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Cocco G, Ricci V. Dynamic ultrasound assessment for insertional achilles tendinopathy: the COcco-RIcci (CORI) sign. Skeletal Radiol 2024:10.1007/s00256-024-04746-9. [PMID: 38987412 DOI: 10.1007/s00256-024-04746-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Revised: 06/21/2024] [Accepted: 07/04/2024] [Indexed: 07/12/2024]
Abstract
OBJECTIVE To describe a novel, dynamic ultrasound assessment of the Achilles tendon at the calcaneal insertion taking advantage of the effusion within the deep retrocalcaneal bursa as a natural contrast agent. MATERIALS AND METHODS Positioning the ultrasound transducer in a longitudinal plane over the Achilles tendon at the calcaneal insertion, manual compression of the deep retrocalcaneal bursa can be performed using the other hand. Dynamically shifting the anechoic effusion from the proximal to the distal compartment of the bursa, the undersurface of the Achilles tendon is lifted from the underlying cortical bone of the superior facet of the calcaneal tuberosity. RESULTS Pushing the anechoic effusion from the bursal cavity toward the undersurface of the Achilles tendon, an eventual focal injury of its deep fibers can be visualized dynamically during the maneuver as a "black crescent" within the tendon-i.e., the COcco-RIcci (CORI) sign. Otherwise, the gliding of the posteroinferior wedge of the Kager's fat pad inside the tendon-bone interface can be observed in normal conditions. CONCLUSION The CORI sign is a novel sonographic sign to further enhance the diagnostic accuracy of dynamic ultrasound imaging in patients with insertional Achilles tendinopathy especially to detect focal injury involving the deep fibers of the tendon.
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Affiliation(s)
- Giulio Cocco
- Department of Neuroscience, Imaging and Clinical Sciences, G. d'Annunzio University, Chieti, Italy
| | - Vincenzo Ricci
- Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy.
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Boccatonda A, Balletta M, D'Ardes D, Cocco G, Piscaglia F, Serra C, Vicari S, Schiavone C. Ultrasound diagnosis of a pseudoaneurysm of the internal right mammary artery. J Ultrasound 2024; 27:393-396. [PMID: 38632171 PMCID: PMC11178712 DOI: 10.1007/s40477-024-00889-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 02/23/2024] [Indexed: 04/19/2024] Open
Abstract
One of the principles of managing trauma patients is that of their continuous re-evaluation over the hours and days. Even if the execution of the computed tomography method is classically recommended, especially in the most serious cases and in polytraumas with major dynamics, the clinician can use or request an ultrasound examination, especially in subsequent re-evaluations. Here we report a clinical case demonstrating how an ultrasound re-evaluation after the acute event can lead to a correct diagnosis of a rare complication of thoracic trauma. The findings were suggestive for a pseudoaneurysm of the internal right mammary artery. Subsequently, an ultrasound-guided injection of thrombin was carried out until complete interruption of the flow within the formation. At subsequent follow-up, no arterial or venous blush was highlighted.
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Affiliation(s)
- Andrea Boccatonda
- Internal Medicine, Bentivoglio Hospital, AUSL Bologna, Via Marconi 35, Bentivoglio, Bologna, Italy.
