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Sonographic and power Doppler semeiotics in musculoskeletal disorders

  • Fabio Martino
  • Enzo Silvestri
  • Walter Grassi
  • Giacomo Garlaschi
  • Emilio Filippucci
  • Carlo Martinoli
  • Gary Meenagh

Abstract

Sonography has great potential for the non-invasive study of hyaline cartilage, as it can depict microscopic lesions to be demonstrated with a high spatial resolution. The main limit to the sonographic study of articular cartilage is the relatively limited dimensions of acoustic windows available for the visualization of the cartilage surfaces. The most frequent errors in the study of cartilage, especially at knee level, are linked to incorrect examination. The most frequent artifacts come out in suprapatellar panoramic views, as the cartilage profile of the femoral trochlea is not perpendicular to the direction of the US beam. An apparent loss in sharpness of the chondro-synovial margin of the cartilage and an apparent reduction or increase of the cartilage thickness are the main artifacts caused by incorrect technique [2].

Keywords

Biceps Tendon Myositis Ossificans Musculoskeletal Sonography Synovial Pannus Septic Bursitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Grassi W, Cervini C (1998) Ultrasonography in rheumatology: an evolving technique. Ann Rheum Dis 57:268–271PubMedGoogle Scholar
  2. 2.
    Grassi W, Filippucci E, Farina A (2005) Ultrasonography in osteoarthritis. Semin Arthritis Rheum 34:19–23PubMedCrossRefGoogle Scholar
  3. 3.
    Grassi W, Tittarelli E, Pirani O et al (1993) Ultrasound examination of metacarpophalangeal joints in rheumatoid arthritis. Scand J Rheumatol 22:243–247PubMedCrossRefGoogle Scholar
  4. 4.
    Grassi W, Lamanna G, Farina A, Cervini C (1999) Sonographic imaging of normal and osteoarthritic cartilage. Semin Arthritis Rheum 28:398–403PubMedCrossRefGoogle Scholar
  5. 5.
    Grassi W, Salaffi F, Filippucci E (2005) Ultrasound in rheumatology. Best Pract Res Clin Rheumatol 19:467–485PubMedCrossRefGoogle Scholar
  6. 6.
    Aisen AM, McCune WJ, MacGuire A et al (1984) Sonographic evaluation of the cartilage of the knee. Radiology 102:781–784Google Scholar
  7. 7.
    McCune WJ, Dedrock DK, Aisen AM, MacGuire A (1990) Sonographic evaluation of osteoarthritic femoral condylar cartilage. Correlation with operative findings. Clin Orthop 254:230–235PubMedGoogle Scholar
  8. 8.
    Grassi W, Tittarelli E, Cervini C (1993) L’ecotomografia nella gonartrosi. Il Reumatologo 14:22–26Google Scholar
  9. 9.
    Richardson ML, Selby B, Montana MA, Mack LA (1988) Ultrasonography of the knee. Radiol Clin North Am 26:63–75PubMedGoogle Scholar
  10. 10.
    Iagnocco A, Coari G, Zoppini A (1992) Sonographic evaluation of femoral condylar cartilage in osteoarthritis and rheumatoid arthritis. Scand J Rheumatol 21:201–203PubMedCrossRefGoogle Scholar
  11. 11.
    Grassi W, Filippucci E, Busilacchi P (2004) Musculoskeletal ultrasound. Best Pract Res Clin Rheumatol 18:813–826PubMedCrossRefGoogle Scholar
  12. 12.
    Martino F, Monetti G (1993) Semeiotica ecografica delle malattie reumatiche. Piccin ed., PadovaGoogle Scholar
  13. 13.
    Frediani B, Filippou G, Falsetti P et al (2005) Diagnosis of calcium pyrophosphate dihydrate crystal deposition disease: ultrasonographic criteria proposed. Ann Rheum Dis 64:638–640PubMedCrossRefGoogle Scholar
  14. 14.
    VanHolsbeeck MT, Introcaso JH (2001) Musculoskeletal ultrasound, 2nd edition, MosbyGoogle Scholar
  15. 15.
    Gibbon WW, Wakefield RJ (1999) Ultrasound in inflammatory disease. Radiol Clin North Am 37:633–651PubMedCrossRefGoogle Scholar
  16. 16.
