Musculoskeletal Ultrasonography in Rheumatic Diseases by Yasser El Miedany
By Yasser El Miedany
This ebook is a pragmatic and evidence-based consultant to acting medical musculoskeletal ultrasound for sufferers being affected by a variety of rheumatic illnesses. It represents the easiest present considering at the function of ultrasonography within the review of pathology, analysis and remedy of those problems. Following introductory chapters masking primary ideas and pitfalls of musculoskeletal ultrasound, the publication discusses the makes use of of ultrasound to spot and video display diversified rheumatic stipulations, together with rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, pediatric musculoskeletal issues, carpal tunnel syndrome and inflammatory stipulations. It concludes with a bankruptcy devoted to ultrasound-guided interventional techniques, with illustrations depicting sufferers and probe positioning. that includes contributions from a wide overseas workforce of leaders in musculoskeletal ultrasonography, Musculoskeletal Ultrasonography in Rheumatic Diseases is an authoritative reference for rheumatologists, sonographers, radiologists and orthopedic specialists.
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Additional info for Musculoskeletal Ultrasonography in Rheumatic Diseases
A synovial hypertrophy image ( S) is seen in the suprapatellar recess with a big calcification inside ( C) with posterior shadow, covering the bone contour behind. QT quadriceps tendon, Pat patella 2 Pitfalls in Musculoskeletal Ultrasound 37 Fig. 22 Transverse view of the peripatellar recess of the knee. Inside knee collection (fluid), a hyperechoic line is seen with another line above it, representing the interface cartilage sign in an osteophyte ( O). Differential diagnosis with a calcification—osteophytes are covered with cartilage ( asterisks).
The top of the Doppler box is at the top of the image Tips to Overcome It is important to remember not to interpret images and “hot spots” below a bone with intact contour. Reverberation Doppler Artifact It is based on the same mechanism as its GS correspondent, with the distinction that in Doppler evaluation the two closely spaced interfaces conducting to repeated wave reflections are the vessel walls. As a consequence of reverberation, false vessels can appear on the screen. A superficial vessel can appear again deeper on the screen image either once (simple reverberation) or more times, with a showering of color behind it (complex reverberation) .
When a strong reflecting structure like a calcification is very small compared to the width of the main US beam, the posterior acoustic shadowing will be eliminated. This situation may occur in case of small calcifications inside a fluid collection. 11). Sometimes focus adjustment strictly in the area of interest will remove the artifact . ), an artifact called lateral shadowing (or refraction shadowing) appears. After reflection of the beam, marginal waves get also refracted at the edges of the structure, therefore no sound beam is returning to the probe; as a consequence, a shadow near 2 Pitfalls in Musculoskeletal Ultrasound 29 Fig.