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BIENVENUE !

Nous souhaitons la bienvenue à tous les chiropraticiens et autres professionnels de santé qui se joignent à nous sur notre site de la SO.F.E.C réservé à l’échographie musculosquelettique.

Cet outil diagnostic va devenir incontournable pour tous les praticiens s’intéressant à l’appareil locomoteur. Notre site s’adresse à vous ! Il a pour ambition de créer une dynamique de communication interprofessionnelle et la mise en ligne d’articles et d’ouvrages de référence indispensables à la sonographie.

Lisez, regardez, travaillez avec l’échographie dans votre cabinet et vous ne tarderez à devenir de véritables passionnés…

Karl Vincent D.C

 

Sonography of the knee

Vendredi, 26 Février 2010 20:16
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Journal of Ultrasound
Volume 12, Issue 2, June 2009, Pages 53-60
A.A.K.A. Razek, N.S. Foudaa, N. Elmetwaleya and E. Elbogdadya

Abstract

The aim of this article is to review the sonographic appearances of common disorders involving the previous termkneenext term joint. Ultrasound is a sensitive method for diagnosis of tendon injuries. Injured ligaments appear swollen with mixed echogenicity. Meniscal injuries and muscle tears can be easily diagnosed. Ultrasound shows synovial thickening and effusion in inflammatory arthropathy and erosions of the articular surface in degenerative arthritis. It can be used effectively in the detection of rheumatoid arthritic activity and for grading degenerative arthritis lesions. Cystic lesions, as well as benign and malignant soft-tissue masses, are clearly delineated. Ultrasound is a safe noninvasive imaging modality that can be used for diagnosis of different disorders involving the previous termkneenext term joint.

 

Ultrasonographic evidence of inflammation is frequent in hands of patients with erosive osteoarthritis

Vendredi, 20 Novembre 2009 11:27
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Osteoarthritis and Cartilage, Volume 17, Issue 10, October 2009, Pages 1283-1287
M. Vlychou, A. Koutroumpas, K. Malizos, L.I. Sakkas

Objective

Erosive osteoarthritis (OA) (EOA) is considered an aggressive form of primary OA that is defined radiographically by intra-articular erosions of the inter-phalangeal joints of the hand and characteristic deformities. The aim of the present study was the sonographic investigation of hand small joints in patients with EOA and comparison of the imaging findings with conventional radiography (CR).

Method

Twenty-two patients (20 women, mean age 62.5 years) with clinical and radiographic diagnosis of EOA formed our study group. A total of 660 joints were assessed by both radiographs and ultrasoundnext term (US). US and plain films were evaluated by two different physicians on a blinded fashion. Erosions, osteophytes and deformities were evaluated by both US and plain films. Synovial thickening, effusion, and power Doppler signal indicative of abnormal vascularity were recorded in each joint during US scanning.

Results

Erosions were detected in 231/660 (35%) small joints by US and in 115/660 (17.4%) small joints by conventional radiographs (P < 0.05). Osteophytes were detected in 360/660 (54.5%) small joints by US, and in 310/660 (47.0%) small joints by conventional radiographs (P < 0.05). Thickened synovium was detected in 19 of 22 patients and increased intra-articular power Doppler signal, indicative of active inflammation, was detected in 18 of 22 patients. Thickened synovium was found in 159/660 (24.1%), effusion in 119/660 (18%) and increased power Doppler in 148/660 (22.4%) small joints. Intra-observer kappa value for agreement regarding US was 0.81 and plain films 0.86. In 31 instances extensive finger tenosynovitis was also evident.

Conclusion

In patients with EOA, US is a reliable and a more sensitive imaging modality than CR in detecting erosions and osteophytes. US detects inflammatory changes in small hand joints in the vast majority of patients with EOA and suggests that current treatment modalities are inadequate treatment for this disease.

 

Ultrasound of the peripheral nerves

Vendredi, 16 Octobre 2009 14:28
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Joint Bone Spine, Volume 75, Issue 6, December 2008, Pages 643-649

Stefano Bianchi

Abstract

Peripheral nerves disorders are common in the rheumatologic practice and can mimic a variety of musculoskeletal diseases. Clinical evaluation remains the mainstay for diagnosing nerve disorders of the extremities. A careful history and an accurate physical examination lead in most patients to a high diagnostic suspicion. Nevertheless several imaging techniques are usually obtained to confirm the clinical data and in the preoperative workup. Although standard radiographs and computed tomography do not visualize the nerves directly, they can reveal the adjacent anatomic structures such as bones and joints and can add additional information that frequently is essential in the choice of adequate treatment. Magnetic resonance imaging and ultrasound show peripheral nerves directly and can reveal their size and internal structure. With the new developments in high resolution, electronic broadband transducers, ultrasound (US) is now considered an optimal imaging technique to evaluate the normal anatomy and disorders of peripheral nerves. Well recognized advantages of this technique in this field are: the possibility of realizing a dynamic examination and assessing long nerves segments in a short time; it is non-invasive and low cost. In addition US is better accepted by the patients. In this article we present a brief description of the normal and US anatomy of the peripheral nerves followed by a description of the US appearance of the most frequent disorders: entrapment neuropathies (EN), tumor and cystic lesions.

 
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