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2.
Diagn Interv Imaging ; 96(12): 1247-60, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26625731

RESUMO

Ultrasound is a useful tool to investigate soft tissue masses in the wrist and hand. In most situations ultrasound helps distinguish between a cyst and a tissue mass. This article provides a simple clinical approach to the use of ultrasound imaging for the diagnosis and preoperative assessment of wrist and hand masses.


Assuntos
Mãos , Neoplasias/diagnóstico por imagem , Idoso , Contratura de Dupuytren/diagnóstico por imagem , Humanos , Masculino , Ultrassonografia , Punho
3.
Diagn Interv Imaging ; 96(4): 349-56, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25680675

RESUMO

PURPOSE: Tears involving the myotendinous junction (MTJ) of the infraspinatus (IS) have been recently described on MRI. These occur centrally in the muscle belly, and are not associated with full thickness tears of the distal infraspinatus tendon. They also induce a rapidly progressive fatty infiltration of the muscles and amyotrophy. The purpose of this study is to assess the accuracy of ultrasonography in diagnosing MTJ tears of the infraspinatus and to describe the usual ultrasonographic appearance compared with MRI. MATERIALS AND METHODS: Retrospective study of 2403 US examinations of the shoulder (over 5 years). Fifteen patients with a reported suspicion of infraspinatus MTJ tears were included. MRI examination was available in all cases, CT arthrography in 13 cases, and one patient underwent surgical confirmation. RESULTS: All patients were sent for an ultrasound for suspect lesion of the tendons of the rotator cuff, with posterior pain in the infraspinatus fossa. All cases seen on ultrasonography were confirmed on MRI. CT arthrography confirmed the absence of tear of the IS tendon in all cases and did not reveal the MTJ tears. Two signs appeared to us as being of special interest: the "tadpole sign" on longitudinal views, and the "black eye sign" on sagittal views. The proximal retraction of the tendon at the MTJ is the anatomical explanation of both signs. CONCLUSION: Tears at the myotendinous junction of the infraspinatus are rare but can be diagnosed on US examination, provided that the sonographer pays attention to the infraspinatus fossa especially in cases of normality of the distal tendinous cuff.


Assuntos
Lesões do Manguito Rotador , Manguito Rotador/diagnóstico por imagem , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Manguito Rotador/patologia , Ultrassonografia
4.
Clin Radiol ; 68(3): 302-9, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22959171

RESUMO

Calcinosis is a typical feature of systemic sclerosis (SSc) and can be found in many different tissues including the superficial soft tissues, periarticular structures, muscles, and tendons. It can also provoke erosive changes on bones. Investigation is conducted most often with plain radiographs. However, when a more detailed assessment is necessary, multidetector computed tomography (MDCT) is helpful owing to its multiplanar reformat (MPR) ability. The purpose of this review is to provide an overview of the various appearances of calcinosis in SSc patients as visualized at MDCT.


Assuntos
Calcinose/diagnóstico por imagem , Tomografia Computadorizada Multidetectores/métodos , Escleroderma Sistêmico/diagnóstico por imagem , Humanos
5.
Diagn Interv Imaging ; 93(9): 674-79, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22853966

RESUMO

In the past, needle aspirations or injections involving the motor system were always carried out either blind or guided by fluoroscopy. Over the last few years, sonography has begun to offer an interesting alternative. Its advantages are that it is a relatively inexpensive technique, while not emitting ionising radiation and being easily accessible. There has been a great deal of technical progress including high frequency transducers, which have led to performance improvements in terms of both diagnosis and treatment of pathologies of the motor system. Due to these technical advances and to sterile covers for the transducers, it is now possible to visualise and to aspirate or inject into a peripheral joint, a tendon sheath or a bursa with or without effusion. This technique does not require a contrast medium injection because the needle position can be checked directly. Minimally invasive, it allows a number of interventions to be carried out with a very low complication rate since the entire path of the needle is followed using sonography, which means that nerves, vessels and other structures can be avoided because they are visualised directly in real time.


Assuntos
Doenças Ósseas/tratamento farmacológico , Artropatias/etiologia , Ultrassonografia de Intervenção/métodos , Desenho de Equipamento , Humanos , Injeções Intralesionais/métodos , Guias de Prática Clínica como Assunto , Ultrassonografia de Intervenção/instrumentação
6.
Diagn Interv Imaging ; 93(9): 652-64, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22921690

RESUMO

In this case series, out of 823 ultrasound-guided injections carried out over a period of one and a half years, 60% were of the lower limb (LL). In the hip (61% of LL injections), the main indications were pathologies of the gluteal tendons and bursae (80%) and pathologies of periprosthetic soft tissue; in the knee (15% of LL punctures), these procedures were for cysts (51%), tendinopathies and bursopathies (18%), and joint aspirations (7%); in the calf, haematoma drainage; in the foot and the ankle (24% of LL punctures), Morton's neuroma (47%), tenosynovitis (22%), pathologies of the plantar fascia (13%), cysts (7%), joint aspirations (5%), and bursopathies. For each of these indications, we will detail the specific technique and equipment used, useful tips, and post-procedure care.


