Ultrasound-guided injection using leucocyte-rich platelet-rich plasma for treatment of meniscal injuries in a duathlete: a case report.

There is a paucity of data regarding using platelet-rich plasma therapy for Baker's cyst-associated medial meniscal tear. To date, conservative treatments for this type of condition include aspiration of fluid effusion with steroid injection and physical therapy. When this treatment fails, arthroscopic debridement, meniscectomy, cyst decompression and open cystectomy are available surgical management options.

Special anatomy series. Imaging inner ear structures with high-frequency ultrasound: Application to physical rehabilitation space medicine.

Objective: The objective of this paper is to document the feasibility of image acquisition, image optimization, and sonographic appearance of the exposed anatomic windows of cadaveric inner ear dissection for purposes of potential future clinical evaluation as part of the developing area of physical and rehabilitation space medicine.

Methods: Cadaveric dissection of the inner ear was conducted with the goal of exposing areas relevant to vestibular balance. Middle and inner ear structures of 3 human cadavers were imaged with multiple broadband transducers, including emphasis with higher frequency transducers.

Alpha-2 macroglobulin for the treatment of neuroma pain in the stump of a below-knee amputee patient.

This case report describes the successful treatment of neuroma pain in the setting of below knee amputations using alpha-2-macroglobulin (A2M). A 34-year-old female patient presented with 9 months of stump pain despite conservative treatment. The exam revealed persistent pain through rest periods and weight-bearing status during therapy.

The value of high-resolution imaging in an occult peroneal intraneural ganglion cyst: illustrative case.

Background: Foot drop is a common complaint with a broad differential diagnosis making imaging a key part of the diagnostic workup. The authors present a patient with an occult peroneal intraneural ganglion cyst who underwent imaging with high-frequency ultrasound (US) and high-resolution magnetic resonance imaging (MRI) to highlight the role of such techniques in cases of peroneal neuropathy.

Observations: Intraneural ganglion cysts are emerging as a common cause of common peroneal neuropathy.

A standardized ultrasound approach in neuralgic amyotrophy.

Neuralgic amyotrophy (NA), also referred to as idiopathic brachial plexitis and Parsonage-Turner syndrome, is a peripheral nerve disorder characterized by acute severe shoulder pain followed by progressive upper limb weakness and muscle atrophy. While NA is incompletely understood and often difficult to diagnose, early recognition may prevent unnecessary tests and interventions and, in some situations, allow for prompt treatment, which can potentially minimize adverse long-term sequalae. High-resolution ultrasound (HRUS) has become a valuable tool in the diagnosis and evaluation of NA.

Preoperative Imaging of Intraneural Ganglion Cysts: A Critical Systematic Analysis of the World Literature.

Background: Advancements in imaging and an understanding of the pathomechanism for intraneural ganglion cyst formation have led to increased awareness and recognition of this lesion. However, the precise role of imaging has been advocated for but not formally evaluated.

Methods: We performed a systematic review of the world literature to study the frequency of imaging used to diagnose intraneural ganglion cysts at different sites and compared trends in identifying joint connections.

Ultrasound Visualization of Torsional Anatomic Changes From External Rotation of the Anterior Shoulder.

Unlabelled: The sonographic appearance of soft tissue can be altered with movement. This can be related to both position change as well as torsional stress. The objective of this article is to demonstrate sonographic anatomy of the anterior shoulder as it moves into full external rotation.

Diagnostic and therapeutic musculoskeletal ultrasound applications of the shoulder.

High frequency ultrasound is a valuable tool for assessing soft tissue injuries about the shoulder. It has advantages over other imaging modalities including relatively low cost, portability, and dynamic real-time visualization. It has a high sensitivity for identifying tendon degeneration, bursitis, and rotator cuff tears.

Neuromuscular ultrasound of the brachial plexus: A standardized approach.

Reliable assessment of brachial plexus disorders can be challenging due to the complexity of the anatomy and variation of potential pathology. Electrodiagnostic testing can be both uncomfortable for the patient and inconclusive. Ultrasound can serve as a complement to clinical assessment, electrodiagnostic testing, and other imaging modalities.

