Clinical applications of dynamic functional musculoskeletal ultrasound

Morton’s neuroma (MN) is a common condition in clinical practice. The compressive etiology is the most accepted, in which compression occurs in the tunnel formed by the adjacent metatarsals, the deep transverse metatarsal ligament (DTML) and the plantar skin. Ultrasound (US) is a reliable method of study. The presence of insufficient space under the DTML may be related to the appearance of MN. Objectives: To verify the relationship between MN and the space under the DTML between the metatarsal heads of the third (M3) and the fourth (M4) metatarsals using US. Methods: This is a cross-sectional epidemiological study. The research study using the ultrasound (US) technique was carried out on 200 feet belonging to 100 patients aged 18 to 65 of both sexes, with a control group formed by 62 patients and a study group formed by 38 patients diagnosed with MN. Results: The presence of MN and the factors associated with it were studied in 100 patients using ultrasound (US). The assessment and comparison with US of the space inferior to the DTML between M3 and M4 in control groups and patients with MN show that patients with MN have a smaller size in the variable “h” (height or distance DTML-plantar skin), in the variable “b” (base or intermetatarsal distance M3 and M4) and in the variable “s” (surface of the parallelogram “h” × ”b”). The predictors of MN are a decrease in dimension “b” and an increase in weight. Sitting in an office chair and the use of a bicycle, due to equinus, have an influence on the space below the DTML, reducing it and promoting the appearance of MN. Conclusions: The two US measurements (“h” and “b”) in the space below the DTML are smaller in patients with MN than in the asymptomatic group. A shorter distance between M3 and M4, and an increase in BMI are predictors of MN.

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“…Dynamic US maneuvers provide reliable, functional data and have been shown to be accurate for diagnosis [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

Study of the Anatomical Association between Morton’s Neuroma and the Space Inferior to the Deep Transverse Metatarsal Ligament Using Ultrasound

Ruiz-Herrera¹,

Criado-Álvarez

Suarez-Ortiz

et al. 2022

Diagnostics

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“…Ultrasound is particularly useful in this setting as computed tomography (CT) and MRI tend to have significant metal artifact. 21 Ultrasound evaluation of meniscal extrusion Though ultrasound is not a reliable modality for evaluating deeper meniscal injuries, it has been shown to be up to 92% accurate at detecting extrusion when compared to MRI as reference (Figure 2). 22 A semi-quantitative grading scale for meniscal extrusion is as follows: grade 0 (<2 mm), grade 1 (≥ 2 mm and < 4 mm), and grade 2 (≥ 4 mm).…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…Ultrasound is particularly useful in this setting as CT and MRI tend to have significant metal artifact. 17…”

Section: Ultrasound Evaluation Of Snapping Syndromesmentioning

confidence: 99%

Functional Imaging of the Knee—A Comprehensive Review

Kim,

Wakeman,

Wissman

2023

J Knee Surg

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Knee pain is a common presenting problem in the general population. Radiographs and magnetic resonance imaging (MRI) are the cornerstones of imaging in current clinical practice. With advancements in technology, there has been increasing utilization of other modalities to evaluate knee disorders. Dynamic assessment utilizing computed tomography and portable ultrasounds have demonstrated the capacity to accurately assess and reproducibly quantify kinematics of knee disorders. Cartilage physiology can be evaluated with MRI. Emerging research has even demonstrated novel musculoskeletal applications of positron emission tomography to evaluate anterior cruciate ligament graft metabolic activity following reconstruction. As technology continues to evolve and traditional ways are improved upon, future comparative studies will elucidate the distinct advantages of the various modalities. Although radiology is still primarily an anatomic specialty, there is immense potential for functional imaging to be the standard of care. This review focuses on the most common musculoskeletal applications of functional imaging as well as future utilization.

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“…Dynamic measurements require motion of the studied object. Typical examples are the investigation of nerve sliding [ 12 ], fascial movement [ 13 , 14 ] or muscle contraction [ 15 , 16 , 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Use of Reflective Tape to Detect Ultrasound Transducer Movement: A Validation Study

Mohr

Vogt

Wilke

2021

Life

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During dynamic ultrasound assessments, unintended transducer movement over the skin needs to be prevented as it may bias the results. The present study investigated the validity of two methods quantifying transducer motion. An ultrasound transducer was moved on a pre-specified 3 cm distance over the semitendinosus muscle of eleven adults (35.8 ± 9.8 years), stopping briefly at intervals of 0.5 cm. Transducer motion was quantified (1) measuring the 2-D displacement of the shadow produced by reflective tape (RT) attached to the skin and (2) using a marker-based, three-dimensional movement analysis system (MAS). Differences between methods were detected with Wilcoxon tests; associations were checked by means of intraclass correlation coefficients (ICC 3.1) and Bland–Altman plots. Values for RT (r = 0.57, p < 0.001) and MAS (r = 0.19, p = 0.002) were significantly higher than true distances (TD). Strong correlations were found between RT and TD (ICC: 0.98, p < 0.001), MAS and TD (ICC: 0.95, p < 0.001), and MAS and RT (ICC: 0.97, p < 0.001). Bland–Altman plots showed narrow limits of agreement for both RT (−0.49 to 0.13 cm) and MAS (−0.49 to 0.34 cm) versus TD. RT and MAS are valid methods to quantify US transducer movement. In view of its low costs and complexity, RT can particularly be recommended for application in research and clinical practice.

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Clinical applications of dynamic functional musculoskeletal ultrasound

Cited by 8 publications

References 65 publications

Study of the Anatomical Association between Morton’s Neuroma and the Space Inferior to the Deep Transverse Metatarsal Ligament Using Ultrasound

Study of the Anatomical Association between Morton’s Neuroma and the Space Inferior to the Deep Transverse Metatarsal Ligament Using Ultrasound

Functional Imaging of the Knee—A Comprehensive Review

Use of Reflective Tape to Detect Ultrasound Transducer Movement: A Validation Study

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