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
| | - Marco Balletta
- Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, Bologna, Italy
| | - Damiano D'Ardes
- Department of Medicine and Aging Science, Institute of "Clinica Medica", "G. d'Annunzio" University of Chieti, 66100, Chieti, Italy
| | - Giulio Cocco
- Internistic Ultrasound Unit, SS Annunziata Hospital, "G. D'Annunzio" University, 66100, Chieti, Italy
| | - Fabio Piscaglia
- Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italia
| | - Carla Serra
- Interventional, Diagnostic and Therapeutic Ultrasound Unit, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Susanna Vicari
- Internal Medicine, Bentivoglio Hospital, AUSL Bologna, Via Marconi 35, Bentivoglio, Bologna, Italy
| | - Cosima Schiavone
- Internistic Ultrasound Unit, SS Annunziata Hospital, "G. D'Annunzio" University, 66100, Chieti, Italy
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Cocco G, Ricci V, Corvino A, Abate M, Vaccaro A, Bernabei C, Cantisani V, Vallone G, Caiazzo C, Caulo M, Pizzi AD. Musculoskeletal disorders in padel: from biomechanics to sonography. J Ultrasound 2024; 27:335-354. [PMID: 38578364 PMCID: PMC11178742 DOI: 10.1007/s40477-023-00869-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 04/06/2024] Open
Abstract
Padel is a racket sport, combining high-frequency and low-intensity athletic gestures, that has been gaining growing scientific interest in recent years. Musculoskeletal injuries are very common among padel players with an incidence rate of 3 per 1000 h of training and 8 per 1000 matches. To the best of our knowledge, a comprehensive collection describing the most common sonographic findings in padel players with musculoskeletal injuries is lacking in the pertinent literature. In this sense, starting from the biomechanical features of padel-specific gestures we have reported the ultrasonographic patterns of most frequent injuries involving the upper limb, the trunk, and the lower limb. Indeed, comprehensive knowledge of the biomechanical and clinical features of musculoskeletal injuries in padel is paramount to accurately perform a detailed ultrasound examination of the affected anatomical site. So, the present investigation aims to provide a practical guide, simple and ready-to-use in daily practice, to optimize the sonographic assessment of padel players by combining it with the clinical findings and the biomechanical features of athletic gestures.
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Affiliation(s)
- Giulio Cocco
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, 6610, Chieti, Italy
- Unit of Ultrasound in Internal Medicine, Department of Medicine and Aging Sciences, University "G. D'Annunzio", Chieti, Italy
| | - Vincenzo Ricci
- Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, 20157, Milan, Italy
| | - Antonio Corvino
- Medical, Movement and Wellbeing Sciences Department, University of Naples "Parthenope", Via Medina 40, 80133, Naples, Italy.
| | - Michele Abate
- IRCSS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
| | - Adele Vaccaro
- Department of Radiology, SS. Annunziata Hospital of Chieti, University "G. D'Annunzio", Chieti, Italy
| | - Carlotta Bernabei
- Department of Radiology, SS. Annunziata Hospital of Chieti, University "G. D'Annunzio", Chieti, Italy
| | - Vito Cantisani
- Department of Radiology, Oncology, Sapienza-University of Rome, Anatomo-Pathology, Rome, Italy
| | - Gianfranco Vallone
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, 86100, Campobasso, Italy
| | - Corrado Caiazzo
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, 86100, Campobasso, Italy
| | - Massimo Caulo
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, 6610, Chieti, Italy
| | - Andrea Delli Pizzi
- Department of Innovative Technologies in Medicine and Dentistry, University "G. D'Annunzio", Chieti, Italy
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Ricci V, Tamborrini G, Zunica F, Chang KV, Kara M, Farì G, Naňka O, Özçakar L. High-resolution ultrasound imaging of elementary lesions in dactylitis. J Ultrasound 2024; 27:281-290. [PMID: 38006512 PMCID: PMC11178685 DOI: 10.1007/s40477-023-00834-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 10/02/2023] [Indexed: 11/27/2023] Open
Abstract
OBJECTIVE The aim of the present study was to illustrate the (potential) diagnostic role of high resolution US images in assessing the elementary lesions of dactylitis. METHODS Using high-frequency US machines/probes, we matched the micro-anatomical cadaveric architecture of the digit with multiple sonographic findings of dactylitis. High-sensitive color/power Doppler assessments have also been performed to evaluate the digital microvasculature. DISCUSSION Modern US equipment/features guarantee prompt and in-depth B-mode and color/power Doppler imaging of tiny anatomical structures of the digit which are usually not properly visible with standard US machines. More specifically, hypervascularization of the digital subcutaneous tissue, fibrous pulleys of flexor tendons, dorsal synovial pads as well as pathological changes of the distal entheseal anchorage network can be accurately detected. CONCLUSION In clinical practice, high-end US equipment can be used to accurately assess the digits in patients with dactylitis. This way, simple and convenient sonographic diagnosis of different elementary lesions can be timely established.
