This book combines orthopedists’ and radiologists’ perspectives to provide a comprehensive overview of the rapidly expanding use of ultrasound in orthopedic surgery. It also highlights the growing awareness of the potential of this non-invasive and portable, real-time imaging tool, which has led to its inclusion in the minimally invasive toolkit of upper limb surgeons.
The book is divided into five parts – shoulder, elbow, forearm, hand and wrist and fingers. Each part focuses on a particular anatomic region or joint, carefully analyzing the sonoanatomy of its nerves, tendons and bones. For each region, experienced experts illustrate how to perform specific techniques under ultrasound control, ranging from classic procedures, like carpal tunnel release, to the treatment of less common conditions.
Covering all the basic and practical aspects of this innovative, multi-disciplinary approach, as well as future perspectives, this unique book is a must-read for all orthopedists, radiologists, sports physicians and physiotherapist wanting to gain insights into this promising field.
Author(s): Thomas Apard, Jean Louis Brasseur
Publisher: Springer
Year: 2022
Language: English
Pages: 211
City: Cham
Foreword
Preface
Contents
Part I: Shoulder
1: Ultrasound in the Pathology of the Rotator Cuff
1.1 Introduction
1.2 Why Use Ultrasound?
1.3 How Do You Do an Ultrasound of the Cuff?
1.4 Analysis of Painful Etiologies
1.5 The Various Acute Disorders
1.5.1 Bone and Osteoarticular Lesions
1.5.2 The Effusion and Bursitis
1.5.3 Capsuloligamentous Lesions
1.5.4 Tendon Pathologies
1.6 Transfixing Ruptures
1.7 Partial Ruptures
1.8 Disinsertions of the Subscapularis
1.8.1 SLAP (Superior Labrum Antero-Posterior)
1.9 The Dislocation of the Head Along the Biceps
1.10 Calcification
1.11 The Different Chronic Conditions
1.11.1 Enthesopathy
1.11.2 Impingements
1.11.2.1 Anterosuperior
1.11.2.2 Anterior Impingement
1.12 Posterosuperior Impingement
1.12.1 Tendon Ruptures
1.13 The Transfixative Rupture
1.14 Partial Ruptures
1.14.1 Calcifying Tendon Disease
1.14.2 Tendinopathy
1.14.3 Adhesive Capsulitis
1.15 Conclusion
References
2: Ultrasound of the Tendon of the Long Biceps Operated
2.1 Biceps Brachial Muscle in Ultrasound
2.2 Insertion of the Long Head of the Biceps to the Upper Pole of the Glenoid and on the Upper Labrum
2.3 Transition to the Upper Pole of the Head
2.4 Passage in the Interval of the Rotators
2.5 Reflection at the Top of the Groove
2.6 In the Background
2.7 Conclusion
References
3: Ultrasound of Coracoid Process
3.1 Introduction
3.2 Anatomy
3.3 Coracoid and Acromioclavicular Joint
3.3.1 Anatomy
3.3.2 Ultrasound Technique
3.3.3 Pathology
3.3.3.1 Acromioclavicular Sprain
3.4 Coracoid and Glenohumeral Joint
3.4.1 Anatomy
3.4.2 Ultrasound Technique
3.4.3 Pathology
3.4.3.1 Retractile Adhesive Capsulitis
3.4.3.2 Traumatic Injury
3.5 Coracoid and Subscapular Tendon/Subcoracoid Bursa
3.5.1 Anatomy
3.5.2 Ultrasound Technique
3.5.3 Pathology
3.5.3.1 Impingement Under the Coracoid
