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Perez-Sanchez A, Johnson G, Pucks N, Soni RN, Lund TJS, Andrade AJ, Le MPT, Solis-McCarthy J, Wong T, Ashraf A, Kumar AD, Banauch GI, Verner JR, Sodhi A, Thomas MK, LoPresti C, Schmitz H, Koratala A, Hunninghake J, Manninen E, Candotti C, Minami T, Mathews BK, Bandak G, Sauthoff H, Mayo-Malasky H, Cho J, Villalobos N, Proud KC, Boesch B, Fenton Portillo F, Reierson K, Malik M, Abbas F, Johnson T, Haro EK, Mader MJ, Mayo P, Franco-Sadud R, Soni NJ. Comparison of 6 handheld ultrasound devices by point-of-care ultrasound experts: a cross-sectional study. Ultrasound J 2024; 16:45. [PMID: 39356371 PMCID: PMC11447175 DOI: 10.1186/s13089-024-00392-3] [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: 03/13/2024] [Accepted: 09/04/2024] [Indexed: 10/03/2024] Open
Abstract
BACKGROUND Point-of-care ultrasound (POCUS) has emerged as an essential bedside tool for clinicians, but lack of access to ultrasound equipment has been a top barrier to POCUS use. Recently, several handheld ultrasound devices ("handhelds") have become available, and clinicians are seeking data to guide purchasing decisions. Few comparative studies of different handhelds have been done. We conducted a cross-sectional study comparing 6 handhelds readily available in the United States (Butterfly iQ + ™ by Butterfly Network Inc.; Clarius™ by Clarius Mobile Health; Kosmos™ by EchoNous; TE Air™ by Mindray; Vscan Air™ SL and CL by General Electric; and Lumify™ by Philips Healthcare). A multi-specialty group of physician POCUS experts (n = 35) acquired three standard ultrasound views (abdominal right upper quadrant, cardiac apical 4-chamber, and superficial neck and lung views) in random order on the same standardized patients and rated the image quality. Afterward, a final survey of the overall ease of use, image quality, and satisfaction of each handheld was completed. RESULTS Thirty-five POCUS experts specializing in internal medicine/hospital medicine, critical care, emergency medicine, and nephrology acquired and rated right upper quadrant, apical 4-chamber, and superficial neck and lung views with 6 different handhelds. For image quality, the highest-rated handhelds were Vscan Air™ for the right upper quadrant view, Mindray TE Air™ for the cardiac apical 4-chamber view, and Lumify™ for superficial views of the neck and lung. Overall satisfaction with image quality was highest with Vscan Air™, Lumify™, and Mindray, while overall satisfaction with ease of use was highest with Vscan Air™. The 5 most desirable characteristics of handhelds were image quality, ease of use, portability, probe size, and battery life. Ultimately, all 6 handhelds had notable advantages and disadvantages, with no single device having all desired qualities or features. CONCLUSIONS The overall satisfaction with image quality was rated highest with Vscan Air™, Lumify™, and Mindray TE Air™when acquiring right upper quadrant, apical 4-chamber, and superficial neck and lung views. No single handheld was perceived to be superior in image quality for all views. Vscan Air™ was rated highest for overall ease of use and was the most preferred handheld for purchase by POCUS experts.
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Affiliation(s)
- Ariadna Perez-Sanchez
- Division of Hospital Medicine, Joe R. Teresa Lozano Long School of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, MC 7885, San Antonio, Texas, 78229, USA.
| | - Gordon Johnson
- Division of Hospital Medicine, Legacy Healthcare System, Portland, OR, USA
| | - Neysan Pucks
- Division of Hospital Medicine, Legacy Healthcare System, Portland, OR, USA
| | - Riya N Soni
- Section of Hospital Medicine, South Texas Veterans Health Care System, San Antonio, Texas, USA
| | - Terry J S Lund
- Division of Hospital Medicine, Joe R. Teresa Lozano Long School of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, MC 7885, San Antonio, Texas, 78229, USA
- Section of Hospital Medicine, South Texas Veterans Health Care System, San Antonio, Texas, USA
| | - Anthony J Andrade
- Division of Hospital Medicine, Joe R. Teresa Lozano Long School of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, MC 7885, San Antonio, Texas, 78229, USA
- Section of Hospital Medicine, South Texas Veterans Health Care System, San Antonio, Texas, USA
| | - Minh-Phuong T Le
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Jessica Solis-McCarthy
- Department of Emergency Medicine, Division of Ultrasound, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health San Antonio, San Antonio, Texas, USA
| | - Tanping Wong
- Division of Hospital Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Arsal Ashraf
- Division of Hospital Medicine, Joe R. Teresa Lozano Long School of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, MC 7885, San Antonio, Texas, 78229, USA
| | - Andre D Kumar
- Division of Hospital Medicine, Stanford University, Stanford, CA, USA
| | - Gisela I Banauch
- Division of Pulmonary & Critical Care Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - James R Verner
- Department of Hospital Medicine, HealthPartners Medical Group, Minneapolis-St. Paul, MN, USA
| | - Amik Sodhi
- Division of Allergy, Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Meghan K Thomas
- Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Charles LoPresti
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Hannah Schmitz
- Department of Medicine, The Queen's Medical Center, Honolulu, HI, USA
| | - Abhilash Koratala
- Division of Nephrology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - John Hunninghake
- Department of Trauma, Brooke Army Medical Center, San Antonio, TX, USA
| | - Erik Manninen
- Department of Trauma, Brooke Army Medical Center, San Antonio, TX, USA
| | - Carolina Candotti
- Division of Hospital Medicine, University of California Davis, Sacramento, CA, USA
| | - Taro Minami
- Division of Pulmonary, Critical Care, and Sleep Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Benji K Mathews
- Department of Hospital Medicine, HealthPartners Medical Group, Minneapolis-St. Paul, MN, USA
- Department of Internal Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Ghassan Bandak
- Division of Nephrology, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health San Antonio, San Antonio, Texas, USA
- Division of Pulmonary Diseases and Critical Care Medicine, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health San Antonio, San Antonio, Texas, USA
| | - Harald Sauthoff
- Division of Pulmonary, Critical Care, and Sleep Medicine, New York University Grossman School of Medicine, New York, NY, USA
- Division of Pulmonary, Critical Care and Sleep Medicine, Westchester Medical Center, New York, USA
| | - Henry Mayo-Malasky
- Division of Pulmonary and Critical Care Medicine, NYC Health + Hospitals/Lincoln, New York, NY, USA
| | - Joel Cho
- Department of Hospital Medicine, Kaiser Permanente Medical Center, San Francisco, CA, USA
| | - Nick Villalobos
- Department of Trauma, Brooke Army Medical Center, San Antonio, TX, USA
| | - Kevin C Proud
- Division of Pulmonary Diseases and Critical Care Medicine, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health San Antonio, San Antonio, Texas, USA
- Section of Pulmonary Medicine, South Texas Veterans Health Care System, San Antonio, Texas, USA
| | - Brandon Boesch
- Cottage Medical Group, Cottage Health, Santa Barbara, CA, USA
| | - Federico Fenton Portillo
- Department of Internal Medicine, Washington State University, Elson S. Floyd College of Medicine, Everett, Washington, USA
| | - Kreegan Reierson
- Department of Hospital Medicine, HealthPartners Medical Group, Minneapolis-St. Paul, MN, USA
- Department of Internal Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Manpreet Malik
- Division of Hospital Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Firas Abbas
- Department of Hospital Medicine, University of Arizona, Phoenix, AZ, USA
| | - Tim Johnson
- Division of Hospital Medicine, Virginia Commonwealth University Health, Richmond, VA, USA
| | - Elizabeth K Haro
- Division of Pulmonary Diseases and Critical Care Medicine, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health San Antonio, San Antonio, Texas, USA
| | - Michael J Mader
- Research and Development Service, South Texas Veterans Health Care System, San Antonio, Texas, USA
| | - Paul Mayo
- Division of Pulmonary and Critical Care Medicine, NYC Health + Hospitals/Lincoln, New York, NY, USA
| | - Ricardo Franco-Sadud
- Department of Medicine, University of Central Florida, NCH Healthcare System, Naples, FL, USA
| | - Nilam J Soni
- Division of Hospital Medicine, Joe R. Teresa Lozano Long School of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Drive, MC 7885, San Antonio, Texas, 78229, USA
- Section of Hospital Medicine, South Texas Veterans Health Care System, San Antonio, Texas, USA
- Division of Pulmonary Diseases and Critical Care Medicine, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health San Antonio, San Antonio, Texas, USA
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Sundanum S, Eder L, Aydin SZ, Kaeley GS. Using Ultrasound to Improve Diagnostic Confidence and Management of Psoriatic Disease: Highlights From the GRAPPA 2023 Ultrasound Workshop. J Rheumatol 2024; 51:12-15. [PMID: 39009393 DOI: 10.3899/jrheum.2024-0231] [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] [Accepted: 03/03/2024] [Indexed: 07/17/2024]
Abstract
The sensitivity of ultrasound (US) to detect, characterize, and monitor the relevant pathologies of psoriatic arthritis (PsA), including synovitis, enthesitis, tenosynovitis, and dactylitis, has made it an attractive tool for informing clinical decisions. The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) US working group ran 2 sessions during the annual GRAPPA meeting held in July 2023 in Dublin, Ireland. During the first workshop, the group presented 2 topics, followed by a live demonstration and a group discussion. The 2 topics were (1) an overview of the Diagnostic Ultrasound Enthesitis Tool (DUET) enthesitis scoring methodology, and (2) small hand-held probes-will the promise deliver? The live demonstration that followed compared the performance of 2 hand-held US (HHUS) devices vs a console US machine in patients with PsA, and the interactive group discussion considered gaps in the literature and future research suggestions relating to HHUS and its application in psoriatic disease. During the second session, the US working group provided further updates regarding the GRAPPA US studies currently underway or recently completed.
