Prevalence of spondyloarthritis in inflammatory bowel disease according ASAS and ultrassonography and its correlation with plasma calprotectin.

BACKGROUND: Enteropathic spondyloarthritis is underdiagnosed and inflammatory biomarkers and ultrasonography (US) could be useful for screening inflammatory bowel disease (IBD) patients. The objective of this study was to evaluate the prevalence of spondyloarthritis (SpA) in IBD patients, according to the Assessment of SpondyloArthritis International Society (ASAS) criteria and the correlation of results of US of entheses and joints with plasma calprotectin levels. METHODS: This was an observational cross-sectional study. Patients from the IBD outpatient clinic of a reference center were evaluated according to ASAS criteria classification, results of US of entheses and joints, and inflammatory biomarker measurements (erythrocyte sedimentation rates, C-reactive protein levels, fecal and plasma calprotectin levels). A p value lower than 0.05 was considered significant. RESULTS: A total of 30.5% of the studied sample (n = 118) of patients with IBD presented at least one inflammatory musculoskeletal manifestation. The overall prevalence of enteropathic SpA was 13.55%, with 10.16% axial SpA and 4.23% peripheral SpA according to the ASAS criteria. A total of 42.1% of patients had an MASEI score greater than 18, 35.2% had synovitis, and 14.7% had tenosynovitis on US, increasing the frequency of diagnosis of enteropathic SpA to 22.8%. Plasma calprotectin levels were similar to those in healthy controls, and correlated only with the fecal calprotectin level (p 0.041). CONCLUSIONS: A total of 13.5% of patients met the criteria in accordance with the ASAS criteria for enteropathic SpA, which increased to 22.8% with the addition of US. The prevalence of enthesitis, synovitis and tenosynovitis by US of symptomatic joints and entheses were 42%, 35% and 14.7% respectively. Plasma calprotectin was correlated with fecal calprotectin but not with inflammatory biomarkers or US or ASAS criteria.

Prevalence of spondyloarthritis in inflammatory bowel disease according ASAS and ultrassonography and its correlation with plasma calprotectin

Abstract Background Enteropathic spondyloarthritis is underdiagnosed and inflammatory biomarkers and ultrasonography (US) could be useful for screening inflammatory bowel disease (IBD) patients. The objective of this study was to evaluate the prevalence of spondyloarthritis (SpA) in IBD patients, according to the Assessment of SpondyloArthritis International Society (ASAS) criteria and the correlation of results of US of entheses and joints with plasma calprotectin levels. Methods This was an observational cross-sectional study. Patients from the IBD outpatient clinic of a reference center were evaluated according to ASAS criteria classification, results of US of entheses and joints, and inflammatory biomarker measurements (erythrocyte sedimentation rates, C-reactive protein levels, fecal and plasma calprotectin levels). A p value lower than 0.05 was considered significant. Results A total of 30.5% of the studied sample (n = 118) of patients with IBD presented at least one inflammatory musculoskeletal manifestation. The overall prevalence of enteropathic SpA was 13.55%, with 10.16% axial SpA and 4.23% peripheral SpA according to the ASAS criteria. A total of 42.1% of patients had an MASEI score greater than 18, 35.2% had synovitis, and 14.7% had tenosynovitis on US, increasing the frequency of diagnosis of entero- pathic SpA to 22.8%. Plasma calprotectin levels were similar to those in healthy controls, and correlated only with the fecal calprotectin level (p 0.041). Conclusions A total of 13.5% of patients met the criteria in accordance with the ASAS criteria for enteropathic SpA, which increased to 22.8% with the addition of US. The prevalence of enthesitis, synovitis and tenosynovitis by US of symptomatic joints and entheses were 42%, 35% and 14.7% respectively. Plasma calprotectin was correlated with fecal calprotectin but not with inflammatory biomarkers or US or ASAS criteria.

