1
|
Beyazal M, Beyazal MS, Çeliker FB, Devrimsel G, Yıldırım M. The Association of Achilles Sonoelastography Findings with Disease
Activity, Functional Status and Enthesitis Index in Patients with Axial
Spondyloarthritis. AKTUEL RHEUMATOL 2022. [DOI: 10.1055/a-1749-4695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Abstract
Background Sonoelastography (SE) is a new ultrasound (US)-based technique
able to assess tissue elasticity. Using conventional US, it is sometimes
difficult or even impossible to distinguish pathologic tissue because it often
presents with the same echogenicity as the surrounding healthy tissue. This
study aimed to evaluate SE findings in Achilles tendons of patients with axial
spondyloarthritis (axSpA) and to assess how these findings are associated with
disease-related parameters.
Material and Methods Sixty-four consecutive patients (37 men, 27 women;
mean age 39.7 years; range 20–65 years) with axSpA and 30 sex and
age-matched healthy controls were enrolled in the study. Disease activity was
evaluated using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI),
whereas functional capacity was evaluated using the Bath Ankylosing Spondylitis
Functional Index (BASFI). Erythrocyte sedimentation rate (ESR), C-reactive
protein (CRP) and the Spondyloarthritis Research Consortium of Canada (SPARCC)
enthesitis index were recorded. All participants underwent an SE examination of
the Achilles tendon and measurement of the strain index (SI).
Results The mean right and left SI were significantly higher in axSpA
patients than in controls (2.96±0.94 vs. 1.90±0.45;
p<0.001; 2.95±0.95 vs. 1.92±0.48, p<0.001,
respectively). In axSpA patients, both right and left SI were significantly
correlated with the BASDAI, BASFI and SPARCC enthesitis indices, but not with
ESR or CRP.
Conclusion AxSpA patients had an increased SI compared with healthy
subjects and these values were associated with disease activity, functional
capacity and the enthesitis index. SE may be a useful tool for the evaluation of
Achilles tendons in patients with axSpA.
Collapse
Affiliation(s)
- Mehmet Beyazal
- Department of Radiology, Recep Tayyip Erdogan University Training and
Research Hospital, Rize, Turkey
| | - Münevver Serdaroğlu Beyazal
- Department of Physical Medicine and Rehabilitation, Recep Tayyip
Erdogan University Training and Research Hospital, Rize, Turkey
| | - Fatma Beyazal Çeliker
- Department of Radiology, Recep Tayyip Erdogan University Training and
Research Hospital, Rize, Turkey
| | - Gul Devrimsel
- Department of Physical Medicine and Rehabilitation, Recep Tayyip
Erdogan University Training and Research Hospital, Rize, Turkey
| | - Murat Yıldırım
- Department of Physical Medicine and Rehabilitation, Recep Tayyip
Erdogan University Training and Research Hospital, Rize, Turkey
| |
Collapse
|
2
|
Frizziero A, Vittadini F, Bigliardi D, Costantino C. Low Molecular Weight Hyaluronic Acid (500-730 Kda) Injections in Tendinopathies-A Narrative Review. J Funct Morphol Kinesiol 2021; 7:3. [PMID: 35076509 PMCID: PMC8788555 DOI: 10.3390/jfmk7010003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/23/2021] [Accepted: 12/27/2021] [Indexed: 11/25/2022] Open
Abstract
Tendinopathies are common causes of pain and disability in general population and athletes. Conservative treatment is largely preferred, and eccentric exercise or other modalities of therapeutic exercises are recommended. However, this approach requests several weeks of consecutive treatment and could be discouraging. In the last years, injections of different formulations were evaluated to accelerate functional recovery in combination with usual therapy. Hyaluronic acid (HA) preparations were proposed, in particular LMW-HA (500-730 kDa) for its unique molecular characteristics in favored extracellular matrix homeostasis and tenocyte viability. The purpose of our review is to evaluate the state-of-the-art about the role of 500-730 kDa in tendinopathies considering both preclinical and clinical findings and encourage further research on this emerging topic.
