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Elbow ultrasound

Michael Rutter, Louis C Grandizio, W James Malone, Joel C Klena
PURPOSE: To assess the use of preoperative, dynamic ultrasound to predict ulnar nerve instability following in situ decompression for cubital tunnel syndrome. METHODS: Prior to undergoing in situ decompression, 43 consecutive patients underwent dynamic ultrasound to assess the stability of the ulnar nerve during elbow flexion. The dynamic ultrasound findings were compared with the intraoperative assessment of nerve stability following in situ decompression. RESULTS: The preoperative dynamic ultrasound agreed with intraoperative findings in 38 of 43 patients (88%)...
November 27, 2018: Journal of Hand Surgery
Bestami Yalvaç, Nilgün Mesci, Duygu Geler Külcü, Ozan Volkan Yurdakul
OBJECTIVE: The aim of this study was to compare the efficacy of extracorporeal shock wave therapy (ESWT) and therapeutic ultrasound (US) in the treatment of lateral epicondylosis (LE). METHODS: Our study enrolled 50 patients with LE. Patients were randomized into two groups. Group 1 underwent therapeutic US (n = 24; 5 males and 15 females; mean age: 43.75 ± 4.52) Group 2 underwent ESWT (n = 20; 8 males and 16 females; mean age: 46.04 ± 9.24). Patients were evaluated at baseline, after treatment,and 1 month following treatment...
September 2018: Acta Orthopaedica et Traumatologica Turcica
David Brenner, Gabriella Iohom, Padraig Mahon, George Shorten
BACKGROUND: Axillary and infraclavicular brachial plexus blocks are commonly used for upper limb surgery. Clinicians require information on the relative benefits of each to make a rational selection for specific patients and procedures. OBJECTIVES: The main objective of the study was to compare axillary and infraclavicular brachial plexus block in terms of the incidence and severity of tourniquet pain. DESIGN: Single blinded, randomised trial...
November 19, 2018: European Journal of Anaesthesiology
Victor Jiménez-Yuste, María Teresa Álvarez-Román, Mónica Martín-Salces, Hortensia De la Corte-Rodríguez, Carmen Altisent, Rafael Parra, Ramiro Núñez, Rosario Pérez, Faustino García-Candel, Santiago Bonanad, Felipe Querol, Nieves Alonso, Nuria Fernández-Mosteirín, Elsa López-Ansoar, Luis Javier García-Frade, Nuria Bermejo, Noelia Pérez-González, María José Gutiérrez-Pimentel, Carlo Martinoli, Isabel Fernández-Arias, Hae Kyung Kim
AIM: The use of musculoskeletal ultrasound (MSK-US) following protocols for haemophilic arthropathy and the Haemophilia Early Arthropathy Detection with Ultrasound (HEAD-US) score can help standardize monitoring in haemophilia. This study evaluated the joint status (elbows, knees and ankles) of patients with haemophilia B (HB) in Spain using MSK-US and the HEAD-US score. METHODS: Haemophilia B patients ≥14 years old were included in this observational, multicentre, cross-sectional study, regardless of their clinical condition, HB severity and treatment received...
November 16, 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
Babak Afsharipour, Sourav Chandra, Jongsang Son, William Z Rymer, Nina L Suresh
Botulinum toxin (BT) is widely prescribed by physicians for managing spasticity post stroke. In an ongoing study, we examine the spatial pattern of muscle activity in biceps brachii of stroke survivors before and after receiving BT, examined over the course of 11 weeks (2 weeks before - 9 weeks after). We hypothesize that BT alters muscle electrophysiology by disrupting fiber neuromuscular transmission in an inhomogeneous manner and we seek to detect these changes using grid surface electromyography (sEMG)...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Tae-Hwan Yoon, Chong-Hyuk Choi, Sung-Jae Kim, Yun-Rak Choi, Soon-Phil Yoon, Yong-Min Chun
PURPOSE: The purpose of this study was to investigate the natural history of intact rotator cuff in impingement syndrome patients with concomitant spur protruding from the undersurface of acromion. METHODS: This retrospective study included 119 patients with an intact rotator cuff who underwent conservative treatment for a spur protruding from the undersurface of the acromion. The protruded spur was defined as a trapezoid- or tetragon-shaped bony protrusion with a downward peak extending more than 3 mm in length from the baseline drawn along the acromial undersurface on the coronal view of magnetic resonance imaging (MRI) or computed tomography arthrography (CTA)...
