Musculoskeletal Ultrasound Sonosite

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Dr Jose Antonio Bouffard Dr Shivani Gupta, Sports Medicine Ultrasound Resident Physician PGY 1. DMC Sports Detroit Medical Center,Dr Ami Mac Medical Student Year 4. Physical Medicine Rehabilitation,Daniel Shelton RT R. Dr Brian M Smiley MSK Development SonoSite,Radiology PGY 4. Step 4 Medical Arts,Sonosite Inc a subsidiary of FUJIFILM.
All rights reserved No part of this publication may be reproduced distributed or transmitted in any form or. by any means including photocopying recording or other electronic or mechanical methods without the. prior written permission of the publisher except in the case of brief quotations embodied in critical reviews. and certain other noncommercial uses permitted by copyright law. MKT02673 UK,Introduction,Musculoskeletal,4 Introduction. Objective of this guide,The Musculoskeletal Ultrasound Pocket. Guide is a portable and easy to use,reference for students residents and. physicians It is a beginner s guide for the,most common diagnostic musculoskeletal. ultrasound studies The images provided,are those most frequently obtained.
during the sonographic evaluation of each,respective joint. Each chapter covers the examination of,a joint The examinations covered for the. upper extremity are the shoulder elbow,hand and wrist The examinations covered. for the lower extremity are the hip knee,foot and ankle In addition each chapter. concludes with some of the more common,ultrasound guided injection techniques.
Introduction 5, Each section is organised using the following system. 1 Anatomy of the region,4 Important areas to assess during. 2 Patient position 5 Mistakes to avoid during the study. 6 Common pathology of the region, 3 Transducer placement 7 MRI images and corresponding. and position sonograms with identifying landmarks,6 Introduction. Musculoskeletal ultrasound today,Musculoskeletal ultrasound is being utilised in a.
variety of specialties such as physical medicine,rehabilitation sports medicine rheumatology and. orthopaedics Its modern day uses are vast as there. are many advantages to using ultrasound for imaging. It is comparatively a lower cost real time,dynamic imaging modality that can be utilised. in the clinic or in the field,Ultrasound can provide immediate verification. of findings suspected on physical exam,Easy comparison with the unaffected side can. serve as a control in assessing for pathology, Dynamic studies allow for the evaluation of pathology during movement.
Ultrasound can be utilised for needle placement in treatment. of the patient,Introduction 7, As a diagnostic tool ultrasound is often used to assess for. Joint effusions, Bony irregularities osteophytes loose bodies fractures erosions. degenerative changes lytic changes, Tendon pathology tears ruptures dislocations tendinitis. tendinosis tenosynovitis, Muscle pathology tears atrophy impingement herniations. Bursal pathology thickening enlargement,Nerve pathology entrapments subluxations.
Tips for using this guide, When utilising this guide remember that the patient s right side is used by. convention All images MRI ultrasound anatomic drawings and patient. positioning correlate with the patient s right side Remember to flip or rotate. the images in your mind to better understand the relationships between each. of them From this guide you will better understand the spatial relationships. between structures,1 Sonographic Evaluation of the Shoulder. Sonographic Evalu,10 Sonographic Evaluation of the Shoulder. The Shoulder, In the hands of a skilled operator ultrasound is more sensitive than even MRI. for the diagnosis of rotator cuff tears,Rotator Cuff Tears Ultrasound MRI.
Full thickness tear,Sensitivity 94 3 91 2,Specificity 95 3 94 2. Partial thickness tear,Sensitivity 79 1 63 1,Specificity 94 6 93 7. Sensitivity 91 0 79 6,Specificity 87 0 90 6, Data from Diagnostic Imaging of Rotator Cuff Tears A Meta Analysis of the Accuracy of US and MR. Department of Radiology Thomas Jefferson University Hospital Philadelphia Pennsylvania. Sonographic Evaluation of the Shoulder 11,Overview of Shoulder Evaluation. Anterior Shoulder,An Tendon of the long head of the biceps brachii.
Dynamic Manoeuvre Medial subluxation of the,tendon of the long head of the biceps brachii. Subscapularis tendon,Po Posterior Shoulder,Glenohumeral joint and. glenoid labrum Su Superior Shoulder,Infraspinatus tendon and Acromioclavicular joint. teres minor,Suprascapular nerve,Anterolateral Shoulder. Al Supraspinatus tendon,Dynamic Manoeuvre Subacromial impingement.
12 Sonographic Evaluation of the Shoulder,An Anterior Shoulder. Tendon of the long head of the biceps brachii,Anatomy Biceps Brachii. Origin Proximal Attachment,Short head Coracoid process of scapula. ong head Supraglenoid tubercle,of scapula,Insertion Distal Attachment. Radial tuberosity,lexion and supination of the forearm at.
Flexion of the arm at the shoulder,Innervation,Nerve root C5 C6 C6. Peripheral nerve Musculocutaneous,Sonographic Evaluation of the Shoulder 13. Neutral Patient Position, Seat your patient with the shoulder adducted and elbow. flexed to approximately 90 Supinate the forearm and rest. it on the thigh,Transducer Position,Short Axis,The long head of the biceps. brachii is located lateral to that,of the short head On initial.
placement of the transducer,start lateral to the region where. the short head can be palpated,Transducer Tips Long Axis. On short axis angle the transducer superiorly to,eliminate echogenicity of the tendon The degree. of external rotation of the forearm will directly, influence the position of the long head of the biceps. brachii tendon relative to the head of the humerus. Adjust the patient s forearm such that the long head. appears centered over the humerus,14 Sonographic Evaluation of the Shoulder.
99 Assess the following, Integrity of the cortical surface and depth of the bicipital groove. Thickness and echogenicity of the tendon,Assess for fluid within the tendon sheath. Assess for neovascularisation, Dynamic Manoeuvre Medial dislocation of the tendon upon external. rotation of the shoulder,Mistakes to avoid, o not confuse anisotropy in the proximal tendon with pathologic. o not confuse tenosynovitis with fluid that originates from within. Do not assume that fluid in the tendon sheath is limited to biceps tendon. pathology rotator cuff estimate, Do not confuse flow within the anterior circumflex artery.
with neovascularisation,Sonographic Evaluation of the Shoulder 15. Biceps tendon joint effusion,Biceps tenosynovitis,Biceps ganglion cyst. Biceps brachii tenodesis,Biceps brachii subluxation. Musculoskeletal ultrasound today Musculoskeletal ultrasound is being utilised in a variety of specialties such as physical medicine amp rehabilitation sports medicine rheumatology and orthopaedics Its modern day uses are vast as there are many advantages to using ultrasound for imaging It is comparatively a lower cost real time

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