3.5.3.2 Effusion/Secondary Osteochondromatosis of Subcoracoid Recess
3.6 Traumatic Coracoid
3.6.1 Ultrasound Technique
3.6.2 Pathology
3.7 Coracoid and Tendinous Insertions (Coracobiceps/Coracobrachialis and Pectoralis Minor)
3.7.1 Anatomy
3.7.2 Ultrasound Technique
3.7.3 Pathology
3.7.3.1 Tendinopathy/Enthesopathy
3.7.3.2 Traumatic Avulsion
3.7.3.3 Coracobrachialis Accessory
References
4: Ultrasound of the Acromioclavicular Joint
4.1 Anatomy
4.1.1 General
4.1.2 Content
4.1.3 Ligaments
4.1.3.1 AC Ligaments
4.1.3.2 Coracoclavicular Ligaments (CC)
4.1.3.3 Variants
4.1.4 Muscles
4.1.5 Vascularization and Innervation
4.2 Biomechanics
4.2.1 Function
4.2.2 Movements
4.2.3 Stability
4.2.3.1 Ligament Resistance
4.2.3.2 Capsule and Ligaments AC
4.2.3.3 CC Ligamentous Complex
4.2.3.4 Trapezius and Deltoid Muscles
4.2.3.5 Summary
4.3 Normal Ultrasound
4.3.1 Normal Ultrasound
4.3.1.1 AC Joint (Anterior Frontal and Sagittal Sections) (Figs. 4.2 and 4.3)
4.3.1.2 Superior AC Ligament (Frontal Section) (Fig. 4.2)
4.3.1.3 CC Ligaments (Anterior Sagittal Sections) (Fig. 4.4)
4.3.1.4 Muscle Cap (Upper Sagittal Sections) (Fig. 4.5)
4.3.1.5 Joint Mobility (Dynamic Maneuvers, Frontal Sections)
4.3.2 Advantages and Disadvantages of Ultrasound vs MRI
4.3.2.1 Interest of Ultrasound [39, 43, 47]
4.3.2.2 Disadvantages of Ultrasound
4.4 Pathology
4.4.1 Traumatic: AC Sprain
4.4.1.1 Epidemiology and Mechanism
4.4.1.2 Lesion
Direct Mechanism
Indirect Mechanism
4.4.1.3 Tossy Classification
4.4.1.4 Rockwood Classification (Fig. 4.6)
4.4.1.5 Associated Lesions
4.4.1.6 Reproducibility and Limitations
4.4.1.7 Standard X-Rays
Front X-Rays
Profile X-Rays
Stress X-Rays
Problem of Posterior Displacement
4.4.1.8 Ultrasound and MRI
Joint
Ligaments
Muscular Cap
Joint Instability
4.4.1.9 Sequelae and Chronic Lesions
Posttraumatic Osteoarthritis
Chronic Posttraumatic Instability
4.4.1.10 Perspectives of Imaging in AC Sprain
4.5 Distal Fractures of the Clavicle
4.6 Degenerative AC Arthropathy
4.6.1 Pathophysiology
4.6.2 Imaging
4.7 Arthritis
4.7.1 Rheumatic Arthritis
4.7.2 Septic Arthritis
4.7.3 Microcrystalline Arthritis
4.8 Joint Cysts
4.9 Distal Clavicle Osteolysis (DCO)
4.10 Os Acromiale
4.11 Conclusion
References
5: Ultrasound on Shoulder Prosthesis
5.1 Ultrasound and Anatomical Shoulder Prosthesis
5.2 Ultrasound and Reverse Prosthesis
References
Part II: Elbow
6: Ultrasound of the Lateral Face of the Elbow
6.1 Ultrasound Examination
6.2 Superficial Structures: Subcutaneous Tissues, Nerves
6.2.1 Subcutaneous Lesions
6.2.2 Nerve Lesions
6.2.2.1 Superficial Neuromas
6.2.2.2 Radial Nerve
6.3 Bone Lesions and Entheses Other Than Epicondylitis
6.3.1 Lesions of the Lateral Humerus
6.3.1.1 Radial Head
6.3.2 Arthritis Lesions
6.4 Musculo-aponeurotic Lesions
6.4.1 Lateral Epicondylitis
6.4.2 The Ultrasound-Guided Review
6.4.3 Longitudinal Exploration
6.4.4 Cross-Sectional Exploration
6.4.5 Ultrasound in the Treatment of Epicondylitis
6.5 Conclusion
References
7: Ultrasound of the Median Nerve at the Elbow