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Affiliation(s)
- Sonia Sundanum
- S. Sundanum, MD, MB BCh BAO, MRCPI, Tallaght University Hospital, Dublin, Ireland;
| | - Lihi Eder
- L. Eder, MD, PhD, Women's College Research Institute, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sibel Z Aydin
- S.Z. Aydin, MD, University of Ottawa Faculty of Medicine, Rheumatology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Gurjit S Kaeley
- G.S. Kaeley, MD, MBBS, RhMSUS, University of Florida College of Medicine, Jacksonville, Florida, USA
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Ghandour S, Ashkani-Esfahani S, Kwon JY. The Emerging Role of Automation, Measurement Standardization, and Artificial Intelligence in Foot and Ankle Imaging: An Update. Clin Podiatr Med Surg 2024; 41:823-836. [PMID: 39237186 DOI: 10.1016/j.cpm.2024.04.011] [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] [Indexed: 09/07/2024]
Abstract
In the past few years, advances in clinical imaging in the realm of foot and ankle have been consequential and game changing. Improvements in the hardware aspects, together with the development of computer-assisted interpretation and intervention tools, have led to a noticeable improvement in the quality of health care for foot and ankle patients. Focusing on the mainstay imaging tools, including radiographs, computed tomography scans, and ultrasound, in this review study, the authors explored the literature for reports on the new achievements in improving the quality, accuracy, accessibility, and affordability of clinical imaging in foot and ankle.
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Affiliation(s)
- Samir Ghandour
- Department of Orthopaedic Surgery, Foot & Ankle Research and Innovation Lab (FARIL), Massachusetts General Hospital, Harvard Medical School, FARIL Center, 158 Boston Post Road, Weston, MA 02493, USA
| | - Soheil Ashkani-Esfahani
- Department of Orthopaedic Surgery, Foot & Ankle Research and Innovation Lab (FARIL), Massachusetts General Hospital, Harvard Medical School, FARIL Center, 158 Boston Post Road, Weston, MA 02493, USA; Department of Orthopaedic Surgery, Foot and Ankle Center, Massachusetts General Hospital, Harvard Medical School, 52 2nd Avenue, Waltham, MA 02451, USA.
| | - John Y Kwon
- Department of Orthopaedic Surgery, Foot & Ankle Research and Innovation Lab (FARIL), Massachusetts General Hospital, Harvard Medical School, FARIL Center, 158 Boston Post Road, Weston, MA 02493, USA; Department of Orthopaedic Surgery, Foot and Ankle Center, Massachusetts General Hospital, Harvard Medical School, 52 2nd Avenue, Waltham, MA 02451, USA
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Murdoch R, Terslev L, Martin J, Mihov B, Gamble GD, Torp-Pedersen S, Horne AM, Dalbeth N. Comparison of a handheld ultrasound device with cart-based ultrasound for the assessment of gout lesions in people with established gout. Semin Arthritis Rheum 2024; 68:152533. [PMID: 39173332 DOI: 10.1016/j.semarthrit.2024.152533] [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: 04/26/2024] [Revised: 07/18/2024] [Accepted: 08/05/2024] [Indexed: 08/24/2024]
Abstract
OBJECTIVES Use of handheld portable ultrasound is increasing and would improve access for people with rheumatic disease when conventional, cart-based ultrasound is unavailable. This study compared handheld and cart-based ultrasound for the assessment of gout lesions in people with gout. METHODS The lower limbs of 21 participants with gout were independently scanned at six sites (1st and 2nd metatarsophalangeal joints, knee, patellar ligament, Achilles tendon, and peroneal tendons) using cart-based (LOGIQ P9) and handheld (Vscan Air™) ultrasound by two rheumatologists. One rheumatologist was randomized to scan the right or left leg first with the cart-based or handheld ultrasound. The other rheumatologist scanned the legs in the opposite order with the imaging devices reversed. Images were saved and blinded images scored for double contour, tophus, erosion and aggregates using OMERACT definitions by two rheumatologists experienced in gout ultrasound. RESULTS On handheld ultrasound, 90% of participants had at least one site with double contour, tophus and erosions, and 100% had at least one site with aggregates. There were similar findings using cart-based ultrasound. However, site-level inter-device analysis showed only fair-good agreement: kappa (percentage agreement) for double contour 0.22 (67%), tophus 0.46 (77%), erosion 0.63 (83%) and aggregates 0.37 (75%). There were more aggregates detected by cart-based ultrasound in joints and more tophi detected by handheld ultrasound in ligaments and tendons. CONCLUSIONS Handheld ultrasound can detect gout lesions in people with established gout. However, concordance between cart-based and handheld ultrasound in detection of some gout lesions is low, particularly double contour and aggregates.
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Affiliation(s)
- Rachel Murdoch
- Department of Medicine, University of Auckland, 85 Park Rd, Auckland, New Zealand.
| | - Lene Terslev
- Centre for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Julia Martin
- Department of Rheumatology, Te Whatu Ora Te Toka Tumai, Auckland, New Zealand
| | - Borislav Mihov
- Department of Medicine, University of Auckland, 85 Park Rd, Auckland, New Zealand
| | - Gregory D Gamble
- Department of Medicine, University of Auckland, 85 Park Rd, Auckland, New Zealand
| | | | - Anne M Horne
- Department of Medicine, University of Auckland, 85 Park Rd, Auckland, New Zealand
| | - Nicola Dalbeth
- Department of Medicine, University of Auckland, 85 Park Rd, Auckland, New Zealand; Department of Rheumatology, Te Whatu Ora Te Toka Tumai, Auckland, New Zealand
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Ranger BJ, Lombardi A, Kwon S, Loeb M, Cho H, He K, Wei D, Park J. Ultrasound for assessing paediatric body composition and nutritional status: Scoping review and future directions. Acta Paediatr 2024. [PMID: 39295087 DOI: 10.1111/apa.17423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 08/29/2024] [Accepted: 09/03/2024] [Indexed: 09/21/2024]
Abstract
AIM This scoping review aims to assess the utility of ultrasound as a prospective tool in measuring body composition and nutritional status in the paediatric population. We provide a comprehensive summary of the existing literature, identify gaps, and propose future research directions. METHODS We conducted a systematic scoping review following the PRISMA Extension for Scoping Reviews guidelines. This involved screening titles and abstracts of relevant studies, followed by a detailed full-text review and extraction of pertinent data. RESULTS We identified and synthesised 34 articles. The review revealed that while ultrasound has been used to assess body composition and bone properties in children, significant gaps remain in the literature. These include limited studies on ultrasound performance, insufficient attention to relevant sample characteristics, reliance on manual image measurements, and limited sample diversity. CONCLUSION Point-of-care ultrasound shows significant promise for assessing paediatric body composition and nutritional status. To validate and enhance its effectiveness, further research is needed. Future studies should include larger and more diverse patient cohorts and conduct longitudinal investigations to evaluate nutritional interventions. Additionally, developing artificial intelligence (AI) for standardising and automating data interpretation will be crucial in improving the accuracy and efficiency of ultrasound assessments.
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Affiliation(s)
- Bryan J Ranger
- Department of Engineering, Boston College, Chestnut Hill, Massachusetts, USA
- William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
| | - Allison Lombardi
- William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
| | - Susie Kwon
- William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
| | - Mary Loeb
- Department of Engineering, Boston College, Chestnut Hill, Massachusetts, USA
| | - Hayoung Cho
- Department of Engineering, Boston College, Chestnut Hill, Massachusetts, USA
| | - Keshi He
- Department of Engineering, Boston College, Chestnut Hill, Massachusetts, USA
| | - Donglai Wei
- Department of Computer Science, Boston College, Chestnut Hill, Massachusetts, USA
| | - Jinhee Park
- William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
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Moran CM, McLeod C, Inglis S, Pye SD. An Assessment of the Imaging Performance of Hand-Held Ultrasound Scanners Using the Edinburgh Pipe Phantom. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:1178-1182. [PMID: 38705784 DOI: 10.1016/j.ultrasmedbio.2024.04.003] [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: 01/29/2024] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVE Although hand-held ultrasound devices (HHUSDs) are currently used for a diverse range of diagnostic and interventional applications the imaging performance of such scanners is rarely considered. The aim of this study was to assess the imaging performance of a wide-range of HHUSDs and compare their imaging performance to cart-based systems utilized for the same clinical applications. METHODS The grayscale imaging performances of 19 HHUSDs from eight different manufacturers, manufactured between 2016 and 2021, were measured using a figure-of-merit known as the resolution integral. The imaging performance of the HHUSDs were compared to 142 cart-based ultrasound scanners. RESULTS The HHUSD with the overall highest resolution integral (66) was a Butterfly (Burlington, MA, USA) wired phased array for small parts applications, followed by a Philips (Bothell, WA, USA) Lumify wired curvilinear transducer (57) for abdominal applications, a Butterfly wired phased array (56) for abdominal applications, a GE (Freiburg, Baden-Wurttemberg, Germany) VScan Air wireless linear array (56) for small parts applications, and a Healcerion (Seoul, Korea) Sonon 300L wireless linear array (56) for small parts applications. A GE VScan Extend wired phased array had the highest resolution integral (44) for cardiac applications. CONCLUSIONS The Butterfly phased array had the highest resolution integral of all the 19 HHUSDs, although this value is still less than the majority of cart-based cardiac and abdominal ultrasound scanners manufactured from 2010 to 2017. Clinical users of HHUSDs should be mindful of the limitations in imaging performance of hand-held ultrasound devices.