Chronic Inflammatory Arthropathy Preceding Acute Systemic Manifestations of Sarcoidosis: A Possible Overlap of Idiopathic Juvenile Arthritis and Sarcoidosis.

Sarcoidosis is a multisystem disease with unknown etiology, marked by T lymphocytes and macrophages agglomeration, which leads to the formation of noncaseating granulomas in the affected tissues. We describe a case of a 40-year-old black patient referred to our service for evaluation of nephrolithiasis and persistent elevation of plasma creatinine. He reported important weight loss, fever episodes, and abdominal and low back intermittent pain in the past 6 months. The investigation revealed elevated serum calcium level, hepatosplenomegaly, retroperitoneal lymphadenopathy, anemia, thrombocytopenia, and nephrolithiasis. The initial diagnostic hypothesis was lymphoproliferative disease, but the laparoscopic propaedeutic showed multiple white lesions on the liver surface, which biopsy identified as noncaseating granulomas with asteroid corpuscles, suggestive of sarcoidosis. He was treated with corticosteroids with significant improvement in symptoms and in calcium and creatinine levels. Besides, the patient presented a long-term large joints arthropathy, especially on the knees (with bilateral prosthesis), wrists, and ankles, of unknown etiology. We discuss the systemic manifestations of sarcoidosis related to the reported case, as well as the possible overlapping of idiopathic juvenile arthritis with sarcoidosis.

Evaluation of the effectiveness of platelet-rich plasma in the bone consolidation of patients submitted to lumbar arthrodesis.

OBJECTIVE: To determine whether the use of autograft associated with platelet-rich plasma (PRP) increases bone healing in patients undergoing lumbar fusion. METHOD: This was a prospective, descriptive, and comparative study, which included 40 patients undergoing lumbar fusion, who were divided into two groups: group I, autograft only, and group II, autograft associated with PRP. After surgery, patients were followed-up on the first, third, and sixth month. The Molinari radiographic classification and Glassman tomographic classification were used as criteria to analyze the bone consolidation. RESULT: Comparing the group I with group II, according to the criteria of Molinari, bilateral fusion was observed in 27.5% of the patients in group I in the first month after surgery. In group II, the rate of bilateral fusion was 25.0% and 20% in the third and sixth months, respectively. The results of computed tomography scans performed at six months after surgery indicated, according to the criteria of Glassman, a rate of bilateral solid fusion of 15.0% and 10.0% in groups I and II, respectively. CONCLUSION: The use of PRP showed no significant difference in bone healing in cases of lumbar arthrodesis.

OBJETIVO: Analisar se o uso de enxerto autólogo associado a plasma rico em plaqueta (PRP) aumenta a consolidação óssea em pacientes submetidos à artrodese lombar. MÉTODO: Estudo prospectivo, de caráter descritivo e comparativo, com 40 pacientes submetidos à artrodese lombar, que foram divididos em dois grupos: grupo I, somente enxerto autólogo, e grupo II, enxerto autólogo associado a PRP. Após o procedimento cirúrgico, o acompanhamento foi feito no primeiro, terceiro e sexto mês. Os critérios de classificação radiográfica de Molinari e tomográfica de Glassman foram usados como padrão para analisar a consolidação. RESULTADO: Na comparação do grupo I com o grupo II no primeiro mês de pós-operatório, de acordo com os critérios de Molinari, 27,5% dos pacientes apresentaram fusão bilateral no grupo I. No terceiro e sexto mês, observou-se uma taxa de fusão bilateral de 25% e 20% para o grupo II. O resultado das tomografias feitas no sexto mês de pós-operatório indicou, de acordo com os critérios de Glassman, uma taxa de fusão sólida bilateral de 15% e 10% nos grupos I e II, respectivamente. CONCLUSÃO: Observou-se que o uso do PRP não apresentou diferença significativa na consolidação óssea nas artrodeses lombares.