7.1 Anatomy of the Median Nerve at the Elbow [1–3]
7.2 Ultrasound of the Median Nerve at the Elbow
7.3 Anatomical Variants [1, 4, 5]
7.4 Pathology [6–10]
7.5 Conclusion
References
8: Ultrasound of the Ulnar Nerve at the Elbow
8.1 Anatomy and Sonoanatomy
8.2 Pathological Appearances of the Nerve in Ultrasound
8.3 Etiologies of Ulnar Nerve Damage at the Elbow
8.3.1 Nervous “Irritation” in Case of Abnormal Mobility
8.3.2 Locations and Etiologies of Nerve Impingement
8.3.2.1 Struthers Arcade [12–14]
8.3.2.2 Accessory Muscle
8.3.2.3 Hypertrophy of the Triceps Muscle
8.3.2.4 Tumor Formations
8.3.2.5 Lesions at Joint Origins
8.3.2.6 Thickening of the Retinaculum
8.3.3 Nerve Irritation in Case of Neighboring Lesion
8.3.4 Direct Trauma
8.3.5 Other Lesions of Ulnar Nerve
8.4 Conclusion
References
9: Ultrasound Radial Nerve of the Elbow
9.1 Radial Nerve Above the Elbow
9.2 Radial Nerve at the Elbow
9.2.1 The Radial Nerve in Front of the Humeral Pallet and Its Division
9.2.2 The Two Branches of the Radial Nerve
9.2.3 Radial Tunnel
9.3 The Radial Nerve Beyond the Elbow
9.3.1 Distribution of Motor Branches in the Posterior Compartment of the Forearm
9.3.2 The Path of the Sensory Branch in the Anterior Compartment of the Forearm
9.4 Conclusion
References
Part III: Forearm
10: Ultrasound of the Interosseous Membrane of the Forearm
10.1 Introduction
10.2 Anatomo-pathological Reminders
10.3 Traumatic Lesions of the IOM
10.4 Ultrasound of the Interosseous Membrane
10.4.1 When to Perform an Ultrasound of the IOM?
10.4.2 What Is the Normal Ultrasound Appearance of the IOM?
10.4.3 What Is the Ultrasound Appearance of the Disrupted IOM?
10.5 Conclusion
References
11: Ultrasound of the Pronator Quadratus PQ
11.1 Introduction
11.2 Anatomy and Sonoanatomy
11.3 The Pronator Quadratus in Pathology
11.3.1 Lesions of the Pronator Quadratus PQ
11.3.2 The Pronator Quadratus PQ: Indirect Sign of Lesion
11.3.2.1 Thickening of the Pronator Quadratus PQ
11.3.2.2 Hyperechogenic Changes of the Pronator Quadratus PQ
11.3.3 The Pronator Quadratus PQ Used as a Marker
11.4 Conclusion
References
Part IV: Wrist/Hand
12: Ultrasound of the Extensor Carpi Ulnaris
12.1 Introduction
12.2 Anatomical Presentation [7–9]
12.3 Imaging Techniques and Normal Appearance
12.4 Ultrasound Technique and Normal Appearance
12.5 Pathological Appearances
12.5.1 Instabilities, Subluxation, and Dislocation
12.5.1.1 Acute Dislocation of ECU
12.5.1.2 Subluxation and Chronic Lesions
12.5.2 Tendon Ruptures
12.5.3 Tenosynovitis and Tendinopathy
12.5.4 Enthesopathy
12.6 Conclusion
References
13: Ultrasound of the Scapholunate Ligament
13.1 How to Carry Out Ultrasound Examination?
References
14: Ultrasound of the Carpal Tunnel
14.1 Introduction
14.2 Anatomy of the Median Nerve
14.3 Anatomy of Tendon Flexors
14.4 Anatomy of the Anterior Surface of the Carpus
14.5 Anatomy of the Retinaculum of Flexors
14.5.1 Special Case of Carpal Tunnel Syndrome in Children
14.6 Carpal Tunnel Ultrasound Educational