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Affiliation(s)
- Carmel M Moran
- University-BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, Edinburgh EH16 4TJ, UK.
| | | | | | - Stephen D Pye
- University-BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, Edinburgh EH16 4TJ, UK
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Thibault DA, Ellis C, Lencke JS, Frieswyk KM, Hemric LD. Utility of Handheld Ultrasound in Identifying Millimeter-Sized Vasculature in Living and Cadaveric Subjects. Cureus 2024; 16:e67383. [PMID: 39310486 PMCID: PMC11413976 DOI: 10.7759/cureus.67383] [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] [Accepted: 08/21/2024] [Indexed: 09/25/2024] Open
Abstract
Objective This study aims to investigate the utility of handheld, Bluetooth-capable ultrasound in identifying millimeter-sized vasculature in both living and cadaveric subjects. Methods Using handheld, linear ultrasound probes, the carpal tunnel of 87 living individuals (174 forearms) was assessed for the presence of a persistent median artery (PMA). Radial, ulnar, and persistent median arterial diameters were measured, along with forearm circumference. Using the same probes, 46 cadaveric forearms were assessed for the presence of a "potential" PMA. Those same forearms were subsequently dissected to confirm the presence of the artery. Results A PMA was identified in 3.4% of individuals (1.7% of forearms). Radial, ulnar, and persistent median arterial diameters were 2.12 ± 0.40 mm, 1.89 ± 0.41 mm, and 0.82 ± 0.33 mm, respectively. The radial artery was significantly larger than the ulnar artery (p < 0.0001). In cadaveric subjects, four "potential" PMAs were identified by pre-dissection ultrasound. Upon dissection, only one of the "potential" PMAs was confirmed, and three previously unidentified PMAs were identified. Conclusions The prevalence of PMA in living subjects was lower than previously reported. Additionally, handheld ultrasound had low accuracy in identifying PMAs in cadavers prior to dissection. This could be an indication that current handheld ultrasound lacks the sensitivity to identify millimeter-sized vasculature, such as a PMA. In both populations of subjects, key, non-anomalous anatomy was readily seen, indicating the utility of handheld ultrasound in the proper context.
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Affiliation(s)
- Drew A Thibault
- Department of Anatomical Sciences, Liberty University College of Osteopathic Medicine, Lynchburg, USA
| | - Connor Ellis
- Department of Anatomical Sciences, Liberty University College of Osteopathic Medicine, Lynchburg, USA
| | - Josh S Lencke
- Department of Anatomical Sciences, Liberty University College of Osteopathic Medicine, Lynchburg, USA
| | - Karen M Frieswyk
- Department of Anatomical Sciences, Liberty University College of Osteopathic Medicine, Lynchburg, USA
| | - Laurieanne D Hemric
- Department of Anatomical Sciences, Liberty University College of Osteopathic Medicine, Lynchburg, USA
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Elsner A, Klemmer K, Vordemvenne T, Wähnert D. [Treatment of acute ankle distortion in footballers : Are we doing it particularly right or particularly wrong?]. ORTHOPADIE (HEIDELBERG, GERMANY) 2024; 53:393-403. [PMID: 38787408 DOI: 10.1007/s00132-024-04506-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/16/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Despite the high incidence of ankle sprains, the ideal treatment is controversial and a significant percentage of patients who have suffered an ankle sprain never fully recover. Even professional athletes are affected by this post-traumatic complication. There is strong evidence that permanent impairment after an ankle injury is often due to an inadequate rehabilitation and training program and too early return to sport. THERAPY AND REHABILITATION Therefore, athletes should start a criteria-based rehabilitation after ankle sprain and gradually progress through the programmed activities, including e.g. cryotherapy, edema reduction, optimal load management, range of motion exercises to improve ankle dorsiflexion and digital guidance, stretching of the triceps surae with isometric exercises and strengthening of the peroneus muscles, balance and proprioception training, and bracing/taping. The fact that this is professional sport does not exempt it from consistent, stage-appropriate treatment and a cautious increase in load. However, there are a number of measures and tools that can be used in the intensive care of athletes to improve treatment and results.
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Affiliation(s)
- Andreas Elsner
- DIOOS - Deutsches Institut für Orthopädie, Osteopathie und Sportmedizin, Lipper Hellweg 10, 33604, Bielefeld, Deutschland.
- Orthopädische Gemeinschaftspraxis am Bültmannshof, Bielefeld, Deutschland.
| | - Kira Klemmer
- DIOOS - Deutsches Institut für Orthopädie, Osteopathie und Sportmedizin, Lipper Hellweg 10, 33604, Bielefeld, Deutschland
| | - Thomas Vordemvenne
- Medizinische Fakultät und Universitätsklinikum OWL, Evangelisches Klinikum Bethel, Universitätsklinik für Unfallchirurgie und Orthopädie, Universität Bielefeld, Bielefeld, Deutschland
| | - Dirk Wähnert
- Medizinische Fakultät und Universitätsklinikum OWL, Evangelisches Klinikum Bethel, Universitätsklinik für Unfallchirurgie und Orthopädie, Universität Bielefeld, Bielefeld, Deutschland
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Umlauf JA, Cervero R, Teng Y, Battista A. Influencing Physical Therapist's Self-efficacy for Musculoskeletal Ultrasound Through Blended Learning: A Mixed Methods Study. JOURNAL, PHYSICAL THERAPY EDUCATION 2024; 38:125-132. [PMID: 38625694 DOI: 10.1097/jte.0000000000000332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 12/15/2023] [Indexed: 04/17/2024]
Abstract
BACKGROUND AND PURPOSE With the growing interest for physical therapists to incorporate musculoskeletal (MSK) ultrasound comes a need to understand how to organize training to promote the transfer of training to clinical practice. A common training strategy blends asynchronous learning through online modules and virtual simulations with synchronous practice on live simulated participants. However, few physical therapists who attend MSK ultrasound continuing education courses integrate ultrasound into clinical practice. Self-efficacy is a significant predictor of training transfer effectiveness. This study describes to what degree and how a blended learning strategy influenced participants' self-efficacy for MSK ultrasound and transfer of training to clinical practice. SUBJECTS Twenty-one outpatient physical therapists with no previous MSK ultrasound training. METHODS Twenty-one participants assessed their self-efficacy using a 26-item self-efficacy questionnaire at 3 intervals: before asynchronous, before synchronous training, and before returning to clinical practice. Participants were interviewed within 1 week of training using a semi-structured interview guide. Quantitative analysis included descriptive statistics and repeated-measures ANOVA. Thematic analysis was used to examine participants' experiences, and "following the thread" was used to integrate findings. RESULTS Self-efficacy questionnaire mean scores increased significantly across the 3- time points ( F [2, 40] = 172.7, P < .001, η 2 = 0.896). Thematic analysis indicated that asynchronous activities scaffolded participants' knowledge, enhanced their self-efficacy, and prepared them for synchronous learning; however, it did not replicate the challenges of MSK ultrasound. Synchronous activities further improved self-efficacy and helped participants better calibrate their self-judgments of their abilities and readiness to integrate MSK ultrasound training into clinical practice. Despite individual-level improvements in self-efficacy, interviewees recognized their limitations and a need for longitudinal training in a clinical environment. DISCUSSION AND CONCLUSION A blended learning approach positively affects participants' self-efficacy for MSK ultrasound; however, future training designs should provide learners with additional support during the transition phase.
