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Diagnostics
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Ultrasound Diagnosis and Guided Intervention of Musculoskeletal/Neuromuscular Pathology
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Ultrasound Diagnosis and Guided Intervention of Musculoskeletal/Neuromuscular Pathology

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (30 April 2020) | Viewed by 81420

Special Issue Editors

Dr. Ke-Vin Chang

E-Mail Website
Guest Editor
1. Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan
2. Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan
3. Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei, Taiwan
Interests: muscuoloskeletal ultrasound; pain management research; meta-analysis
Special Issues, Collections and Topics in MDPI journals
Dr. Kentaro Onishi

E-Mail Website
Guest Editor
Department of Physical Medicine and Rehabilitation, Universiy of Pittsburgh, School of Medicine, Pittsburgh, PA 15213, USA
Interests: diagnostic ultrasound; sport medicine; regenerative medicine
Dr. Timur Ekiz

E-Mail Website
Guest Editor
Department of Physical Therapy and Rehabilitation, Faculty of Healthy Sciences, İstanbul Gedik University, İstanbul, Turkey
Interests: musculoskeletal ultrasound; osteoporosis; rehabiitation

Special Issue Information

Dear Colleagues,

The use of clinical symptoms and physical findings for the diagnosis of musculoskeletal disorders is often unreliable. The advancement of ultrasound technology has enabled the delineation of the reciprocal anatomy of the regions, thereby enhancing identification of the underlying pathology. There are many advantages of using ultrasound to explore musculoskeletal pain, including the lack of radiation, real-time imaging, non-invasive evaluation of vascularity and allowance of dynamic studies. Recently, the development of elastography has improved the qualitative and quantitative evaluation of mechanical properties of tendons and muscles, providing better diagnostic accuracy and follow-up of musculoskeletal disorders. Furthermore, compared with magnetic resonance imaging, ultrasound is comparatively better for identifying origins of peripheral and axial musculoskeletal pain.

Once the cause of pain is correctly diagnosed, the intervention instrument can also be directed through ultrasound guidance, increasing the rate of treatment success. Several systematic reviews and meta-analyses have pointed out that ultrasound guidance leads to more effective treatment of musculoskeletal pain than landmark guidance. Since pain severely hampers quality of life and is treated as the fifth vital sign, the determination of how ultrasound can assist in the management of pain has emerged as one of the most important issues for pain physicians. Therefore, this Special Issue will provide a collection of narrative or systematic reviews, basic research and clinical studies which employ ultrasound to identify the origin and associations of musculoskeletal pain as well as to guide interventions. Since nerve entrapment is a common etiology of musculoskeletal pain, we also welcome articles investigating ultrasound-guided treatment for peripheral nerve entrapment syndrome.

Potential topics include, but are not limited to, the following:

  • Association of ultrasound diagnosed musculoskeletal painful disorders with pathologies obtained from other imaging modalities;
  • Accuracy of ultrasound imaging in the diagnosis of musculoskeletal pain compared with surgical and radiological findings;
  • Education/training of musculoskeletal ultrasound in the diagnosis of musculoskeletal painful syndrome;
  • Comparative effectiveness of ultrasound-guided treatments for musculoskeletal painful syndrome;
  • Use of ultrasound elastography for diagnosis and follow up of musculoskeletal pain.

Dr. Ke-Vin Chang
Dr. Kentaro Onishi
Dr. Timur Ekiz
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • diagnosis
  • ultrasound
  • pain
  • muscle
  • tendon
  • nerve
  • rehabiltation

Related Special Issue

Published Papers (8 papers)

