Sonographic evaluation of the extensor carpi ulnaris in asymptomatic tennis players.

Objective: To determine the prevalence of structural abnormalities and instability affecting the extensor carpi ulnaris (ECU) tendons of asymptomatic recreational tennis players by the use of high-resolution ultrasonography.

Design: Cross-sectional observational study.

Setting: Academic sports medicine center.

Enthesopathy of the lateral cord of the plantar fascia.

The objective of this study was to raise awareness of the diagnosis of enthesopathy of the lateral cord of the plantar fascia (LCPF) and describe its sonographic findings. We conducted a retrospective case series of 13 sonographic examinations with the diagnosis of LCPF enthesopathy. Two cadaver dissections of the plantar foot were performed for anatomic correlation.

Sonographically guided distal biceps tendon injections: techniques and validation.

Objectives: The primary purpose of this investigation was to describe and validate sonographically guided techniques for distal biceps peritendinous/intratendinous injections using a cadaveric model.

Methods: A single experienced operator completed 18 sonographically guided distal biceps peritendinous injections and 15 sonographically guided distal biceps intratendinous injections in 18 unembalmed cadaveric elbow specimens (11 male and 7 female; age, 53-100 years; body mass index, 19.4-42.

Combined flexor carpi radialis tear and flexor carpi radialis brevis tendinopathy identified by ultrasound: a case report.

A 63-year-old right-handed office worker presented with acute right wrist pain after lifting a heavy file at work. Results of a clinical examination suggested flexor carpi radialis tendinopathy. Diagnostic ultrasound (US) not only detected a complete flexor carpi radialis tear but also revealed the presence of a concomitant flexor carpi radialis brevis (FCRB) tendon with associated tenosynovitis.

Posttraumatic fat necrosis presenting as prepatellar loose bodies in an adolescent football player.

A 16-year-old high school football player presented with 4 months of anterior knee pain and small, mobile, prepatellar "lumps" after falling onto an opponent's cleat. He reported knee pain primarily during knee flexion and direct pressure during squatting and kneeling. Knee radiographs were unremarkable.

The source of fluid deep to the iliotibial band: documentation of a potential intra-articular source.

Objective: To determine whether there is a consistent extension of the lateral synovial recess under the iliotibial band (ITB) in an unembalmed cadaveric model.

Design: A prospective laboratory investigation.

Setting: A procedural skills laboratory of a tertiary medical center.

The role of exercise in the treatment of obesity.

The United States is in the midst of a significant public health problem that relates to obesity and inactivity. This epidemic has far-ranging consequences for our workforce and our children and shows no signs of slowing in the near future. Significant research has been performed on the effects of exercise for the reduction of body weight; results of most studies indicate that exercise alone has a small effect on body-weight reduction independent of caloric restriction.

Feasibility of first metatarsophalangeal joint injections for sesamoid disorders: a cadaveric investigation.

Objective: To determine whether accurately placed first metatarsophalangeal joint (MTPJ) injections consistently deliver injectate to the metatarsosesamoid articulations.

Design: Prospective anatomic cadaver study.

Setting: Procedural skills laboratory at a tertiary care academic institution.

Biomarkers, genetics, and risk factors for concussion.

It is estimated that between 1.6 and 3.8 million concussions occur annually in the United States.

Treatment of chronic tendinopathy with ultrasound-guided needle tenotomy and platelet-rich plasma injection.

Objective: To determine whether ultrasound (US)-guided percutaneous needle tenotomy followed by a platelet-rich plasma (PRP) injection would result in pain reduction, functional improvement, or structural alterations in patients with chronic, recalcitrant tendinopathy.

Design: Part A was a retrospective observational study. Part B was a prospective observational study.

Hip strength and knee pain in high school runners: a prospective study.

Objective: To determine whether pre-injury hip muscle weakness is associated with the development of patellofemoral pain (PFP) in high school running athletes.

Design: Prospective cohort study.

Setting: Academic institution sports medicine center.

The accuracy of ultrasound-guided and palpation-guided peroneal tendon sheath injections.

Objective: The aim of this study was to describe and to validate an ultrasound-guided peroneal tendon sheath (PTS) injection technique and to compare the accuracy of ultrasound-guided vs. palpation-guided PTS injections in a cadaveric model.

Design: Twenty cadaveric lower limbs were injected with and without ultrasound guidance, using a different color of liquid latex for each injection technique.

Accuracy of ultrasound-guided and palpation-guided knee injections by an experienced and less-experienced injector using a superolateral approach: a cadaveric study.