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Affiliation(s)
- Jon A Umlauf
- Jon A. Umlauf is the assistant professor in the Army-Baylor University Doctoral Program in Physical Therapy, 134 Hiler Road San Antonio, TX 78209 ( ). Please address all correspondence to Jon A. Umlauf
- Ronald Cervero is the professor and deputy director in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
- Yating Teng is the adjunct assistant professor in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
- Alexis Battista is the scientist II in the The Henry M Jackson Foundation for the Advancement of Military Medicine, and is the associate professor of medicine in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
| | - Ronald Cervero
- Jon A. Umlauf is the assistant professor in the Army-Baylor University Doctoral Program in Physical Therapy, 134 Hiler Road San Antonio, TX 78209 ( ). Please address all correspondence to Jon A. Umlauf
- Ronald Cervero is the professor and deputy director in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
- Yating Teng is the adjunct assistant professor in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
- Alexis Battista is the scientist II in the The Henry M Jackson Foundation for the Advancement of Military Medicine, and is the associate professor of medicine in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
| | - Yating Teng
- Jon A. Umlauf is the assistant professor in the Army-Baylor University Doctoral Program in Physical Therapy, 134 Hiler Road San Antonio, TX 78209 ( ). Please address all correspondence to Jon A. Umlauf
- Ronald Cervero is the professor and deputy director in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
- Yating Teng is the adjunct assistant professor in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
- Alexis Battista is the scientist II in the The Henry M Jackson Foundation for the Advancement of Military Medicine, and is the associate professor of medicine in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
| | - Alexis Battista
- Jon A. Umlauf is the assistant professor in the Army-Baylor University Doctoral Program in Physical Therapy, 134 Hiler Road San Antonio, TX 78209 ( ). Please address all correspondence to Jon A. Umlauf
- Ronald Cervero is the professor and deputy director in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
- Yating Teng is the adjunct assistant professor in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
- Alexis Battista is the scientist II in the The Henry M Jackson Foundation for the Advancement of Military Medicine, and is the associate professor of medicine in the Center for Health Professions Education at the Uniformed Services University of the Health Sciences
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Lerchbaumer MH, Perschk M, Gwinner C. [Ultrasound in sports traumatology]. SPORTVERLETZUNG SPORTSCHADEN : ORGAN DER GESELLSCHAFT FUR ORTHOPADISCH-TRAUMATOLOGISCHE SPORTMEDIZIN 2024; 38:89-99. [PMID: 38781978 DOI: 10.1055/a-2267-1074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Ultrasound (US) has numerous applications in sports traumatology. The technical progress of mobile US devices has led to increasing use of ultrasound as a primary diagnostic tool. New applications such as elastography and 3 D vascularization are used for special indications.The purpose of this review is to present the current status of ultrasound in the diagnosis of sports injuries and sport traumatology including established applications and new technical advances. US is presented both in its comparison to other imaging modalities and as a sole diagnostic tool.US can be used for initial diagnosis to improve the clinical examination and for intensive shortterm follow-up imaging. The main areas of application are currently the diagnosis of acute muscle and tendon injuries as well as overuse injuries. In particular, the exclusion of structural muscle injuries can be adequately ensured with US in the majority of anatomical regions. The recently published guideline on fracture ultrasound has strengthened the clinical evidence in this area, especially in comparison to conventional radiography and in the development of algorithms and standards. The increasing use of mobile ultrasound equipment with adequate image quality makes US a location-independent modality that can also be used at training sites or during road games.
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Affiliation(s)
- Markus Herbert Lerchbaumer
- Department of Radiology, Charité Universitätsmedizin Berlin, Berlin, Germany
- 1. FC Union Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany
| | | | - Clemens Gwinner
- 1. FC Union Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany
- Center for Musculoskeletal Surgery, Charité Universitätsmedizin Berlin, Berlin, Germany
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Alfuraih AM, Aldahlawi RH, Habib YS, Alhowimel AS, Bedewi MA. Reliability of Ultrasound Measurements of the Median Nerve in Asymptomatic Subjects Using a Handheld Device. SENSORS (BASEL, SWITZERLAND) 2024; 24:3444. [PMID: 38894235 PMCID: PMC11175092 DOI: 10.3390/s24113444] [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: 05/06/2024] [Revised: 05/18/2024] [Accepted: 05/25/2024] [Indexed: 06/21/2024]
Abstract
This study investigated the reliability of measuring the median nerve cross-sectional area (CSA) at the carpal tunnel inlet using a handheld ultrasound device (HUD) compared to a standard ultrasound system, focusing on intra- and inter-operator reproducibility among novice and expert operators. Employing a prospective cross-sectional design, 37 asymptomatic adults were assessed using both devices, with measurements taken by an expert with over five years of experience and a novice with less than six months. The CSA was determined using manual tracing and ellipse methods, with reproducibility evaluated through intraclass correlation coefficients (ICCs) and agreement assessed via Bland-Altman plots. Results showed a high degree of agreement between the devices, with excellent intra-operator reproducibility (ICC > 0.80) for the expert, and moderate reproducibility for the novice (ICCs ranging from 0.539 to 0.841). Inter-operator reliability was generally moderate, indicating acceptable consistency across different experience levels. The study concludes that HUDs are comparable to standard ultrasound systems for assessing median nerve CSA in asymptomatic subjects, with both devices providing reliable measurements. This supports the use of HUDs in diverse clinical environments, particularly where access to traditional ultrasound is limited. Further research with a larger sample and symptomatic patients is recommended to validate these findings.
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Affiliation(s)
- Abdulrahman M. Alfuraih
- Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Kharj 16278, Saudi Arabia
| | - Rana Hussain Aldahlawi
- Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 14511, Saudi Arabia;
| | - Yomna S. Habib
- Department of Radiology, University Hospital, Prince Sattam bin Abdulaziz University, Kharj 16278, Saudi Arabia;
| | - Ahmed S. Alhowimel
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Kharj 16278, Saudi Arabia;
| | - Mohamed Abdelmohsen Bedewi
- Department of Internal Medicine, College of Medicine, Prince Sattam bin Abdulaziz University, Kharj 16278, Saudi Arabia;
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Lerchbaumer MH, Perschk M, Gwinner C. Ultrasound in sports traumatology. ROFO-FORTSCHR RONTG 2024; 196:440-449. [PMID: 37944936 DOI: 10.1055/a-2185-8264] [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: 11/12/2023]
Abstract
BACKGROUND Ultrasound (US) has numerous applications in sports traumatology. The technical progress of mobile US devices has led to increasing use of ultrasound as a primary diagnostic tool. New applications such as elastography and 3 D vascularization are used for special indications. METHOD The purpose of this review is to present the current status of ultrasound in the diagnosis of sports injuries and sport traumatology including established applications and new technical advances. US is presented both in its comparison to other imaging modalities and as a sole diagnostic tool. RESULTS AND CONCLUSION US can be used for initial diagnosis to improve the clinical examination and for intensive short-term follow-up imaging. The main areas of application are currently the diagnosis of acute muscle and tendon injuries as well as overuse injuries. In particular, the exclusion of structural muscle injuries can be adequately ensured with US in the majority of anatomical regions. The recently published guideline on fracture ultrasound has strengthened the clinical evidence in this area, especially in comparison to conventional radiography and in the development of algorithms and standards. The increasing use of mobile ultrasound equipment with adequate image quality makes US a location-independent modality that can also be used at training sites or during road games. KEY POINTS · Typically used for quick, focused initial diagnostic assessment and short-term follow-up after injury. · Mobile US devices allow increased use in training centers and training camps. · New US applications (SWE, 3 D) increase standardization in follow-up of tendon injuries. · Targeted use of US for musculoskeletal diagnostic assessment saves money and frees up capacity. CITATION FORMAT · Lerchbaumer MH, Perschk M, Gwinner C. Ultrasound in sports traumatology. Fortschr Röntgenstr 2024; 196: 440 - 449.
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Affiliation(s)
- Markus Herbert Lerchbaumer
- Department of Radiology, Charité Universitätsmedizin Berlin, Germany
- 1. FC Union Berlin, Charité Universitätsmedizin Berlin, Germany
| | | | - Clemens Gwinner
- Center for Musculoskeletal Surgery, Charité Universitätsmedizin Berlin, Germany
- 1. FC Union Berlin, Charité Universitätsmedizin Berlin, Germany
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Hamoudi C, Martins A, Debordes PA, Goetsch T, Liverneaux P, Facca S. A Cadaveric Study Examining the Accuracy of Wireless Hand-Held Guided Ultrasound Injections Versus Blind Injections in the Flexor Tendon Sheath. JOURNAL OF HAND SURGERY GLOBAL ONLINE 2023; 5:650-654. [PMID: 37790827 PMCID: PMC10543784 DOI: 10.1016/j.jhsg.2023.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 04/22/2023] [Indexed: 10/05/2023] Open
Abstract
Purpose Hand-held ultrasound (HHUS) is gaining popularity among clinicians. Although its use for procedural guidance could have several advantages in hand surgery, other surgeons may wonder about its added benefits. This cadaveric study aimed to examine the hypothesis of increased accuracy of wireless HHUS-guided injections versus that of blind injections into the flexor sheath. Methods Our series included 20 fresh cadaveric hands with 80 fingers randomly assigned to 2 groups. In group A, 10 hands were randomly assigned to receive a landmark injection and then received a blinded injection to the flexor tendon sheath (FTS). In group B, 10 hands were blinded in the same manner and received an ultrasound-guided injection with HHUS. Methylene blue was injected, and anatomic dissection was performed to evaluate the injection accuracy based on the dye's filling pattern in the FTS as stage I (no filling), stage II (<50% filling), and stage III (>50% filling). Statistical analysis was performed, and P <.05 indicated a significant difference. Results One finger was excluded because of severe Dupuytren contracture. In group A, 39 blind injections of the FTS were performed, with 82% (32/39) fingers achieving stage III filling. In group B, 40 ultrasound-guided FTS injections were performed, with 90% (36/40) of fingers achieving stage III filing. Our study did not reveal any superiority in accuracy when ultrasound guidance was used (P = .35). Conclusions Hand-held ultrasound-guided FTS injections were not more accurate than blind injections performed by an experienced hand surgeon. These findings suggest that blind injections can be used as routine practice when performed by experienced operators to treat trigger finger. However, the use of HHUS may offer other advantages in hand surgery practice. Clinical relevance Ultimately, choosing to perform HHUS-guided injection versus blind injection to treat trigger finger depends on the surgeon's experience and preference for a particular technique.