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Research

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15 pages, 925 KiB  
Article
The Quantitative Skeletal Muscle Ultrasonography in Elderly with Dynapenia but Not Sarcopenia Using Texture Analysis
by Kuen-Cheh Yang, Yin-Yin Liao, Ke-Vin Chang, Kuo-Chin Huang and Der-Sheng Han
Diagnostics 2020, 10(6), 400; https://doi.org/10.3390/diagnostics10060400 - 12 Jun 2020
Cited by 13 | Viewed by 3990
Abstract
(1) Background: Dynapenia is defined as lower muscle strength alone. Only a few studies have investigated muscle quality in subjects with dynapenia. (2) Methods: The muscle quality, characterized by texture parameters of biceps brachii, triceps brachii, rectus femoris, and medial gastrocnemius muscles, were [...] Read more.
(1) Background: Dynapenia is defined as lower muscle strength alone. Only a few studies have investigated muscle quality in subjects with dynapenia. (2) Methods: The muscle quality, characterized by texture parameters of biceps brachii, triceps brachii, rectus femoris, and medial gastrocnemius muscles, were collected using ultrasonography. The risk of dynapenia was assessed by the multiple logistic regression model. (3) Results: There were a total of 36 participants (72.7 ± 5.8 yrs, 1:1 case-control matched). The values of texture parameters of autocorrelation (AUT) and sum variance (SVAR) in all four muscles were higher in the dynapenia group significantly (p < 0.05). AUT and SVAR had the significant associations for dynapenia in biceps (dds ratio[OR]:2.51, 95% CI = 1.25–5.07 for AUT; OR = 1.45, 95% CI:1.1–1.91 for SVAR), triceps (OR: 2.48, 95% CI = 1.60–5.3 for AUT; OR: 1.57, 95% CI = 1.08–2.28 for SVAR), and rectus femoris (OR: 1.58, 95% CI = 1.01–2.46 for AUT; OR: 1.2, 95% CI = 1.0–1.44 for SVAR). The areas under the receiver-operating curves of all texture parameters was between 0.84–0.94 after adjusting confounding factors. (4) Conclusions: The muscle quality in the dynapenia can be detected by the texture-feature quantitative ultrasound. Ultrasound measurement in the aging muscle might be promising, and further studies should validate its application in the context of dynapenia. Full article
(This article belongs to the Special Issue Ultrasound Diagnosis and Guided Intervention of Musculoskeletal/Neuromuscular Pathology)
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11 pages, 2335 KiB  
Article
Grip Force Measurement as a Complement to High-Resolution Ultrasound in the Diagnosis and Follow-Up of A2 and A4 Finger Pulley Injuries
by Xeber Iruretagoiena-Urbieta, Javier De la Fuente-Ortiz de Zarate, Marc Blasi, Felix Obradó-Carriedo, Andoni Ormazabal-Aristegi and Elena Sonsoles Rodríguez-López
Diagnostics 2020, 10(4), 206; https://doi.org/10.3390/diagnostics10040206 - 08 Apr 2020
Cited by 8 | Viewed by 3743
Abstract
The ability of finger flexors to generate force has been studied in relation to climbing performance. However, not much attention has been paid to the decrease in finger grip force in relation to annular pulley injuries. The purpose of the present study was [...] Read more.
The ability of finger flexors to generate force has been studied in relation to climbing performance. However, not much attention has been paid to the decrease in finger grip force in relation to annular pulley injuries. The purpose of the present study was to determine if an injured annular pulley implies a finger flexor force decrease, as well as its relation to clinical and sonographic changes. We performed an observational study in 39 rock climbers with A2 or A4 pulley injuries to the 3rd or 4th fingers. The variables considered were pain upon palpation, ultrasound tendon–bone distance, and finger grip strength decrease. Three rock climbing grip types were considered: the one finger crimp, open crimp, and close crimp. Injured rock climbers presented a decrease in finger grip strength compared to non-injured controls when performing a one finger crimp (p < 0.001). There exists a significant correlation between a tendon–bone distance at the level of the injured pulley and a decreased finger grip strength measured by performing a one finger crimp (p = 0.006). A decrease in finger grip strength could be considered in the diagnostic and follow-up process of A2 and A4 pulley injuries to the 3rd and 4th fingers. Full article
(This article belongs to the Special Issue Ultrasound Diagnosis and Guided Intervention of Musculoskeletal/Neuromuscular Pathology)
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10 pages, 889 KiB  
Article
Ultrasound Imaging of the Abdominal Wall and Trunk Muscles in Patients with Achilles Tendinopathy versus Healthy Participants
by Carlos Romero-Morales, Pedro Martín-Llantino, César Calvo-Lobo, Marta San-Antolín, Daniel López-López, María Blanco-Morales and David Rodríguez-Sanz
Diagnostics 2020, 10(1), 17; https://doi.org/10.3390/diagnostics10010017 - 30 Dec 2019
Cited by 11 | Viewed by 7348
Abstract
Purpose: To compare and quantify with ultrasound imaging (USI) the inter-recti distance (IRD), rectus abdominis (RA), external oblique (EO), internal oblique (IO), transversus abdominis (TrAb), and multifidus thickness and the RA and multifidus cross-sectional area (CSA) between individuals with and without chronic mid-portion [...] Read more.
Purpose: To compare and quantify with ultrasound imaging (USI) the inter-recti distance (IRD), rectus abdominis (RA), external oblique (EO), internal oblique (IO), transversus abdominis (TrAb), and multifidus thickness and the RA and multifidus cross-sectional area (CSA) between individuals with and without chronic mid-portion Achilles tendinopathy (AT). Methods: A cross-sectional study. A sample of 143 patients were recruited and divided into two groups: A group comprised of chronic mid-portion AT (n = 71) and B group composed of healthy subjects (n = 72). The IRD, RA, EO, IO, TrAb, and multifidus thickness, as well as RA and multifidus CSA, were measured by USI. Results: USI measurements for the EO (p = 0.001), IO (p = 0.001), TrAb (p = 0.041) and RA (p = 0.001) thickness were decreased as well as IRD (p = 0.001) and multifidus thickness (p = 0.001) and CSA (p = 0.001) were increased for the tendinopathy group with respect the healthy group. Linear regression prediction models (R2 = 0.260 − 0.494; p < 0.05) for the IRD, RA, EO, and IO thickness (R2 = 0.494), as well as multifidus CSA and thickness were determined by weight, height, BMI and AT presence. Conclusions: EO, IO, TrAb, and RA thickness was reduced and IRD, multifidus thickness and CSA were increased in patients with AT. Full article
(This article belongs to the Special Issue Ultrasound Diagnosis and Guided Intervention of Musculoskeletal/Neuromuscular Pathology)
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Review

