the other ruptured finger tendons.

RESULTS

Discontinuity of the tendon was the most common sonographic findings and retraction of the ruptured tendon was the second most common findings. Fourteen of 16 cases with a dynamic study on sonography showed loss of normal motion of the tendon. Pseudomass formation was the second most common feature in ruptured extensor pollicis longus tendons, in contrast to the other ruptured finger tendons (p < 0.05).

CONCLUSION

Using ultrasonography, detection of discontinuity of the tendon, retraction of the ruptured tendon, and limitation of tendon motion could be very helpful for diagnosing a tendon rupture in hand and wrist trauma. Pseudomass formation could be more specific for diagnosing extensor pollicis longus tendon ruptures compared with other finger tendons.

Ultrasound velocity in human muscle in vivo: perspective for edema studies

The present study examines the association of the changes in ultrasound velocity measured at 1 MHz using 1.5 micros duration tone burst in the human soleus muscle in vivo with several pathologies including patients with chronic renal failure (CRF) and disorders of the cardiovascular system. Total 127 subjects were investigated, with approximately equal number of male and female subjects uniformly distributed by age, from 15 to 70 years old. Since molecular composition of the tissue is thought to have greater effect on the bulk ultrasound velocity, potential contribution of both water and fat, two main variable components of a muscle, were taken into account. Observed negative correlation of ultrasound velocity with the body mass index was considered a result of an elevated fat content. Based on the obtained data, presence of leg edemas results in a measurably lower ultrasound velocity in the soleus muscle. Unless patients had visibly detected leg edema, no difference between healthy individuals, patients with chronic heart failure, or CRF was found. Despite relatively high individual variations in velocity, ranging from 1530 to 1615 m/s, a statistically significant gender correlated difference between average values of the velocity was observed. No dependence of velocity on subject age was detected. An indirect confirmation of the muscle fluid homeostasis was revealed in patients with CRF undergoing hemodialysis procedure. After hemodialysis, a significantly smaller increase (0.3% in average) of ultrasound velocity in the soleus muscle was observed than otherwise could be expected if a uniform relative loss of total body fluids was assumed (1-1.3%). In general, the study findings set a premise for using ultrasound velocity as a potential quantitative parameter for edema assessment.