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Affiliation(s)
- Ceyran Hamoudi
- Department of Hand Surgery, SOS main, University hospital of Strasbourg, Strasbourg, France
| | - Antoine Martins
- Department of Hand Surgery, SOS main, University hospital of Strasbourg, Strasbourg, France
| | | | - Thibaut Goetsch
- Department of Public Health, Strasbourg University Hospital, Strasbourg, France
| | - Philippe Liverneaux
- Department of Hand Surgery, SOS main, University hospital of Strasbourg, Strasbourg, France
- UMR7357, ICube CNRS, Strasbourg University, Strasbourg, France
| | - Sybille Facca
- Department of Hand Surgery, SOS main, University hospital of Strasbourg, Strasbourg, France
- UMR7357, ICube CNRS, Strasbourg University, Strasbourg, France
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Ghandour S, Ashkani-Esfahani S, Kwon JY. The Emerging Role of Automation, Measurement Standardization, and Artificial Intelligence in Foot and Ankle Imaging: An Update. Foot Ankle Clin 2023; 28:667-680. [PMID: 37536824 DOI: 10.1016/j.fcl.2023.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
In the past few years, advances in clinical imaging in the realm of foot and ankle have been consequential and game changing. Improvements in the hardware aspects, together with the development of computer-assisted interpretation and intervention tools, have led to a noticeable improvement in the quality of health care for foot and ankle patients. Focusing on the mainstay imaging tools, including radiographs, computed tomography scans, and ultrasound, in this review study, the authors explored the literature for reports on the new achievements in improving the quality, accuracy, accessibility, and affordability of clinical imaging in foot and ankle.
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Affiliation(s)
- Samir Ghandour
- Department of Orthopaedic Surgery, Foot & Ankle Research and Innovation Lab (FARIL), Massachusetts General Hospital, Harvard Medical School, FARIL Center, 158 Boston Post Road, Weston, MA 02493, USA
| | - Soheil Ashkani-Esfahani
- Department of Orthopaedic Surgery, Foot & Ankle Research and Innovation Lab (FARIL), Massachusetts General Hospital, Harvard Medical School, FARIL Center, 158 Boston Post Road, Weston, MA 02493, USA; Department of Orthopaedic Surgery, Foot and Ankle Center, Massachusetts General Hospital, Harvard Medical School, 52 2nd Avenue, Waltham, MA 02451, USA.
| | - John Y Kwon
- Department of Orthopaedic Surgery, Foot & Ankle Research and Innovation Lab (FARIL), Massachusetts General Hospital, Harvard Medical School, FARIL Center, 158 Boston Post Road, Weston, MA 02493, USA; Department of Orthopaedic Surgery, Foot and Ankle Center, Massachusetts General Hospital, Harvard Medical School, 52 2nd Avenue, Waltham, MA 02451, USA
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Hamoudi C, Martins A, Willaume T, Debordes PA, Liverneaux P, Facca S. Accuracy of Wireless Hand-Held Guided Ultrasound Injections in the Trapeziometacarpal Joint: A Cadaveric Study. Cureus 2023; 15:e45779. [PMID: 37745743 PMCID: PMC10516259 DOI: 10.7759/cureus.45779] [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] [Accepted: 09/22/2023] [Indexed: 09/26/2023] Open
Abstract
Background Symptomatic trapeziometacarpal osteoarthrosis can be treated with an ultrasound-guided injection in the early stages. This cadaveric study aimed to assess the hypothesis suggesting enhanced accuracy and reliability of hand-held ultrasound (HHUS) injections compared to blind injections into the trapeziometacarpal joint (TMC). Materials and method Our series included 20 fresh cadaveric hands, with a total of 20 TMC randomly assigned to two groups. In group A, 10 TMC received a blinded injection, and in group B, 10 TMC received an ultrasound-guided injection with HHUS. Methylene blue was injected, and anatomical dissection was performed to assess the intra-articular location of the dye. The injection was considered accurate if the intra-articular synovial fluid was stained after opening the articular capsule on the dorsal approach. If there was no injection, it was inaccurate. A statistical analysis was performed, and p <.05 indicated a significant difference. Results Two thumbs were excluded during the study due to an existing trapeziectomy. In group A, 10 blind injections of TMC were performed, with 70% (7/10) of injections graded as accurate. In group B, eight ultrasound-guided injections were performed, with 75% (6/8) achieving accuracy. A Fisher's exact test was performed, and the results indicated no statistically significant difference in injection accuracy between the two groups (P = 1, odds ratio = 0.788). Conclusion Hand-held ultrasound guided TMC injections were not more accurate than blind injections performed by an experienced hand surgeon. Nonetheless, additional studies with a larger sample and comparative studies with conventional cart-based machines are necessary to evaluate the potential of this newly accessible device.
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Affiliation(s)
- Ceyran Hamoudi
- Department of Hand Surgery, University Hospital of Strasbourg, Strasbourg, FRA
| | - Antoine Martins
- Department of Hand Surgery, University Hospital of Strasbourg, Strasbourg, FRA
- Department of Hand Surgery, Private Hospital La Châtaigneraie, ELSAN, Beaumont, FRA
| | - Thibault Willaume
- Department of Radiology, University Hospital of Strasbourg, Strasbourg, FRA
| | | | - Philippe Liverneaux
- Department of Hand Surgery, University Hospital of Strasbourg, Strasbourg, FRA
- Orthopedics, Strasbourg University, Strasbourg, FRA
| | - Sybille Facca
- Department of Hand Surgery, University Hospital of Strasbourg, Strasbourg, FRA
- Orthopedics, Strasbourg University, Strasbourg, FRA
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Corroenne R, Chesnais M, Khawand C, Attali I, Boucherie AS, Defrance M, Morgan R, Maurey L, Ville Y, Salomon LJ. Physicians' perceptions of the daily use of a handheld ultrasound device in the labor room. J Gynecol Obstet Hum Reprod 2023; 52:102618. [PMID: 37290728 DOI: 10.1016/j.jogoh.2023.102618] [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: 03/20/2023] [Revised: 05/23/2023] [Accepted: 06/05/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The objective of our study was to describe the perception of physicians who use a handheld ultrasound (US) device in an intensive perinatal care unit. METHODS We conducted a prospective observational study in the labor ward of an intensive perinatal care unit between November 2021 and May 2022. Obstetrics & Gynecology residents in rotation in our department during this time were recruited as participants in this study. All the participants were provided with a handheld US device Vscan Air™ (GE Healthcare, Zipf, Austria) to use during their normal days and nights practice in labor ward. At the end of their 6 months rotation, participants completed an anonymous surveys about their perceptions of the handheld US device. The survey included questions about the ease of use in clinical situations, the amount of time of initial diagnosis, performances of the device, feasibility to use, and patient's satisfaction with the use of the device. RESULTS 6 residents in their last year of residency were included. All the participants were satisfied with the device and would like to use it in their future practice. They all agreed that the probe was easy to handle and that the mobile application was easy to use. Image quality was always considered good by the participants and 5/6 of them declared that the handheld US device was always sufficient and did not require any confirmation with a conventional US machine. 5/6 of the participants considered that the handheld US device allowed them to gain time for clinical decision but half of them did not estimate that the use of the handheld US device improved their ability to make a clinical diagnosis. CONCLUSION Our study suggests that the Vscan Air™ is easy to use, with a good quality image and reduces the amount of time to make a clinical diagnosis. Handheld US device could be useful in the daily practice in maternity hospital.
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Affiliation(s)
- Romain Corroenne
- Department of Obstetrics, Fetal Medicine and Surgery, Necker Enfants Malades Hospital, Paris, France; EA fetus 7328 and LUMIERE Platform, University of Paris, Paris, France
| | - Marion Chesnais
- Department of Obstetrics, Fetal Medicine and Surgery, Necker Enfants Malades Hospital, Paris, France
| | - Chelsea Khawand
- Department of Obstetrics, Fetal Medicine and Surgery, Necker Enfants Malades Hospital, Paris, France
| | - Isabelle Attali
- Department of Obstetrics, Fetal Medicine and Surgery, Necker Enfants Malades Hospital, Paris, France
| | - Anne Sophie Boucherie
- Department of Obstetrics, Fetal Medicine and Surgery, Necker Enfants Malades Hospital, Paris, France
| | - Manon Defrance
- Department of Obstetrics, Fetal Medicine and Surgery, Necker Enfants Malades Hospital, Paris, France
| | - Rosemary Morgan
- Department of Obstetrics, Fetal Medicine and Surgery, Necker Enfants Malades Hospital, Paris, France
| | - Louise Maurey
- Department of Obstetrics, Fetal Medicine and Surgery, Necker Enfants Malades Hospital, Paris, France
| | - Yves Ville
- Department of Obstetrics, Fetal Medicine and Surgery, Necker Enfants Malades Hospital, Paris, France; EA fetus 7328 and LUMIERE Platform, University of Paris, Paris, France
| | - Laurent J Salomon
- Department of Obstetrics, Fetal Medicine and Surgery, Necker Enfants Malades Hospital, Paris, France; EA fetus 7328 and LUMIERE Platform, University of Paris, Paris, France.