14.7 Anatomy of the Operated Carpal Tunnel
14.8 Conclusion
References
15: Ultrasound of the TFCC
15.1 Sonoanatomy
15.2 Pathological Ultrasound Appearances
15.3 Conclusion
References
16: Ultrasound of De Quervain’s Tendonitis
References
17: Ultrasound of Rhizarthrosis
17.1 Introduction
17.2 How to Carry Out an Ultrasound of Rhizarthrosis?
17.2.1 Mode B
17.2.2 Doppler Mode
17.3 Differential Diagnosis of Rhizarthrosis Pain
17.3.1 De Quervain’s Tendonitis
17.3.1.1 Tendonitis of Flexor Carpi Radialis (Fig. 17.4)
17.3.1.2 Scaphotrapeziotrapezoidal Osteoarthritis (Fig. 17.5)
17.3.2 Trapeziometacarpal Instability
17.3.3 Trapeziometacarpal (Osteo)chondral Fracture
17.4 The Patient Looks at the Ultrasound Screen
17.4.1 Echo-pedagogy
17.4.2 The Medicolegal Interest
17.5 Postoperative Ultrasound of Rhizarthrosis
17.5.1 Scaphometacarpal Impingement After Trapeziectomy
17.5.2 Aseptic Tenosynovitis of FCR
17.5.3 Ultrasound of TM Implants
17.5.4 Neuroma of the Dorso-radial Branch of the Radial Nerve
17.6 Conclusion
References
Part V: Finger
18: Ultrasound of the Flexor Tendons of the Fingers
18.1 Installation
18.2 Dynamic and Comparative Review
18.3 Trigger Finger
18.4 Cyst of the A1 Pulley
18.5 Pulley Rupture
18.6 Distal Rupture of the FDP Tendon (“Jersey Finger”)
18.7 Operative Suites After Tendon Suture
References
19: Ultrasound Extensor Tendons of the Fingers
19.1 Introduction
19.2 Normal and Pathological Imaging of the Five
19.2.1 Anchoring and Stabilization Formations of the Extensor Tendons
19.2.1.1 Normal Imaging
19.2.1.2 Main Pathologies
19.2.2 On the Back of the Hand, Intertendinous Connections Transform Four Independent Strips into a Plexiform Structure
19.2.2.1 Normal Imaging
19.2.2.2 Main Pathologies
19.2.3 Sagittal Bands Are a Powerful Strap that Keeps the Extensor Tendons on the Back of the MCPs
19.2.3.1 Normal Imaging
19.2.4 Main Pathologies
19.2.5 The Interosseous Hood Is a Delicate Shroud that Covers the Base of P1 and the Extensor Tendon by Connecting the Dorsal and Palmar Tendon Apparatus
19.2.5.1 Normal Imaging
19.2.5.2 Pathology
19.2.6 A Sophisticated Enthesis Consisting of a System of Bands
19.2.6.1 Normal Imaging
19.2.6.2 Main Pathologies
“Mallet Finger”
19.2.6.3 “Boutonniere” Finger
19.3 Conclusion
References
20: Ultrasound of the Metacarpophalangeal Joint of the Thumb
20.1 Introduction
20.2 Anatomopathological Reminders, Classification, and Treatment
20.2.1 Anatomy and Stener Lesion
20.2.2 Lesion Classification of Ulnar Sprains of MCP [7, 8]
20.2.3 Cure
20.3 Imaging
20.3.1 Simple X-Rays
20.3.2 Magnetic Resonance Imaging [13, 16–18]
20.3.3 Ultrasound [19–29]
20.3.3.1 Valgus Maneuver
20.3.3.2 Flexion-Extension Maneuver of IP
20.4 Conclusion
References
21: Ultrasound of the Nail
21.1 Ultrasound Anatomy of the Nail (Fig. 21.1)
21.2 Ultrasound Examination in Practice
21.3 Ultrasound of the Pathological Nail
21.3.1 Foreign Body Search
21.3.2 Solid Tumor Search
21.3.3 Analysis of the Distal Interphalangeal Joint
21.4 Posttraumatic Nail
21.5 Conclusion
References