Assuntos
Extremidade Inferior , Doenças Musculoesqueléticas/diagnóstico por imagem , Doenças Musculoesqueléticas/terapia , Ultrassonografia de Intervenção/métodos , Humanos , Guias de Prática Clínica como Assunto
7.
Diagn Interv Imaging ; 93(9): 665-73, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22921692

RESUMO

Forty percent of the 823 ultrasound-guided injections performed in our centre over a year and a half concerned the upper limb, injections involving the shoulder, for subacromial bursitis and the treatment of calcific tendinitis, being the prime indications (24%). The wrist represented 8% of the prescriptions, for treatment of tendinopathy, ganglion cysts, carpal tunnel syndrome and rhizarthrosis. Trigger finger, tenosynovitis and pulley ganglia made up 6% of the indications and the elbow 2.5%. Ultrasound improves the accuracy of the procedure by helping guide the path of the needle and allowing the distribution of the substance injected to be visualised. We shall give details of the technique used for each indication, with advice and hints and post-procedure recommendations.


Assuntos
Doenças Musculoesqueléticas/diagnóstico por imagem , Doenças Musculoesqueléticas/tratamento farmacológico , Ultrassonografia de Intervenção , Extremidade Superior , Humanos , Injeções Intralesionais/métodos
8.
J Ultrasound ; 15(1): 7-15, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23396264

RESUMO

The supraspinatus tendon is composed of 5 different layers consisting of intertwining bundles. On a front portion of the tendon, the layers become coated bundles which insert on the trochanter. At the insertion, the superficial or bursal surface of the tendon corresponding to the tendon fibers in contact with the subacromial bursa can be distinguished from the deep surface corresponding to the fibers in contact with the glenohumeral joint. A tendon tear may involve partial or total disruption of the tendon fibers and is called full-thickness tear if it affects the entire tendon, and partial-thickness tear if it involves only part of the tendon. Partial-thickness tears of the supraspinatus tendon include lesions of the superficial, deep and central surface or tendon delamination.A contrast enhanced examination requires injection of contrast agent into the joint (arthrography followed by computed tomography (CT) or magnetic resonance imaging (MRI)) to study the deep surface, and injection into the subacromial bursa (bursography followed by CT) to study the superficial surface. MRI and ultrasound (US) examination allow the study of these different tendon layers without the use of contrast agent (which is not possible at CT).

9.
J Ultrasound ; 15(1): 20-8, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23396894

RESUMO

Tenosynovitis refers to an inflammatory condition involving the synovial sheath of a tendon. Stenosing tenosynovitis is a peculiar entity caused by multiple factors, including local anatomy, mechanical factors, and hormonal factors. The main forms include de Quervain tendinopathy; trigger finger (stenosing tenosynovitis involving the flexor digitorum tendons); stenosing tenosynovitis of the extensor carpi ulnaris, extensor carpi radialis, or extensor comunis tendons; stenosing tenosynovitis of the flexor hallucis tendon; and stenosing tenosynovitis of the peroneal tendons. The cardinal finding on ultrasonography is the presence of a thickened retinaculum or pulley that constricts the osseofibrous tunnel through which the tendon runs.

10.
J Ultrasound ; 15(1): 56-60, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23396899

RESUMO

While blind or fluoroscopically guided infiltration works well for intra-articular injections, injections into the tendon sheath are much more difficult. Ultrasound guidance with high-frequency transducers now allows visualization and infiltration of tendon sheaths. The interventional phase should be preceded by a diagnostic scan. Patients should be questioned to identify possible contraindications to the procedure and informed of the potential risks. Strict asepsis must be maintained for both patient and operator. This review includes separate discussions of the tendons in different areas of the body that are most commonly treated with ultrasound-guided injections, with descriptions of the lesions that are treated and the approach used for each. Interventional sonography is currently the only technique that allows visualization of the tendon being infiltrated. It requires training and experience as well as good knowledge of the indications and equipment used for the procedures, and the anatomy of the areas being treated.

11.
Chir Main ; 30(6): 368-84, 2011 Dec.
Artigo em Francês | MEDLINE | ID: mdl-22047745

RESUMO

Ultrasound examination is inexpensive, easily accessible and has numerous applications. Its diagnostic or even therapeutic use is developing in the context of hand surgery. The purpose of this work is to review the literature dealing with hand ultrasonograpy by recalling its physical basis and by showing the normal and pathological aspects of different structures and pathologies.