Evaluation of the effectiveness of platelet-rich plasma in the bone consolidation of patients submitted to lumbar arthrodesis / Avaliação da eficácia do plasma rico em plaquetas na consolidação óssea de pacientes submetidos a artrodese lombar

ABSTRACT OBJECTIVE: To determine whether the use of autograft associated with platelet-rich plasma (PRP) increases bone healing in patients undergoing lumbar fusion. METHOD: This was a prospective, descriptive, and comparative study, which included 40 patients undergoing lumbar fusion, who were divided into two groups: group I, autograft only, and group II, autograft associated with PRP. After surgery, patients were followed-up on the first, third, and sixth month. The Molinari radiographic classification and Glassman tomographic classification were used as criteria to analyze the bone consolidation. RESULT: Comparing the group I with group II, according to the criteria of Molinari, bilateral fusion was observed in 27.5% of the patients in group I in the first month after surgery. In group II, the rate of bilateral fusion was 25.0% and 20% in the third and sixth months, respectively. The results of computed tomography scans performed at six months after surgery indicated, according to the criteria of Glassman, a rate of bilateral solid fusion of 15.0% and 10.0% in groups I and II, respectively. CONCLUSION: The use of PRP showed no significant difference in bone healing in cases of lumbar arthrodesis.

RESUMO OBJETIVO: Analisar se o uso de enxerto autólogo associado a plasma rico em plaqueta (PRP) aumenta a consolidação óssea em pacientes submetidos à artrodese lombar. MÉTODO: Estudo prospectivo, de caráter descritivo e comparativo, com 40 pacientes submetidos à artrodese lombar, que foram divididos em dois grupos: grupo I, somente enxerto autólogo, e grupo II, enxerto autólogo associado a PRP. Após o procedimento cirúrgico, o acompanhamento foi feito no primeiro, terceiro e sexto mês. Os critérios de classificação radiográfica de Molinari e tomográfica de Glassman foram usados como padrão para analisar a consolidação. RESULTADO: Na comparação do grupo I com o grupo II no primeiro mês de pós-operatório, de acordo com os critérios de Molinari, 27,5% dos pacientes apresentaram fusão bilateral no grupo I. No terceiro e sexto mês, observou-se uma taxa de fusão bilateral de 25% e 20% para o grupo II. O resultado das tomografias feitas no sexto mês de pós-operatório indicou, de acordo com os critérios de Glassman, uma taxa de fusão sólida bilateral de 15% e 10% nos grupos I e II, respectivamente. CONCLUSÃO: Observou-se que o uso do PRP não apresentou diferença significativa na consolidação óssea nas artrodeses lombares.

Discordance between clinical and imaging criteria: assessment by magnetic resonance imaging of the foot of patients with rheumatoid arthritis.

Evaluation of the correlation between disease activity and joint involvement was assessed by MRI in the clinically dominant foot of patients with RA. We conducted a cross-sectional descriptive study of 55 patients with RA, who were subjected to clinical evaluation and MRI assessment. Imaging of the clinically dominant foot was performed, and both the Disease Activity Score 28 (DAS28-CRP) and the Health Assessment Questionnaire-Disability Index (HAQ-DI) were measured. The majority of patients classified as in clinical remission presented some degree of inflammatory activity upon MRI evaluation. Statistical analysis demonstrated no correlation between MRI findings and clinical scores. There is evidence of disease activity on MRI of the clinically dominant foot even in patients classified as in clinical remission according to the DAS28-CRP criteria.

Survival score scales of patients operated with spinal metastases: retrospective application in a Brazilian population / Escalas de prognóstico em pacientes operados com metástases vertebrais: aplicação retrospectiva em população brasileira

ABSTRACT Spinal cord epidural metastasis (SEM) is a common complication of systemic cancer. Predicting these patient’s survival is a key factor to select the proper treatment modality, but the three most used score scales to predict their survival (Tokuhashi revised score, Tomita score and Bauer modified score) were designed in single institutions and their reliability to predict correctly the patient’s survival were first tested only in those specific populations. This prognostication issue is addressed in this article, evaluating retrospectively the survival of 17 patients with SEM from a Brazilian general hospital with these score scales. Our results show that the actual survival of those patients were worse than the predicted of all three score scales, suggesting that differences between the different populations might have affected their reliability and alert that their usage as a major factor to select the most appropriate treatment have to be done with caution.

