Outcomes of ultrasound-guided injections of Bennett lesions of the shoulder.

Purpose: To describe our technique and short term follow up of ultrasound-guided injections of symptomatic Bennett lesions.

Methods: We performed 13 ultrasound-guided injections in 10 baseball players from August 2014 to August 2021. The cohort was comprised of 10 males, with a mean age of 25 years and 1 month (age range: 17 years, 10 months-33 years, 1 month).

When to lavage in the absence of a sonographically visible joint effusion in painful total knee arthroplasty: a retrospective longitudinal study.

Objective: To determine if knee arthroplasty without sonographically visible effusion needs to undergo lavage to rule out infection.

Methods: Patients were accrued by a retrospective search of a longitudinally maintained radiology database looking for patients referred for ultrasound guided aspiration of suspected TKA infection. Clinical presentations, laboratory tests, intraoperative findings, and follow-up were reviewed.

No Difference in Reintervention at 1-Year Between Ultrasound-Guided versus Blind Dorsal Carpal Ganglion Aspiration.

Purpose: The purpose of this retrospective comparative study was to compare the efficacy of dorsal carpal ganglion aspiration in patients who underwent either "blind" (using surface anatomy alone) or ultrasound-guided (US-guided) aspiration.

Methods: Outcome measures were conducted during the coronavirus disease 2019 pandemic via telephone for a minimum of 12 months after aspiration, with efficacy defined by reintervention with either repeat aspiration or surgical excision.

Results: Data are reported for 141 patients (46 blind; 95 US-guided) at an average of 28 months (range, 12-55 months) from aspiration.

Ultrasound assessment of synovitis in total knee replacements: concordance with MR imaging and joint aspiration.

Objective: To determine if diagnostic ultrasound can reliably distinguish between synovial patterns of prosthetic joint infection and polymeric wear in total knee replacements.

Methods And Methods: This retrospective study was approved by our hospital IRB. Using the radiology report database, MR examinations performed within a week of diagnostic ultrasound and/or ultrasound-guided aspiration were identified.

Imaging of the Hip Prior to Replacement: What the Surgeon Wants to Know.

Total hip arthroplasty is an effective treatment for severe degenerative arthritis and is increasingly being used. Radiography is the primary modality for the initial diagnosis of osteoarthritis and preoperative planning. Additional radiographic views may include the spine and lower extremities in order to optimize implant positioning for the individual patient.

Pain After Hip Arthroplasty: MR Imaging/Ultrasound Correlation.

MR imaging and ultrasound (US) have complementary roles for the comprehensive assessment of painful hip arthroplasty. Both modalities demonstrate synovitis, periarticular fluid collections, tendon tears and impingement, and neurovascular impingement, often with features indicating the causative etiology. MR imaging assessment requires technical modifications to reduce metal artifact, such as multispectral imaging, and optimization of image quality, and a high-performance 1.

Imaging of the Peripheral Nerves of the Lower Extremity.

Continued advancements in magnetic resonance (MR) neurography and ultrasound have made both indispensable tools for the workup of peripheral neuropathy. Ultrasound provides high spatial resolution of superficial nerves, and techniques such as "sonopalpation" and dynamic maneuvers can improve accuracy. Superior soft tissue contrast, ability to evaluate both superficial and deep nerves with similar high resolution, and reliable characterization of denervation are strengths of MR neurography.

Dynamic ultrasound assessment of hip instability and anterior and posterior hip impingement.

Objective: In this technical report, we describe our protocol for the dynamic sonographic evaluation of the hip and assess reliability of the ultrasound assessment of hip microinstability.

Materials And Methods: Our clinical experience with a standardized dynamic ultrasound of the hip performed in a series of 27 patients with imaging performed by an experienced musculoskeletal radiologist during physical examination by an orthopedic surgeon specializing in hip preservation is illustrated with clinical photographs and ultrasound images from volunteers and selected patients. Interrater reliability for the diagnosis of microinstability was calculated.

Sonographic Changes in the Median Nerve Predict Conversion to Surgery after Corticosteroid Injection of the Carpal Tunnel.

Background: Risk factors for conversion to surgical management of moderate severity carpal tunnel syndrome are poorly understood. The authors hypothesized that sonographic findings along the carpal tunnel could predict failure of conservative management for carpal tunnel syndrome.

Methods: The authors report on 96 wrists with moderate clinical signs and symptoms of carpal tunnel syndrome.

Dermal ultrasound measurements for bone quality assessment : An investigation of advanced glycation endproducts derived from confocal fluorescence microscopy.

Bone quality is increasingly being recognized in the assessment of fracture risk. Nonenzymatic collagen cross-linking with the accumulation of advanced glycation end products stiffens and embrittles collagen fibers thus increasing bone fragility. Echogenicity is an ultrasound (US) parameter that provides information regarding the skin collagen structure.

Ultrasound-guided injection of the pisotriquetral joint: technique and case series.

Purpose: To describe our techniques for ultrasound-guided injection of the pisotriquetral joint (PTJ), and to report our experience in a case series.

Methods: Between 7/1/14 and 11/30/20, we performed 42 injections in 33 patients with ulnar-sided wrist pain, referred by clinicians who suspected the PTJ as the pain generator. There were 16 males and 17 females, average age 46.

Isolated Traumatic Tear of the Middle Head of the Deltoid Muscle: A Case Report.

Case: A 27-year-old male pedestrian struck presented with left shoulder pain and weakness 4 months postinjury, with an isolated middle head of the deltoid tear. The patient's pain persisted despite extensive nonoperative management. The deltoid was primarily repaired to the lateral acromion using a transosseous suture repair technique.