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Affiliation(s)
- Vincenzo Ricci
- Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy.
| | - Giorgio Tamborrini
- UZR, Ultraschallzentrum und Institut für Rheumatologie, Basel, Switzerland
- Rheumatology Clinic, University Hospital of Basel, Basel, Switzerland
| | - Fiammetta Zunica
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, 20154, Milan, Italy
| | - Ke-Vin Chang
- Department of Physical Medicine and Rehabilitation and Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Huy Branch, Taipei, Taiwan
| | - Murat Kara
- Department of Physical and Rehabilitation Medicine Ankara, Hacettepe University Medical School, Ankara, Turkey
| | - Giacomo Farì
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, Aldo Moro University of Bari, Bari, Italy
- Department of Biological and Environmental Science and Technologies (Di.S.Te.B.A.), University of Salento, Lecce, Italy
| | - Ondřej Naňka
- Institute of Anatomy, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine Ankara, Hacettepe University Medical School, Ankara, Turkey
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Boccatonda A, Piscaglia F. New perspectives on the use of artificial intelligence in the ultrasound evaluation of lung diseases. J Ultrasound 2024; 27:429-431. [PMID: 38315408 PMCID: PMC11178746 DOI: 10.1007/s40477-023-00866-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 12/20/2023] [Indexed: 02/07/2024] Open
Affiliation(s)
- Andrea Boccatonda
- Internal Medicine, Bentivoglio Hospital, AUSL Bologna, 40010, Bentivoglio, Italy.
| | - Fabio Piscaglia
- Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italia
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Becciolini M, Bonacchi G, Stella SM, Tamborrini G. Intermittent flexor hallucis longus dislocation: ultrasound findings. J Ultrasound 2024:10.1007/s40477-024-00880-1. [PMID: 38602647 DOI: 10.1007/s40477-024-00880-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 02/12/2024] [Indexed: 04/12/2024] Open
Abstract
We report a case of intermittent dislocation of the flexor hallucis longus at its passage in the retro-malleolar area, related to a post-traumatic detachment of the retrotalar pulley from the medial tubercle of the talus. High-resolution ultrasound depicted the anterior dislocation of the tendon during dynamic stress, by asking the patient to flex his hallux against the examiner resistance, with the ankle in slight dorsiflexion. The tendon normally relocated after the dynamic maneuver. Tendon dislocation was associated with a painful snap.
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Affiliation(s)
- Marco Becciolini
- Misericordia di Pistoia, Via Bonellina 1, 51100, Pistoia, Italy.
- Scuola Siumb di Ecografia Muscoloscheletrica, Pisa, Italy.
| | - Giovanni Bonacchi
- Misericordia di Pistoia, Via Bonellina 1, 51100, Pistoia, Italy
- Scuola Siumb di Ecografia Muscoloscheletrica, Pisa, Italy
| | | | - Giorgio Tamborrini
- Swiss Ultrasound Center, Institute of Rheumatology, Basel, Switzerland
- Clinic for Rheumatology, University Hospital of Basel, Basel, Switzerland
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Yalçınkaya B, Sağ BT, Aksakal MF, Analay P, Ocak H, Kara M, Kaymak B, Özçakar L. Optimal examination for traumatic nerve/muscle injuries in earthquake survivors: a retrospective observational study. JOURNAL OF YEUNGNAM MEDICAL SCIENCE 2024; 41:120-127. [PMID: 38576339 DOI: 10.12701/jyms.2024.00087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/14/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Physiatrists are facing with survivors from disasters in both the acute and chronic phases of muscle and nerve injuries. Similar to many other clinical conditions, neuromusculoskeletal ultrasound can play a key role in the management of such cases (with various muscle/nerve injuries) as well. Accordingly, in this article, a recent single-center experience after the Turkey-Syria earthquake will be rendered. METHODS Ultrasound examinations were performed for various nerve/muscle lesions in 52 earthquake victims referred from different cities. Demographic features, type of injuries, and applied treatment procedures as well as detailed ultrasonographic findings are illustrated. RESULTS Of the 52 patients, 19 had incomplete peripheral nerve lesions of the brachial plexus (n=4), lumbosacral plexus (n=1), and upper and lower limbs (n=14). CONCLUSION The ultrasonographic approach during disaster relief is paramount as regards subacute and chronic phases of rehabilitation. Considering technological advances (e.g., portable machines), the use of on-site ultrasound examination in the (very) early phases of disaster response also needs to be on the agenda of medical personnel.
