Developments in musculoskeletal ultrasound and clinical applications

Klauser, Andrea; Peetrons, P

doi:10.1007/s00256-009-0782-y

Cited by 81 publications

(66 citation statements)

References 52 publications

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“…Types of peripheral nerve abnormalities suited to visualization by imaging include changes in nerve caliber, continuity, and echogenicity or magnetic resonance signal characteristics. [1][2][3] Imaging can identify peripheral nerve tumors, traumatic neuromas, lacerations, entrapments with nerve damage, inflammation, demyelinating features, and infections. [4][5][6][7][8][9][10][11][12][13][14][15] Ultrasound and MRI are the most commonly used methods for visualizing peripheral nerves.…”

Section: Discussionmentioning

confidence: 99%

Detection of peripheral nerve pathology

et al. 2013

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Objective: To compare accuracy of ultrasound and MRI for detecting focal peripheral nerve pathology, excluding idiopathic carpal or cubital tunnel syndromes.Methods: We performed a retrospective review of patients referred for neuromuscular ultrasound to identify patients who had ultrasound and MRI of the same limb for suspected brachial plexopathy or mononeuropathies, excluding carpal/cubital tunnel syndromes. Ultrasound and MRI results were compared to diagnoses determined by surgical or, if not performed, clinical/electrodiagnostic evaluation. Results:We identified 53 patients who had both ultrasound and MRI of whom 46 (87%) had nerve pathology diagnosed by surgical (n 5 39) or clinical/electrodiagnostic (n 5 14) evaluation. Ultrasound detected the diagnosed nerve pathology (true positive) more often than MRI (43/46 vs 31/46, p , 0.001). Nerve pathology was correctly excluded (true negative) with equal frequency by MRI and ultrasound (both 6/7). In 25% (13/53), ultrasound was accurate (true positive or true negative) when MRI was not. These pathologies were typically (10/13) long (.2 cm) and only occasionally (2/13) outside the MRI field of view. MRI missed multifocal pathology identified with ultrasound in 6 of 7 patients, often (5/7) because pathology was outside the MRI field of view.Conclusions: Imaging frequently detects peripheral nerve pathology and contributes to the differential diagnosis in patients with mononeuropathies and brachial plexopathies. Ultrasound is more sensitive than MRI (93% vs 67%), has equivalent specificity (86%), and better identifies multifocal lesions than MRI. In sonographically accessible regions ultrasound is the preferred initial imaging modality for anatomic evaluation of suspected peripheral nervous system lesions. Neurology â 2013;80: [1634][1635][1636][1637][1638][1639][1640] Nerve imaging augments patient management by providing information regarding lesion morphology, anatomic location, relationship of lesions to surrounding soft tissue, and evaluation of areas difficult to evaluate by electrodiagnostic testing. Imaging can also identify peripheral nerve lesions that are not apparent on electrodiagnostic testing. Types of peripheral nerve abnormalities suited to visualization by imaging include changes in nerve caliber, continuity, and echogenicity or magnetic resonance signal characteristics.1-3 Imaging can identify peripheral nerve tumors, traumatic neuromas, lacerations, entrapments with nerve damage, inflammation, demyelinating features, and infections. [4][5][6][7][8][9][10][11][12][13][14][15] Ultrasound and MRI are the most commonly used methods for visualizing peripheral nerves. Ultrasonography of nerve lesions impacts management beyond the electrodiagnostic findings in as many as 43% of patients 16 and, by identifying nerve continuity, can change surgical decisions after traumatic neuropathies.17 MRI visualizes nerves, characterizes soft tissue structures when evaluating atypical sites of compression, identifies features of malignancy in peripheral ner...

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Section: Discussionmentioning

confidence: 99%

Detection of peripheral nerve pathology

et al. 2013

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“…As edema, hemorrhage, mucoid degeneration, and partial ruptures can be seen as isoechoic changes, differentiation of tendon changes on musculoskeletal imaging might be difficult. 9,[29][30][31][32] Because of their advantages and limitations in the evaluation of musculoskeletal diseases, sonography and sonoelastography are currently used frequently in routine practice. 12 There are several different sonoelastographic techniques, such as compression strain imaging, shear wave or real-time shear velocity imaging, vibration sonoelastography, and acoustic radiation force sonoelastography.…”

Section: Discussionmentioning

confidence: 99%

“…Although sonoelastography is used more frequently in breast and thyroid examinations, its use in the musculoskeletal system is still considered new but has increased in recent years. [9][10][11][12] In the evaluation of a quadriceps tendon rupture of the knee, assessment with sonography is one of the first approaches, in addition to clinical evaluation and radiography. 2 No elastographic studies about the quadriceps tendon and its rupture were found in the literature.…”

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confidence: 99%

Real‐time Sonoelastography of the Quadriceps Tendon in Patients Undergoing Chronic Hemodialysis

Teber¹,

Oğur²,

Bozkurt³

et al. 2015

J of Ultrasound Medicine

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Objectives This study aimed to compare sonoelastographic findings for the quadriceps tendon in patients with chronic renal failure who were in a dialysis program to findings in a control group. Methods Fifty‐three randomly allocated patients (mean age, 54.3 years; range, 27–86 years) with chronic renal failure who were in a dialysis program 3 days a week between January and May 2012 were included. The measurements were performed in both knees of 53 patients undergoing dialysis and 25 individuals in the control group. The tendons were classified as follows: type 1, very stiff tissue (blue); type 2, stiff tissue (blue‐green); and type 3, intermediate tissue (green‐yellow) according to color mapping. Results The mean quadriceps tendon thicknesses in the patient group were 4.9 mm (range, 1.9–6.5 mm) for the right knee and 4.9 mm (1.4–6.5 mm) for the left knee; the values in the control group were 5.4 mm (3.6–7.0 mm) for the right knee and 5.4 mm (3.4–7.0 mm) for the left knee. The mean elasticity scores in the patient group were 3.14 (1.03–5.23) for the right knee and 3.33 (1.29–5.00) for the left knee; in the control group, the values were 3.79 (1.73–5.23) and 3.69 (1.23–5.53) for the right and left knees, respectively (right knee, P = .025; left knee, P = .018; Mann‐Whitney U test). The quadriceps tendons were significantly thinner in the patient group (right knee, P = .054; left knee, P = .015; Mann‐Whitney U test). Conclusions Quadriceps tendons in patients with chronic renal failure are thinner and have lower elasticity scores compared to controls.

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“…US strain elastography evaluates tissue deformation or compressibility from an external force [8,9]. It has been used extensively in assessing tendon pathology, based on the detection of alteration in the normal US elastography appearance of the tendon [10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of ultrasound elastography in detecting active myositis in children: can it replace MRI?

et al. 2015

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Compression-strain US elastography does not accurately detect active myositis in children with juvenile idiopathic inflammatory myopathy and cannot replace MRI as the imaging standard for detecting myositis in these children. The association between abnormal US elastography and increased muscle echogenicity suggests that elastography is capable of detecting muscle derangement in patients with myositis; however further studies are required to determine the clinical significance of these findings.

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Developments in musculoskeletal ultrasound and clinical applications

Abstract: In summary, exciting developments are expanding the applications of US in the MSK field, offering the advantages of real-time performance, high tissue resolution and relative speed at a reasonable cost.

Cited by 81 publications

References 52 publications

Detection of peripheral nerve pathology

Detection of peripheral nerve pathology

Real‐time Sonoelastography of the Quadriceps Tendon in Patients Undergoing Chronic Hemodialysis

Efficacy of ultrasound elastography in detecting active myositis in children: can it replace MRI?

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