Nail unit ultrasound: a complete guide of the nail diseases

Abstract

Ultrasound is an excellent technique for evaluation of normal anatomy, diagnosis, and follow-up of patients with nail unit diseases. This is an alternative for other imaging methods and may be used for an accurate diagnosis approach.

Ultrasonography of the nail unit reveals quantitative and qualitative alterations in patients with psoriasis and psoriatic arthritis

“…The clinical evaluation of the nail permitted to recognize the elementary lesions of the nail bed and nail plate and these structures were specifically targeted during the ultrasound assessment [37][38][39]. According to previous data, mean values for the nail bed range from 1.5 to 3 mm [19,37,39].…”

Subungual osteochondroma: case report and review of clinical, radiologic and ultrasound presentation versus subungual exostosis

“…9,11 Clinical differential diagnosis of either subungual osteochondromas or exostosis includes ingrown toenails, verruca vulgaris, pyogenic granulomas, glomus tumors, fibromas, keratoacanthomas, squamous cell carcinomas, subungual malignant melanomas as well as bacterial or mycotic infections. 8,12 Subungual osteochondroma's US findings have been briefly described as well-defined rounded hypoechoic images with increased vascularization 13,14 our case showed an hypoechoic band in keeping with the cartilaginous cap, bounded by an echogenic bony protuberance on its deep surface, enlarging the nail bed and displacing upwards the nail plates; however, Color Doppler US did not reveal vascularity. On the other hand, subungual exostosis are described as hyperechoic linear images, with posterior acoustic shadowing, located immediately under the nail plates and directly connected to the bone margin of the distal phalanx, with a relative hypovascularity or mild vascularity.…”

“…Protuberances lack clear continuity of both the medullary cavity and cortex 1,4,9,10 Ultrasound findings Well-defined rounded hypoechoic images with increased vascularization 13,14 Hyperechoic linear images, with posterior acoustic shadowing with relative hypovascularity or mild vascularity [14][15][16] Case synopsis…”

High-Frequency and Ultra-High Frequency Ultrasound: Musculoskeletal Imaging up to 70 MHz

“…Several articles reported the impressive image detail in the evaluation of the complexity of the nail unit and its most common disorders including tumors, trauma, infection, inflammatory, and autoimmune conditions. 64,65 The thickness of the nail plate is 0.3 to 0.65 mm; the nail bed has an average thickness of 1.5 mm. 66 This examination requires linear probes of 15 MHz or higher, compound imaging, and a panoramic field of view, as well as an extensive knowledge of clinical and imaging findings of these disorders.…”