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Dugan S, Schwab SM, Seward R, Avant J, Zhang T, Li SR, Eary K, Mast TD, Riley MA, Boyce S. A Qualitative Analysis of Clinician Perspectives of Ultrasound Biofeedback for Speech Sound Disorders. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:1252-1274. [PMID: 36961960 PMCID: PMC10484626 DOI: 10.1044/2023_ajslp-22-00194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/14/2022] [Accepted: 01/14/2023] [Indexed: 05/06/2023]
Abstract
PURPOSE Ultrasound biofeedback therapy (UBT) is a relatively new type of technology-assisted speech-language therapy and has shown promise in remediating speech sound disorders. However, there is a current lack of understanding of the barriers and benefits that may influence the usage behavior and clinical decision making for the implementation of UBT from a clinician perspective. In this qualitative study, we explore the perspectives of speech-language pathologists (SLPs) who have used ultrasound biofeedback in programs of speech sound therapy using the unified theory of acceptance and use of technology (UTAUT) model. METHOD Seven SLPs who had clinical experience treating speech sound disorders with UBT participated. Semistructured in-depth interviews were conducted and video-recorded. Two coders coded and categorized the transcribed data, with consensus established with a third coder. Using thematic analysis, the data were exploratorily grouped into themes along components of the UTAUT model. RESULTS The highest number of codes was sorted into the "effort expectancy" theme, followed by "performance expectancy," "social influence," and "facilitating conditions" themes of the UTAUT model. Clinicians identified multiple perceived barriers and benefits to the use of ultrasound technology. The top identified barrier was limited accessibility, and the top benefit was the ability to visualize a client's articulatory response to cues on a display. CONCLUSIONS Clinicians prioritized "effort expectancy" and "performance expectancy" when reflecting on the use of ultrasound biofeedback for speech sound disorders. Clinicians spoke favorably about using UBT for speech sound disorder treatment but acknowledged institutional barriers and limitations at organizational and social levels.
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Affiliation(s)
- Sarah Dugan
- Department of Rehabilitation, Exercise, & Nutrition Sciences, University of Cincinnati, OH
| | - Sarah M. Schwab
- Department of Rehabilitation, Exercise, & Nutrition Sciences, University of Cincinnati, OH
| | - Reneé Seward
- Myron E. Ullman, Jr. School of Design, University of Cincinnati, OH
| | - James Avant
- Myron E. Ullman, Jr. School of Design, University of Cincinnati, OH
| | - Ting Zhang
- Myron E. Ullman, Jr. School of Design, University of Cincinnati, OH
| | - Sarah R. Li
- Department of Biomedical Engineering, University of Cincinnati, OH
| | - Kathryn Eary
- Department of Biomedical Engineering, University of Cincinnati, OH
| | - T. Douglas Mast
- Department of Biomedical Engineering, University of Cincinnati, OH
| | - Michael A. Riley
- Department of Rehabilitation, Exercise, & Nutrition Sciences, University of Cincinnati, OH
| | - Suzanne Boyce
- Department of Communication Sciences & Disorders, University of Cincinnati, OH
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Elliott-Burke T, Dillon T, Bailey J, Miller S, Joos R, Buros Stein A. Lumbar multifidus muscle ultrasound imaging: Is handheld technology reliable? Musculoskelet Sci Pract 2023; 65:102771. [PMID: 37182391 DOI: 10.1016/j.msksp.2023.102771] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Advancement in ultrasound imaging technology has led to the development of handheld devices that are more accessible to physical therapists due to decreased cost, reduced size, and improved ease of use relative to current established units. Physical therapists use ultrasound imaging of the lumbar multifidus muscle (LMM) to assist in rehabilitation of patients with lumbar pathology. OBJECTIVES To identify the inter-device reliability of measuring the LMM thickness during a sustained contraction when comparing handheld (Butterfly iQ+) and established (SonoSite M-Turbo) ultrasound units. A secondary purpose was to determine the reliability of a student physical therapist using both devices. DESIGN A reliability measurement study METHOD: A blinded examiner identified the LMM at the L4 vertebral level and measured the thickness of the contracted muscle utilizing both the handheld and established ultrasound devices. ICC values were calculated to determine the inter-device and intra-rater reliability. RESULTS The study included 42 healthy participants, 30 females and 12 males, with a mean age of 38.5 years. The inter-device reliability during a sustained LMM contraction was excellent (ICC = 0.92, 95% CI: 0.87-0.94) and the intra-rater reliability was good for both the handheld (ICC = 0.85, 95% CI: 0.73-0.92) and established (ICC = 0.89, 95% CI: 0.82-0.93) ultrasound units. CONCLUSION Results support the use of handheld ultrasound by physical therapists and students to measure the LMM thickness. Future studies could investigate the reliability of handheld ultrasound in a variety of musculoskeletal and pathological structures important to PT practice.
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Affiliation(s)
- Teresa Elliott-Burke
- Department of Physical Therapy, College of Health Sciences, Midwestern University, Downers Grove, IL, USA.
| | - Thomas Dillon
- Department of Physical Therapy, College of Health Sciences, Midwestern University, Downers Grove, IL, USA
| | - Jasmin Bailey
- Department of Physical Therapy, College of Health Sciences, Midwestern University, Downers Grove, IL, USA
| | - Shannon Miller
- Department of Physical Therapy, College of Health Sciences, Midwestern University, Downers Grove, IL, USA
| | - Rachel Joos
- Department of Physical Therapy, College of Health Sciences, Midwestern University, Downers Grove, IL, USA
| | - Amy Buros Stein
- Office of Research and Sponsored Programs, Midwestern University, Glendale, AZ, USA
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Chen YL, Chiang HK. Development of Single-Channel Dual-Element Custom-Made Ultrasound Scanner with Miniature Optical Position Tracker for Freehand Imaging. BIOSENSORS 2023; 13:bios13040431. [PMID: 37185505 PMCID: PMC10136573 DOI: 10.3390/bios13040431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/10/2023] [Accepted: 03/20/2023] [Indexed: 05/17/2023]
Abstract
Handheld ultrasound has great potential in resource-limited areas, and can improve healthcare for rural populations. Single-channel ultrasound has been widely used in many clinical ultrasound applications, and optical tracking is considered accurate and reliable. In this study, we developed a 10 MHz lead magnesium niobate-lead titanate (PMN-PT) dual-element ultrasound transducer combined with a miniature optical position tracker, and then measured the rectus femoris of the thigh, upper arm, and cheek muscles. Compared to single-element transducers, dual-element transducers improve the contrast of near-field signals, effectively reduce noise, and are suitable for measuring curved surfaces. The purpose of position tracking is to calculate the location of the ultrasound transducer during the measurement process. By utilizing positioning information, 2D ultrasound imaging can be achieved while maintaining structural integrity. The dual-element ultrasound scanner presented in this study can enable continuous scanning over a large area without a scanning width limitation. The custom-made dual-element ultrasound scanner has the advantage of being a portable, reliable, and low-cost ultrasound device, and is helpful in popularizing medical care for remote villages.
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Affiliation(s)
- Yen-Lung Chen
- Department of BioMedical Engineering, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Huihua Kenny Chiang
- Department of BioMedical Engineering, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
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Utility of hand-held ultrasound for image acquisition and interpretation by trained Kenyan providers. Ultrasound J 2023; 15:12. [PMID: 36884093 PMCID: PMC9995612 DOI: 10.1186/s13089-023-00308-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/23/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Point-of-care ultrasound (POCUS) plays a prominent role in the timely recognition and management of multiple medical, surgical, and obstetric conditions. A POCUS training program for primary healthcare providers in rural Kenya was developed in 2013. A significant challenge to this program is the acquisition of reasonably priced ultrasound machines with adequate image quality and the ability to transmit images for remote review. The goal of this study is to compare the utility of a smartphone-connected, hand-held ultrasound with a traditional ultrasound device for image acquisition and interpretation by trained healthcare providers in Kenya. METHODS This study took place during a routine re-training and testing session for healthcare providers who had already received POCUS training. The testing session involved a locally validated Observed Structured Clinical Exam (OSCE) that assessed trainees' skills in performing the Extended Focused Assessment with Sonography for Trauma (E-FAST) and focused obstetric exams. Each trainee performed the OSCE twice, once using a smartphone-connected hand-held ultrasound and once using their notebook ultrasound model. RESULTS Five trainees obtained a total of 120 images and were scored on image quality and interpretation. Overall E-FAST imaging quality scores were significantly higher for the notebook ultrasound compared to the hand-held ultrasound but there was no significant difference in image interpretation. Overall focused obstetric image quality and image interpretation scores were the same for both ultrasound systems. When separated into individual E-FAST and focused obstetric views, there were no statistically significant differences in the image quality or image interpretation scores between the two ultrasound systems. Images obtained using the hand-held ultrasound were uploaded to the associated cloud storage using a local 3G-cell phone network. Upload times were 2-3 min. CONCLUSION Among POCUS trainees in rural Kenya, the hand-held ultrasound was found to be non-inferior to the traditional notebook ultrasound for focused obstetric image quality, focused obstetric image interpretation, and E-FAST image interpretation. However, hand-held ultrasound use was found to be inferior for E-FAST image quality. These differences were not observed when evaluating each E-FAST and focused obstetric views separately. The hand-held ultrasound allowed for rapid image transmission for remote review.
