Compartments of the crural fascia: clinically relevant ultrasound, anatomical and histological findings.

Purpose: Compartment syndrome is a surgical emergency that can occur in any part of the body and can cause cell necrosis when maintained over time. The resulting defects can affect the nerves, muscle cells, bone tissue, and other connective tissues inside the compartment, and fasciotomy has to be performed. The anatomical and histological characteristics of the leg make acute, chronic, and exertional compartment syndrome more likely in this limb.

Possible Points of Ulnar Nerve Entrapment in the Arm and Forearm: An Ultrasound, Anatomical, and Histological Study.

Background: Ulnar nerve entrapment is one of the most common entrapment neuropathies, usually occurring in the cubital tunnel of the elbow and in Guyon's canal of the wrist. However, it can also occur at other anatomical locations.

Purpose: Our aim was to review other possible locations of ulnar nerve entrapment in an ultrasound and anatomical study.

Variations in the Course and Diameter of the Suprascapular Nerve: Anatomical Study.

(1) Background: Suprascapular neuropathy is an important factor contributing to shoulder pain. Given the prevalence of nerve injury and nerve block in the suprascapular notch region, as well as the frequency of arthroscopic procedures on the suprascapular notch, which are recommended in shoulder pain management, its morphology is relevant from a clinical perspective. (2) Methods: Suprascapular nerve course was studied in twelve shoulders by dissection.

Compartments of the antebrachial fascia of the forearm: clinically relevant ultrasound, anatomical and histological findings.

Purpose: Acute compartment syndrome is defined as a limb-threatening condition caused by bleeding or oedema in a closed muscle compartment surrounded by fascia or bone. It is most commonly encountered in the forearm, which has three compartments: posterior, anterior and lateral. These are surrounded and closed in by the antebrachial fascia, formed by dense connective tissue that facilities their study on ultrasound and is key to fasciotomy treatment.

Ultrasound and Anatomical Study of Accessing the Nerves in the Knee by Fascial Planes.

The fascia is an undifferentiated mesenchymal tissue related to the peripheral nerves. Both can be identified by ultrasound, which is useful when performing peripheral nerve blocks. However, there is no unanimity about the approaching point of each nerve, nor is there a consensus on how to name the appropriate infiltration zone, although the paraneural zone is frequently mentioned.

Anatomical causes of compression of the sciatic nerve in the pelvis. Piriform syndrome.

Objective: The piriformis syndrome is one of the etiologies of pelvic pain due to the sciatic nerve's entrapment by the piriformis muscle. Nowadays this syndrome might be difficult to be diagnosed. The aim of this study is to know the prevalence of anatomic variations in our population that may contribute to the appearance of piriformis syndrome.

Nerve Entrapment Syndromes at the Wrist and Elbow by Sonography.

Nerve entrapment syndromes of the upper extremity are associated with structural abnormalities or by an intrinsic abnormality of the nerve. Nerve entrapment syndromes generally have a typical clinical presentation, and findings on physical examination and in conjunction with electrodiagnostic studies imaging is used to evaluate the cause, severity, and etiology of the entrapment. With the development of high-frequency linear array transducers (12-24 MHz), ultrasound (US) is incomparable in terms of spatial resolution to depict morphological aspects and changes in nerves.

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.

Meralgia paraesthetica: Ultrasound-guided injection at multiple levels with 12-month follow-up.

Objectives: To evaluate the efficacy of ultrasound (US)-guided injections around the lateral femoral cutaneous nerve (LFCN) at different levels in meralgia paraesthetica (MP) patients.

Methods: The study was approved by the university ethics committee and informed oral and written consent were obtained from all patients. Between June 2008 and August 2013, 20 patients with symptoms of MP, including nine men (mean age, 61.

An anatomical and histological study of the structures surrounding the proximal attachment of the hamstring muscles.

Introduction: The proximal attachment of hamstring muscles has a very high incidence of injuries due to a wide number of factors and its morphology may be one of the underlying factors as scientific literature points out. The connective tissue component of the attachment of hamstring muscles is not well known. For this reason the aim of this study is to describe the anatomy and histology surrounding the proximal attachment of the hamstring muscles (PAHM) and its direct anatomic relations.

Intracarpal tunnel contents: evaluation of the effects of corticosteroid injection with sonoelastography.

Purpose: To define the stiffness of the intracarpal tunnel contents and to evaluate the effect of corticosteroid injection on the intracarpal tunnel contents by using sonoelastography.

Materials And Methods: This study was conducted with the approval of the institutional review boards, and all participants provided written, informed consent. Both hands were studied in 20 healthy volunteers, including eight men (mean age, 59.

Ultrasound demonstration of distal biceps tendon bifurcation: normal and abnormal findings.

We demonstrate the US appearance of the distal biceps tendon bifurcation in normal cadavers and volunteers and in those affected by various disease processes. Three cadaveric specimens, 30 normal volunteers, and 75 patients were evaluated by means of US. Correlative MR imaging was obtained in normal volunteers and patients.

Mammographic density estimation: comparison among BI-RADS categories, a semi-automated software and a fully automated one.

Although breast density is considered a strong predictor of breast cancer risk, its quantitative assessment is difficult. The aim of this study is to demonstrate that breast density assessment with a fully automated software is feasible and correlates with the semi-automated evaluation and the quantitative BI-RADS standards. A data set of 160 mammograms was evaluated by three blinded radiologists.

