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Wrist Ultrasound

Aakanksha Agarwal, Abhishek Chandra, Usha Jaipal, Narender Saini
The ulnar nerve is a branch of the C8 and T1 nerve roots and arises from the medial cord of the brachial plexus. It supplies the intrinsic muscles of the hand and assists the median nerve in functioning of the flexors. Also known as the musician's nerve, it is the second most common nerve involved in compressive neuropathy following the median nerve. Common sites of entrapment include cubital tunnel at the elbow, the ulnar groove in the humerus and the Guyon's canal at the wrist. Patients present with altered sensation in the ulnar fourth and the fifth digit and the medial side of arm with loss of function of intrinsic muscles of the hand, the flexor carpi ulnaris and ulnar fibres of flexor digitorum superficialis in more severe cases...
March 20, 2019: Insights Into Imaging
David A Rubin
Advanced imaging has become just as vital for diagnosing, staging, and monitoring disease in rheumatoid arthritis (RA) patients as it is for cancer patients. Part 1 of this review discussed synovitis, tenosynovitis, erosions, and osteitis-key imaging findings that occur in patients with RA. Part 2 will now show how these features, in combination with clinical and serologic data, can assist clinical decision-making at various stages of a patient's disease course. Specifically, assessing current disease activity and prognosticating future aggressiveness inform treatment decisions at initial presentation, during medical treatment, and at clinical remission...
February 26, 2019: Skeletal Radiology
Ing-Jeng Chen, Ke-Vin Chang, Yueh-Ming Lou, Wei-Ting Wu, Levent Özçakar
BACKGROUND: High-resolution ultrasound (US) becomes a reliable tool for diagnosing carpal tunnel syndrome (CTS), but whether it can be applied to patients with preexisting diabetes mellitus (DM) remains unclear. METHODS: We searched PubMed and Embase and systemically reviewed studies exploring the median nerve CSAs at the wrist level by US imaging. Nine studies enrolling at least one subgroup comprising patients with both DM and CTS were included for network meta-analysis...
February 25, 2019: Journal of Neurology
David A Rubin
The management of patients with rheumatoid arthritis (RA) has rapidly evolved with the development of newer disease-modifying drugs and the recognition that long-term damage can be mitigated by an earlier and more-informed use of these medications. Historically, radiographs were the mainstay of imaging in RA patients, but radiographic joint narrowing and erosions are late and insensitive findings in the disease. MRI (with intravenous contrast agent) and ultrasound (with power Doppler interrogation) of the hands and wrists are able to demonstrate erosions earlier and with greater sensitivity than radiographs...
February 23, 2019: Skeletal Radiology
N J Besselink, J W G Jacobs, A A A Westgeest, P van der Meijde, P M J Welsing, A C A Marijnissen, F P J G Lafeber, W E Van Spil
OBJECTIVE: To determine whether optical spectral transmission (OST) can be used to assess synovitis in hand and wrist joints of patients with hand osteoarthritis (OA). DESIGN: Hand and wrist joints of 47 primary hand OA patients with at least one clinically inflamed hand or wrist joint were assessed for synovitis by OST and ultrasound (US). Associations between standardized OST and US synovitis were studied in linear mixed effects models, across all joint types together and individually for wrist, proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints, and were adjusted for OA features that showed associations with US synovitis...
2019: PloS One
Sarah Ohrndorf, Aleid C Boer, Debbie M Boeters, Robin M Ten Brinck, Gerd-R Burmester, Marion C Kortekaas, Annette H M van der Helm-van Mil
OBJECTIVE: Ultrasound (US) and magnetic resonance imaging (MRI) are recommended in the diagnostic process of rheumatoid arthritis. Research on its comparability in early disease phases is scarce. Therefore, we compared synovitis and tenosynovitis detected by US and MRI on joint/tendon level. METHODS: Eight hundred forty joints and 700 tendons of 70 consecutive patients, presenting with inflammatory arthritis or clinically suspect arthralgia, underwent US and MRI of MCP (2-5), wrist and MTP (1-5) joints at the same day...