Collapse
Affiliation(s)
- Antonio Frizziero
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (D.B.); (C.C.)
| | - Filippo Vittadini
- Department of Physical and Rehabilitation Medicine, Casa di Cura Policlinico S. Marco, 30100 Venice, Italy;
| | - Davide Bigliardi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (D.B.); (C.C.)
| | - Cosimo Costantino
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (D.B.); (C.C.)
| |
Collapse
|
3
|
Serial Ultrasonographic and Real-Time Elastosonographic Assessment of the Ovine Common Calcaneal Tendon, after an Experimentally Induced Tendinopathy. Vet Sci 2021; 8:vetsci8040054. [PMID: 33806121 PMCID: PMC8064454 DOI: 10.3390/vetsci8040054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/17/2021] [Accepted: 03/19/2021] [Indexed: 12/31/2022] Open
Abstract
Real-time elastosonography (RTE) is a recently described, non-invasive, ultrasonographic technique developed to assess tissue elasticity. The main aim of this study was to investigate the ultrasonographic and elastosonographic appearance of the common calcaneal tendon (CCT) in an ovine model, and to monitor the progression of tendon healing after an experimentally-induced tendinopathy. Sound tendons were initially evaluated (T0) with a caliper and by a single operator with ultrasound. Ultrasonographic and elastosonographic images were then acquired. Subsequently, ultrasound-guided tendon lesions were induced by injecting 500 IU of Type IA collagenases proximally to the calcaneal tuberosity. Caliper measurement, ultrasonography and elastosonography were then repeated at 15 (T1), 30 (T2) and 60 (T3) days. Clinically measured width of the tendon, ultrasonographic thickness and width and percentage of hard (Elx-t%hrd) and soft (Elx-t%sft) tissue were recorded. Statistical analysis was performed on the data collected; statistical significance was set at p < 0.05. Intra-class correlation coefficient (ICC) revealed good (0.68) repeatability of elastosonographic evaluation of the CCT. The tendon width was significantly increased when comparing T0 with T1–2 and decreased when comparing T1–2 with T3. Ultrasound-assessed thickness was significantly increased between T0–T1 and decreased between T1-T2–3. Elx-t%hrd was significantly decreased at T1–2–3 and Elx-t%sft was significantly increased at T1–2–3. In conclusion, the ovine CCT is a highly stiff structure that undergoes a severe loss of stiffness during the healing process. Thickness and width of the tendon increased during the first 30 days and then reduced progressively along the subsequent 30 days. Ultrasonographic appearance of the tendon remained severely abnormal and the tendon showed severely reduced elastic proprieties 60 days after lesion induction.
Collapse
|
4
|
McCagherty J, Longo M, Pennington C, Liuti T, Morrison LR, Brown H, Clements DN. Effect of Stifle Flexion Angle on the Repeatability of Real-Time Elastosonography of the Patellar Ligament in Medium- to Large-Breed Dogs. Vet Comp Orthop Traumatol 2020; 33:391-397. [PMID: 32942326 DOI: 10.1055/s-0040-1715493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The aims of this study were to describe the elastosonographic findings of the patellar ligament in healthy dogs >15 kg in different positions and determine the most appropriate stifle angle to perform elastosonography of the patellar ligament. STUDY DESIGN Eighteen clinically healthy dogs, weighing >15 kg, were prospectively recruited. B-mode ultrasound and real-time elastosonography of both patellar ligaments were performed on days 0 and 14. Elastosonography examinations were performed with the stifle in four positions: standing position, lateral recumbency with the stifle positioned at 135 degrees extension and in full passive flexion and extension. RESULTS The percentage hardness of the patellar ligament was significantly lower when the elastosonographic examination was performed with the dog standing, compared with the other positions (p < 0.005). The variability in the elastosonography readings for each stifle position was lowest when the dog was standing (89.32%). CONCLUSION Elastosonography is a feasible technique for evaluating the elasticity of the normal canine patellar ligament in dogs >15 kg and would be a useful technique for investigating the mechanical changes within the patellar ligament following stifle surgery. Elastosonography of the patellar ligament should be performed with the dog standing to provide the most accurate elastosonograms with lowest variability between readings.
