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Raouf MM, Alsaeed MA, Hassanien M, Talaat EA, Esmael TE, Kamel EZ. Intracarpal midazolam: does it offer better pain relief than dexamethasone in carpal tunnel syndrome patients? A randomized double-blind clinical trial. EGYPTIAN JOURNAL OF ANAESTHESIA 2022. [DOI: 10.1080/11101849.2022.2059612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Mina Maher Raouf
- Anesthesia, intensive care and pain management department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Mohammad Awad Alsaeed
- Anesthesia, intensive care and pain management department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Manal Hassanien
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Esraa A Talaat
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Tamer Elzaem Esmael
- Radiodiagnosis and intervention radiology department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Emad Zarief Kamel
- Anesthesia, intensive care, and pain management department, Faculty of Medicine, Assiut University, Assiut, Egypt
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Jorgensen SP, Cartwright MS, Norbury J. Neuromuscular Ultrasound: Indications in the Electrodiagnostic Laboratory. Am J Phys Med Rehabil 2022; 101:78-88. [PMID: 33990480 DOI: 10.1097/phm.0000000000001790] [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: 11/26/2022]
Abstract
ABSTRACT Accurate assessment of neuromuscular disorders is critical to facilitate timely treatment and achieve the best outcomes. Historically, electrodiagnostic studies have filled this role, but recently, neuromuscular ultrasound is being used in the electrodiagnostic laboratory. This review discusses the uses of neuromuscular ultrasound in the electrodiagnostic laboratory that have strong evidence, emphasizing those that could be adopted in a typical electrodiagnostic laboratory with a reasonable level of equipment and training. The evidence currently supports using neuromuscular ultrasound to diagnose carpal tunnel syndrome and ulnar neuropathies at the elbow and as a supplementary test when electrodiagnostic studies are suspected to be falsely negative or in axonal nonlocalizing lesions. Neuromuscular ultrasound can identify the causes of focal mononeuropathies, which can change treatment in specific cases. It is sensitive at identifying fasciculations and providing complementary evidence of autoimmune demyelinating polyneuropathies. It is particularly helpful in assessing nerves after trauma. Neuromuscular ultrasound is likely to prove even more useful in the electrodiagnostic laboratory as the technology continues to advance.
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Affiliation(s)
- Shawn P Jorgensen
- From the Department of Physical Medicine and Rehabilitation, Albany Medical College, Albany, New York (SPJ); Department of Family Medicine, Larner Medical College at the University of Vermont, Burlington, Vermont (SPJ); Adirondack Rehabilitation Medicine, PLLC, Queensbury, New York (SPJ); Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, North Carolina (MSC); and Division of Physical Medicine and Rehabilitation, Department of Neurology, Texas Tech University Health Sciences Center, Lubbock, Texas (JN)
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Lai ZH, Yang SP, Shen HL, Luo Y, Cai XH, Jiang WT, Liao LP, Wu KB, Lv GR. Combination of high-frequency ultrasound and virtual touch tissue imaging and quantification improve the diagnostic efficiency for mild carpal tunnel syndrome. BMC Musculoskelet Disord 2021; 22:112. [PMID: 33499842 PMCID: PMC7836488 DOI: 10.1186/s12891-021-03982-7] [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: 07/07/2020] [Accepted: 01/17/2021] [Indexed: 11/15/2022] Open
Abstract
Background Carpal tunnel syndrome (CTS) is the most common entrapment symptom in the peripheral nerves. High-frequency ultrasound (HFUS) is widely used in the diagnosis of CTS. Virtual Touch Tissue Imaging and Quantification (VTIQ), which provides more information about the hardness of organization, is used to diagnose CTS. However, the data of diagnostic value of them in various degrees of CTS are limited. Whether the combination of HFUS and VTIQ can improve the diagnostic efficiency also remains unknown. The study aimed to explore the diagnostic value of HFUS and VTIQ in various degrees of CTS and whether combination of HFUS and VTIQ could improve the diagnostic efficiency of CTS. Methods A collection and analysis of 133 CTS patients and 35 volunteers from January 2016 to January 2019 were performed. We compared the clinical characteristics, cross-sectional area (CSA) value and shear wave velocity SWVmean value of CTS group with volunteer group. Results The CSA value and SWVmean value of CTS cohort were significantly higher than volunteer group (10.79 ± 2.88 vs. 8.06 ± 1.39, p < 0.001, 4.36 ± 0.95 vs. 3.38 ± 1.09, p < 0.001, respectively). The area under the curve (AUC) of receiver operating characteristic (ROC) curve of CSA value and SWVmean value were 0.794 and 0.757, respectively. Hierarchical analysis of CSA value and SWVmean value showed that the AUC in the moderate and severe CTS group were higher than in mild CTS group. Furthermore, the CSA value combined with SWVmean value used to diagnose mild CTS was 0.758, which was higher than that of single CSA value or single SWVmean value. Conclusions Both HFUS and VTIQ technology were feasible to evaluate CTS. HFUS was suitable for use in diagnosis of moderate and severe CTS. For mild CTS, combination of HFUS and VTIQ was relevant to improve the diagnostic efficiency of CTS.
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Affiliation(s)
- Zhen-Han Lai
- Department of Ultrasound, Zhangzhou Hospital Affiliated to Fujian Medical University, Zhangzhou, 363000, Fujian, China
| | - Shu-Ping Yang
- Department of Ultrasound, Zhangzhou Hospital Affiliated to Fujian Medical University, Zhangzhou, 363000, Fujian, China
| | - Hao-Lin Shen
- Department of Ultrasound, Zhangzhou Hospital Affiliated to Fujian Medical University, Zhangzhou, 363000, Fujian, China
| | - Yi Luo
- Department of Ultrasound, Zhangzhou Hospital Affiliated to Fujian Medical University, Zhangzhou, 363000, Fujian, China
| | - Xiao-Han Cai
- Department of Ultrasound, Zhangzhou Hospital Affiliated to Fujian Medical University, Zhangzhou, 363000, Fujian, China
| | - Wen-Ting Jiang
- Department of Ultrasound, Zhangzhou Hospital Affiliated to Fujian Medical University, Zhangzhou, 363000, Fujian, China
| | - Li-Ping Liao
- Department of Ultrasound, Zhangzhou Hospital Affiliated to Fujian Medical University, Zhangzhou, 363000, Fujian, China
| | - Kun-Bin Wu
- Department of Ultrasound, Zhangzhou Hospital Affiliated to Fujian Medical University, Zhangzhou, 363000, Fujian, China
| | - Guo-Rong Lv
- Collaborative Innovation Center for Maternal and Infant Health Service Application Technology, Quanzhou, 362000, Fujian, China. .,Department of Ultrasound, Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, Fujian, China.
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