February 14, 2019: Arthritis Research & Therapy
Yushiro Endo, Keita Fujikawa, Tomohiro Koga, Akinari Mizokami, Masanobu Mine, Toshiaki Tsukada, Masataka Uetani, Atsushi Kawakami
Spondyloarthritis may be increasingly present in older patients as life expectancy increases. We investigated clinical differences between early-onset and late-onset spondyloarthritis in Japan.We retrospectively reviewed 114 patients consecutively diagnosed with spondyloarthritis. The clinical course of each patient was observed for ≥1 year. We defined early-onset and late-onset spondyloarthritis as <57 or ≥57 years at a median age of this study group, respectively. We compared clinical characteristics between these 2 groups...
February 2019: Medicine (Baltimore)
Guang Yang, Eghbal Amidi, Sreyankar Nandy, Atahar Mostafa, Quing Zhu
An optimized hand-held photoacoustic and ultrasound probe suitable for endo-cavity tumor subsurface imaging was designed and evaluated. Compared to previous designs, the prototype probe, consisting of four 1 mm multi-mode optical fibers attached with 1.5 mm diameter ball-shaped fiber tips sandwiched between a transvaginal ultrasound transducer and a custom-made sheath, demonstrated a higher light output and better beam homogeneity on tissue subsurface. The output power and fluence profile were simulated for different design parameters...
March 2019: Photoacoustics
Kundan Iqbal, Dennis W Lendrem, Ben Hargreaves, John D Isaacs, Ben Thompson, Arthur G Pratt
Objective: The diagnostic value added by musculoskeletal ultrasound (MSUS) over standard clinical and laboratory parameters has proved difficult to quantify. The additive contribution to diagnostic classification of a pragmatic, 15 min MSUS protocol was appraised in a large, unselected cohort of early arthritis clinic attendees. Methods: Detailed baseline characteristics were recorded. Semi-quantitative MSUS scoring of the most symptomatic wrist, second/third MCPs and PIPs and second/fifth MTPs was recorded, along with the sonographer's scan impression (definitely inflammatory, possibly inflammatory or non-inflammatory)...
February 8, 2019: Rheumatology
Yu Guo, Zairong Wei, Kewei Zeng, Fengling Zhang, Chengliang Deng, Wenduo Zhang, Dali Wang
Objective: To investigate the application of high frequency color Doppler ultrasound (HFCDU) combined with wide-field imaging in the preoperative navigation of anterolateral thigh perforator flap graft. Methods: Between January 2017 and March 2018, 28 patients with skin and soft tissue defects were treated, including 22 males and 6 females, with an average age of 33.5 years (range, 17-66 years). The causes of injury included 2 cases of scald scar, 7 cases of heavy object crushing injury, 12 cases of traffic accident injury, 4 cases of fall injury, 2 cases of machine injury, and 1 case of infection ulcer...
February 1, 2019: Chinese Journal of Reparative and Reconstructive Surgery
N Mittal, H Sangha, J Flannery, L R Robinson, A Agur
BACKGROUND: Carpal tunnel syndrome (CTS) is the most common entrapment mono-neuropathy of the median nerve. In comparison to open surgical and endoscopic carpal tunnel release, a new ultrasound guided hook knife carpal tunnel release (CTR) procedure was reported to have superior results in terms of reduced morbidity and early return to work. OBJECTIVE: To evaluate the reproducibility of the hook knife CTR procedure when performed by musculoskeletal ultrasound trained physicians without a prior experience in this technique...
February 7, 2019: PM & R: the Journal of Injury, Function, and Rehabilitation
İsmail Demirkale, Hakan İmamoğlu, Selim Şık, Özkan Öztürk
Background: Localisation of the radial nerve (RN) in the spiral groove by previously reported methods has a wide range and is generalised. The objective of this study was to establish a method unique to a patient to accurately localise the nerve. Methods: The distance between RN at the midpoint of the spiral groove (D) and the tip of the olecranon (O) was compared with the most distal wrist flexion crease and fingertips on 100 healthy volunteers. The RN was found by ultrasound examination...
January 2019: Journal of Orthopaedic Translation
Ole Ackermann, Piotr Wojciechowski, Maria Dzierzega, Kay Grosser, Ansgar Schmitz-Franken, Henrik Rudolf, Kolja Eckert
BACKGROUND:  Distal forearm fractures are the most common fractures in childhood and can be diagnosed with ultrasound. The aim of this study was to demonstrate the eligibility of Wrist SAFE for clinical use and the avoidance of X-ray application in children. METHODS:  We enrolled patients from 0 - 12 years with suspected distal forearm fractures. They were treated according to the Wrist SAFE algorithm, a detailed pathway for ultrasound fracture diagnosis, treatment decisions and control options...