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13 pages, 1927 KiB  
Review
Recent Advances in Ultrasound Diagnosis of Carpal Tunnel Syndrome
by Yuichi Yoshii, Chunfeng Zhao and Peter C. Amadio
Diagnostics 2020, 10(8), 596; https://doi.org/10.3390/diagnostics10080596 - 15 Aug 2020
Cited by 51 | Viewed by 11785
Abstract
With the widespread use of high-resolution ultrasonography, ultrasonic examination has been shown to be useful as a diagnostic method for carpal tunnel syndrome. The main advantages of ultrasonography are that it is simple, quick, non-invasive, and economical. Another advantage is that tissue dynamics [...] Read more.
With the widespread use of high-resolution ultrasonography, ultrasonic examination has been shown to be useful as a diagnostic method for carpal tunnel syndrome. The main advantages of ultrasonography are that it is simple, quick, non-invasive, and economical. Another advantage is that tissue dynamics can be observed with real-time imaging. In recent reports, it has been shown that ultrasonic examination can provide similar diagnostic accuracy as nerve conduction study in the diagnosis of carpal tunnel syndrome. It has been expected that ultrasound demand in daily medical care will continue to increase. Ultrasonography in carpal tunnel syndrome shows an enlarged median nerve in proximal carpal tunnel, thickening of the flexor retinaculum, and edema around flexor tendons in cross-sectional images. In addition, with the introduction of new technologies such as ultrasonic elastography and speckle tracking, it has become possible to quantify dynamics and material property changes of nerves, tendons, and their surrounding structures. In this review, we describe recent advancements of carpal tunnel syndrome diagnosis based on ultrasound dynamic images, and discuss its pathology. Full article
(This article belongs to the Special Issue Ultrasound Diagnosis and Guided Intervention of Musculoskeletal/Neuromuscular Pathology)
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15 pages, 10662 KiB  
Review
Sonographic Pearls for Imaging the Brachial Plexus and Its Pathologies
by Po-Cheng Hsu, Ke-Vin Chang, Kamal Mezian, Ondřej Naňka, Wei-Ting Wu, Yi-Chiang Yang, Stefan Meng, Vincenzo Ricci and Levent Özçakar
Diagnostics 2020, 10(5), 324; https://doi.org/10.3390/diagnostics10050324 - 20 May 2020
Cited by 21 | Viewed by 24190
Abstract
The brachial plexus (BP) is a complicated neural network, which may be affected by trauma, irradiation, neoplasm, infection, and autoimmune inflammatory diseases. Magnetic Resonance Imaging is the preferred diagnostic modality; however, it has the limitations of high cost and lack of portability. High-resolution [...] Read more.
The brachial plexus (BP) is a complicated neural network, which may be affected by trauma, irradiation, neoplasm, infection, and autoimmune inflammatory diseases. Magnetic Resonance Imaging is the preferred diagnostic modality; however, it has the limitations of high cost and lack of portability. High-resolution ultrasound has recently emerged as an unparalleled diagnostic tool for diagnosing postganglionic lesions of the BP. Existing literature describes the technical skills needed for prompt ultrasound imaging and guided injections for the BP. However, it remains particularly challenging for beginners to navigate easily while scanning its different parts. To address this, we share several “clinical pearls” for the sonographic examination of the BP as well as its common pathologies. Full article
(This article belongs to the Special Issue Ultrasound Diagnosis and Guided Intervention of Musculoskeletal/Neuromuscular Pathology)
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13 pages, 3321 KiB  
Review
Effectiveness of Platelet-Rich Plasma Injection in Rotator Cuff Tendinopathy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Meng-Ting Lin, Kuo-Chang Wei and Chueh-Hung Wu
Diagnostics 2020, 10(4), 189; https://doi.org/10.3390/diagnostics10040189 - 28 Mar 2020
Cited by 43 | Viewed by 7164
Abstract
Background: To investigate the effectiveness of platelet-rich plasma (PRP) injection among patients with rotator cuff tendinopathy in comparison with sham injection, no injection, or physiotherapy alone. Methods: From the earliest records to November 1, 2018, all published or unpublished randomized controlled trial (RCTs) [...] Read more.
Background: To investigate the effectiveness of platelet-rich plasma (PRP) injection among patients with rotator cuff tendinopathy in comparison with sham injection, no injection, or physiotherapy alone. Methods: From the earliest records to November 1, 2018, all published or unpublished randomized controlled trial (RCTs) comparing PRP injection with a control group (sham injection, no injection, or physiotherapy alone) in patients with rotator cuff tendinopathy were included. Eligible trials were included from the search results of electronic databases including PubMed, EMBASE, Scopus, The Cochrane Library, as well as the bibliographies of relevant trials. Five RCTs were enrolled in our meta-analysis. Two authors independently assessed the quality of RCTs with the Cochrane risk of bias tool. We designated pain reduction as the primary outcome and functional improvement as the secondary outcome. Standardized mean difference (SMD) was applied for random-effect meta-analysis. Results: In the short term (3–6 weeks) and medium term (12 weeks), the effectiveness of PRP injection and control group was indistinguishable in terms of both outcomes (pain reduction and functional improvement). Nevertheless, PRP injection led to significant long-term (>24 weeks) pain relief (SMD: 0.42, 95% confidence interval (CI): 0.12–0.72, without heterogeneity). For functional improvement in the long term, PRP injection was not more effective than the control group (SMD: 1.20, 95% CI: −0.20–2.59, with heterogeneity). Conclusions: PRP injection may provide benefit over the control group (sham injection, no injection, or physiotherapy alone) in reducing pain at long-term follow-up for patients with rotator cuff tendinopathy. Full article
(This article belongs to the Special Issue Ultrasound Diagnosis and Guided Intervention of Musculoskeletal/Neuromuscular Pathology)
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30 pages, 15545 KiB  
Review
Advanced Ankle and Foot Sonoanatomy: Imaging Beyond the Basics
by Chen-Yu Hung, Ke-Vin Chang, Kamal Mezian, Ondřej Naňka, Wei-Ting Wu, Po-Cheng Hsu and Levent Özçakar
Diagnostics 2020, 10(3), 160; https://doi.org/10.3390/diagnostics10030160 - 14 Mar 2020
Cited by 15 | Viewed by 16345
Abstract
Ankle/foot pain is a common complaint encountered in clinical practice. Currently, due to the complex anatomy, the diagnosis and management of the underlying musculoskeletal disorders are extremely challenging. Nowadays, high-resolution ultrasound has emerged as the first-line tool to evaluate musculoskeletal disorders. There have [...] Read more.
Ankle/foot pain is a common complaint encountered in clinical practice. Currently, due to the complex anatomy, the diagnosis and management of the underlying musculoskeletal disorders are extremely challenging. Nowadays, high-resolution ultrasound has emerged as the first-line tool to evaluate musculoskeletal disorders. There have been several existing protocols describing the fundamental sonoanatomy of ankle/foot joints. However, there are certain anatomic structures (e.g., Lisfranc ligament complex or Baxter nerve) which are also clinically important. As they are rarely elaborated in the available literature, a comprehensive review is necessary. In this regard, the present article aims to brief the regional anatomy, illustrate the scanning techniques, and emphasize the clinical relevance of the ankle/foot region. Full article
(This article belongs to the Special Issue Ultrasound Diagnosis and Guided Intervention of Musculoskeletal/Neuromuscular Pathology)
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Other