Collapse
Affiliation(s)
- Joanna McCagherty
- Small Animal Hospital, College of Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Maurizio Longo
- Division of Veterinary Clinical Sciences, Easter Bush Veterinary Centre, The University of Edinburgh, The Royal (Dick) School of Veterinary Studies, Hospital for Small Animals, Roslin, United Kingdom.,CTO Veterinario, Arenzano, Genoa, Italy
| | - Catrina Pennington
- Division of Veterinary Clinical Sciences, Easter Bush Veterinary Centre, The University of Edinburgh, The Royal (Dick) School of Veterinary Studies, Hospital for Small Animals, Roslin, United Kingdom
| | - Tiziana Liuti
- Division of Veterinary Clinical Sciences, Easter Bush Veterinary Centre, The University of Edinburgh, The Royal (Dick) School of Veterinary Studies, Hospital for Small Animals, Roslin, United Kingdom
| | - Linda R Morrison
- The Royal (Dick) School of Veterinary Studies and Roslin Institute, Easter Bush Veterinary Centre, The University of Edinburgh, Roslin, United Kingdom
| | - Helen Brown
- The Royal (Dick) School of Veterinary Studies and Roslin Institute, Easter Bush Veterinary Centre, The University of Edinburgh, Roslin, United Kingdom
| | - Dylan Neil Clements
- The Royal (Dick) School of Veterinary Studies and Roslin Institute, Easter Bush Veterinary Centre, The University of Edinburgh, Roslin, United Kingdom
| |
Collapse
|
5
|
Utility of sonoelastography for the evaluation of rotator cuff tendon and pertinent disorders: a systematic review and meta-analysis. Eur Radiol 2020; 30:6663-6672. [PMID: 32666319 DOI: 10.1007/s00330-020-07059-2] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/17/2020] [Accepted: 07/01/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Sonoelastography has been increasingly used to investigate musculoskeletal disorders. The aim of this meta-analysis was to investigate the utility of sonoelastography in diagnosing rotator cuff tendon pathology and pertinent disorders. METHODS Searching through PubMed and Embase, we systemically reviewed clinical studies in which sonoelastography has been used for imaging rotator cuff tendon pathology and relevant disorders. The primary outcome was the standardized mean difference (SMD) of tendon elasticity between shoulders (or patients) with and without the designated pathological conditions. RESULTS A total of 11 cross-sectional studies were included in the meta-analysis. The supraspinatus and infraspinatus tendons assessed by shear wave sonoelastography were likely to be stiffer in shoulders with adhesive capsulitis, with a SMD of 2.103 (95% confidence interval (CI), - 0.151 to 4.357, p = 0.067) and a SMD of 1.548 (95% CI, - 0.032 to 3.127, p = 0.055), respectively. Regarding rotator cuff tendinopathy, there was no significant difference in the elasticity of supraspinatus tendons evaluated by shear wave velocity (SMD = - 0.107; 95% CI, - 0.524 to 0.310, p = 0.615) or strain ratios (SMD = 0.153, 95% CI, - 2.134 to 2.440, p = 0.896). Only one study used shear wave sonoelastography to investigate patients with rotator cuff tendon tears and found tendon that elasticity was similar between diseased and normal shoulders. CONCLUSION This meta-analysis revealed that supraspinatus and infraspinatus tendons tended to be stiffer in shoulders with adhesive capsulitis. Furthermore, no significant difference in tendon elasticity could be identified between shoulders with and without rotator cuff tendinopathy or tendon tears. KEY POINTS • Supraspinatus and infraspinatus tendons are likely to have decreased elasticity in shoulders with adhesive capsulitis, as assessed by shear wave sonoelastography. • There was no significant difference in tendon elasticity between shoulders with and without rotator cuff tendinopathy or tendon tears when evaluated by strain and shear wave sonoelastography.