Three Degrees External to the Posterior Condylar Axis Has Little Relevance in Femoral Component Rotation: A Computed Tomography-Based Total Knee Arthroplasty Simulation Study.

Background: Femoral component rotation in total knee arthroplasty (TKA) has a significant impact on balance and patellofemoral kinematics. However, normal anatomic relationships between rotational axes are poorly understood. As such, we sought to characterize anatomic femoral rotational axes in patients undergoing primary TKA.

Utility of lavage in addition to native fluid collection during fluoroscopically guided joint aspiration in infection diagnosis.

Image-guided prosthetic joint aspirations have been criticized in the literature as having poor sensitivity and specificity. Native fluid is typically analyzed for the presence of infection. Joint lavage during fluoroscopically guided aspiration of prosthetic joints is not routinely performed, and the lavage aspirate is not typically analyzed unless native fluid could not be aspirated for culture.

Quantitative assessment of change in upper extremity muscle stiffness following fluid injection using shear wave elastography.

Objective: To quantitatively assess changes in muscle stiffness following intramuscular saline injection using shear wave elastography (SWE).

Materials And Methods: Thirty muscles (lateral deltoid (LD), biceps brachii (BB), brachialis, pronator teres (PT), flexor carpi radialis (FCR), flexor carpi ulnaris (FCU)) from fresh-frozen cadaveric specimens were injected with saline under ultrasound guidance. Pre- and post-injection muscle thickness (MT) (mm) and SWE (kPa) measurements were recorded.

Ultrasound of the distal biceps brachii tendon using four approaches: reproducibility and reader preference.

Objectives: To determine which sonographic appearance of the distal biceps brachii tendon (DBBT) is preferred by readers, and if images obtained by two different operators are reproducible.

Methods: We performed an IRB-approved prospective sonographic evaluation of the DBBT in 50 healthy elbows using four different approaches (anterior, lateral, medial, posterior) performed by two operators. Five musculoskeletal radiologists independently reviewed the images, and ranked the four approaches based on overall appearance of echogenicity of the tendon, visualized length, and visualization of the insertion.

Ultrasound-guided aspiration of anterior cruciate ligament mucinous cysts in the posterior intercondylar notch: Technique and short-term outcomes.

Purpose: To describe our technique of aspirating symptomatic anterior cruciate ligament (ACL) mucinous cysts in the posterior intercondylar notch with ultrasound guidance, and to detail short-term patient outcomes.

Methods: We identified 13 patients from February 2008 to May 2020 who underwent ultrasound-guided aspiration of symptomatic ACL mucinous cysts in the posterior intercondylar notch. Post-procedural imaging was reviewed to evaluate the degree of cyst decompression.

Optimal Choice of Ultrasound-Based Measurements for the Diagnosis of Ulnar Neuropathy at the Elbow: A Meta-Analysis of 1961 Examinations.

The purpose of this study was to determine the optimal ultrasound (US) measurement technique and cutoff value for the diagnosis of ulnar neuropathy at the elbow. A systematic literature search was conducted of the PubMed, Embase, Scopus, and Web of Science databases for studies evaluating the diagnostic accuracy of US of patients with ulnar neuropathy at the elbow before April 2019. Random-effects modeling was performed to compare the sensitivity, specificity, and diagnostic odds ratio (DOR) of different US measurements, including diameter and cross-sectional area (CSA) of the nerve at the medial epicondyle or proximal and distal levels, maximal diameter, maximal CSA, and nerve ratios.

Ultrasound of Musculoskeletal Hematomas: Relationship of Sonographic Appearance to Age and Ease of Aspiration.

Objective: The purpose of this study was to evaluate the safety and efficacy of ultrasound-guided aspiration of musculoskeletal hematomas, evaluate the associations between the sonographic appearance of hematomas and their age with ease of aspiration, and determine if there is an optimal time frame for aspiration.

Materials And Methods: A retrospective search of our radiology database was conducted using the keywords "hematoma" and "aspiration" for procedures performed from January 1, 2008, through September 28, 2017, by three fellowship-trained musculoskeletal radiologists. Associations between the ease of aspiration and echotexture of the hematoma and between the ease of aspiration and age of the hematoma were assessed with a marginal ordinal logistic regression model to account for patient-level clusters.

Biplanar Low-Dose Radiography Is Accurate for Measuring Combined Anteversion After Total Hip Arthroplasty.

Background: Acetabular component position alone has not been predictive of stability after total hip arthroplasty (THA). Combined anteversion of the acetabulum and femur has the potential of being more predictive of stability. Unfortunately, femoral component position is difficult to measure on plain radiographs.

Clinical tests for assessing the presence and quality of the palmaris longus tendon: diagnostic accuracy of examination compared with ultrasound.

Various clinical tests are used to evaluate the palmaris longus tendon, but their accuracy is unknown. We assessed the accuracy of clinical tests (Schaeffer's, Thompson's, Mishra-I, Mishra-II) against ultrasound as the reference standard. We hypothesized that Schaeffer's was most accurate and that examination can reliably assess the palmaris longus tendon's length.

The Effect of Plate Design on the Flexor Pollicis Longus Tendon After Volar Locked Plating of Distal Radial Fractures.

Background: Injury to and rupture of the flexor pollicis longus (FPL) tendon are known complications after volar locking plate fixation for distal radial fractures. Recent investigations have demonstrated that plate positioning contributes to the risk of tendon rupture; however, the impact of plate design has yet to be established. The purpose of this study was to compare FPL tendon-to-plate distance, FPL tendon-plate contact, and sonographic changes in the FPL tendon for 2 volar locking plate designs (ADAPTIVE compared with FPL) using ultrasound examination.