Diagnostic Ultrasound in Sports Medicine

Nofsinger, Charles; Konin, Jeff G.

doi:10.1097/jsa.0b013e3181982add

Cited by 31 publications

(17 citation statements)

References 18 publications

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“…[4][5][6] Unfortunately, although plain radiography can provide evidence of classic impingement and degenerative changes, it does not show any specific signs predictive of coracoid impingement. 5 Standard CT and MRI allow only static evaluation Diagnostic sonography has been established as a valid tool for investigating rotator cuff conditions, 12,13 including the diagnosis of subacromial impingement, 14 and guiding therapeutic injections. 15,16 We describe the use of sonography to measure the CHI in asymptomatic volunteers and in patients with symptomatic coracoid impingement.…”

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confidence: 99%

Sonography of the Coracohumeral Interval

Tracy

Trella

Nazarian

et al. 2010

Journal of Ultrasound in Medicine

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Objective. Coracoid impingement has been recognized as an etiology for anterior shoulder pain; however, no imaging reference standard exists. We used sonography to compare the coracohumeral interval (CHI) in asymptomatic volunteers with the CHI in patients with coracoid impingement. Methods. Bilateral shoulder sonography was performed in 19 asymptomatic volunteers (10 men and 9 women) and in 8 shoulders in 7 patients (6 men and 1 woman) with a clinical diagnosis of coracoid impingement. With the arm adducted across the chest, the interval between the coracoid process and the lesser tuberosity of the humerus was measured using a linear array ultrasound transducer with a peak frequency of 13 MHz. Results. In the asymptomatic volunteers, the mean ± SD for the CHI was 12.2 ± 2.5 mm (range, 7.8-17.5 mm). In the symptomatic shoulders, the mean ± SD for the CHI was 7.9 ± 1.4 mm (range, 5.9-9.6 mm). Repeated measures analysis of variance revealed the CHI to be significantly narrower in symptomatic shoulders than in asymptomatic volunteers (P < .0001). Conclusions. These data suggest a role for sonography in diagnosing coracoid impingement. Key words: coracohumeral interval; coracoid impingement; shoulder. Most commonly, impingement of the supraspinatus tendon occurs deep to the coracoacromial arch. Less commonly, the space between the coracoid and the lesser tuberosity (ie, the coracohumeral interval [CHI]) is too narrow to allow unencumbered passage of the subscapularis tendon.2 This results in the entity known as coracoid impingement, which can be difficult to identify on both physical examination and imaging studies.Cadaveric studies have revealed tremendous variability in the bony anatomy of the coracoid process and subcoracoid recess.3 Plain radiography, computed tomography (CT), and magnetic resonance imaging (MRI) all have been used to evaluate the CHI. [4][5][6] Unfortunately, although plain radiography can provide evidence of classic impingement and degenerative changes, it does not show any specific signs predictive of coracoid impingement.5 Standard CT and MRI allow only static evaluation

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confidence: 99%

Sonography of the Coracohumeral Interval

Tracy

Trella

Nazarian

et al. 2010

Journal of Ultrasound in Medicine

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“…They reported 100 % positive predictive value for their ultrasound screening and suggested that a distinctive loss of the smooth articular surface on ultrasound was a good indicator of an osteochondral lesion [16••]. While ultrasound provides a quick screening tool, it still remains a user-dependent modality that requires significant training for diagnostic acumen [35,36].…”

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confidence: 99%

Osteochondritis dissecans of the elbow

Churchill

Muñoz

Ahmad

2016

Curr Rev Musculoskelet Med

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Capitellar osteochondritis dissecans (OCD) can be a significant problem in adolescent overhead athletes. The cause is likely multifactorial secondary to repetitive stresses, biomechanical mismatch, and a tenuous vascular supply of the capitellum. Recent literature reveals that the prevalence is likely higher than previously thought. This, in conjunction with increased levels of athletic competition in children at younger ages, has fed the recent interest in this topic. The literature continues to show that non-operative treatment is still successful for stable lesions. Unstable lesions, therefore, have been the focus of the new literature regarding operative management and outcomes. The aim of this paper is to provide a summary of current literature and an up-to-date approach to the diagnosis, evaluation, and treatment of osteochondritis dissecans of the capitellum.

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“…Finally, diagnostic ultrasound is useful during the healing and rehabilitation process, to assess soft tissue and areas with muscular dysfunction [12]. The main shortcomings of diagnostic ultrasound are the considerable inter-observer variation, lack of standardized training programmes and minimal consensus on how and what to measure at various time points [36].…”

Section: Diagnosis Of Muscle Haematomamentioning

confidence: 99%

Muscle bleeds in professional athletes – diagnosis, classification, treatment and potential impact in patients with haemophilia

2010

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Muscle haematoma represents 10-25% of bleeds in patients with severe haemophilia. There is limited consensus on diagnostic or treatment strategies and little knowledge about the natural history of muscle haematoma and optimal treatment goals. The aim of this review was to perform a systematic description of the natural history of muscle haematoma in healthy athletes, focusing on diagnosis, classification and treatment options. Publications and educational textbooks on management of sports injuries were used as data source. Muscle haematomas occur following contusion, strain, or laceration and can be categorized as mild, moderate, or severe. Muscle haematoma may be inter- or intramuscular. In healthy athletes, the healing process takes 20-40 days. Optimal diagnosis includes history, physical examination (inspection, palpation, active and passive range of motion (ROM) test, muscle length test, isometric strength test, biomechanical examination, full spinal examination, peripheral nerve test and slump test), ultrasound, MRI or CT. Treatment is conducted based on: (i) super-acute stage, control of the bleeding and minimizing the size of the haematoma; (ii) acute stage, restoration of pain-free ROM; (iii) subacute stage, functional rehabilitation; and (iv) gradual return to normal activity. Treatment and preventive strategies include RICE (rest, ice, compression and elevation), protected mobilization, stretching and strengthening exercises, manual therapy (articular, neural and soft tissue mobilization and massage), correction of movement dysfunction, functional rehabilitation and electro-therapeutic interventions. The study reviews the natural history of muscle haematoma and state-of-the-art diagnosis and treatment in healthy athletes. Results may be useful to optimize diagnosis and treatment of muscle haematoma in patients with haemophilia.

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Diagnostic Ultrasound in Sports Medicine

Cited by 31 publications

References 18 publications

Sonography of the Coracohumeral Interval

Sonography of the Coracohumeral Interval

Osteochondritis dissecans of the elbow

Muscle bleeds in professional athletes – diagnosis, classification, treatment and potential impact in patients with haemophilia

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