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van der Kraats AM, Peeters NH, Janssen ER, Lambers Heerspink FO. Handheld Ultrasound Does not Replace Magnetic Resonance Imaging for Diagnosis of Rotator Cuff Tears. Arthrosc Sports Med Rehabil 2023; 5:e381-e387. [PMID: 37101874 PMCID: PMC10123419 DOI: 10.1016/j.asmr.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/12/2022] [Accepted: 01/04/2023] [Indexed: 03/05/2023] Open
Abstract
Purpose The purpose of this study was to examine the reliability and validity of handheld ultrasound (HHUS) alone versus conventional ultrasound (US) or magnetic resonance imaging (MRI) for diagnosis of rotator cuff tears and versus MRI plus computed tomography (CT) for diagnosis of fatty infiltration. Methods Adult patients with shoulder complaints were included in this study. HHUS of the shoulder was performed twice by an orthopedic surgeon and once by a radiologist. RCTs, tear width, retraction and FI were measured. Inter- and intrarater reliability of the HHUS was calculated using a Cohen's kappa coefficient. Criterion and concurrent validity were calculated using a Spearman's correlation coefficient. Results Sixty-one patients (64 shoulders) were included in this study. Intra-rater agreement of HHUS for assessment of RCTs (к = 0.914, supraspinatus) and FI (к = 0.844, supraspinatus) was moderate to strong. Interrater agreement was none to minimal for the diagnosis of RCTs (к = 0.465, supraspinatus) and FI (к = 0.346, supraspinatus). Concurrent validity of HHUS compared to MRI was fair for diagnosis of RCTs (r = 0.377, supraspinatus) and fair-to-moderate FI (r = 0.608, supraspinatus). HHUS shows a sensitivity of 81.1% and specificity of 62.5% for diagnosis of supraspinatus tears, 60% and 93.1% for subscapularis tears, 55.6% and 88.9% for infraspinatus tears. Conclusions On the basis of findings in this study, we conclude that HHUS is an aid in diagnosis of RCTs and higher degrees of FI in patients who are not obese, but it does not replace MRI as the gold standard. Further clinical studies on the application of HHUS comparing HHUS devices in larger patient populations and healthy patients are required to identify its utility in clinical practice. Level of Evidence Level III.
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van der Kraats AM, Winkes M, Janzing HM, Eijkelenboom RP, de Koning MT. Review of Reliable and Valid Noninvasive Tools for the Diagnosis of Chronic Exertional Compartment Syndrome. Orthop J Sports Med 2023; 11:23259671221145151. [PMID: 36655016 PMCID: PMC9841863 DOI: 10.1177/23259671221145151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 09/26/2022] [Indexed: 01/15/2023] Open
Abstract
Background Currently, invasive dynamic intracompartmental pressure (ICP) measurements are considered the gold standard for diagnosis of chronic exertional compartment syndrome (CECS). During recent years, different noninvasive imaging modalities have been presented as a possible replacement for ICP measurement. Purpose To provide an overview of the current state of evidence and possibilities regarding noninvasive diagnostic methods for CECS. Study Design Scoping review; Level of evidence, 4. Methods The PubMed (MEDLINE) and Embase databases were searched using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Full-text articles were included if they reported on noninvasive diagnostic methods for CECS, included ≥5 patients with CECS, and were published between 1994 and 2022. Articles not written in English were excluded. Systematic reviews, letters to the editor, and case reports were not eligible for inclusion. Out of 961 articles identified in the initial search, 25 studies (N = 1257 participants) were included. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies-Comparative (QUADAS-C) tool for comparative studies and the QUADAS-2 tool for noncomparative studies. Narrative synthesis was used to present results. Results The level of evidence for the 25 studies ranged from 2 to 4. Four studies were classified as having a low risk of bias, 21 studies were classified as being at risk of bias. The following noninvasive diagnostic tools for CECS were reported: magnetic resonance imaging/diffusion tensor imaging (n = 8), near-infrared spectroscopy (n = 6), electromyography (n = 4), single-photon emission computed tomography (n = 5), ultrasound (n = 2), myotonometry (n=1) and predictive clinical model (n = 1). There was insufficient evidence in the literature to support the use of any of these noninvasive diagnostic tools as a gold standard for CECS. Conclusion Despite the need to replace the controversial use of ICP for the diagnosis of CECS, our review indicated a lack of validity on all discussed noninvasive diagnostic tools as a replacement.
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Affiliation(s)
- Annick M. van der Kraats
- Department of Surgery, VieCuri Medical Center, Venlo, the Netherlands.,Annick M. van der Kraats, BSc, Department of Surgery, VieCuri Medical Center, Tegelseweg 210, 5912 BL, Venlo, the Netherlands ()
| | - Michiel Winkes
- Department of Surgery, VieCuri Medical Center, Venlo, the Netherlands
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Le MPT, Voigt L, Nathanson R, Maw AM, Johnson G, Dancel R, Mathews B, Moreira A, Sauthoff H, Gelabert C, Kurian LM, Dumovich J, Proud KC, Solis-McCarthy J, Candotti C, Dayton C, Arena A, Boesch B, Flores S, Foster MT, Villalobos N, Wong T, Ortiz-Jaimes G, Mader M, Sisson C, Soni NJ. Comparison of four handheld point-of-care ultrasound devices by expert users. Ultrasound J 2022; 14:27. [PMID: 35796842 PMCID: PMC9263020 DOI: 10.1186/s13089-022-00274-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/16/2022] [Indexed: 11/30/2022] Open
Abstract
Background Point-of-care ultrasound (POCUS) is rapidly becoming ubiquitous across healthcare specialties. This is due to several factors including its portability, immediacy of results to guide clinical decision-making, and lack of radiation exposure to patients. The recent growth of handheld ultrasound devices has improved access to ultrasound for many clinicians. Few studies have directly compared different handheld ultrasound devices among themselves or to cart-based ultrasound machines. We conducted a prospective observational study comparing four common handheld ultrasound devices for ease of use, image quality, and overall satisfaction. Twenty-four POCUS experts utilized four handheld devices (Butterfly iQ+™ by Butterfly Network Inc., Kosmos™ by EchoNous, Vscan Air™ by General Electric, and Lumify™ by Philips Healthcare) to obtain three ultrasound views on the same standardized patients using high- and low-frequency probes. Results Data were collected from 24 POCUS experts using all 4 handheld devices. No single ultrasound device was superior in all categories. For overall ease of use, the Vscan Air™ was rated highest, followed by the Lumify™. For overall image quality, Lumify™ was rated highest, followed by Kosmos™. The Lumify™ device was rated highest for overall satisfaction, while the Vscan Air™ was rated as the most likely to be purchased personally and carried in one’s coat pocket. The top 5 characteristics of handheld ultrasound devices rated as being “very important” were image quality, ease of use, portability, total costs, and availability of different probes. Conclusions In a comparison of four common handheld ultrasound devices in the United States, no single handheld ultrasound device was perceived to have all desired characteristics. POCUS experts rated the Lumify™ highest for image quality and Vscan Air™ highest for ease of use. Overall satisfaction was highest with the Lumify™ device, while the most likely to be purchased as a pocket device was the Vscan Air™. Image quality was felt to be the most important characteristic in evaluating handheld ultrasound devices. Supplementary Information The online version contains supplementary material available at 10.1186/s13089-022-00274-6.