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Affiliation(s)
- Berkay Yalçınkaya
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Büşranur Tüten Sağ
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Mahmud Fazıl Aksakal
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Pelin Analay
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Hasan Ocak
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Murat Kara
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Bayram Kaymak
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
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Tamborrini G, Hügle T, Ricci V, Filippou G. Ultrasound imaging in crystal arthropathies: a pictorial review. Reumatismo 2023; 75. [PMID: 38115778 DOI: 10.4081/reumatismo.2023.1583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 08/08/2023] [Indexed: 12/21/2023] Open
Abstract
OBJECTIVE The prevalence of crystal arthropathies in the general population is rising. The purpose of this pictorial study is to describe the sonographic elements of the most prevalent crystal arthropathies by emphasizing particular sonographic findings using illustrative images and cases while considering technical details and common pitfalls. METHODS Using established recommendations, specialists in the fields of sonography and crystal arthropathies agreed by consensus on the unique ultrasound signs associated with each of the conditions. RESULTS Gout, calcium pyrophosphate deposition arthropathy, and hydroxyapatite arthropathy are the three most prevalent crystal arthropathies. Today's high-resolution sonography enables reliable evaluation of the underlying crystal deposits, post-inflammatory changes, and a precise description of joint inflammation. CONCLUSIONS High-prevalence crystal arthropathies are reliably detectable by ultrasound with current ultrasound equipment. It is necessary to have extensive ultrasound training, know specific sonographic findings, and understand all possible differential diagnoses for disorders affecting the musculoskeletal system.
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Affiliation(s)
- G Tamborrini
- Swiss Ultrasound Center, Institute of Rheumatology, Basel; Clinic for Rheumatology, University Hospital of Basel.
| | - T Hügle
- Rheumatology, Vaud University Hospital, Lausanne.
| | - V Ricci
- Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan.
| | - G Filippou
- Department of Rheumatology, Galeazzi - Sant'Ambrogio IRCCS Hospital, Milan.
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Kandil NM, Hassan MAEF, Moharram AN, Saleh OAEFH, Hashem AB. Can ultrasound replace MRI in diagnosing causes of ankle impingement in different compartments? J Ultrasound 2023; 26:829-844. [PMID: 37526836 PMCID: PMC10632229 DOI: 10.1007/s40477-023-00803-6] [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: 04/15/2023] [Accepted: 06/23/2023] [Indexed: 08/02/2023] Open
Abstract
PURPOSE This prospective study aims to determine the role of ultrasound (US) in diagnosing different types of ankle impingement due to osseous and soft tissue pathologies and to compare the results with magnetic resonance imaging (MRI), which is considered our gold standard. METHODS The study population included 90 patients with unilateral ankle pain who presented with symptoms and signs suggestive of ankle impingement. Their age ranged from 17 to 57 years, with a mean age of 33.7 years. Using US and MRI, our cases were classified into bony and soft tissue ankle impingement. They were further classified according to the anatomical compartments affected, into anteromedial, anterior, anterolateral, posteromedial, and posterior. RESULTS 90 patients were enrolled in this study: 51 males and 39 females. In our study, posterior ankle impingement was the commonest impingement type, while anteromedial ankle impingement was the rarest type, followed by posteromedial impingement. The accuracy of US in diagnosing osseous impingement was found to have the following: sensitivity 70.37%, specificity 100%, PPV 100%, NPV 75%, accuracy 84.31%, and p value < 0.001; meanwhile, the accuracy of US in diagnosing soft tissue impingement was found to have the following: sensitivity 83.33%, specificity 100%, PPV 100%, NPV 87.10%, accuracy 92.16%, and p value < 0.001. CONCLUSION US is a good diagnostic tool in bone and soft tissue impingements, with a significant p value of 0.001 for both. US cannot replace MRI as a diagnostic tool, but as a widely available imaging modality, it can save time and cost and allows dynamic imaging.