Assuntos
Mãos/diagnóstico por imagem , Mãos/cirurgia , Procedimentos Ortopédicos/educação , Ultrassonografia de Intervenção , Congressos como Assunto , Humanos
12.
Chir Main ; 30(4): 306-10, 2011 Sep.
Artigo em Francês | MEDLINE | ID: mdl-21856201

RESUMO

In the aftermath of a forearm trauma, tendon contractures are difficult to diagnose and evoke nerve compression or muscle ischemia (Volkmann's syndrome). One rarely thinks of tendon incarceration within the fracture and the diagnosis is often made long after. During claw fingers retraction, it is known as "false Volkmann's syndrome" (Baudet and Lafond, 1979) or "pseudo Volkmann's syndrome" (Deeney et al., 1998). The authors report the case of ulnar claw fingers retraction, one year after a fracture of both bones of the forearm, treated surgically with recuperation of normal mobility immediately after emergence of the conflict.


Assuntos
Fraturas do Rádio/complicações , Encarceramento do Tendão/etiologia , Fraturas da Ulna/etiologia , Adolescente , Humanos , Masculino
13.
Ann Rheum Dis ; 70(4): 630-3, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21131648

RESUMO

OBJECTIVE: To examine the outcomes of hand radiographic x-rays in patients with systemic sclerosis (SSc) and to identify risk factors for the progression of hand radiographic lesions in a prospective cohort. METHODS: Dual time-point x-rays were systematically performed after a median interval of 5 years (range 4-7 years) in 103 consecutively recruited patients with SSc. Univariate and multivariate Cox proportional hazards models evaluated predictors of progression of hand radiographic lesions. RESULTS: Radiographic progression of erosive arthritis, acro-osteolysis, calcinosis and flexion contracture occurred in 24, 22, 27 and 18 patients, respectively. Multivariate Cox regression analysis did not identify any predictor of the progression of erosive arthritis. Digital ulcers were shown independently to predict the progression of acro-osteolysis and calcinosis (HR 12.43, 95% CI 1.97 to 88.40 and 3.16, 95% CI 1.22% to 9.43%, respectively). The diffuse cutaneous subset was shown to be an independent predictor of the progression of flexion contracture (HR 7.52, 95% CI 1.21 to 43.93). CONCLUSION: The results highlight the striking level of hand radiographic lesions in SSc and suggest close monitoring of patients with the diffuse cutaneous subset for the occurrence or worsening of this complication. The results also show that severe peripheral vascular involvement predicts both acro-osteolysis and calcinosis, highlighting their vascular background.


Assuntos
Mãos/diagnóstico por imagem , Escleroderma Sistêmico/diagnóstico por imagem , Acro-Osteólise/diagnóstico por imagem , Acro-Osteólise/etiologia , Artrite/diagnóstico por imagem , Artrite/etiologia , Calcinose/diagnóstico por imagem , Calcinose/etiologia , Progressão da Doença , Métodos Epidemiológicos , Feminino , Ossos da Mão/diagnóstico por imagem , Articulação da Mão/diagnóstico por imagem , Humanos , Masculino , Radiografia , Escleroderma Sistêmico/complicações
15.
J Radiol ; 91(9 Pt 2): 1057-67, 2010 Sep.
Artigo em Francês | MEDLINE | ID: mdl-20814396

RESUMO

The new diagnostic criteria for ankylosing spondylitis include MRI. MRI frequently allows early diagnosis of inflammatory lesions in patients with normal plain films. In addition, MRI is useful for the detection and quantification of inflammatory and structural lesions, and to assess disease activity.


Assuntos
Aumento da Imagem , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Espondilite Anquilosante/diagnóstico , Adolescente , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Vértebras Lombares/patologia , Masculino , Pessoa de Meia-Idade , Articulação Sacroilíaca/patologia , Sacro/patologia , Espondilite Anquilosante/etiologia , Vértebras Torácicas/patologia , Adulto Jovem
16.
J Radiol ; 91(3 Pt 1): 271-9, 2010 Mar.
Artigo em Francês | MEDLINE | ID: mdl-20508557

RESUMO

Dedifferentiated chondrosarcomas are highly malignant tumors characterized by conventional low-grade chondrosarcoma with abrupt transition to foci that have dedifferentiated into a higher-grade noncartilaginous more aggressive sarcoma. The dedifferentiated component, an osteosarcoma or fibrosarcoma, determines the prognosis. Its identification is key for management. A diagnosis of dedifferentiated chondrosarcoma should be suggested by the presence of "tumoral dimorphism" with cartilaginous component and aggressive lytic component invading adjacent soft tissues.