Ultrasound-Guided Peripheral Nerve Procedures.

Ultrasound guidance allows real-time visualization of the needle in peripheral nerve procedures, improving accuracy and safety. Sonographic visualization of the peripheral nerve and surrounding anatomy can provide valuable information for diagnostic purposes and procedure enhancement. Common procedures discussed are the suprascapular nerve at the suprascapular notch, deep branch of the radial nerve at the supinator, median nerve at the pronator teres and carpal tunnel, lateral cutaneous nerve of the thigh, superficial fibular nerve at the leg, tibial nerve at the ankle, and interdigital neuroma.

Sonographic Visualization of Thenar Motor Branch of the Median Nerve: A Cadaveric Validation Study.

Background: The thenar motor branch (TMB) of the median nerve may be affected in carpal tunnel syndrome and can be injured during carpal tunnel surgery. Although ultrasound has been used to identify small nerves throughout the body, the sonographic evaluation of the TMB has not been investigated formally.

Objective: To document the ability of ultrasound to visualize the TMB of the median nerve in an unembalmed cadaveric model.

Ultrasound evaluation of focal neuropathies in athletes: a clinically-focused review.

Focal neuropathies represent a rare but clinically important and potentially challenging aetiology of pain in athletes. Diagnostic ultrasound is commonly used in the evaluation of nerve entrapments, and has several advantages over other imaging modalities, including high resolution, portability, lack of ionising radiation, low cost, point-of-care access, ease of contralateral comparison and capability of Doppler and dynamic imaging techniques. In this review, we discuss the use of ultrasound for the evaluation of injuries to the brachial plexus including 'stingers,' suprascapular nerve, ulnar nerve, radial nerve, common fibular nerve, tibial nerve and interdigital nerves of the foot at selected common sites of entrapment.

Electrodiagnosis of plexopathy.

Electrodiagnostic evaluation of the brachial and lumbosacral plexus can be challenging even to an experienced practitioner. Detailed attention to anatomy and correlation with the history and physical examination results are needed to have a comprehensive differential diagnosis and to develop reliable conclusions. Electrophysiologic techniques, when applied appropriately, provide invaluable functional information after a plexus injury.

Acute common peroneal neuropathy due to hand positioning in normal labor and delivery.

Background: Foot drop has been described as an infrequent complication from common peroneal nerve injury related to external compression and forceful knee flexion while pushing during vaginal delivery. Past recommendations include placing the hands at the posterior thighs rather than the legs to avoid this complication.

Case: A 32-year-old woman developed unilateral foot drop after vaginal delivery.

The use of ultrasound in guiding musculoskeletal interventional procedures.

There has been an increase in the use of ultrasound (US) to help guide interventional procedures involving the musculoskeletal system. To perform these procedures safely and accurately, two steps must occur. First, the appropriate structure must be localized using diagnostic US imaging.

Phrenic nerve stimulation in the evaluation of ventilator-dependent individuals with C4- and C5-level spinal cord injury.

Three individuals with C4 or C5 spinal cord injuries (SCI) were seen in follow-up for management of their late complications, which included impaired ventilation. Electrodiagnostic studies were performed on all three as part of the assessment of the function of their phrenic nerves and diaphragm muscles in relation to their need for mechanical ventilator support. Each patient had evidence of lower-motor neuron injury to the phrenic nerves.

Management of common running injuries.

Runners are susceptible to a variety of potential injuries because of the considerable stress of this activity. This can create a challenge for the treating practitioner; however, many of the common ailments occur in a reasonably predictable pattern. A careful history and physical examination are necessary for accurate diagnosis.

An instance of an atypical intraspinal cyst presenting as S1 radiculopathy: a case report and brief review of pathophysiology.

Intraspinal cysts are rare, but typically they originate from a degenerate zygapophyseal joint. These cysts have been commonly referred to as juxtafacet cysts and occur concomitantly with lumbar and occasionally lower-limb radicular pain. Documented cases have shown pseudoarthroses developing from nonhealing pars defects.