Collapse
|
6
|
Yongliang Y, Honglei J, Wupeng Z, Shihong X, Fu W, Bomin W, Qinghu L, Yonghui W, Shumei H. Intraoperative ultrasonography assistance for minimally invasive repair of the acute Achilles tendon rupture. J Orthop Surg Res 2020; 15:258. [PMID: 32653002 PMCID: PMC7353778 DOI: 10.1186/s13018-020-01776-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 06/30/2020] [Indexed: 11/13/2022] Open
Abstract
Background Minimally invasive repair is a better option for Achilles tendon rupture with low re-rupture and wound-related complications than conservative treatment or traditional open repair. The major problem is sural nerve injury. The purpose of this study was to evaluate the effect and advantage of the intraoperative ultrasonography assistance for minimally invasive repair of the acute Achilles tendon rupture. Methods A retrospective study was performed on 36 cases of acute Achilles tendon rupture treated with minimally invasive repair assisted with intraoperative ultrasonography from January 2015 to December 2017. The relationship of the sural nerve and small saphenous vein was confirmed on the preoperative MRI. The course of the small saphenous vein and the sural nerve was identified and marked by intraoperative ultrasonography. The ruptured Achilles tendon was repaired with minimally invasive Bunnell suture on the medial side of the small saphenous vein (SSV). Results All patients were followed up for at least 12 months. No sural nerve injury or other complications was found intraoperatively and postoperatively. All the patients returned to work and light sporting activities at a mean of 12.78 ± 1.40 weeks and 17.28 ± 2.34 weeks, respectively. The Mean American Orthopaedic Foot & Ankle Society (AOFAS) scores improved from 59.17 ± 5.31 preoperatively to 98.92 ± 1.63 at the time of 12 months follow-up. There was a statistically significant difference (P < 0.001). No patient complained of a negative effect on their life. Conclusions The minimally invasive repair assisted with intraoperative ultrasonography can yield good clinical outcomes, less surgical time, and less complications, especially sural nerve injury. It is an efficient, reliable, and safe method for acute Achilles tendon (AT) rupture.
Collapse
Affiliation(s)
- Yang Yongliang
- Department of Trauma and Emergency, Shandong Provincial Hospital affiliated to Shandong University, No. 324 of Jingwu Road, 250021, Jinan, People's Republic of China.,Department of Trauma and Emergency, Shandong Provincial Hospital affiliated to Shandong First Medical University, No. 324 of Jingwu Road, 250021, Jinan, People's Republic of China
| | - Jia Honglei
- Department of Trauma and Emergency, Shandong Provincial Hospital affiliated to Shandong University, No. 324 of Jingwu Road, 250021, Jinan, People's Republic of China.,Department of Trauma and Emergency, Shandong Provincial Hospital affiliated to Shandong First Medical University, No. 324 of Jingwu Road, 250021, Jinan, People's Republic of China
| | - Zhang Wupeng
- Department of Trauma and Emergency, Shandong Provincial Hospital affiliated to Shandong University, No. 324 of Jingwu Road, 250021, Jinan, People's Republic of China
| | - Xu Shihong
- Department of Trauma and Emergency, Shandong Provincial Hospital affiliated to Shandong University, No. 324 of Jingwu Road, 250021, Jinan, People's Republic of China.,Department of Trauma and Emergency, Shandong Provincial Hospital affiliated to Shandong First Medical University, No. 324 of Jingwu Road, 250021, Jinan, People's Republic of China
| | - Wang Fu
- Department of Trauma and Emergency, Shandong Provincial Hospital affiliated to Shandong University, No. 324 of Jingwu Road, 250021, Jinan, People's Republic of China.,Department of Trauma and Emergency, Shandong Provincial Hospital affiliated to Shandong First Medical University, No. 324 of Jingwu Road, 250021, Jinan, People's Republic of China
| | - Wang Bomin
- Department of Trauma and Emergency, Shandong Provincial Hospital affiliated to Shandong University, No. 324 of Jingwu Road, 250021, Jinan, People's Republic of China.,Department of Trauma and Emergency, Shandong Provincial Hospital affiliated to Shandong First Medical University, No. 324 of Jingwu Road, 250021, Jinan, People's Republic of China
| | - Li Qinghu
- Department of Trauma and Emergency, Shandong Provincial Hospital affiliated to Shandong University, No. 324 of Jingwu Road, 250021, Jinan, People's Republic of China.,Department of Trauma and Emergency, Shandong Provincial Hospital affiliated to Shandong First Medical University, No. 324 of Jingwu Road, 250021, Jinan, People's Republic of China
| | - Wang Yonghui
- Department of Trauma and Emergency, Shandong Provincial Hospital affiliated to Shandong University, No. 324 of Jingwu Road, 250021, Jinan, People's Republic of China. .,Department of Trauma and Emergency, Shandong Provincial Hospital affiliated to Shandong First Medical University, No. 324 of Jingwu Road, 250021, Jinan, People's Republic of China.
| | - Han Shumei
- Department of Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250021, China.