RESUMO Metástases vertebrais são uma complicação comum em pacientes com câncer sistêmico. Avaliar o prognóstico e a sobrevida desses pacientes é um fator de grande importância para escolher o tratamento mais adequado, porém as três escalas mais usadas atualmente para prever a sobrevida deles (Tokuhashi revisada, Tomita e Bauer modificada) foram desenhadas em instituições isoladas, e sua habilidade em estimar corretamente a sobrevida desses pacientes foram testadas primeiramente apenas nessas populações específicas. Essa questão de estimar o prognóstico é abordada nesse artigo, analisando retrospectivamente a sobrevida de 17 pacientes com metástase vertebral provenientes de um hospital geral no Brasil com essas escalas. Nossos resultados apontam que a sobrevida real desses pacientes foi menor que a prevista pelas três escalas, sugerindo que as diferenças entres as diferentes populações podem ter afetado a aplicabilidade delas. Assim, alertamos que o uso dessas escalas em populações diferentes das estudadas originalmente deve ser feito com cuidado.

Survival score scales of patients operated with spinal metastases: retrospective application in a Brazilian population.

Spinal cord epidural metastasis (SEM) is a common complication of systemic cancer. Predicting these patient's survival is a key factor to select the proper treatment modality, but the three most used score scales to predict their survival (Tokuhashi revised score, Tomita score and Bauer modified score) were designed in single institutions and their reliability to predict correctly the patient's survival were first tested only in those specific populations. This prognostication issue is addressed in this article, evaluating retrospectively the survival of 17 patients with SEM from a Brazilian general hospital with these score scales. Our results show that the actual survival of those patients were worse than the predicted of all three score scales, suggesting that differences between the different populations might have affected their reliability and alert that their usage as a major factor to select the most appropriate treatment have to be done with caution.

Bone mineral density evaluation among patients with neuromuscular scoliosis secondary to cerebral palsy.

OBJECTIVE: To evaluate bone mineral density among patients with neuromuscular scoliosis secondary to quadriplegic cerebral palsy. METHODS: This was a descriptive prospective study in which both bone densitometric and anthropometric data were evaluated. The inclusion criteria used were that the patients should present quadriplegic cerebral palsy, be confined to a wheelchair, be between 10 and 20 years of age and present neuromuscular scoliosis. RESULTS: We evaluated 31 patients (20 females) with a mean age of 14.2 years. Their mean biceps circumference, calf circumference and body mass index were 19.4 cm, 18.6 cm and 16.9 kg/m(2), respectively. The mean standard deviation from bone densitometry was -3.2 (z-score), which characterizes osteoporosis. CONCLUSION: There is high incidence of osteoporosis in patients with neuromuscular scoliosis secondary to quadriplegic cerebral palsy.

OBJETIVO: avaliar a densidade mineral óssea em pacientes portadores de escoliose neuromuscular secundária à paralisia cerebral tetraespástica. MÉTODOS: estudo prospectivo, descritivo, em que se avaliaram, além da densitometria óssea, dados antropométricos. Como critério de inclusão, adotamos pacientes com paralisia cerebral tetraespástica, cadeirantes, entre 10 e 20 anos e com escoliose neuromuscular. RESULTADOS: avaliamos 31 pacientes, 20 do sexo feminino, cuja média de idade foi de 14,2 anos. A média da circunferência bicipital, da panturrilha e do IMC foi de 19,4 cm, 18,6 cm e 16,9 Kg/m2, respectivamente. O desvio padrão médio encontrado na densitometria óssea foi de ­3,2 (z-score), o que caracteriza osteoporose. CONCLUSÃO: existe elevada incidência de osteoporose em pacientes portadores de escoliose neuromuscular secundária à paralisia cerebral tetraespástica.