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Affiliation(s)
| | | | | | | | - Aya Bassam Hashem
- Radiology Department, Faculty of Medicine, Cairo University, Giza, Egypt
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Cocco G, Ricci V, Corvino A, Pacini P, Boccatonda A, Naňka O, Sensi SL, Caulo M, Delli Pizzi A. Ultrasound Imaging of the Sciatic Nerve. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2023; 44:e263-e273. [PMID: 37832532 DOI: 10.1055/a-2095-2842] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
Abstract
The sciatic nerve (SN) is the biggest nerve in the human body and innervates a large skin surface of the lower limb and several muscles of the thigh, leg, and foot. It originates from the ventral rami of spinal nerves L4 through S3 and contains fibers from both the posterior and anterior divisions of the lumbosacral plexus. After leaving the neural foramina, the nerve roots merge with each other forming a single peripheral nerve that travels within the pelvis and thigh. Non-discogenic pathologies of the SN are largely underdiagnosed entities due to nonspecific clinical tests and poorly described imaging findings. Likewise, to the best of our knowledge, a step-by-step ultrasound protocol to assess the SN is lacking in the pertinent literature. In this sense, the aim of the present manuscript is to describe the normal sono-anatomy of the SN from the greater sciatic foramen to the proximal thigh proposing a standardized and simple sonographic protocol. Then, based on the clinical experience of the authors, a few tips and tricks have been reported to avoid misinterpretation of confounding sonographic findings. Last but not least, we report some common pathological conditions encountered in daily practice with the main purpose of making physicians more confident regarding the sonographic "navigation" of a complex anatomical site and optimizing the diagnosis and management of non-discogenic neuropathies of the SN.
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Affiliation(s)
- Giulio Cocco
- Department of Neuroscience, Imaging and Clinical Sciences, Gabriele d'Annunzio University of Chieti and Pescara, Chieti, Italy
- Unit of Ultrasound in Internal Medicine, Department of Medicine and Science of Aging, Gabriele d'Annunzio University of Chieti and Pescara, Chieti, Italy
| | - Vincenzo Ricci
- Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, Milano, Italy
| | - Antonio Corvino
- Movement Sciences and Wellbeing Department, University of Naples Parthenope, Napoli, Italy
| | - Patrizia Pacini
- Department of Radiological, Oncological and Anatomopathological Sciences, Umberto I Polyclinic of Rome, Roma, Italy
| | | | - Ondřej Naňka
- Institute of Anatomy, First Faculty of Medicine, Charles University, Praha, Czech Republic
| | - Stefano L Sensi
- Advanced Computing Core, Center of Advanced Studies and Technology (CAST), Gabriele d'Annunzio University of Chieti and Pescara, Chieti, Italy
- Department of Neuroscience, Imaging and Clinical Sciences, Gabriele d'Annunzio University of Chieti and Pescara, Chieti, Italy
| | - Massimo Caulo
- Department of Neuroscience, Imaging and Clinical Sciences, Gabriele d'Annunzio University of Chieti and Pescara, Chieti, Italy
| | - Andrea Delli Pizzi
- Department of Innovative Technologies in Medicine and Dentistry, Gabriele d'Annunzio University of Chieti and Pescara, Chieti, Italy
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Vijayan AM, Aslam SA, Abidha R, Cherian MP, Thomas T, Kandathil AM. A Study to Evaluate the Efficacy of Ultrasonography as a Diagnostic Screening Tool in Maxillofacial Fractures: A Prospective Study. J Contemp Dent Pract 2023; 24:645-650. [PMID: 38152936 DOI: 10.5005/jp-journals-10024-3564] [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: 12/29/2023]
Abstract
AIM The aim of the study was to estimate the diagnostic efficacy of high-resolution ultrasonography (USG) in the diagnosis of maxillofacial fractures. MATERIALS AND METHODS A descriptive diagnostic evaluation study was carried out on 30 patients with suspected maxillofacial fractures, out of which 26 were male (86.7%) and 4 were female (13.3%). After initial management, detailed clinical examinations were carried out and significant findings were noted. Computed tomography (CT) scans were performed in fracture-suspecting patients followed by USG examination which was done in a standardized pattern on both sides of the face. The result of USG was compared with the CT scan report. RESULT Based on CT findings, 65 sites were found to be fractured, and this was considered the gold standard. Ultrasonography detected 58 fractures at these 780 sites, of which 54 were true fractures, while 4 were false-positive results. However, USG was not able to detect eleven fractures. The overall sensitivity and specificity of USG were 83.1% and 99%, respectively. The positive and negative predictive values were 93% and 98%, respectively. CONCLUSION According to our study, it may be concluded that USG may be recommended as a diagnostic screening tool to detect superficial maxillofacial fractures. CLINICAL SIGNIFICANCE Ultrasonography provides a safe, cost-effective, reliable, non-invasive, easily available, and portable imaging modality to screen for maxillofacial fractures.