Objectives: To evaluate the accuracy of ultrasound (US)-guided and palpation-guided knee injections by an experienced and a less-experienced clinician with use of a superolateral approach.

Design: Single-blinded, prospective study.

Setting: Academic institution procedural skills laboratory.

Musculoskeletal complications of fluoroquinolones: guidelines and precautions for usage in the athletic population.

Fluoroquinolone antibiotics are associated with a wide spectrum of musculoskeletal complications that involve not only tendon but also cartilage, bone, and muscle. Insights into the pathoetiology of fluoroquinolone toxicity on musculoskeletal tissues have been evolving over recent years. Although the pathoetiology is certainly multifactorial, alterations in cell signaling proteins and direct toxic effects on musculoskeletal tissues have been strongly implicated.

Musculoskeletal ultrasound education for sports medicine fellows: a suggested/potential curriculum by the American Medical Society for Sports Medicine.

The following musculoskeletal ultrasound (MSK US) curriculum was developed by the American Medical Society for Sports Medicine (AMSSM) to provide a pathway by which a sports medicine fellow can obtain adequate MSK US training during their fellowship to meet the requirements of competency outlined by the American Institute of Ultrasound in Medicine (AIUM) Training Guidelines for the Performance of MSK US Examination. Many fellowship programmes may not be able to follow all of the recommendations outlined by this document owing to their available resources. However, this curriculum can be used as a suggested/potential guideline for MSK US training within a sports medicine fellowship, and may assist programmes in developing or modifying their own internal training methods.

Ultrasonography of the shoulder.

The shoulder is the most common region to be evaluated with musculoskeletal ultrasound. The shoulder's complex anatomy enables an exceptional range of mobility at the expense of static stability. Consequently, the shoulder is susceptible to a multitude of traumatic and atraumatic injuries.

Neuropathies in runners.

Nerve entrapment represents an uncommon but important cause of lower limb pain among runners. This article reviews the diagnosis and management of several nerve entrapment syndromes that may be encountered among runners, but clinicians must be aware that any peripheral nerve may be affected. Successful diagnosis and management are predicated on several underlying principles: (1) maintain a high index of suspicion for neurologic syndromes, (2) recognize common presentations of neuropathic pain, (3) perform a meticulous physical examination, including postexercise examination when necessary, (4) consider a broad differential diagnosis (neurologic and nonneurologic), (5) use diagnostic testing appropriately, and (6) make rational clinical decisions, including referral for second opinion when indicated.

Accuracy of ultrasound-guided versus unguided pes anserinus bursa injections.

Objective: To compare the accuracy of ultrasound (US)-guided versus unguided pes anserinus bursa injections in a cadaveric model.

Design: Single blind, prospective study.

Setting: Academic institution procedural skills laboratory.

Sonographic evaluation of the distal biceps tendon using a medial approach: the pronator window.

Objective: The purpose of this report is to describe and demonstrate the potential advantages of a technique to image the distal biceps tendon using a medial approach: the pronator window.

Methods: Distal biceps tendon imaging via the medial approach was shown using real-time sonography on an asymptomatic volunteer as well as cadaveric anatomic dissection.

Results: The medial approach images the biceps tendon with minimal anisotropy while providing several potential advantages, including (1) complete visualization of the ulnarly facing radial tuberosity and the tapered distal biceps insertion, (2) increased contrast and reduced beam attenuation at the interface between the biceps tendon and overlying brachial artery, and (3) avoidance of the beam-attenuating effects of the supinator encountered when imaging the tendon from a lateral approach.

Sonographically guided proximal tibiofibular joint injection: technique and accuracy.

Objective: The purpose of this investigation was to describe a technique for sonographically guided proximal tibiofibular joint (PTFJ) injections and compare its accuracy with that of palpation guided injections in a cadaveric model.

Methods: A single experienced operator completed 12 sonographically guided and 12 palpation guided PTFJ injections in unembalmed cadavers. The injection order was randomized, and all injections were completed with diluted colored latex.

Sonographically guided popliteus tendon sheath injection: techniques and accuracy.

Objective: The purpose of this investigation was to describe two sonographically guided popliteus tendon sheath injection techniques and determine their accuracy in a cadaveric model.

Methods: A single experienced operator completed 24 sonographically guided popliteus tendon sheath injections, 12 using a longitudinal approach and 12 using a transverse approach relative to the tendon. The injection order was randomized, and all injections were completed with diluted colored latex.