Musculoskeletal Ultrasound in Orthopedic and Rheumatic disease in Adults: Semiology – Pathologic patterns – Therapy control and Guidance

This book presents the major advances and technological updates in diagnostic ultrasound procedures, focusing on the principal technological aspects and multiple exam procedures for the pertinent anatomy, both under basal conditions and using Doppler techniques. It offers a comprehensive and precise evaluation of the ultrasound semiotics of the musculoskeletal apparatus, with descriptions of numerous rheumatic and orthopedic disease patterns. It also discusses in detail the vital role of ultrasound in monitoring chronic inflammatory joint disease during therapy, and brand-new highly sensitive Doppler techniques. In view of the tremendous impact of ultrasound-guided interventional procedures on the management of drug delivery in a musculoskeletal setting, the book also includes a chapter on the practical aspects of performing US-guided diagnostic and therapeutic procedures. Providing outstanding diagrams, dynamic images and videos to guide readers, it is a valuable resource for radiologists and clinicians (rheumatologists, orthopedists, physiatrists and anesthesiologists) with different levels of experience ― ranging from physicians in training to those who already perform US examinations and US-guided procedures. Foreword Contents Contributors Part I: Sonographic Semiology in Musculoskeletal Pathologic Involvement 1: Osseous and Cartilaginous Surface 1.1 Sonographic and Doppler Normal Anatomy 1.1.1 Cartilage 1.1.2 Osseous Tissue 1.2 Osteochondral Degenerative Changes 1.3 Osteochondral Erosive Lesion 1.4 Bone Fracture Further Readings 2: Synovial Spaces 2.1 Sonographic and Doppler Normal Anatomy 2.2 Joint Effusion 2.3 Synovial Inflammation and Proliferation 2.4 Bursitis 2.4.1 Non-communicating Bursitis 2.4.2 Communicating Bursitis 2.5 Synovial Ganglia 2.6 Synovial Calcifications 2.7 Meniscal Lesions 2.8 Endoarticular Loose Bodies Further Readings 3: Tendons and Ligaments 3.1 Sonographic and Doppler Normal Anatomy 3.2 Paratenonitis 3.2.1 Tenosynovitis 3.2.2 Peritendinitis 3.3 Tendinosis 3.4 Degenerative and Inflammatory Enthesopathy 3.5 Entheseal Tear and Tendon Rupture 3.6 Tendon Dislocation 3.7 Tendon Cysts 3.8 Ligament Tears Further Readings 4: Muscles 4.1 Sonographic and Doppler Normal Anatomy 4.2 Inflammatory and Degenerative Diseases 4.3 Traumatic Injury Further Readings 5: Peripheral Nerves 5.1 Sonographic and Doppler Normal Anatomy 5.2 Compressive Chronic Involvement 5.3 Acute Traumatic Injuries Further Readings 6: Dermis and Hypodermis 6.1 Sonographic and Doppler normal anatomy 6.2 Main Pathological Findings Further Readings Part II: Ultrasound Pathologic Findings in Rheumatic Diseases 7: Osteoarthritis 7.1 Introduction 7.2 Synovitis 7.3 Synovial Fluid 7.4 Cartilage Damage 7.5 Osteophytes Further Readings 8: Rheumatoid Arthritis 8.1 Introduction 8.2 Synovitis 8.3 Bone Erosions 8.4 Cartilage Damage 8.5 Tenosynovitis 8.6 Tendon Damage Further Readings 9: Seronegative Spondyloarthritis 9.1 Introduction 9.2 General Concepts 9.3 Joint Involvement 9.4 Dactylitis 9.5 Enthesitis 9.6 Tendon Involvement Further Readings 10: Crystal-Related Arthropathies 10.1 Introduction 10.2 Gout 10.2.1 Ultrasound Findings at Joint Level 10.2.2 Ultrasound Findings at Tendon, Bursa, and Subcutaneous Level 10.2.3 Scanning Protocol 10.2.4 Disease Monitoring 10.3 Pyrophosphate Arthropathy 10.3.1 Ultrasound Findings at Joint Level 10.3.2 Ultrasound Findings at Tendon and Periarticular Level 10.4 Basic Calcium Phosphate Crystal Deposition Disease Further Readings 11: Connective Tissue Disorders 11.1 Systemic Lupus Erythematosus 11.2 Systemic Sclerosis 11.3 Salivary Gland Ultrasonography in Sjögren’s Syndrome 11.4 Lung Ultrasound in Patients with Connective Tissue Disease Further Readings 12: Metabolic Diseases 12.1 Metabolic Diseases Further Readings 13: Synovial Osteochondromatosis 13.1 Introduction 13.2 Diagnostic Imaging Further Readings 14: Pigmented Villonodular Synovitis 14.1 Introduction 14.2 Diagnostic Imaging Further Readings 15: Shoulder Calcific Tendinopathy 15.1 Introduction 15.2 Imaging of Calcifying Tendinitis 15.3 Complications: Subacromial Bursitis—Bone Involvement Further Readings 16: Frozen Shoulder 16.1 Introduction 16.2 Diagnostic Imaging Further Readings 17: Septic Arthritis 17.1 Introduction 17.2 Diagnostic