    Gibbon WW (2004) Applications of ultrasound in arthritis. Semin Musculoskelet Radiol 8:313–328PubMedCrossRefGoogle Scholar
  17. 17.
    Newman JS, Adler R, Bude RO, Rubin J (1994) Detection of soft-tissue hyperemia: value of power Doppler sonography. AJR 163:385–389PubMedGoogle Scholar
  18. 18.
    Silvestri E, Martinoli C, Onetto F et al (1994) Valutazione dell’artrite reumatoide del ginocchio con color Doppler. Radiol Med 88:364–367PubMedGoogle Scholar
  19. 19.
    Carotti M, Salaffi F, Manganelli P et al (2002) Power Doppler sonography in the assessment of synovial tissue of the knee joint in reumathoid arthritis: a preliminary experience. Ann Rheum Dis 61:877–882PubMedCrossRefGoogle Scholar
  20. 20.
    Schmidt WA, Volker L, Zacher J et al (2000) Colour Doppler ultrasonography to detect pannus in kneejoint synovitis. Clin Exp Rheumatol 18:439–444PubMedGoogle Scholar
  21. 21.
    Fitzgerald O, Bresnihan B (1992) Synovial vascularity is increased in rheumatoid arthritis: comment on the article by Stivens et al (letter). Arthritis Rheum 35:1540–1541PubMedCrossRefGoogle Scholar
  22. 22.
    Walsh DA (1999) Angiogenesis and arthritis. Rheumatology 38:103–112PubMedCrossRefGoogle Scholar
  23. 23.
    Klauser A, Frauscher F, Schirmer M et al (2002) The value of contrast enhanced color Doppler ultrasound in the detection of vascularization of finger joint in patients with rheumatoid arthritis. Arthritis Rheum 46:647–653PubMedCrossRefGoogle Scholar
  24. 24.
    Szkudlarek M, Court-Payen M, Strandberg C et al (2000) contrast enhanced power Doppler ultrasound examination of metacarpophalangeal joints in patients with Rheumatoid Arthritis. Ann Rheum Dis 59(Suppl 1)Google Scholar
  25. 25.
    Klauser A, Demharten J, DeMarchi A et al (2005) Contrast enhanced gray-scale sonography in assessment of joint vascularity in rheumatoid arthritis: result from the IACUS study group. Eur Radiol 15:2404–2410PubMedCrossRefGoogle Scholar
  26. 26.
    Martino F, Angelelli G, Ettorre GC et al (1992) Aspetto normale della borsa sovrarotulea nell’ecografia del ginocchio. Radiol Med 83:43–48PubMedGoogle Scholar
  27. 27.
    VanHolsbeeck M, Strouse PJ (1993) Sonography of the shoulder: evaluation of the subacromial-subdeltoid bursa. AJR 160:561–564PubMedGoogle Scholar
  28. 28.
    Fornage BD, Schernberg FL, Rifkin MD (1985) Ultrasound examination of the hand. Radiology 155:785–788PubMedGoogle Scholar
  29. 29.
    Steiner E, Steinbach LS, Schnarkowski P et al (1996) Ganglia and cysts around joints. Radiol Clin North Am 34:395–425PubMedGoogle Scholar
  30. 30.
    DeFlaviis L, Musso MG (1995) Hand and wrist. Clin Diagn Ultrasound 30:151–178PubMedGoogle Scholar
  31. 31.
    Cardinal E, Buckwalter KA, Braunstein EM, Mih AD (1994) Occult dorsal carpal ganglion: comparison of US and MR imaging. Radiology 193:259–262PubMedGoogle Scholar
  32. 32.
    Teefey SA, Middleton WD, Patel V et al (2004) The accuracy of high-resolution ultrasound for evaluating focal lesions of the hand and wrist. J Hand Surg 29:393–399CrossRefGoogle Scholar
  33. 33.
    Bianchi S, Martinoli C (1999) Detection of loose bodies in joints. Radiol Clin North Am 37:679–690PubMedCrossRefGoogle Scholar
  34. 34.
    Roberts D, Miller TT, Erlanger SM (2004) Sonographic appearance of primary synovial chondromatosis of the knee. J Ultrasound Med 23:707–709PubMedGoogle Scholar
  35. 35.
