ABSTRACT
Musculoskeletal ultrasound has a rich history originally rooted in nautical technology. In recent years, it has proliferated significantly for both diagnostic and interventional purposes in the point-of-care clinical setting by nonradiologist musculoskeletal clinicians. This article outlines the history of musculoskeletal ultrasound, examines present developments, and discusses its future outlook.
Subject(s)
Musculoskeletal System/diagnostic imaging , Ultrasonography/history , History, 20th Century , History, 21st Century , Humans , Ultrasonography/trendsABSTRACT
INTRODUCTION: The purpose of this study was to develop an evidence-based guideline for the use of neuromuscular ultrasound in the diagnosis of carpal tunnel syndrome (CTS). METHODS: Two questions were asked: (1) What is the accuracy of median nerve cross-sectional area enlargement as measured with ultrasound for the diagnosis of CTS? (2) What added value, if any, does neuromuscular ultrasound provide over electrodiagnostic studies alone for the diagnosis of CTS? A systematic review was performed, and studies were classified according to American Academy of Neurology criteria for rating articles of diagnostic accuracy (question 1) and for screening articles (question 2). RESULTS: Neuromuscular ultrasound measurement of median nerve cross-sectional area at the wrist is accurate and may be offered as a diagnostic test for CTS (Level A). Neuromuscular ultrasound probably adds value to electrodiagnostic studies when diagnosing CTS and should be considered in screening for structural abnormalities at the wrist in those with CTS (Level B).
Subject(s)
Carpal Tunnel Syndrome/diagnosis , Median Nerve/diagnostic imaging , Muscle, Skeletal/diagnostic imaging , Carpal Tunnel Syndrome/diagnostic imaging , Evidence-Based Medicine , Humans , Neural Conduction/physiology , Ultrasonography , Wrist/diagnostic imaging , Wrist/innervationSubject(s)
Electrodiagnosis/standards , Neuromuscular Diseases/diagnostic imaging , Neuromuscular Diseases/diagnosis , Neurophysiology/standards , Physicians/standards , Ultrasonography/standards , Carpal Tunnel Syndrome/diagnosis , Education, Medical, Continuing , Humans , Neurophysiology/educationABSTRACT
Physiatrists are sensitive to the importance of using a diagnostic test as an extension of the clinical examination. Training in electrodiagnostic testing provides an excellent base to learn about integrating ultrasound into one's practice. Given their education in the diagnosis and treatment of neuromusculoskeletal disorders and injuries, with an emphasis on quality of life and functional gains, ultrasound can help physiatrists design the most efficacious and accurate treatment plan. This ultimately provides for adequate patient access and improved outcomes.