Assuntos
Neoplasias Ósseas/diagnóstico , Condrossarcoma/diagnóstico , Idoso , Medula Óssea/diagnóstico por imagem , Medula Óssea/patologia , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/patologia , Cartilagem/diagnóstico por imagem , Cartilagem/patologia , Desdiferenciação Celular , Condrossarcoma/diagnóstico por imagem , Condrossarcoma/patologia , Feminino , Fêmur/diagnóstico por imagem , Fêmur/patologia , Fibrossarcoma/diagnóstico , Fibrossarcoma/diagnóstico por imagem , Fibrossarcoma/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Osteólise/diagnóstico , Osteólise/diagnóstico por imagem , Osteólise/patologia , Osteossarcoma/diagnóstico , Osteossarcoma/diagnóstico por imagem , Osteossarcoma/patologia , Prognóstico , Tíbia/diagnóstico por imagem , Tíbia/patologia , Tomografia Computadorizada por Raios X
17.
J Radiol ; 91(1 Pt 2): 99-110, 2010 Jan.
Artigo em Francês | MEDLINE | ID: mdl-20212386

RESUMO

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by progressive damage of synovial-lined joints and variable extra-articular manifestations. Synovitis is usually found in the wrist, metacarpophalangeal, proximal interphalangeal and metatarsophalangeal joints. For these reasons, we believe that ultrasound with power doppler can be used for the detection and monitoring of synovitis with a simplified "hands and feet" protocol. In this article, we will describe this protocol used daily in our institution for early diagnosis and therapeutic management of this disease.


Assuntos
Artrite Reumatoide/diagnóstico por imagem , Articulações do Pé/diagnóstico por imagem , Articulação da Mão/diagnóstico por imagem , Ultrassonografia Doppler em Cores/métodos , Artrite Reumatoide/classificação , Humanos , Sensibilidade e Especificidade , Membrana Sinovial/diagnóstico por imagem , Sinovite/classificação , Sinovite/diagnóstico por imagem , Transdutores
18.
J Radiol ; 91(1 Pt 2): 140-50, 2010 Jan.
Artigo em Francês | MEDLINE | ID: mdl-20212390

RESUMO

The new diagnostic criteria for spondyloarthropathy include MRI. MRI frequently allows early diagnosis of inflammatory lesions of the spine and sacroiliac joints in patients with normal plain films. Moreover, MRI is useful for the detection and quantification of inflammatory and structural lesions, and to assess disease activity.


Assuntos
Aumento da Imagem , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Articulação Sacroilíaca/patologia , Espondilite Anquilosante/diagnóstico , Adulto , Vértebras Cervicais/patologia , Discite/diagnóstico , Progressão da Doença , Feminino , Humanos , Vértebras Lombares/patologia , Masculino , Pessoa de Meia-Idade , Espondilite Anquilosante/classificação , Vértebras Torácicas/patologia
20.
J Radiol ; 89(5 Pt 2): 654-63; quiz 664-6, 2008 May.
Artigo em Francês | MEDLINE | ID: mdl-18535512

RESUMO

Man, with his erect posture, evolves in a world subject to the laws of gravity. His spine reflects these constraints. The morphology and static of human spine and biomechanical relationships between spine and pelvis are in direct relation with bipedia. Owing to this position the pelvis widened and straightened, characteristic sagittal spinal curves appeared and the perispinal muscles were deeply reorganized. Each pelvis is characterized by an important anatomical landmark: the pelvic incidence that reflects the sagittal morphology of the pelvis. Based on this anatomical characteristic, a chain of reactions determines the more efficient equilibrium of the whole body in the sagittal plane in term of energy consumption. Incidence affects the sacral slope, which determines lumbar lordosis, which itself influences pelvic tilt, thoracic kyphosis, and even hip and knee position. All these landmarks can easily be studied on a sagittal radiograph. Knowledge of these functional relationships is essential to understand the origin of low back pain, sagittal imbalance and above all before surgical treatment of spine disorders especially when arthrodesis is considered.


Assuntos
Ossos Pélvicos/diagnóstico por imagem , Coluna Vertebral/diagnóstico por imagem , Idoso , Artroplastia de Quadril , Fenômenos Biomecânicos , Feminino , Articulação do Quadril/diagnóstico por imagem , Humanos , Articulação do Joelho/diagnóstico por imagem , Cifose/diagnóstico por imagem , Lordose/diagnóstico por imagem , Dor Lombar/diagnóstico por imagem , Vértebras Lombares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Equilíbrio Postural/fisiologia , Postura/fisiologia , Radiografia , Sacro/diagnóstico por imagem , Curvaturas da Coluna Vertebral/diagnóstico por imagem , Doenças da Coluna Vertebral/diagnóstico por imagem , Fusão Vertebral , Espondilolistese/cirurgia , Vértebras Torácicas/diagnóstico por imagem
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