    Puddu G, Ippolito E, Postacchini F (1976) A classification of Achilles tendon disease. Am J Sports Med 4:145–150PubMedCrossRefGoogle Scholar
  36. 36.
    Garlaschi G, Silvestri E, Satragno L, Cimmino MA (2002) The rheumatoid hand: diagnostic imaging. Springer, MilanoGoogle Scholar
  37. 37.
    Bianchi S, Martinoli C, Abdelwhab IF (2005) Ultrasound of tendon tears.Part 1: general considerations and upper extremity. Skeletal Radiol 34:500–512PubMedCrossRefGoogle Scholar
  38. 38.
    Bianchi S, Poletti, PA, Martinoli C (2006) Ultrasound appearance of tendon tears.Part 2: lower extremity and myotendinous tears. Skeletal Radiol 35:63–77PubMedCrossRefGoogle Scholar
  39. 39.
    Fredberg U, Bolvig L (2002) Significance of ultrasonographically detected asymptomatic tendinosis in the patellar and achilles tendons. Am J Sports Med 30:488–491PubMedGoogle Scholar
  40. 40.
    Maganaris CN, Narici MV, Almekinders LC (2004) Biomechanics and pathophysiology of overuse tendon injuries: ideas on insertional tendinopathy. Sports Med 34:1005–1017PubMedCrossRefGoogle Scholar
  41. 41.
    Clement JP 4th, Kassarjian A, Palmer WE (2005) Synovial inflammatory processes in the hand. Eur J Radiol 56:307–318PubMedCrossRefGoogle Scholar
  42. 42.
    Simmen BR, Gschwend N (1995) Tendon diseases in chronic rheumatoid arthritis Orthopade 24:224–236PubMedGoogle Scholar
  43. 43.
    Small LN, Ross JJ (2005) Suppurative tenosynovitis and septic bursitis. Infect Dis Clin North Am 19:991–1005PubMedCrossRefGoogle Scholar
  44. 44.
    Grassi W, Tittarelli E, Pirani O et al (1995) Finger tendon involvement in rheumatoid arthritis: evaluation with high-frequency sonography. Arthritis Rheum 38:186–194CrossRefGoogle Scholar
  45. 45.
    Nagaoka M, Matsuzaki H, Suzuki T (2000) Ultrasonographic examination of de Quervain’s disease. J Orthop Sci 5:96–99PubMedCrossRefGoogle Scholar
  46. 46.
    Giovagnorio F, Andreoli C, DeCicco ML. Ultrasonographic evaluation of de Quervain disease. J Ultrasound Med, Vol 16, Issue 10:685–689Google Scholar
  47. 47.
    Silvestri E, Biggi E, Molfetta L et al (2003) Power Doppler analysis of tendon vascularization. Int J Tissue React 25:149–158PubMedGoogle Scholar
  48. 48.
    Richards PJ, Win T, Jones PW (2005) The distribution of microvascular response in Achilles tendonopathy assessed by colour and power Doppler. Skeletal Radiol 34:336–342PubMedCrossRefGoogle Scholar
  49. 49.
    Martinoli C, Derchi LE, Pastorino C et al (1993) Analysis of echotexture of tendons with US. Radiology 186:839–843PubMedGoogle Scholar
  50. 50.
    Ulreich N, Kainberger F, Huber W, Nehrer S (2002) Achilles tendon and sports. Radiologe 42:811–817PubMedCrossRefGoogle Scholar
  51. 51.
    Lohrer H, Arentz S (2003) Impingement lesion of the distal anterior Achilles tendon in sub-Achilles bursitis and Haglund-pseudoexostosis-a therapeutic challenge Sportverletz Sportschaden 17:181–188PubMedCrossRefGoogle Scholar
  52. 52.
    Terslev L, Qvistgaard E, Torp-Pedersen S et al (2001) Ultrasound and Power Doppler findings in jumper’s knee — preliminary observations. Eur J Ultrasound 13:183–189PubMedCrossRefGoogle Scholar
  53. 53.
    DeFlaviis L, Nessi R, Scaglione P et al (1989) Ultrasonic diagnosis of Osgood-Schlatter and Sinding-Larsen-Johansson diseases of the knee. Skeletal Radiol 18:193–197PubMedCrossRefGoogle Scholar
  54. 54.
