Targeted Musculoarticular Sonography in the Detection of Joint Effusions

Valley, Verena T.; Stahmer, Sarah A.

doi:10.1111/j.1553-2712.2001.tb02114.x

Cited by 49 publications

(36 citation statements)

References 14 publications

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“…8 Recently, the US technology available to EPs has seen many improvements such as high-resolution linear array probes for musculoskeletal and superficial applications. 9,10 Also appearing in the emergency US literature is the use of color and power Doppler. 11,12 A new modality that is now available on many US units is tissue harmonic (TH) imaging.…”

mentioning

confidence: 99%

Tissue Harmonic Imaging Improves Organ Visualization in Trauma Ultrasound When Compared with Standard Ultrasound Mode

Blaivas

DeBehnke

Sierzenski

et al. 2002

Academic Emergency Medicine

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Abstract. The focused abdominal sonography for trauma (FAST) examination is complicated by brightly lit trauma bays, limited time, and body habitus. Recently, new ultrasound (US) technology has become available that improves organ visualization in abdominal scans. Objective: The hypothesis was that a new US mode, tissue harmonic (TH) imaging, improves visualization of critical organ relationships in the FAST examination by making use of previously unused frequencies. The authors performed a blind, prospective observational study to compare the images obtained in typical FAST views with those obtained in standard US and TH modes. Methods: Blunt trauma patients presenting to a level I trauma center between April and September 2000 were enrolled on a convenience basis. Typical FAST views were obtained in standard and TH modes. The emergency ultrasonographer (EU) switched between modes for each view, optimizing the gain each time. Multiple digital still images were made with all indications of the mode used disguised. For each view on a patient, the best image in each mode was selected in a blinded fashion. Three experienced EUs, blinded to the mode used, rated each image pair for resolution, detail, and total image quality as previously defined on a ten-point Likert scale, 10 being the best for each category. Wilcoxon signed-ranks test, 95% confidence intervals (95% CIs), and interobserver correlation were calculated. Results: A total of 76 image groups (39 of Morison's pouch, 20 splenorenal, and 17 bladder) from 52 patients were rated. Tissue harmonics produced improved resolution, detail, and quality when compared with the standard US mode, with median scores of 6.7 vs. 6.0, 6.7 vs. 6.0, and 6.3 vs. 6.0, respectively. The differences of 0.7 (95% CI = 0.4 to 0.93), 0.7 (95% CI = 0.4 to 0.93), and 0.33 (95% CI = 0.17 to 0.67) were statistically significant, with p = 0.0001, 0.0001, and 0.0003, respectively. There was good interobserver agreement (kappa = 0.74; 95% CI = 0.68 to 0.79). Conslusions: Tissue harmonics produced FAST images higher in detail, resolution, and total image quality than standard-mode US images.

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mentioning

confidence: 99%

Tissue Harmonic Imaging Improves Organ Visualization in Trauma Ultrasound When Compared with Standard Ultrasound Mode

Blaivas

DeBehnke

Sierzenski

et al. 2002

Academic Emergency Medicine

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“…Recognize specific pitfalls involved in POCUS for arthrocentesisIncorrectly ruling out a septic joint due to lack of effusion, as infection may be present in the “normal” amount of joint fluid or only in the synovial tissue.Artifact induced false-positive effusions due to anisotropy of the muscles of the hip joint and lack of provider expertise [356]. …”

Section: Ultrasound-guided Proceduresmentioning

confidence: 99%

Pediatric emergency medicine point-of-care ultrasound: summary of the evidence

et al. 2016

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The utility of point-of-care ultrasound is well supported by the medical literature. Consequently, pediatric emergency medicine providers have embraced this technology in everyday practice. Recently, the American Academy of Pediatrics published a policy statement endorsing the use of point-of-care ultrasound by pediatric emergency medicine providers. To date, there is no standard guideline for the practice of point-of-care ultrasound for this specialty. This document serves as an initial step in the detailed “how to” and description of individual point-of-care ultrasound examinations. Pediatric emergency medicine providers should refer to this paper as reference for published research, objectives for learners, and standardized reporting guidelines.

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“…In the normal joint, the suprapatellar bursa communicates with the knee joint and appears on US as a thin hypoechoic line no more than 2 mm wide extending approximately 6 cm above the patella, inferior to the quadriceps tendon (21). Fluid in the joint appears as an anechoic stripe in this area, with abnormal fluid filling the suprapatellar bursa and lateral joints recesses (Figure 3) (22).…”

Section: Discussionmentioning

confidence: 98%