Imaging Further Readings 18: Hemophiliac Arthropathy 18.1 Introduction 18.2 Diagnostic Imaging Further Readings Part III: Ultrasound Pathologic Findings in Orthopedic Diseases 19: Bone Trauma 19.1 Introduction 19.2 Fractures 19.3 Stress Fractures Further Readings 20: Muscle Injury 20.1 Introduction 20.2 Imaging of Muscle Injuries 20.3 Classification of Muscle Injuries 20.3.1 Injuries from Direct Trauma 20.3.2 Injuries from Indirect Trauma 20.3.2.1 Nonstructural Muscle Injuries 20.3.2.2 Structural Muscle Injuries 20.3.3 Complications Further Readings 21: Tendon Trauma 21.1 Introduction 21.2 Tendinosis 21.3 Enthesopathy 21.4 Tendon Rupture 21.5 Tendon Dislocations Further Readings 22: Superficial Interosseous Ligament Injury 22.1 Introduction 22.2 Superficial Interosseous Ligament Injuries 22.2.1 Stener Lesion 22.2.2 Scapholunate Ligament Disruption 22.2.3 Coracohumeral Ligament 22.2.4 Coracoclavicular Ligaments 22.2.5 Ankle Interosseous Ligaments Further Readings 23: Peripheral Entrapment Neuropathies 23.1 Introduction 23.2 Entrapment Neuropathies of Upper Limb 23.2.1 Suprascapular Nerve 23.2.2 Musculocutaneous Nerve 23.2.3 Axillary Nerve 23.2.4 Radial Nerve 23.2.4.1 Spiral Groove Syndrome 23.2.4.2 Posterior Interosseus Syndrome 23.2.5 Ulnar Nerve 23.2.5.1 Cubital Tunnel Syndrome 23.2.5.2 Guyon’s Canal Syndrome 23.2.6 Median Nerve 23.2.6.1 Carpal Tunnel Syndrome 23.3 Entrapment Neuropathies of Lower Limb 23.3.1 Lateral Femoral Cutaneous Nerve Entrapment 23.3.2 Sciatic Nerve 23.3.2.1 Deep Gluteal Syndrome 23.3.3 Common Peroneal Nerve 23.3.4 Superficial Peroneal Nerve 23.3.5 Deep Peroneal Nerve 23.3.5.1 Anterior Tarsal Tunnel Syndrome 23.3.6 Tibial Nerve 23.3.6.1 Tarsal Tunnel Syndrome (Posterior Tibial Nerve) 23.3.6.2 Jogger’s Foot (Medial Plantar Nerve) 23.3.6.3 Baxter Neuropathy (Inferior Calcaneal Nerves) 23.3.7 Interdigital Nerves 23.3.8 Medial Proper Plantar Digital Nerve Further Readings Part IV: Ultrasound in Healing Evaluation and in Therapy Monitoring 24: Bone Fracture Healing 24.1 Introduction 24.2 Ultrasound Evaluation of Bone Fracture Healing Further Readings 25: Tendon and Muscle Rupture Repair 25.1 Introduction 25.2 Healing After Muscle Injury 25.2.1 Skeletal Muscle Healing Process 25.2.2 Hematoma and Scar Tissue 25.3 Muscle Healing Process Complications 25.3.1 Cyst 25.3.2 Calcific Myonecrosis 25.3.3 Myositis Ossificans 25.3.4 Muscle Hernia 25.3.5 Morel-Lavallée Lesion 25.4 Ultrasound After Tendon Surgery Repair Further Readings 26: Therapy Efficacy Evaluation in Synovitis 26.1 Introduction 26.2 Musculoskeletal Ultrasound Scoring Methods 26.2.1 Ultrasound Scoring Systems 26.2.2 Examined Joints 26.2.3 Color and/or Power Doppler Ultrasound Methods 26.2.4 Doppler Quantitative Assessment of Synovial Blood Flow 26.3 Role of CEUS in the Assessment of Inflammatory Arthritis 26.3.1 Quantitative Analysis of CEUS 26.3.2 Applications of Quantitative Analysis of CEUS in Inflammatory Arthritis 26.3.3 Clinical Application of CEUS in Therapeutic Monitoring in Inflammatory Arthritis 26.3.4 Limitations Further Readings Part V: Generalities in Ultrasound-guided Procedures 27: Introduction 27.1 Introduction Further Readings 28: Joint and Bursal Infiltration 28.1 Generalities in Ultrasound-Guided Procedures in Rheumatology 28.2 Viscosupplementation: Technique and Indications Further Readings 29: Tendon Infiltrative and Regenerative Treatments 29.1 Introduction 29.2 Tendon Infiltrative Treatments 29.2.1 Tendon Synovial Sheath Injection 29.2.2 High-Volume Injection 29.3 Tendon Regenerative Treatments 29.3.1 Tendon Scarification (Dry Needling) 29.3.2 Platelet-Rich Plasma (PRP) 29.3.3 Adipose-Derived Mesenchymal Stem Cells (ASCs) Further Readings 30: Shoulder Calcific Tendinitis Treatment 30.1 Introduction 30.2 Therapeutic Options and Clinical Indications 30.3 How to Do 30.3.1 Pre-procedural Phase 30.3.2 Procedure 30.4 Clinical Outcome and Complications Further Readings 31: Peripheral Nerve Block 31.1 Upper Limb Ultrasound-Guided Blocks: How to Do 31.1.1 Interscalene Block 31.1.2 Supraclavicular Block 31.1.3 Infraclavicular Block 31.1.4 Axillary Block 31.2 Lower Limb Ultrasound-Guided Blocks 31.2.1 Femoral Nerve Block 31.2.2 Obturator Nerve Block 31.2.3 Lateral Femoral Cutaneous Nerve Block 31.2.4 Saphenous Nerve Block 31.2.5 Sciatic Nerve Block Further Readings 32: Fluid Collection Evacuation 32.1 Introduction 32.2 Abscess 32.3 Hematoma Further Readings Index