High-resolution sonography of the palmar cutaneous branch of the median nerve.

Objective: The aim of this study was to describe the potential value of high-resolution sonography for evaluation of the palmar cutaneous branch of the median nerve (MN).

Subjects And Methods: The volar wrists of 12 healthy volunteers and 22 consecutive patients with sensory deficit in the palmar triangle and thenar eminence suggesting neuropathy of the palmar cutaneous branch of the MN were examined with high-frequency sonography. Nine patients underwent carpal tunnel release, five had a history of penetrating trauma, six had symptoms suggesting concurrent carpal tunnel syndrome, one received surgery for palmaris tendon transfer, and one underwent resection of a ventral carpal ganglion cyst.

Wrist and hand ultrasound.

With adequate equipment, training, and expertise, ultrasound (US) should be regarded as the first-line imaging modality for the assessment of a wide range of pathological conditions affecting the soft tissues around the wrist and hand. With high-resolution transducers, US allows detection of foreign bodies and a reliable identification of a variety of traumatic lesions affecting tendons, retinacula and annular pulleys, ligaments, vessels, and nerves. In addition, inflammatory arthropathies, infectious disorders, overuse tendinopathies, and degenerative conditions can be diagnosed with this technique.

Imaging of rock climbing injuries.

Competition climbing has grown increasingly in popularity, and many people are being drawn to this sport with a parallel increase in the occurrence of sport-related injuries. One of the most common and unique lesions occurring in the rock climbing population is the closed rupture of the flexor pulley system of the fingers. This lesion is strictly related to some climbing techniques in which the entire body weight is placed on fingerholds, which causes bowstringing of the flexor tendons with subsequent loss of strength across the full range of motion of the finger.

Imaging of early postoperative complications after polypropylene mesh repair of inguinal hernia.

Purpose: We report our experience with the use of US and CT in postoperative complications of inguinal hernioplasty using a prosthetic polypropylene mesh.

Materials And Methods: This study was divided into two parts. In the first we evaluated the in-vitro sonographic and CT appearance of a fragment of prosthetic mesh.

[Ultrasonography of peripheral nerves].

With the recent advances in broadband transducer technology and refinements in scanning technique, an increasing number of nerves and related pathologic conditions are identified with sonography. High-resolution sonography can support clinical and electrophysiological testing for detection of a variety of nerve abnormalities, including entrapment neuropathies, traumas, infectious disorders, and tumors. In addition, procedures of regional anesthesia and percutaneous treatment of painful neuromas can be effectively guided by sonography in real time.

US of the shoulder: non-rotator cuff disorders.

The most common indication for shoulder ultrasonography (US) is the diagnosis of rotator cuff disease. However, there is a spectrum of non-rotator cuff abnormalities that are amenable to US examination, including instability of the biceps tendon, glenohumeral joint, and acromioclavicular joint; arthropathies and bursites (inflammatory diseases, degenerative and infiltrative disorders, infections); nerve entrapment syndromes; and space-occupying lesions. Many of these conditions may be overlooked clinically or can even mimic rotator cuff tears, and US can help redirect the diagnosis if a complete shoulder examination rather than a simple rotator cuff assessment is performed.

Brachial plexus sonography: a technique for assessing the root level.

Objective: Our study was intended to establish a technique to assess the level of the roots of the brachial plexus using high-resolution sonography.

Materials And Methods: The skeleton of a cervical spine was examined in vitro to determine whether the vertebrae may be identified individually on sonography by means of the evaluation of their transverse processes. Then 20 healthy subjects and five patients who had undergone CT of the cervical spine were evaluated sonographically, and we attempted to identify the level of individual roots of the brachial plexus using the transverse processes as landmarks.

Sonography of the median nerve in Charcot-Marie-Tooth disease.

Objective: The purpose of our study was to describe the features on high-frequency sonography of median nerves in patients with Charcot-Marie-Tooth disease and determine whether sonography can help in the detection and characterization of the disease in these patients.

Subjects And Methods: The median nerves of 24 patients with genetically proven Charcot-Marie-Tooth disease (12 patients with Charcot-Marie-Tooth disease type 1A, seven with Charcot-Marie-Tooth disease type 2, and five with Charcot-Marie-Tooth disease type X) were prospectively examined at the right mid forearm with a 12-5-MHz transducer. Image analysis for each patient included measurement of both the cross-sectional area and fascicular diameter of the nerve.

Ultrasound of tendons and nerves.

Tendons and nerves represent probably one of the best application of musculoskeletal US due to the high lesion detection rate and accuracy of US combined with its low cost, wide availability, and ease of use. The refinement of high-frequency broadband linear-array transducers, and sensitive color and power Doppler technology, have improved the ability of US to detect fine textural abnormalities of these structures as well as to identify a variety of pathological conditions. Characteristic echotextural patterns, closely resembling the histological ones, are typically depicted in these structures using high US frequencies.

Ultrasound of the elbow.

Ultrasonography (US) is an efficient alternative to magnetic resonance (MR) imaging for evaluation of soft tissues of the elbow. US is able to diagnose several abnormalities affecting tendons, muscles, ligaments and bursae around the elbow joint. In cubital tunnel syndrome, US identifies ulnar nerve abnormalities and extrinsic lesions that may cause nerve entrapment.