    Mahlfeld K, Kayser R, Franke J, Merk H (2001) Ultrasonography of the Osgood-Schlatter disease. Ultraschall Med 22:182–185PubMedCrossRefGoogle Scholar
  55. 55.
    Bianchi S, Cohen M, Jacob D (2005) Tendons traumatic lesions. J Radiol 86(12 Pt 2):1845–1857PubMedGoogle Scholar
  56. 56.
    Bouffard JA, Lee SM, Dhanju J (2000) Ultrasonography of the shoulder. Semin Ultrasound CT MR 21:164–191PubMedCrossRefGoogle Scholar
  57. 57.
    Middleton WD, Teefey SA, Yamaguchi K (2004) Sonography of the rotator cuff: analysis of interobserver variability. AJR 183:1465–1468PubMedGoogle Scholar
  58. 58.
    Teefey SA, Middleton WD, Yamaguchi K (1999) Shoulder sonography: state of the art. Radiol Clin North Am 37:767–785PubMedCrossRefGoogle Scholar
  59. 59.
    Ptasznik R (1997) Sonography of the shoulder. In: vanHolsbeeck MT, Introcaso JH (eds) Musculoskeletal ultrasound. Saunders, St. Louis, pp 463–516Google Scholar
  60. 60.
    Werner A, Mueller T, Boehm D, Gohlke F (2000) The stabilizing sling for the long head of the biceps tendon in the rotator cuff interval: a histoanatomic study. Am J Sports Med 28:28–31PubMedGoogle Scholar
  61. 61.
    Farin PU, Jaroma H, Harju A, Soimakallio S (1995) Medial displacement of the biceps brachii tendon: evaluation with dynamic sonography during maximal external shoulder rotation. Radiology 195:845–848PubMedGoogle Scholar
  62. 62.
    Patton WC, McCluskey GM (2001) Biceps tendinitis and subluxation. Clin Sports Med 20:505–529PubMedCrossRefGoogle Scholar
  63. 63.
    Ptasznik R, Hennesy O (1995) Abnormalities of the biceps tendon of the shoulder: sonographic findings. AJR 164:409–414PubMedGoogle Scholar
  64. 64.
    Prato N, Derchi LE, Martinoli C (1996) Sonographic diagnosis of biceps tendon dislocation. Clin Radiol 51:737–739PubMedCrossRefGoogle Scholar
  65. 65.
    Neustadter J, Raikin SM, Nazarian LN (2004) Dynamic sonographic evaluation of peroneal tendon subluxation. AJR 183:985–988PubMedGoogle Scholar
  66. 66.
    Bianchi S, Martinoli C, Gaignot C et al (2005) Ultrasound of the ankle: anatomy of the tendons, bursae, and ligaments. Semin Musculoskelet Radiol 9:243–259PubMedCrossRefGoogle Scholar
  67. 67.
    Chau CL, Griffith JF (2005) Musculoskeletal infections: ultrasound appearances. Clin Radiol 60:149–159PubMedCrossRefGoogle Scholar
  68. 68.
    Bureau NJ, Chhem RK, Cardinal E (1999) Musculoskeletal infections: US manifestations. Radiographics 19:1585–1592PubMedGoogle Scholar
  69. 69.
    Okayama A, Futani H, Kyo F et al (2003) Usefulness of ultrasonography for early recurrent myositis ossificans. J Orthop Sci 8:239–242PubMedCrossRefGoogle Scholar
  70. 70.
    Park A, Lehnerdt G, Lautermann J (2006) Myositis of the sternocleidomastoid muscle as a result of arthritis of the sternoclavicular joint. Laryngorhinootologie. Epub ahead of printGoogle Scholar
  71. 71.
    DeMarchi A, DePetro P, Linari A et al (2002) Preliminary experience in the study of soft tissue superficial masses. Color-Doppler US and wash-in and wash-out curves with contrast media compared to histological result. Radiol Med 104:451–458PubMedGoogle Scholar
  72. 72.
    DeMarchi A, DePetro P, Faletti C et al (2003) Echocolor power Doppler with contrast medium to evaluate vascularization in lesions of the soft tissues of the limbs. Chir Organi Mov 88:225–231PubMedGoogle Scholar
  73. 73.