Bone mineral density evaluation among patients with neuromuscular scoliosis secondary to cerebral palsy / Avaliação da densidade mineral óssea em pacientes portadores de escoliose neuromuscular secundária a paralisia cerebral

To evaluate bone mineral density among patients with neuromuscular scoliosis secondary to quadriplegic cerebral palsy. METHODS: This was a descriptive prospective study in which both bone densitometric and anthropometric data were evaluated. The inclusion criteria used were that the patients should present quadriplegic cerebral palsy, be confined to a wheelchair, be between 10 and 20 years of age and present neuromuscular scoliosis. RESULTS: We evaluated 31 patients (20 females) with a mean age of 14.2 years. Their mean biceps circumference, calf circumference and body mass index were 19.4 cm, 18.6 cm and 16.9 kg/m2, respectively. The mean standard deviation from bone densitometry was -3.2 (z-score), which characterizes osteoporosis. CONCLUSION: There is high incidence of osteoporosis in patients with neuromuscular scoliosis secondary to quadriplegic cerebral palsy...

Avaliar a densidade mineral óssea em pacientes portadores de escoliose neuromuscular secundária à paralisia cerebral tetraespástica. MÉTODOS: estudo prospectivo, descritivo, em que se avaliaram, além da densitometria óssea, dados antropométricos. Como critério de inclusão, adotamos pacientes com paralisia cerebral tetraespástica, cadeirantes, entre 10 e 20 anos e com escoliose neuromuscular. RESULTADOS: avaliamos 31 pacientes, 20 do sexo feminino, cuja média de idade foi de 14,2 anos. A média da circunferência bicipital, da panturrilha e do IMC foi de 19,4 cm, 18,6 cm e 16,9 Kg/m2, respectivamente. O desvio padrão médio encontrado na densitometria óssea foi de -3,2 (z-score), o que caracteriza osteoporose. CONCLUSÃO: existe elevada incidência de osteoporose em pacientes portadores de escoliose neuromuscular secundária à paralisia cerebral tetraespástica...

Skeletal muscle abnormalities in pulmonary arterial hypertension.

BACKGROUND: Pulmonary arterial hypertension is a progressive disease that is characterized by dyspnea and exercise intolerance. Impairment in skeletal muscle has recently been described in PAH, although the degree to which this impairment is solely determined by the hemodynamic profile remains uncertain. The aim of this study was to verify the association of structural and functional skeletal muscle characteristics with maximum exercise in PAH. METHODS: The exercise capacity, body composition, CT area of limb muscle, quality of life, quadriceps biopsy and hemodynamics of 16 PAH patients were compared with those of 10 controls. RESULTS: PAH patients had a significantly poorer quality of life, reduced percentage of lean body mass, reduced respiratory muscle strength, reduced resistance and strength of quadriceps and increased functional limitation at 6MWT and CPET. VO2 max was correlated with muscular variables and cardiac output. Bivariate linear regression models showed that the association between muscular structural and functional variables remained significant even after correcting for cardiac output. CONCLUSION: Our study showed the coexistence of ventilatory and quadriceps weakness in face of exercise intolerance in the same group of PAH patients. More interestingly, it is the first time that the independent association between muscular pattern and maximum exercise capacity is evidenced in PAH, independently of cardiac index highlighting the importance of considering rehabilitation in the treatment strategy for PAH.

