Focal Bone Abnormality as a Complication of Ultrasound Diathermy: A Report of Eight Cases

Yeh, Lee‐Ren; Chen, Clement K. H.; Tsai, Meng-Hung; Teng, Hui-Chung; Lin, Ko-Long

doi:10.1148/radiol.11101301

Cited by 4 publications

(12 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patient 1, on follow-up MR evaluation, demonstrated near complete resolution of bone marrow abnormalities at 13 months after ultrasound diathermy procedure. These results are similar to those of previous observations of resolution of lesions within 12 months [ 4 ]. However, patient 2 had small, residual focal bone marrow lesions in MR examinations taken 5 years after initial visit.…”

Section: Discussionsupporting

confidence: 93%

“…Review of past literature revealed only one study on focal bone abnormality as a complication of ultrasound diathermy. Yeh et al [ 4 ] described eight patients who developed marrow lesions similar to those of focal osteonecrosis at various joints after undergoing physiotherapy using ultrasound diathermy. Pre-ultrasound diathermy procedure MR image evaluations were not available in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Focused ultrasound directed at rabbit femurs resulted in significant thermal damage to bone, characterized by histological evidence of completely empty lacunae and MRI evidence of damage and edema of the bone [ 8 ]. It was hypothesized that development of osteonecrosis-like focal bone marrow changes seen in MRIs of human patients could be related to ultrasound diathermy treatments [ 4 ]. Similarly, osteonecrosis of humeral head was reported in a patient after receiving extracorporeal shock-wave therapy for rotator cuff tendinopathy [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…In a previous report of osseous injury after ultrasound diathermy, resolution of such lesions was observed on cessation of therapeutic ultrasound treatment [ 4 ]. Smith et al [ 8 ] described the process of bone healing after ultrasound thermal damage.…”

Section: Discussionmentioning

confidence: 99%

“…General heat precautions and contraindications have been described, but there is a lack of information on specific complications of ultrasound diathermy [ 1 ]. To date, only one report of focal bone abnormalities as a result of ultrasound diathermy has been published [ 4 ]. The cases described in the current study presented with bone marrow abnormalities after receiving ultrasound diathermy.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Focal Bone Marrow Lesions: A Complication of Ultrasound Diathermy

Kim

Kang

Kim³

et al. 2019

Clin Shoulder Elbow

View full text Add to dashboard Cite

Ultrasound diathermy is widely used for the treatment of musculoskeletal disorders and other soft tissue injuries. Its use as a therapeutic modality is believed to be safe, with very few reported complications. Here, we report two patients who developed focal bone marrow abnormalities after receiving ultrasound diathermy. Both patients’ magnetic resonance (MR) evaluations revealed linear subchondral bone lesions of the superolateral humeral head similar to those in osteonecrosis. The patients’ symptoms subsequently improved, and available follow-up MR evaluation revealed near complete resolution of bone lesions. These findings suggest that ultrasound diathermy, and its interaction with bone tissue through thermal mechanisms, can cause focal bone marrow abnormalities. Furthermore, the bone marrow abnormalities seem to be transient, resolving upon cessation of ultrasound diathermy, therefore osteonecrosis should be differentiated from this temporal lesion.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Focal Bone Marrow Lesions: A Complication of Ultrasound Diathermy

Kim

Kang

Kim³

et al. 2019

Clin Shoulder Elbow

View full text Add to dashboard Cite

show abstract

Unusual bone abnormalities from therapeutic ultrasound diathermy: a radiological case report

Cruz,

Guimarães,

Ratti

et al. 2024

Skeletal Radiol

View full text Add to dashboard Cite

Focal Bone Lesions Following Ultrasound Diathermy: Case Series

Tsai

Lee

Tam

et al. 2022

Hong Kong Journal of Radiology

View full text Add to dashboard Cite

Introduction:We sought to describe focal bone lesions detected on magnetic resonance imaging (MRI) in patients following ultrasound diathermy. Methods: We performed a retrospective analysis of MRI characteristics of bone lesions in 10 patients who underwent ultrasound diathermy for musculoskeletal conditions followed by plain radiographs and MRI for pain. Magnetic resonance arthrography was performed in two patients and one patient had a second follow-up MRI examination. A phone interview was conducted with all patients. Results: All 10 patients had experienced mild to severe pain during ultrasound diathermy, with four (40%) prematurely terminating the treatment session as a result. Plain radiographs were normal. On MRI, a total of 12 lesions were observed in the 10 patients, with nine lesions in eight shoulder joints, two lesions in one ankle joint, and one lesion in the first metacarpal base. All lesions were small to medium-sized (6 × 5 × 3 mm to 32 × 23 × 9 mm), well-demarcated and subcortical in location with a crescentic or oblong configuration. Lesions were highly conspicuous on T2-weighted images and relatively inconspicuous on T1-or intermediate weighted sequences. Typically, larger lesions had a T2-hyperintense rim surrounding an isointense central area. Leakage of arthrographic contrast into the lesion was observed. The overall features favoured focal osteonecrosis in all cases. The affected locations typically had little overlying subcutaneous tissue, were close to tendon insertions, and corresponded to the site of ultrasound diathermy application in all patients. Conclusion: Appearances akin to focal osteonecrosis may result from application of ultrasound diathermy. Recognition of the characteristic appearance will allow this connection to be made to avoid subsequent unnecessary workup.

show abstract

Focal Bone Abnormality as a Complication of Ultrasound Diathermy: A Report of Eight Cases

Abstract: This study demonstrated that ultrasound diathermy may produce an osseous injury. The abnormality itself was usually mild and transient, with apparent full recovery after termination of therapy.

Cited by 4 publications

References 15 publications

Focal Bone Marrow Lesions: A Complication of Ultrasound Diathermy

Focal Bone Marrow Lesions: A Complication of Ultrasound Diathermy

Unusual bone abnormalities from therapeutic ultrasound diathermy: a radiological case report

Focal Bone Lesions Following Ultrasound Diathermy: Case Series

Contact Info

Product

Resources

About