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Affiliation(s)
- Akshay Manakkattupadi Vijayan
- Department of Oral and Maxillofacial Surgery, MES Dental College & Hospital, Perinthalmanna, Kerala, India, Phone: +91 9847304236, e-mail:
| | - Sachin Aslam Aslam
- Department of Oral and Maxillofacial Surgery, MES Dental College & Hospital, Perinthalmanna, Kerala, India
| | - Roshni Abidha
- Department of Oral and Maxillofacial Surgery, MES Dental College & Hospital, Perinthalmanna, Kerala, India
| | | | - Tom Thomas
- Department of Oral and Maxillofacial Surgery, MES Dental College & Hospital, Perinthalmanna, Kerala, India
| | - Ayisha Moonnam Kandathil
- Department of Oral and Maxillofacial Surgery, MES Dental College & Hospital, Perinthalmanna, Kerala, India
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Naveiro JM, Gracia L, Roces J, Albareda J, Puértolas S. Three-Dimensional Computational Model Simulating the Initial Callus Growth during Fracture Healing in Long Bones: Application to Different Fracture Types. Bioengineering (Basel) 2023; 10:bioengineering10020190. [PMID: 36829684 PMCID: PMC9952223 DOI: 10.3390/bioengineering10020190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/19/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
Bone fractures are among the most common and potentially serious injuries to the skeleton, femoral shaft fractures being especially severe. Thanks to recent advances in the area of in silico analysis, several approximations of the bone healing process have been achieved. In this context, the objective of this work was to simulate the initial phase of callus formation in long bones, without a pre-meshed domain in the 3D space. A finite element approach was computationally implemented to obtain the values of the cell concentrations along the whole domain and evaluate the areas where the biological quantities reached the thresholds necessary to trigger callus growth. A voxel model was used to obtain the 3D domain of the bone fragments and callus. A mesh growth algorithm controlled the addition of new elements to the domain at each step of the iterative procedure until complete callus formation. The implemented approach is able to reproduce the generation of the primary callus, which corresponds to the initial phase of fracture healing, independently of the fracture type and complexity, even in the case of several bone fragments. The proposed approach can be applied to the most complex bone fractures such as oblique, severely comminuted or spiral-type fractures, whose simulation remains hardly possible by means of the different existing approaches available to date.
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Affiliation(s)
- José M. Naveiro
- Department of Mechanical Engineering, University of Zaragoza, 50018 Zaragoza, Spain
- Aragón Institute for Engineering Research, 50018 Zaragoza, Spain
| | - Luis Gracia
- Department of Mechanical Engineering, University of Zaragoza, 50018 Zaragoza, Spain
- Aragón Institute for Engineering Research, 50018 Zaragoza, Spain
| | - Jorge Roces
- Department of Construction and Manufacturing Engineering, University of Oviedo, 33204 Gijón, Spain
| | - Jorge Albareda
- Department of Surgery, University of Zaragoza, 50009 Zaragoza, Spain
- Aragón Health Research Institute, 50009 Zaragoza, Spain
| | - Sergio Puértolas
- Department of Mechanical Engineering, University of Zaragoza, 50018 Zaragoza, Spain
- Aragón Institute for Engineering Research, 50018 Zaragoza, Spain
- Correspondence:
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