November 11, 2018: Archives of Orthopaedic and Trauma Surgery
J Li, W Liu, X J Guo, X L Ding, B M Lyu, J Xiao, Q L Sun, D S Li, W F Zhang, J C Zhong, C P Li, R C Yang
Objective: To explore the evaluation of joint injury by HEAD-US-C (Hemophilic Early Arthropathy Detection with UltraSound in China, HEAD-US-C) in patients with moderate or severe hemophilia A treated with prophylaxis vs on-demand. Methods: The patients from June 2015 to July 2017 with moderate or severe hemophilia A were examined by ultrasound imaging of the elbows, knees and ankles; Meanwhile the HEAD-US-C ultrasound assessment scale and hemophilia joint health score scale 2.1 (HJHS2.1) were used to score the joint status...
October 14, 2018: Zhonghua Xue Ye Xue za Zhi, Zhonghua Xueyexue Zazhi
Nicholson Chadwick, Yoav Morag, Brandon W Smith, Corrie Yablon, Sung Moon Kim, Lynda Js Yang
Ulnar neuropathy at the elbow is the second most common entrapment neuropathy of the upper extremity. Yet, there is a paucity of literature focusing on the imaging appearance following surgical decompression of the ulnar nerve at the elbow. Diagnostic imaging studies obtained after surgical decompression at The University of Michigan were reviewed and imaging findings were documented. We aim to describe the various techniques of ulnar nerve decompression and corresponding post-operative appearance on imaging...
November 1, 2018: British Journal of Radiology
Vijayakumar Palaniswamy, Shu-Kay Ng, Nagarajan Manickaraj, Michael Ryan, Michael Yelland, David Rabago, Leanne Bisset
OBJECTIVE: To investigate the relationship between tendon structural changes determined by static ultrasound images (US) and sensory changes using quantitative sensory testing (QST), and clinical measures in lateral epicondylalgia. MATERIALS AND METHODS: Both elbows of 66 adult participants with a clinical diagnosis of lateral epicondylalgia were investigated. Using a standardised ultrasound image rating scale, common extensor hypoechogenicity, heterogenicity, neovascularity, and bony abnormalities at the enthesis were scored, and tendon thickness (longitudinal and transverse plane) was measured by a trained assessor...
2018: PloS One
Chikande Julien, Rampal Virginie, Sadaghianloo Nirvana, Voury-Pons Audrey, Solla Federico
About 10% of supracondylar humerus fractures in children are associated with distal ischemia. In case of acute limb ischemia after reduction and fixation, it is recommended to explore the brachial artery surgically without delay. However, there is no consensus on the management of intermediate situations, like a perfused hand with a weak pulse after fracture fixation. A 6-year-old boy presented a displaced Gartland type III supracondylar humerus fracture with no radial or ulnar pulse and hand ischemia. Immediately after closed reduction and internal fixation, the pulses were still missing...
October 18, 2018: Annals of Vascular Surgery
Weijuan Zhu, Riyong Zhou, Lulu Chen, Yuanqing Chen, Lvdan Huang, Yun Xia, Thomas J Papadimos, Xuzhong Xu
BACKGROUND: Proximal brachial plexus blocks can lead to an extended period of motor paralysis and delay the return of motor function. This could influence patient satisfaction, and extend hospitalizations. The aim of the study is to compare a selective distal nerve block of the arm to a proximal axillary block, both ultrasound-guided, in terms of their motor block intensity of the elbow. Our hypothesis is that a selective nerve block of the arm would result in a different motor block of the elbow, compared to the axillary block...
October 19, 2018: BMC Anesthesiology
Ghulam Rasool, Allison B Wang, William Z Rymer, Sabrina S M Lee
We investigated alterations in material properties such as elasticity and viscoelasticity of stroke-affected muscles using ultrasound induced shear waves and mechanical models. We used acoustic radiation force to generate shear waves along fascicles of biceps muscles and measured their propagation velocity. The shear wave data were collected in muscles of 13 hemiplegic stroke survivors under passive conditions at 90°, 120°, and 150° elbow flexion angles. In a viscoelastic medium, as opposed to a purely elastic medium, the shear wave propagation velocity depends on the frequency content of the induced wave...
October 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Vasanth Seker, Lisa Hackett, Patrick H Lam, George A C Murrell
BACKGROUND: Massive and irreparable rotator cuff tears are difficult to manage surgically. One technique is to use a synthetic polytetrafluoroethylene (PTFE) patch to bridge the tear. However, there is little information regarding the outcomes of this procedure. PURPOSE: To determine the ≥2-year outcomes of patients for whom synthetic patches were used as tendon substitutes to bridge irreparable rotator cuff defects. STUDY DESIGN: Case series; Level of evidence, 4...
