A semiautomatic method for in vivo three-dimensional quantitative analysis of fascial layers mobility based on 3D ultrasound scans.

PURPOSE: Recently, there has been an increasing interest in the role of deep fascia mobility in musculoskeletal dynamics and chronic pain mechanisms; however, no strategies have been presented so far to study in vivo fascial motion in 3D. This paper presents a semiautomatic method, based on ultrasound (US) imaging, enabling a 3D evaluation of fascia mobility. METHODS: The proposed approach relies on the acquisition of 3D US datasets at rest and during a voluntary muscular contraction and consists of two phases: 3D US dataset analysis and generation of a displacement vector field using a block matching technique (Phase 1) and validation and filtering of the resulting displacement vector field for outliers removal (Phase 2). The accuracy and effectiveness of the proposed method were preliminarily tested on different 3D US datasets, undergoing either simulated (procedural) or real (muscular contraction) deformations. RESULTS: As for the simulated deformation, estimated displacement vectors resulting from Phase 1 presented a mean magnitude percentage error of 8.05 % and a mean angular error of 4.78° which, after Phase 2, were reduced by 69.44 and by 83.05 %, respectively. Tests on real deformations further validated the effectiveness of Phase 2 in the removal of outliers from the displacement vector field. CONCLUSIONS: Obtained results preliminarily demonstrate the viability of the proposed algorithm for the analysis of fascia mobility. Such analysis can enable clinicians to better understand the fascia role in musculoskeletal dynamics and disorder. Further experiments are needed to optimize the method in consideration of the anatomical region to be studied.

Comparative ultrasonographic evaluation of the Achilles paratenon in symptomatic and asymptomatic subjects: an imaging study.

Achilles tendon analysis represents one of the most frequently requested ultrasonographic evaluations, due to the high incidence of tendinopathy. Various authors have described inflammatory features of the paratenon recruited 22 subjects complaining of pain in the mid-portion of the Achilles tendon and 22 healthy subjects. Both groups underwent ultrasonographic examination and Victorian Institute of Sport Assessment-Achilles questionnaire administration. It was found statistically significant inter-group differences of the paratenon (p = 0.0001) as well as tendon thickness (p < 0.0001). Our results show that Achilles symptoms could also be associated with an increase in the paratenon thickness. We suggest that clinicians should carefully analyze paratenon thickness when evaluating patients with Achillodynia using ultrasound. It may be that the paratenon, when thickened, may explain some of the painful symptoms reported by patients and it is associated with a tendinopathy process, hence we suggest careful analysis in patients with Achillodynia.

[Up-to-date computed tomographic findings on the para- and perirenal spaces under normal and pathologic conditions]. / Moderne acquisizioni tomodensitometriche sugli spazi para- e perirenali in condizioni normali e patologiche.

The anatomy of the peri- and pararenal spaces was critically reviewed, supported by high-definition CT images. In the past, CT did not allow the visualization of such structures as the perirenal septa. Nowadays, on the contrary, such anatomical structures can be demonstrated, which allows their involvement to be monitored in pathologic conditions. The perirenal septa appear thus to prevent fluid collections from spreading, while they seem to be the preferential pathways for the diffusion of malignant lesions.

Ankylosing spondylitis with predominant involvement of the cervical spine in a woman with Behçet's syndrome.

The case of a 45 year old woman affected by both Behçet's syndrome (BS) and ankylosing spondylitis (AS) is reported. Cervical spine involvement was observed long before the appearance of the sacroiliac and lumbar changes.

[Imaging of enthesopathies of the ligamentum patellae in athletes. Echography and computerized telethermography]. / Imaging delle entesopatie del "ligamentum patellae" negli atleti. Ecografia e teletermografia computerizzata.

The authors examine the diagnostic value of two non-invasive techniques--i.e. ultrasound and computerized teletermography--in the diagnosis of patellar enthesopathies. Such a pathology is quite frequent in young athletes, at various stages. The patients were grouped in two categories, according to their age when the trauma occurred, and to the peculiarities of both enthesopathic localization and imaging. The use of both techniques, either one prevailing over the other according to the different evolutive phases of enthesopathies, provides useful information as to detecting and determining the disease. Finally, the authors recommend a combined use of these techniques, especially in young athletes, possibly avoiding conventional X-rays.

[Computerized tomography in the diagnosis of abscesses of the posterior pararenal space secondary to surgical interventions on the abdomen]. / La tomografia computerizzata nella diagnosi degli ascessi dello spazio pararenale posteriore secondari ad interventi chirurgici sull'addome.

The authors analyse the possibilities offered by CT in the diagnosis of the abscesses of the posterior pararenal space (secondary to surgical operation) relating 10 cases observed. The features described by many authors in the latest literature are compared with those observed in the cases reported, showing the real diagnostic sensibility of CT in these situations of relative urgency. The panoramic image offered by CT is particularly useful in the "blind " examinations and in exactly directing the surgical approach or, in alternative, the echo-guided percutaneous puncture of the abscess.

[Role of computerized tomography in the diagnosis of adipose neoformations of the chest and abdomen]. / Il ruolo della tomografia computerizzata nella diagnosi delle neoformazioni adipose del torace e dell'addome.

The diagnostic accuracy of computed tomography (CT) in several patterns of thoracic and abdominal fatty masses, has been examined. In selected cases our findings overlap the features of the recent literature. The possibility of surgical therapy in peculiar cases of adipose deposits, commonly esteemed benign, is considered.

[Usefulness of CT in the evaluation of hematoma of the iliopsoas muscle in hemophiliacs]. / Utilità della TC nella valutazione degli ematomi del muscolo ileopsoas negli emofilici.

Four iliopsoas hematomas in hemophiliacs are reported, evaluating the diagnostic role of CT. The specificity of the method is stressed in showing the morphological and densitometric patterns, which allow to localize the hematoma, to state the originating structures, and to follow its evolution. Comparing the obtained results to those found in literature, the authors suggest the use of CT in any hemophiliac in which a retroperitoneal hematoma is suspected.