| |
Collapse
|
7
|
Zappia M, Berritto D, Oliva F, Maffulli N. High resolution real time ultrasonography of the sural nerve after percutaneous repair of the Achilles tendon. Foot Ankle Surg 2018; 24:342-346. [PMID: 29409243 DOI: 10.1016/j.fas.2017.03.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 03/13/2017] [Accepted: 03/21/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND Percutaneous Achilles tendon repair has been developed to minimise soft tissue complications following treatment of tendon ruptures. However, there are concerns because of the risk of sural nerve injury. Few studies have investigated the relationship between the Achilles tendon, the sural nerve and its several anatomical course variants. METHODS We studied 7 cadaveric limbs (7 Achilles tendons) in which a percutaneous repair of the Achilles tendon was performed. On each tendon, high resolution real time ultrasonography examination was performed by an experienced musculoskeletal radiologist before and after the procedure, with the surgeons blind to the results of the scan both before and after surgery. RESULTS In two instances, high resolution real time ultrasonography examination revealed nerve entrapment at the level of most proximal lateral suture. CONCLUSIONS Since the sural nerve can be easily visualised using high-frequency high resolution real time ultrasonography, intraoperative ultrasound can be of assistance during percutaneous repair of Achilles tendon rupture. CLINICAL RELEVANCE The sural nerve can be readily visualised by high-frequency high resolution real time ultrasonography probes. It could be beneficial to use high resolution real time ultrasonography intraoperatively or perioperatively to minimise the risks of sural nerve injury when undertaking percutaneous repair of Achilles tendon tears.
Collapse
Affiliation(s)
- Marcello Zappia
- Dipartimento di Medicina e di Scienze della Salute, Università degli Studi del Molise, Via De Sanctis 1, 86100, Campobasso, Italy
| | - Daniela Berritto
- Department of Radiology, Private Hospital "Villa Dei Fiori" S.r.l. Accredited to National Health System, Acerra (NA), Italy.
| | - Francesco Oliva
- Department of Orthopaedics and Traumatology, University of Rome "Tor Vergata", Italy
| | - Nicola Maffulli
- Head of Department of Orthopaedics and Traumatology, Azienda Ospedaliera San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Italy; Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, London, UK
| |
Collapse
|
8
|
Achilles Pain, Stiffness, and Muscle Power Deficits: Midportion Achilles Tendinopathy Revision 2018. J Orthop Sports Phys Ther 2018; 48:A1-A38. [PMID: 29712543 DOI: 10.2519/jospt.2018.0302] [Citation(s) in RCA: 134] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The purpose of these revised clinical practice guidelines is to review recent peer-reviewed literature and make recommendations related to midportion Achilles tendinopathy. J Orthop Sports Phys Ther 2018;48(5):A1-A38. doi:10.2519/jospt.2018.0302.
Collapse
|
9
|
Fernandez-Jaén T, Rey GÁ, Angulo F, Cuesta JA, Loureda RA, España FÁ, Ayala J, Matas RB, Pazos FB, de Dios Beas Jiménez J, Rosell JC, Fernandez CC, del Pilar Doñoro Cuevas M, Ros FE, Colmenero JE, de Prado JF, García Cota JJ, Garrido González JI, de Vega CG, Santander MG, Herrador Munilla MÁ, Ruiz FI, Díaz FJ, Fernandez AM, Marqueta PM, Muñoz Benito JJ, Vilás RO, Pedret C, Teres XP, Amaro JP, Grifell JP, San Roque JP, Parenteu CR, Serna JR, Rodas G, Álvarez MS, Marchori CS, Perez LT, Durán RU, del Valle Soto M, Villalón Alonso JM, García PG. Spanish Consensus Statement: Clinical Management and Treatment of Tendinopathies in Sport. Orthop J Sports Med 2017; 5:2325967117734127. [PMID: 29119124 PMCID: PMC5666520 DOI: 10.1177/2325967117734127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
On October 15, 2016, experts met at Clínica CEMTRO in Madrid, Spain, under the patronage of the Spanish Society for Sports Traumatology (SETRADE), the Spanish Society of Sports Medicine (SEMED), the Spanish Association of Medical Services for Football Clubs (AEMEF), the Spanish Association of Medical Services for Basketball Clubs (AEMB), F.C. Barcelona, and Clínica CEMTRO. The purpose was to consider the most appropriate clinical management and treatment of tendinopathies in sports, based on proven scientific data described in the medical literature as well as on each expert’s experience. Prior to the meeting, each expert received a questionnaire regarding clinical management and treatment of tendinopathies in sports. The present consensus document summarizes the answers to the questionnaire and the resulting discussion and consensus regarding current concepts on tendinopathies in sports.