February 5, 2019: Ultraschall in der Medizin
Ilias Lazarou, Stephen Gerard Kelly, Laurent Meric de Bellefon
Ultrasound-guided synovial biopsy (UGSB) is a minimally-invasive procedure which allows quality synovial tissue retrieval. In this article, we will discuss overarching principles of the procedure performed in wrists, metacarpophalangeal (MCP), metatarsophalangeal (MTP), interphalangeal joints (IP), and tendon sheaths, including basic sonoanatomy, entry site and biopsy technique, as well as special considerations for each structure whenever relevant.
2019: Frontiers in Medicine
Levent Özçakar, Bayram Kaymak, Murat Kara, Ayşen Akinci, Serdar Can Güven
PRP treatment has a potential to become a part of non-surgical approach in CTS as a regenerative method. Platelet-rich plasma (PRP) therapies aim to enhance the self-healing ability of human body, by exposing the injured tissue to a high concentration of autologous growth factors. Nerve tissues also seem to benefit from the regenerative effects of PRP concentrates. The aim of this study is to investigate the possible beneficial effects of platelet-rich plasma (PRP) injection in carpal tunnel syndrome (CTS)...
February 1, 2019: Journal of Tissue Engineering and Regenerative Medicine
Xue Deng, Lai-Heung Phoebe Chau, Suk-Yee Chiu, Kwok-Pui Leung, Yong Hu, Wing-Yuk Ip
Axonal degeneration, indicative of surgical decompression, may coexist in carpal tunnel syndrome (CTS) as the disease progresses. However, the current diagnostic and severity gradation system cannot clearly indicate its coexistence, resulting in confusion of appropriate treatment prescription. There are also constraints in conventional methods for differentiation as well. This study aims at introducing an innovative, efficient, and quick screening protocol to differentiate axonal degeneration associated with CTS, using ultrasound and nerve conduction studies (NCS)...
January 11, 2019: Journal of Visualized Experiments: JoVE
Seong Joo Lee, Seong Hoon Park, Byeong Ho Lee, Jun Won Lee, Jung Woo Noh, In Suck Suh, Hii-Sun Jeong
The distal forearm is the preferred site for hemodialysis access. However, forearm vessels have small diameter, which may lead to complications of arteriovenous fistulas constructed at this site. Indeed, the mean patency rate of such fistulas has been reported at 65.2% (range, 56-79%) at 1 year postoperatively. In this study, we aimed to evaluate the patency rate of Brescia-Cimino arteriovenous fistulas constructed under microscopic guidance. We retrospectively evaluated the records of patients with chronic renal failure who received a Brescia-Cimino arteriovenous fistula between 2014 and 2015 for hemodialysis access...
January 2019: Medicine (Baltimore)
Christos Moschovos, Georgios Tsivgoulis, Andreas Kyrozis, Apostolia Ghika, Persefoni Karachalia, Konstantinos Voumvourakis, Elisabeth Chroni
OBJECTIVE: To assess the effect of age on the accuracy of high-resolution ultrasound (HRUS) in the diagnosis and grading of carpal tunnel syndrome (CTS). METHODS: Patients with symptoms and signs of CTS (N = 527 wrists) were evaluated using electrodiagnostic studies (EDx) for CTS diagnosis and grading. Median nerve cross-sectional areas at carpal tunnel inlet (CSA) and at forearm level were measured by HRUS and the ratio of these values was calculated (WFR)...
March 2019: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Vincenzo Ricci, Levent Özçakar
No abstract text is available yet for this article.
February 2019: American Journal of Physical Medicine & Rehabilitation
José L Arias-Buría, Joshua A Cleland, Youssef R El Bachiri, Gustavo Plaza-Manzano, César Fernández-de-Las-Peñas
STUDY DESIGN: Case report. BACKGROUND: Patients with lateral elbow pain are often diagnosed of lateral epicondylalgia (LE). Lateral elbow pain is often associated with dysfunction of the wrist extensor muscles; however, in some cases, it can also mimic signs and symptoms of radial nerve dysfunction. CASE DESCRIPTION: A 43-year-old male originally referred with a diagnosis of LE as a result of playing table tennis and who previously responded favorably to manual therapy and exercise presented to the clinic for treatment...
January 18, 2019: Journal of Orthopaedic and Sports Physical Therapy
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