Análise comparativa da avaliação da lordose lombar aferida na radiografia em ortostase e na ressonância magnética / Comparative analysis of assessment in computed radiography lumbar lordosis measuredn while standing and magnetic resonance imaging

Objetivo: Comparar os ângulos encontrados na radiografia em ortostase e na ressonância magnética (RM) em decúbito dorsal com coxim sobre os membros inferiores. Métodos: Estudo prospectivo, de caráter descritivo, no qual se avaliou uma amostra de 100 pacientes, sendo 51 do sexo masculino, em que o grau de lordose lombar foi aferido por três examinadores independentes por meio da radiografia em ortostase e da RM em decúbito, com coxim, nos níveis de L1 a L5, de acordo com o método de Cobb. Resultados: A média dos valores encontrados na radiografia e na RM com coxim de L1 a L5 foi de 42,2º e 31,5º, respectivamente (p < 0,001), demonstrando que a angulação da lordose lombar aferida na RM subdimensiona a verdadeira angulação em 25%. Conclusão: A RM é insuficiente para a avaliação da lordose lombar, sendo de extrema importância a avaliação radiológica para avaliar a verdadeira angulação da lordose lombar.

Objective: To compare the angles found in radiography and magnetic resonance imaging (MRI) orthostatic supine with a pad on the lower limbs. Methods: Measurement of lumbar lordosis angles from 100 patients referred to MRI and computed radiography studies, using Cobb?s method (with L1and L5 plateaus as reference). Measurements were done by three independent observers with different skills, and interobserver agreement was evaluated. The lumbar lordosis angle obtained in computedradiography and MRI were compared using statistical analysis with paired t-test. Results: The mean lordosis angles measured in computed radiography and MRI were respectively 42.2º and 31.5º (p < 0.001). Conclusion: There was good interobserver agreement. There was a statistically significantdifference between the angles of lumbar lordosis in computed radiography and MRI. The data suggest that MRI is not reliable in the evaluation of the lumbar lordosis when used alone.

Carcinoma verrucoso da mão: uma rara apresentação avaliada por ressonância magnética / Verrucous carcinoma of the hand: a rare presentation evaluated by magnetic resonance imaging

O carcinoma verrucoso é uma variante do carcinoma de células escamosas, vista em mucosas e pele, raramente encontrada na mão. Nós relatamos um caso de duas lesões no dorso da mão, sem contato entre si, que foram ressecadas em bloco e confirmadas como carcinoma verrucoso.

Verrucous carcinoma is a variant of squamous cell carcinoma seen in mucous membranes and skin, and rarely found in the hand. The present report describes a case of two lesions on the dorsum of the hand, with no contact to each other, which underwent en-block resection and were confirmed as verrucous carcinoma.

Perforated diverticulitis of the appendix: ultrasonographic diagnosis / Diverticulite perfurada do apêndice cecal: diagnóstico ultrassonográfico

Appendiceal diverticulitis is an uncommon condition, mimicking appendicitis, but with greater risk of perforation and complications. Preoperative diagnosis is rare, but can be achieved by ultrasonography as identification of the diverticulum and classical signs of appendicitis. We report a case of ultrasonographic diagnosis of a perforated appendiceal diverticulitis in an adult male and discuss this condition.

A diverticulite do apêndice é uma patologia incomum, eventualmente confundida com a apendicite cecal, tendo, porém, maior risco de perfuração e de outras complicações. Seu diagnóstico pré-cirúrgico é raramente realizado, mas pode ser obtido pela ultrassonografia com a demonstração de um divertículo associado a sinais clássicos de apendicite. Relatamos o caso de um homem adulto em que foi possível o diagnóstico ultrassonográfico de diverticulite do apêndice cecal e revisamos os principais aspectos relacionados a essa condição.

Perforated diverticulitis of the appendix: ultrasonographic diagnosis.

Appendiceal diverticulitis is an uncommon condition, mimicking appendicitis, but with greater risk of perforation and complications. Preoperative diagnosis is rare, but can be achieved by ultrasonography as identification of the diverticulum and classical signs of appendicitis. We report a case of ultrasonographic diagnosis of a perforated appendiceal diverticulitis in an adult male and discuss this condition.

Preaortic iliac confluence (marsupial vena cava): report of 4 cases.

