RESUMEN
PURPOSE: Rupture of the distal triceps tendon is an uncommon injury that may be unrecognized on clinical examination. The purpose of the study is to describe the role of US in distal triceps tendon tears evaluation. MATERIALS AND METHODS: IRB approval was obtained and patients gave written informed consent. Of 77 consecutive US examinations of the elbow obtained over a five-year period, eight patients with correlative MR and surgery available were identified having partial or complete distal triceps tendon tear. RESULTS: N = 4 complete tears of the triceps tendon and n = 4 partial tears of the distal triceps involving the lateral/superficial head were identified. Patients with partial tear had a history of a single traumatic event that determined a sudden eccentric contraction of the triceps muscle against resistance. US demonstrated on axial and longitudinal planes a partial tear of the triceps brachii tendon that resulted in a fusiform swelling and retraction of the lateral/superficial head in four patients. It was possible to identify the normal insertion of the medial head of the triceps moving the transducer medially. MR and surgical findings were concordant with US findings in every patient. CONCLUSION: Ultrasound is able to differentiate complete from partial triceps tendon tears. US has the potential to identify isolated lesions of the lateral/superficial head of the triceps with an intact medial head.
Asunto(s)
Lesiones de Codo , Codo/diagnóstico por imagen , Traumatismos de los Tendones/diagnóstico por imagen , Adolescente , Adulto , Anciano , Diagnóstico Diferencial , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , UltrasonografíaRESUMEN
In newborns, US has an established role in the detection and management of developmental dysplasia of the hip. Later in childhood, when the limping child is a major diagnostic dilemma, US is extremely helpful in the identification of the varied disease processes underlying this condition, as transient synovitis, septic arthritis, Perthes disease and slipped femoral capital epiphysis. In adolescent practicing sporting activities, US is an excellent means to identify apophyseal injures about the pelvic ring, especially when avulsions are undisplaced and difficult-to-see radiographically. Later on, in the adulthood, US is an effective modality to diagnose tendon and muscle injuries about the hip and pelvis, identify effusion or synovitis within the hip joint or its adjacent bursae and guide the treatment of these findings. The aim of this article is to provide a comprehensive review of the most common pathologic conditions about the hip, in which the contribution of US is relevant for the diagnostic work-up.
Asunto(s)
Lesiones de la Cadera/diagnóstico por imagen , Articulación de la Cadera/diagnóstico por imagen , Cadera/diagnóstico por imagen , Artropatías/diagnóstico por imagen , Ultrasonografía/métodos , HumanosRESUMEN
Ultrasound (US) and MR imaging have been shown able to detect in-depth features of brachial plexus anatomy and to localize pathological lesions in disorders where electrophysiology and physical findings are nonspecific or nonlocalizing. High-end gradient technology, phased array coils, and selection of an appropriate protocol of pulse sequences are the main requirements to evaluate the brachial plexus nerves with MR imaging and to distinguish between intrinsic and extrinsic pathological changes. A careful scanning technique based on anatomical landmarks is required to image the brachial plexus nerves with US. In traumatic injuries, MR imaging and myelographic techniques can exclude nerve lesions at the level of neural foramina and at intradural location. Outside the spinal canal, US is an excellent alternative to MR imaging to determine the presence of a lesion, to establish the site and the level of nerve involvement, as well as to confirm or exclude major nerve injuries. In addition to brachial plexus injuries, MR imaging and US can be contributory in a variety of nontraumatic brachial plexopathies of a compressive, neoplastic, and inflammatory nature. In the thoracic outlet syndrome, imaging performed in association with postural maneuvers can help diagnose dynamic compressions. MR imaging and US are also effective to recognize neuropathies about the shoulder girdle involving the suprascapular, axillary, long thoracic, and spinal accessory nerves that may mimic brachial plexopathy. In this article, the clinical entities just listed are discussed independently, providing an overview of the current status of knowledge regarding imaging assessment.
Asunto(s)
Neuropatías del Plexo Braquial/diagnóstico por imagen , Neuropatías del Plexo Braquial/patología , Plexo Braquial/diagnóstico por imagen , Plexo Braquial/patología , Articulación del Hombro/diagnóstico por imagen , Articulación del Hombro/patología , Neuritis del Plexo Braquial/diagnóstico por imagen , Neuritis del Plexo Braquial/patología , Medios de Contraste , Imagen Eco-Planar/métodos , Gadolinio , Humanos , Aumento de la Imagen/métodos , Imagenología Tridimensional/métodos , Imagen por Resonancia Magnética/métodos , Hombro/diagnóstico por imagen , Hombro/inervación , Hombro/patología , Articulación del Hombro/inervación , Síndrome del Desfiladero Torácico/diagnóstico por imagen , Síndrome del Desfiladero Torácico/patología , UltrasonografíaRESUMEN
Specific ultrasound (US)-guided interventional procedures on peripheral nerves are reviewed in this article including regional anesthesia, biopsy of neural lesions, and some injection therapies. For these procedures, US is the best modality to provide a safe imaging guidance because of its excellent spatial resolution and real-time capabilities. With US guidance, the radiologist can visualize the needle tip continuously and ensure that the needle is placed precisely in the desired location, avoiding the risk of inadvertent nerve damage. Practical tips and tricks for US-guided needle placement, biopsy of neural lesions, and US-guided therapy are reviewed in this article. The use of US-guided injections in specific clinical settings, such as the percutaneous treatment of carpal tunnel syndrome, Morton's and saphenous neuromas, painful stump neuromas, piriformis syndrome, and meralgia paresthetica are also illustrated here. US allows the clinician to inject drugs with little or no patient discomfort.