Anatomy and pathology of the nail and subungual space: Imaging evaluation of benign lesions

Rodríguez-Takeuchi, S.Y.; Villota, Vania A; Renjifo, Martín

doi:10.1016/j.clinimag.2018.09.002

Cited by 13 publications

(8 citation statements)

References 19 publications

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“…However, radiographs suffer from poor sensitivity in evaluating bone invasion in subungual carcinoma even when the periosteum has been pathologically invaded; whereas, carcinoma microscopically limited to soft tissue, may show false radiographic evidence of bone invasion. [ 9 ] Radiographic nail findings are listed in Table 2 . [ 2 9 10 11 ]…”

Section: Radiological Techniques and Features Of Nail Unitmentioning

confidence: 99%

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Radiological Imaging in Nail Unit Disorders (Part I) - Modalities Used

Grover

Bansal

Varma

et al. 2022

Indian Dermatology Online Journal

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The nail unit is a unique skin appendage, capable of mounting only a limited number of reaction patterns to a variety of insults. This makes it difficult to diagnose many nail conditions based on clinical features alone. Thus, diagnostic modalities have an important role to play in nail disorders. Emphasis is placed on non-invasive diagnostic methods, of which, radiological imaging forms an important part; however, it is a field largely under-explored with very few studies and reports available in the literature. This could be due to the problems encountered in nail unit radiology including its small size, complex anatomy, requirement for special high-frequency probes to reliably evaluate superficial structures, and non-familiarity with nail unit radiological features even amongst trained radiologists. Nevertheless, it plays a useful role in diagnosing nail disorders (especially tumors), localizing the changes, exploring differential diagnoses, estimating prognosis, and planning management. This article is aimed at collating scientific data pertaining to various radiological modalities used in the diagnosis of nail diseases. The advantages and limitations of various imaging techniques used for evaluating the nail unit, including digital radiographs, high-frequency ultrasound, ultrasound doppler (USD), computed tomography (CT), and magnetic resonance imaging (MRI), are discussed in the first part. The second part will discuss the features of common and uncommon nail diseases.

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Section: Radiological Techniques and Features Of Nail Unitmentioning

confidence: 99%

“…Doppler evaluation helps to pickup intra or peritumoral flow signals. [ 9 ] Low-resistance pulsatile flow suggests malignant and metastatic potential. Limitations of USG include need for special training and skill [ Table 3 ].…”

Section: Radiological Techniques and Features Of Nail Unitmentioning

confidence: 99%

Radiological Imaging in Nail Unit Disorders (Part I) - Modalities Used

Grover

Bansal

Varma

et al. 2022

Indian Dermatology Online Journal

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“…USG examination shows diffuse thickening of periungual folds with foci of increased echogenicity and intervening hypoechoic areas suggestive of abscess (pus collection) [LoE 5]. [ 17 ] Widening of the nail bed and nail matrix may often be noticed. Chronic cases may show a deformed nail plate architecture.…”

Section: Nail Infectionsmentioning

confidence: 99%

“…USG findings support the diagnosis revealing features like increased thickness of the dorsal and ventral nail plates, with essentially normal nail matrix or bed. [ 17 ]…”

Section: Miscellaneous Conditionsmentioning

confidence: 99%

Radiological imaging of nail disorders (PART II) – Radiological features of nail disease

Grover

Bansal

Varma

et al. 2022

Indian Dermatol Online J

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We have seen that radiological techniques like digital x-ray, high-frequency ultrasonography (USG), computed tomography (CT), and magnetic resonance imaging (MRI) have their unique roles in assessing a complex anatomical structure like the nail unit. Broadly speaking, USG and MRI help evaluate soft tissue components well; while, radiographs and CT scans help assess bony lesions better. In the second part of this review, salient radiological features of various nail disorders, as seen on these modalities are detailed. The radiological features mostly play a supportive role and help rule out differential diagnoses. However, in some diseases like retronychia and some nail tumors, radiological findings help clinch the diagnosis. The diagnostic features as well as the investigative modality of choice for a particular disease are highlighted based on the best level of evidence (LoE) available. This narrative review includes both infectious and non-infectious nail unit diseases, with special emphasis on nail unit tumors.

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“…US can differentiate solid and cystic nail lesions and can be used as a valuable aid to optimize the clinical diagnosis of a number of nail disorders [430][431][432][433][434][435]. In onycholysis an anechoic gap between the nail plate and the nail bed is seen on US.…”

Section: Other Nail Conditionsmentioning

confidence: 99%

The EFSUMB Guidelines and Recommendations for Musculoskeletal Ultrasound – Part I: Extraarticular Pathologies

et al. 2021

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The first part of the guidelines and recommendations for musculoskeletal ultrasound, produced under the auspices of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB), provides information about the use of musculoskeletal ultrasound for assessing extraarticular structures (muscles, tendons, entheses, ligaments, bones, bursae, fasciae, nerves, skin, subcutaneous tissues, and nails) and their pathologies. Clinical applications, practical points, limitations, and artifacts are described and discussed for every structure. After an extensive literature review, the recommendations have been developed according to the Oxford Centre for Evidence-based Medicine and GRADE criteria and the consensus level was established through a Delphi process. The document is intended to guide clinical users in their daily practice.

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Anatomy and pathology of the nail and subungual space: Imaging evaluation of benign lesions

Cited by 13 publications

References 19 publications

Radiological Imaging in Nail Unit Disorders (Part I) - Modalities Used

Radiological Imaging in Nail Unit Disorders (Part I) - Modalities Used

Radiological imaging of nail disorders (PART II) – Radiological features of nail disease

The EFSUMB Guidelines and Recommendations for Musculoskeletal Ultrasound – Part I: Extraarticular Pathologies

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