Collapse
Affiliation(s)
| | - Tomas Fernandez-Jaén
- Tomas F. Fernandez-Jaén, MD, PhD, Clínica CEMTRO, Ventisquero de la Condesa 42, Madrid 28035, Spain ()
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Chiu CH, Chen P, Chen ACY, Hsu KY, Chang SS, Chan YS, Chen YJ. Shoulder ultrasonography performed by orthopedic surgeons increases efficiency in diagnosis of rotator cuff tears. J Orthop Surg Res 2017; 12:63. [PMID: 28427416 PMCID: PMC5399436 DOI: 10.1186/s13018-017-0565-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 04/12/2017] [Indexed: 01/23/2023] Open
Abstract
Background Rotator cuff tears are very common and their incidence increases with age. Shoulder ultrasonography has recently gained popularity in detecting rotator cuff tears because of its efficiency, cost-effectiveness, time-saving, and real-time nature of the procedure. Well-trained orthopedic surgeons may utilize shoulder ultrasonography to diagnose rotator cuff tears. The wait time of patients planned to have shoulder MRI (magnetic resonance imaging) to rule in rotator cuff tears may decrease after orthopedic surgeon start doing shoulder ultrasonography as a screening tool for that. Patients with rotator cuff tears may be detected earlier by ultrasonography and have expedited surgical repair. The efficacy in determination of rotator cuff tears will also increase. Methods Patients were retrospectively reviewed from January 2007 to December 2012. They were divided into 2 groups: Ultrasound (-) group and the Ultrasound (+) group. Age, gender, wait time from outpatient department (OPD) visit to MRI exam, MRI exam to operation (OP), and OPD visit to OP, patient number for MRI exam, and number of patients who finally had rotator cuff repair within two groups were compared. Results The wait time of OPD visit to OP and MRI to OP in patients who received shoulder ultrasonography was significantly less than that in patients did not receive shoulder ultrasonography screening. Only 23.8% of the patients with a suspected rotator cuff injury undergone arthroscopic rotator cuff repair before ultrasonography was applied as a screening tool. The percentage increased to 53.6% after orthopedic surgeon started using ultrasonography as a screening tool for rotator cuff tears. Conclusions Office-based shoulder ultrasound examination can reduce the wait time for a shoulder MRI. The efficacy of determination of rotator cuff tears will also increase after the introduction of shoulder ultrasonography.
Collapse
Affiliation(s)
- Chih-Hao Chiu
- Department of Orthopedic Surgery, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Musculoskeletal Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Poyu Chen
- Department of Occupational Therapy and Graduate Institute of Behavioral Science, Chang Gung University, Taoyuan, Taiwan
| | - Alvin Chao-Yu Chen
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. .,Musculoskeletal Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.
| | - Kuo-Yao Hsu
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Musculoskeletal Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Shih-Sheng Chang
- Department of Orthopedic Surgery, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Musculoskeletal Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yi-Sheng Chan
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Musculoskeletal Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yeung-Jen Chen
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Musculoskeletal Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| |
Collapse
|
11
|
Abstract
This article evaluates the utility of radiography, ultrasonography, and MRI in diagnosing Achilles tendon injuries. It reviews the pertinent anatomy of the Achilles and associated structures, and signs of disorder with each imaging technique. The economics of use ultrasonography and MRI are discussed. They should serve as complementary diagnostic tools, with ultrasonography the first choice because of its ease of use, ability to view dynamic function, and cost. However, clinical examination is often best for diagnosis; MRI and ultrasonography often should be considered only when the diagnosis is confounding or a patient does not respond to recommended conservative care.
Collapse
Affiliation(s)
- James M Mahoney
- College of Podiatric Medicine and Surgery, Des Moines University, 3200 Grand Avenue, Des Moines, IA 50312, USA.
| |
Collapse
|