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Falkowski AL, Jacobson JA, Cresswell M, Bedi A, Kalia V, Zhang B. Medial Meniscal Extrusion Evaluation With Weight-Bearing Ultrasound: Correlation With MR Imaging Findings and Reported Symptoms: Correlation With MR Imaging Findings and Reported Symptoms. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:2867-2875. [PMID: 35302664 PMCID: PMC9790463 DOI: 10.1002/jum.15975] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 02/20/2022] [Accepted: 02/26/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To compare medial meniscal extrusion on weight-bearing ultrasound (US) with supine US and magnetic resonance (MR) imaging correlating with meniscal pathology and reported symptoms. METHODS IRB approved study with informed consent. Patients obtaining routine knee MR imaging for suspected knee pathology were prospectively evaluated with supine and weight-bearing US of the medial meniscus. Meniscal extrusion was measured independently by two fellowship-trained musculoskeletal radiologists. Correlation was made to presence or absence of meniscal degeneration or tear on MR imaging, as well as reported symptoms. Statistical significance was calculated via intraclass correlation coefficient (ICC) and analysis of variance (ANOVA). RESULTS Ninety-nine knees from 95 subjects (50 males, 45 females; mean age 45 ± 15 years) were included. Mean medial meniscal extrusion measured at US for a normal meniscus (n = 36) was 0.8 mm when supine, increasing to 1.6 mm on weight-bearing. Mean meniscal extrusion in subjects with mucoid degeneration (n = 20) and those with meniscal tears (n = 43) was 1.6 mm, increasing to 2.3 mm with weight bearing. Inter-reader reliability showed ICC values of 0.853 to 0.940. There was a significant difference in medial meniscal extrusion comparing subjects with a normal medial meniscus at magnetic resonance imaging (MRI) and subjects with either meniscal degeneration or tear. There was no significant difference in degree of meniscal extrusion between subjects with meniscal degeneration or tear. There was trend of worsening symptoms and increasing functional limitations moving from normal meniscus to meniscal degeneration to meniscal tear. CONCLUSIONS A normal meniscus shows lesser mobility between supine and upright position, than a pathologic meniscus. Both mucoid degeneration and meniscal tear demonstrate extrusion in the supine position, which increases with weight-bearing position.
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Affiliation(s)
- Anna L. Falkowski
- Department of RadiologyUniversity of MichiganAnn ArborMI
- Department of Radiology and Nuclear Medicine, Cantonal Hospital WinterthurUniversity of ZurichWinterthur
| | - Jon A. Jacobson
- Department of RadiologyUniversity of CincinnatiCincinnatiOHUSA
| | - Mark Cresswell
- Department of Radiology, St Paul's HospitalUniversity of British ColumbiaVancouverBCCanada
| | - Asheesh Bedi
- Department of Orthopaedic SurgeryUniversity of Michigan, Domino's Farms, MedSportAnn ArborMIUSA
| | - Vivek Kalia
- Department of RadiologyUniversity of MichiganAnn ArborMI
| | - Bin Zhang
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Department of PediatricsUniversity of Cincinnati College of MedicineCincinnatiOHUSA
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Holbert SE, Fowler B, West M, Morris J, Turcotte J, King P. Pain After Preoperative Ultrasound Guided Hip Injections for Total Hip Arthroplasty: A Pilot Randomized Controlled Trial. Surg Innov 2022:15533506221124460. [DOI: 10.1177/15533506221124460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction. Hip replacement is a frequently performed and highly successful treatment for patients with end stage osteoarthritis. Advances in technique and pain management have allowed for rapid mobilization and early discharge after surgery. We hypothesize that pre-incision intra-articular injection of local anesthetic with epinephrine under image guidance combined with post incision peri-articular injection (PAI) may be more effective than PAI alone. Methods. A prospective, randomized, controlled, comparative investigation at a single institution of 41 patients undergoing THA who received standard 30 mL post-arthrotomy, PAI of ropivacaine with epinephrine under direct visualization after prosthesis implantation before closure or an equivalent dose divided into a 10 mL pre-incision, ultrasound guided intra-articular injection and a 20 mL post-arthrotomy PAI. Results. 42 patients were included in this study before its early conclusion with 22 patients in the treatment group and 20 in the control group. There were no significant differences in age, BMI or ASA scores. Additionally, there were no significant differences noted when comparing groups by postoperative outcome measures including OMME, EBL, OR time, PACU minutes, and first and last PACU pain score. Furthermore, there were no significant differences in the PROMs evaluated. Discussion. The addition of ultrasound guided pre-incision intra-articular injection to the standard PAI had no benefit when compared with standard PAI during a THA. Portable mobile phone based ultrasound devices provide a cost effective way to perform musculoskeletal blocks, and further studies on their use and comparative accuracy is warranted. A novel technique for confirmation of injection location is described.
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Affiliation(s)
| | | | | | | | | | - Paul King
- Anne Arundel Medical Center, Annapolis, MD, USA
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26
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Desyatnikova S, Schelke L. Treatment of filler related vascular occlusion using handheld portable ultrasound device. J Cosmet Dermatol 2022; 21:3166-3168. [PMID: 35621245 DOI: 10.1111/jocd.15125] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 05/22/2022] [Accepted: 05/25/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | - Leonie Schelke
- Department of Dermatology, Erasmus Medical Centre, Rotterdam, The Netherlands
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27
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Fotouh AA, Hamdy M, Ali F, Mohamed EF, Allam A, Hassan WA, Elsaman A, El-Najjar A, Amer MA, Mosad D, Tharwat S, El Bakry SA, Saleh H, Zaghloul A, Mahmoud M, Mohammed RHA, El-Saadany H, Fathi HM, Hammam N, Raafat HA, Moharram AN, Gheita TA. The Emerging Era of Interventional Imaging in Rheumatology: An Overview During the Coronavirus Disease-2019 (COVID-19) Pandemic. Open Access Rheumatol 2022; 14:43-56. [PMID: 35449707 PMCID: PMC9018128 DOI: 10.2147/oarrr.s355140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/25/2022] [Indexed: 11/29/2022] Open
Abstract
Imaging has long been taking its place in the diagnosis, monitor, and prognosis of rheumatic diseases. It plays a vital role in the appraisal of treatment. Key progress in the clinical practice of rheumatology is the innovation of advanced imaging modalities; such as musculoskeletal ultrasound (MSUS), computerized tomography (CT) and magnetic resonance imaging (MRI). These modalities introduced a promising noninvasive method for visualizing bone and soft tissues to enable an improved diagnosis. The use of MSUS in rheumatology is considered a landmark in the evolution of the specialty and its ease of use and many applications in rheumatic diseases make it a forerunner instrument in the practice. The use of MSUS among rheumatologists must parallel the development rate of the excellence revealed in the specialty. Moreover, innovative interventional imaging in rheumatology (III-R) is gaining fame and key roles in the near future for a comprehensive management of rheumatic diseases with precision. This review article throws light on the emergence of these robust innovations that may reshape the guidelines and practice in rheumatology, in particular, efforts to enhance best practice during the coronavirus disease 2019 (COVID-19) pandemic are endorsed.
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Affiliation(s)
| | - Mona Hamdy
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Fatma Ali
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Eman F Mohamed
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, AlAzhar Girls, Cairo, Egypt
| | - Abdallah Allam
- Rheumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Waleed A Hassan
- Rheumatology Department, Faculty of Medicine, Benha University, Banha, Egypt
| | - Ahmed Elsaman
- Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Amany El-Najjar
- Rheumatology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Marwa A Amer
- Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Doaa Mosad
- Rheumatology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Samar Tharwat
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Samah A El Bakry
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hanan Saleh
- Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmed Zaghloul
- Interventional Pain Management and Anesthesia, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mostafa Mahmoud
- Orthopedic and Microsurgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Reem H A Mohammed
- Rheumatology and Clinical Immunology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hanan El-Saadany
- Rheumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Hanan M Fathi
- Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Nevin Hammam
- Rheumatology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Hala A Raafat
- Rheumatology and Clinical Immunology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ashraf N Moharram
- Orthopedic and Microsurgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Tamer A Gheita
- Rheumatology and Clinical Immunology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Performance of a Handheld Ultrasound Device to Assess Articular and Periarticular Pathologies in Patients with Inflammatory Arthritis. Diagnostics (Basel) 2021; 11:diagnostics11071139. [PMID: 34206675 PMCID: PMC8305786 DOI: 10.3390/diagnostics11071139] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/08/2021] [Accepted: 06/18/2021] [Indexed: 12/27/2022] Open
Abstract
The purpose of this study was to assess the accuracy and performance of a new handheld ultrasound (HHUS) machine in comparison to a conventional cart-based sonographic machine in patients with inflammatory arthritis (IA). IA patients with at least one tender and swollen joint count were enrolled. US was performed on the clinically affected joints using a cart-based sonographic device (Samsung HS40) and a HHUS device (Butterfly iQ). One blinded reader scored all images for the presence of erosions, bony enlargement, synovial hypertrophy, joint effusion, bursitis, tenosynovitis, and enthesitis. Synovitis was graded (B mode and power Doppler (PD)) by the 4-level EULAR-OMERACT scale. To avoid bias by the blinded reader, we included 67 joints of two healthy volunteers in the evaluation. We calculated the overall concordance and the concordance by type of joint and pathological finding. We also measured the time required for the US examination per joint with both devices. Thirty-two patients (20 with RA, 10 with PsA, and one each with gout and SLE-associated arthritis) were included, and 186 joints were examined. The overall raw concordance in B mode was 97% (κappa 0.90, 95% CI (0.89, 0.94)). In B mode, no significant differences were found in relation to type of joint or pathological finding examined. The PD mode of the HHUS device did not detect any PD signal, whereas the cart-based device detected a PD signal in 61 joints (33%). The portable device did not offer any time savings compared to the cart-based device (47.0 versus 46.3 s). The HHUS device was accurate in the assessment of structural damage and inflammation in patients with IA, but only in the B mode. Significant improvements are still needed for HHUS to reliably demonstrate blood flow detection in PD mode.
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