November 2018: American Journal of Sports Medicine
Liyun Wang, Xi Xiang, Yuanjiao Tang, Yujia Yang, Li Qiu
Background: High frequency ultrasound is often used to measure the thickness of fluid in peripheral joints and bursae of healthy asymptomatic populations. Two major steps critical to this procedure are obtaining the detection rates and analyzing the relevant factors. Methods: Healthy Chinese adult volunteers with no history of arthritis, past trauma or surgery and joint pain were enrolled in this study. Ultrasonography was performed on the bilateral shoulders, elbows, wrists, metacarpophalangeal joints (MCP) 1-5, proximal interphalangeal joints (PIP) 1-5, distal interphalangeal joints (DIP) 2-5, suprapatellar knees, ankles, metatarsophalangeal joints (MTP) 1-5, subacromial and subdeltoid bursae, deep infrapatellar bursae, retrocalcaneal bursae and long biceps tendons in B mode...
September 2018: Quantitative Imaging in Medicine and Surgery
Brennan J Boettcher, Jonathan T Finnoff
A 19-year-old female collegiate swimmer presented to our sports medicine clinic with a history and physical examination consistent with right ulnar neuropathy at the cubital tunnel. Diagnostic ultrasound (US) revealed compression of the ulnar nerve under the cubital tunnel retinaculum (CTR) with nerve swelling proximal to the site of compression. Electrodiagnostic studies confirmed the diagnosis of a moderate to severe ulnar neuropathy at the elbow. Treatment consisted of an US-guided decompression of the ulnar nerve in the cubital tunnel by cutting the CTR using a rotated stylet "v" cutting technique...
October 8, 2018: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
D Ai, X J Li, W R Yao, Q Zhang, M Zhou, L Tang, X B Luo, N N Zhang, S Yang, Y Wang, P Ding, S Y Cai, Z P Chen, R H Wu
Objective: To detect the arthropathies on no bleeding history joints in pre-school hemophilia A children in order to provide evidence for further prevention and control of joint disease in children with hemophilia A. Methods: This study was a cross-sectional study based on China Hemophilia Individualized prophylaxis study (CHIPS). The basic data of outpatients with hemophilia in Beijing Children's Hospital and Chengdu Women's and Children's Central Hospital between August 2016 and June 2017 were collected and a three-month follow-up was conducted...
October 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Nathaniel Millard, Andrew DeMoss, Gary McIlvain, Joseph A Beckett, John J Jasko, Mark K Timmons
OBJECTIVES: The medial elbow is stabilized during valgus loading by the ulnar collateral ligament, the flexor pronator mass (FPM), and the radial head. Impairment of the FPM can occur as a result of repeated wrist flexion activity. The purpose of this study was to determine the effect of repeated elbow flexion exercise on medial elbow stability. METHODS: Thirty volunteers were included in this study. Ultrasound images of the medial joint space of the nondominant elbow of the participants were collected during a valgus stress test...
October 2, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
C Tesch
Focused sonography of the musculoskeletal system in the emergency room should be done for time-effective and symptom-oriented detection of suspected findings. Analogous to other point-of-care ultrasound in emergency medicine, it is by definition not a complete ultrasound examination of the respective organ (e.g., shoulder, elbow). It allows detection of important findings (luxation, effusion, fracture or rupture) with good to excellent diagnostic accuracy. Afterwards computed tomography, magnetic resonance imaging or complete sonographic examination (according to the guidelines of the working group Bewegungsorgane der Deutschen Gesellschaft für Ultraschall in der Medizin, which are identical to those of the working group Orthopädie und Unfallchirurgie) should be added as clinically required...
November 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
M Grinac, J Brtková, T Kučera, P Šponer
PURPOSE OF THE STUDY When treating tears of the distal biceps brachii muscle tendon, we repeatedly noticed a difference between the preoperative ultrasound findings and the operative findings. The aim of the study was to retrospectively correlate these findings in order to determine the sensitivity of the ultrasound examination in everyday orthopaedic practice. Moreover, we compared the results and complications of surgical treatment through two operative techniques used at our department. MATERIAL AND METHODS In the 2004-2016 period 20 patients underwent a surgery at our department for total tear of the distal tendon of the biceps brachii muscle...
2018: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Megan Conti Mica, Roger van Riet
Although triceps tendon ruptures can result from a traumatic incident, chronic overuse causing degenerative changes to the insertion and leading to a complete or partial rupture is more common. In our practice, we have found that anabolic steroid abuse by weightlifters is the most common predisposing factor. The initial diagnosis is often missed. A thorough clinical examination is imperative to avoid missing a partial or complete rupture. Ultrasound or magnetic resonance imaging can confirm the diagnosis. Early diagnosis increases the chance of a direct repair...
March 28, 2018: JBJS Essential Surgical Techniques
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