    Melis M, Marongiu L, Scintu F et al (2002) Primary hydatid cysts of psoas muscle. ANZ J Surg 72:443–445PubMedCrossRefGoogle Scholar
  74. 74.
    Peetrons P (2002) Ultrasound of muscles. Eur Radiol 12:35–43PubMedCrossRefGoogle Scholar
  75. 75.
    Newman JS, Adler RS, Bude RO, Rubin JM (1994) Detection of soft-tissue hyperemia: value of power Doppler sonography. AJR 163:385–389PubMedGoogle Scholar
  76. 76.
    Krix M, Weber MA, Krakowski-Roosen H et al (2005) Assessment of skeletal muscle perfusion using contrast-enhanced ultrasonography. J Ultrasound Med 24:431–441PubMedGoogle Scholar
  77. 77.
    Hammer HB, Hovden IA, Haavardsholm EA et al (2005) Ultrasonography shows increased cross-sectional area of the median nerve in patients with arthritis and carpal tunnel syndrome. Rheumatology (in press)Google Scholar
  78. 78.
    Beekman R, Visser LH (2004) High-resolution sonography of the peripheral nervous system: a review of the literature. Eur J Neurology 11:305–314CrossRefGoogle Scholar
  79. 79.
    Ziswiler HR, Reichenbach S, Vögelin E et al (2005) Diagnostic value of sonography in patients with suspected carpal tunnel syndrome: a prospective study. Arthritis Rheum 52:304–311PubMedCrossRefGoogle Scholar
  80. 80.
    Redd RA, Peters VJ, Emery SF et al (1989) Morton neuroma: sonographic evaluation. Radiology 171:415–417PubMedGoogle Scholar
  81. 81.
    Read JW, Noakes JB, Kerr D et al (1999) Morton’s metatarsalgia: sonographic findings and correlated histopathology. Foot Ankle Int 20:153–161PubMedGoogle Scholar
  82. 82.
    Sobiesk GA, Wertheimer SJ, Schulz R et al (1997) Sonographic evaluation of interdigital neuromas. J Foot Ankle Surg 36:364–366PubMedCrossRefGoogle Scholar
  83. 83.
    Quinn TJ, Jacobson JA, Craig JG, vanHolsbeeck MT (2000) Sonography of Morton’s neuromas. AJR 174:1723–1728PubMedGoogle Scholar
  84. 84.
    Batz R, Sofka CM, Adler RS et al (2006) Dermatomyositis and calcific myonecrosis in the leg: ultrasound as an aid in management. Skeletal Radiol 35:113–116PubMedCrossRefGoogle Scholar
  85. 85.
    Gibbon WW (2004) Applications of ultrasound in arthritis. Semin Musculoskelet Radiol 8:313–328PubMedCrossRefGoogle Scholar
  86. 86.
    Inampudi P, Jacobson JA, Fessell DP et al (2004) Softtissue lipomas: accuracy of sonography in diagnosis with pathologic correlation. Radiology 233:763–767PubMedCrossRefGoogle Scholar
  87. 87.
    Griffith JF, Wong TY, Wong SM et al (2002) Sonography of plantar fibromatosis. AJR 179:1167–1172PubMedGoogle Scholar
  88. 88.
    Teefey SA, Middleton WD, Boyer MI (2000) Sonography of the hand and wrist. Semin Ultrasound CT MR 21:192–204PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2007

Authors and Affiliations

  • Fabio Martino
    • 1
  • Enzo Silvestri
    • 2
  • Walter Grassi
    • 3
  • Giacomo Garlaschi
    • 4
  • Emilio Filippucci
    • 5
  • Carlo Martinoli
    • 4
  • Gary Meenagh
    • 6
  1. 1.Giovanni XXIII-Policlinico HospitalBariItaly
  2. 2.Department of RadiologySan Martino HospitalGenoaItaly
  3. 3.Jesi Medical CenterUniversity Politecnica delle MarcheAnconaItaly
  4. 4.University of GenoaItaly
  5. 5.University Politecnica delle MarcheAnconaItaly
  6. 6.Musgrave Park HospitalBelfastUK

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