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Elbow ultrasound

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...
October 11, 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...
October 2, 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
J Doll, C Fischer
INTRODUCTION: Acute capsular injuries of the elbow joint and its ligaments predominantly occur after joint dislocation or subluxation. Together with lateral and medial epicondylitis they represent a common injury pattern in radiology, orthopedic and trauma surgery. CLINICAL ISSUE: Because of the complexity of the elbow joint, knowledge of the elbow dislocation and injury pattern as well as the anatomy is essential in order to adequately estimate the injury severity and joint stability...
September 14, 2018: Der Radiologe
Alexandros Mallios, William Jennings, Alessandro Costanzo, Benoit Boura, Myriam Combes
Ulnar-basilic arteriovenous fistula is an alternative option when a radiocephalic arteriovenous fistula is not feasible. We review our technique of basilic vein transposition in the upper arm for difficult to puncture forearm ulnar-basilic non-transposed arteriovenous fistulae. Technical note: Three patients were referred for forearm ulnar-basilic arteriovenous fistulae with difficult cannulation where the forearm basilic vein was left in situ (non-transposed). Surgeon performed ultrasound examination confirmed a patent arteriovenous fistula with adequate diameter and flow, draining to the basilic vein in the forearm and into the upper arm...
September 6, 2018: Journal of Vascular Access
M Blasi, J De la Fuente, A Pérez-Bellmunt, O Zabalza, S Martínez, O Casasayas, M Miguel-Pérez
OBJECTIVE: To establish a high-resolution US technique that enables a systematic morphometric examination of the three components that form the distal biceps brachii tendinous complex; the internal bicipital aponeurosis, the distal biceps brachii tendon and the external bicipital aponeurosis (also known as lacertus fibrosus). MATERIALS AND METHODS: Fifty cryopreserved cadaver body donor elbows were dissected to obtain morphometric reference values and to establish reliable landmarks for the US examination...
September 5, 2018: Skeletal Radiology
Kamal Mezian, Stanislav Machač, Ali Zavareh, Lucia Majerníková, Jan Vacek, Leoš Navrátil, Marc Schmitz
We introduce an ergonomic positioning for sonographic scanning of elbow joint where the patient is lying semisupine on the examination bed. This is in contrast with the conventional positioning where the patient is sitting on the edge of the bed or across the table on a chair. Our proposed positioning is more comfortable for both the patient and ultrasound practitioner. It also allows immediate ultrasound-guided injections with lesser risk regarding a vasovagal syncope of the patient.
August 31, 2018: Ultrasound Quarterly
Mihaela Cosmina Micu, Daniela Fodor, Romeo Micu, Sorana Dana Bolboacă, Ruxandra Ionescu
Pregnancy induces profound changes in the maternal body and the normality spectrum may differ compared to non-pregnant subjects. AIMS: The main objective was to establish the presence, frequency and distribution of articular and peri-articular abnormal findings in healthy women, pregnant and non-pregnant, using clinical examination (CE) and musculoskeletal ultrasound (MSUS). Second objective was to identify which joint/tendon set would show fewer modifications in both groups of healthy subjects and would remain stable throughout pregnancy...
August 30, 2018: Medical Ultrasonography
Selvakumar Palaniappan, Venkatesh Subbiah, V Raja Gopalan, Poornima Vijaya Kumar, R John Santa Vinothan
Background and Aims: Arteriovenous (AV) fistula surgery is commonly performed for AV access for hemodialysis. However the ideal anaesthetic technique of choice remains debated. We aimed to assess operative conditions, vascular patency, and complication rate following AV fistula surgery with isolated brachial plexus block among end-stage renal disease (ESRD) patients. Methods: This prospective, observational study included 214 patients undergoing AV fistula surgery under isolated supraclavicular brachial plexus block between January and December 2017...
August 2018: Indian Journal of Anaesthesia
Christa M Nelson, Wendy M Murray, Julius P A Dewald
Poststroke deficits in upper extremity function occur during activities of daily living due to motor impairments of the paretic arm, including weakness and abnormal synergies, both of which result in altered use of the paretic arm. Over time, chronic disuse and a resultant flexed elbow posture may result in secondary changes in the musculoskeletal system that may limit use of the arm and impact functional mobility. This study utilized extended field-of-view ultrasound to measure fascicle lengths of the biceps (long head) and triceps (distal portion of the lateral head) brachii in order to investigate secondary alterations in muscles of the paretic elbow...
September 2018: Neurorehabilitation and Neural Repair
Luciana Pelosi, Dominic Ming Yin Tse, Eoin Mulroy, Andrew M Chancellor, Michael R Boland
OBJECTIVE: To systematically study demographic, clinical, electrophysiological and nerve ultrasound characteristics of ulnar neuropathy with abnormal non-localizing electrophysiology (NL-UN) and further define the utility of ultrasound over and above the conventional electro-diagnostic approach. METHOD: NL-UNs were prospectively identified from 113 consecutive referrals with suspected ulnar neuropathy. All received electro-diagnostic tests and ulnar nerve ultrasound...
October 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Angela Sm Salinet, Nathália Cc Silva, Juliana Caldas, Daniel S de Azevedo, Marcelo de-Lima-Oliveira, Ricardo C Nogueira, Adriana B Conforto, Manoel J Texeira, Thompson G Robinson, Ronney B Panerai, Edson Bor-Seng-Shu
We aimed to assess cerebral autoregulation (CA) and neurovascular coupling (NVC) in stroke patients of differing severity comparing responses to healthy controls and explore the association between CA and NVC with functional outcome. Patients admitted with middle cerebral artery (MCA) stroke and healthy controls were recruited. Stroke severity was defined by the National Institutes of Health Stroke Scale (NIHSS) scores: ≤4 mild, 5-15 moderate and ≥16 severe. Transcranial Doppler ultrasound and Finometer recorded MCA cerebral blood flow velocity (CBFv) and blood pressure, respectively, over 5 min baseline and 1 min passive movement of the elbow to calculate the autoregulation index (ARI) and CBFv amplitude responses to movement...
August 17, 2018: Journal of Cerebral Blood Flow and Metabolism
Ellen Shanley, Matthew Smith, Braden K Mayer, Lane Brooks Bailey, Charles A Thigpen, John M Tokish, Michael J Kissenberth, Thomas J Noonan
Background: Ulnar collateral ligament (UCL) injury of the elbow is a common and debilitating problem seen frequently among elite baseball pitchers. Ultrasound is a useful diagnostic tool in evaluating UCL injuries. Hypothesis: Evaluation with stress ultrasound of the elbow to measure the morphology of the UCL and the ulnohumeral joint space gapping is indicative of higher risk of UCL injury among professional baseball pitchers. Study Design: Cohort study; Level of evidence, 2...
August 2018: Orthopaedic Journal of Sports Medicine
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