Congenital anomalies of the inferior vena cava (IVC) can represent a difficult for abdominal surgeries, and the radiologist must be aware even of the less common of these anatomical variations. Preaortic iliac venous confluence, also known as marsupial vena cava, is a rare congenital anomaly of the development of the IVC in which the IVC or the left common iliac vein is located anterior to the aortic bifurcation or the right common iliac artery. We report 4 cases of marsupial vena cava detected on multidetector computed tomography examinations in asymptomatic patients and discuss that this congenital anomaly can be recognized more frequently with the use of this new technique based on thinner images.

Ultrassonografia na avaliação das afeccões agudas do sistema músculo-esquelético: parte II: afecções traumáticas e procedimentos guiados por ultrassom / Ultrasonographic assessment of acute musculoskeletal diseases: part II: traumatic lesions and ultrasound-guided interventions

A ultrassonografia é um método eficaz na avaliação de afecções agudas acometendo o sistema músculo-esquelético, constituindo importante arma propedêutica nos serviços de atendimento de urgência. O ultrassom permite a avaliação de lesões de origem traumática acometendo uma variedadede estruturas de partes moles (por exemplo: músculos, tendões e ligamentos), bem como a caracterização de fraturas ocultas e corpos estranhos. Permite ainda a orientação de procedimentos intervencionistas diagnósticos ou terapêuticos. Será apresentada uma breve revisão dasprincipais indicações do exame ultrassonográfico no contexto das urgências, ilustrada com casos típicos provenientes de arquivo digital, sendo discutidos os achados fundamentais para a caracterização e o diagnóstico das afecções traumáticas mais frequentes, além das principais indicações de procedimentos intervencionistas guiados por ultrassom. Todos os casos apresentados procuraramo serviço de pronto-atendimento do nosso hospital, devido a queixas agudas relacionadas ao sistema músculo-esquelético.

Ultrasonography is accurate in the evaluation of acute musculoskeletalinjuries, and became an important diagnostic method in the urgency department. Sonography allows evaluation of diverse traumatic lesions, as muscle, tendon, ligament and pulley lesions. Ultrasonography also allows evaluation of occult fractures andforeign body. Finally, ultrasonography also can guide diagnostic or therapeutic interventional procedures. This article review the role of ultrasonographic assessment in the acute musculoskeletalsetting, illustrated with cases from soft copy archives, discussing the main aspects of the most common musculoskeletal complains in the urgency department.

Ultra-sonografia na avaliação das afeccões agudas do sistema músculo-esquelético: parte I: afecções não-traumáticas / Ultrasonographic assessment of acute musculoskeletal diseases: part I: non-traumatic lesions

A ultra-sonografia é um método eficaz na avaliação de afecções agudas acometendo o sistema músculo-esquelético, constituindo importante arma propedêutica nos serviços de atendimento de urgência. O ultra-som permite a avaliação de ampla variedade de lesões de origem não-traumática,tais como lesões infecciosas articulares ou extra-articulares, e a avaliação de lesões não-infecciosas, tais como doenças bursais e tendíneas agudas ou agudizadas. Será apresentada breve revisão das principais indicações do exame ultra-sonográfico, ilustrada com casos típicos provenientes de arquivo digital, sendo discutidos os achados fundamentais para a caracterização e o diagnóstico das afecções não-traumáticas mais freqüentes. Todos os casos apresentados procuraram o serviço de pronto-atendimento do nosso hospital devido a queixas agudas relacionadas ao sistema músculo-esquelético.

Ultrasonography is accurate in the evaluation of acute musculoskeletal injuries and became an important diagnostic method in the urgency department. Ultrasonography allows evaluation of diverse non-traumatic lesions, as infectious articular or extra-articular lesions, and non-infectious diseases, as acute tendon or bursaldiseases. This article review the role of sonographic assessment in the acute musculoskeletal setting, illustrated with cases from soft copy archives, discussing the main aspects of the mostcommon musculoskeletal complains in the urgency department.