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9 pages, 33557 KiB  
Case Report
Shear Wave Elastography to Guide Perineural Hydrodissection: Two Case Reports
by Daniel Chiung-Jui Su, Ke-Vin Chang and Stanley K. H. Lam
Diagnostics 2020, 10(6), 348; https://doi.org/10.3390/diagnostics10060348 - 28 May 2020
Cited by 7 | Viewed by 5035
Abstract
Radial nerve palsy is not uncommon after humeral shaft fractures. Ultrasound-guided hydrodissection is an emerging treatment for nerve entrapment. Two cases of radial nerve injury after humeral shaft fractures with plate fixation are presented. Shear wave elastography was used to identify hardened scars [...] Read more.
Radial nerve palsy is not uncommon after humeral shaft fractures. Ultrasound-guided hydrodissection is an emerging treatment for nerve entrapment. Two cases of radial nerve injury after humeral shaft fractures with plate fixation are presented. Shear wave elastography was used to identify hardened scars surrounding the nerve, causing entrapment. These areas were marked on the skin as targets for ultrasound-guided hydrodissection. Each patient experienced full recovery of their radial nerve function. Shear wave elastography may be used to precisely identify sites of neural entrapment by scar tissue and accurately guide perineural hydrodissection, particularly in complex postoperative cases. Full article
(This article belongs to the Special Issue Ultrasound Diagnosis and Guided Intervention of Musculoskeletal/Neuromuscular Pathology)
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