Ultrasound-guided injections in musculo-skeletal system - An overview.
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ABSTRACT:
SUBMITTER: Kumar Sahu A
PROVIDER: S-EPMC6611943 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The goal of this study was to investigate the frequency of gout-specific ultrasonography findings in a cohort of hyperuricemic patients with various musculo-skeletal complaints. A blinded examiner regarding the patients' clinical and laboratory assessment performed standardized ultrasound examinations of 12 joints in 74 individuals with diverse musculo-skeletal complaints. Gout-specific changes were assessed and combined with the patients' medical history (diagnosis gout vs. non-gout) and laboratory values of hyperuricemia. Of 74 patients, 58 (mean age 55 yrs) had hyperuricemia (serum uric acid levels?>?7 mg/dl/420 ?mol/L). Of those, 27 (47%) had a history of gout attacks. In total, 888 joints were examined by ultrasound. With 44/324 joints (14%) the pathological finding most often found in joints of gout patients was the double contour sign compared to 29/372 joints (8%) in patients with asymptomatic hyperuricemia and 2/192 joints (1%) in normouricemic controls. In patients with gout, the ultrasound showed pathological findings in 67/324 joints (21%). In 26/39 (67%) previously affected joints, gout-specific sonographic indications were found. With regard to the first metatarsophalangeal joint, sonographic pathologies were detectable in 16/22 (73%) so far asymptomatic joints on the contralateral. Ultrasonographic gout-specific signs are not only found in joints affected by gout attacks, but often also in the corresponding contralateral, asymptomatic joint. Patients with asymptomatic hyperuricemia already showed sonographic features implicating an as yet "silent" precipitation of urate crystals. As the examined cohort represents patients at high risk, further research for gout-specific findings is indicated, especially for hyperuricemic patients.
| S-EPMC4203789 | biostudies-other
Project description: Not available
| S-EPMC3903945 | biostudies-literature
Project description:PurposeTo review the current literature to determine which injection technique and needle portal placement provide the greatest accuracy for intra-articular access to the knee.MethodsThis study followed Preferred Reporting Items and Systematic Reviews and Meta-Analyses guidelines. A comprehensive literature search was conducted in March 2020 and repeated in May 2020 using electronic databases PubMed, MEDLINE, and the Cochrane Library. Data on the accuracy of intra-articular knee injection (successful injections/total number of injections) were collected. Only Level I studies were included. Study design, demographic variables, needle sizes, and method of validating accuracy were recorded. The Jadad score was used to assess methodologic quality, and a risk-of-bias assessment was performed.ResultsA total of 12 Level I human studies (1431 patients, 1315 knees) were included in this review. Seven of the studies did a direct comparison between ultrasound-guided and blind knee injections. Ultrasound-guided injections were more accurate compared with blinded knee injections in every study. The most accurate anatomical approach was an isometric quadricep contraction method with the superolateral approach.ConclusionsThis study showed that ultrasound-guided knee injections were more accurate across every anatomical needle injection site compared with blind injections. Injections made by a blind/anatomically guided method had inconsistent accuracy rates that seemed highly dependent on the portal of entry.Level of evidenceLevel I, systematic review of Level I studies.
| S-EPMC8365196 | biostudies-literature
Project description:ObjectiveThis umbrella review synthesizes systematic reviews and meta-analyses to reach a conclusion concerning the overall effectiveness of ultrasound-guided vs landmark-guided injections for treating musculoskeletal pain.DesignUmbrella review.MethodsPubMed, EMBASE, MEDLINE, and Web of Science were searched for relevant systematic reviews and meta-analyses from inception to March 2024. Critical appraisal, data extraction, and synthesis were performed in accordance with the criteria for conducting an umbrella review.ResultsSeventeen articles, comprising 4 systematic reviews and 13 meta-analyses, were included. Using the AMSTAR2 instrument for quality assessment, 3 articles were rated as high quality, 1 as moderate, 7 as low, and 6 as critically low. Generally, ultrasound-guided injections were found to be more accurate than landmark-guided injections, particularly in the shoulder joint, though the results for pain relief and functional outcomes varied. Ultrasound guidance was notably effective for injections into the bicipital groove, wrist, hip, and knee - yielding greater accuracy and improved pain management. Both ultrasound-guided and landmark-guided techniques showed low incidence of adverse effects.ConclusionThis umbrella review offers an in-depth analysis of the comparative effectiveness of ultrasound-guided and landmark-guided injections across a range of musculoskeletal sites/conditions. The findings suggest that ultrasound-guided is a reliable method.
| S-EPMC11367678 | biostudies-literature
Project description:Abdominal aortic aneurysms (AAAs) represent a potentially life-threatening condition that predominantly affects the infrarenal aorta. Several preclinical murine models that mimic the human condition have been developed and are now widely used to investigate AAA pathogenesis. Cell- or pharmaceutical-based therapeutics designed to prevent AAA expansion are currently being evaluated with these animal models, but more minimally invasive strategies for delivery could improve their clinical translation. The purpose of this study was to investigate the use of self-assembling type I collagen oligomers as an injectable therapeutic delivery vehicle in mice. Here we show the success and reliability of a para-aortic, ultrasound-guided technique for injecting quickly-polymerizing collagen oligomer solutions into mice to form a collagen-fibril matrix at body temperature. A commonly used infrarenal mouse AAA model was used to determine the target location of these collagen injections. Ultrasound-guided, closed-abdominal injections supported consistent delivery of collagen to the area surrounding the infrarenal abdominal aorta halfway between the right renal artery and aortic trifurcation into the iliac and tail arteries. This minimally invasive approach yielded outcomes similar to open-abdominal injections into the same region. Histological analysis on tissue removed on day 14 post-operatively showed minimal in vivo degradation of the self-assembled fibrillar collagen and the majority of implants experienced minimal inflammation and cell invasion, further confirming this material's potential as a method for delivering therapeutics. Finally, we showed that the typical length and position of this infrarenal AAA model was statistically similar to the length and targeted location of the injected collagen, increasing its feasibility as a localized therapeutic delivery vehicle. Future preclinical and clinical studies are needed to determine if specific therapeutics incorporated into the self-assembling type I collagen matrix described here can be delivered near the aorta and locally limit AAA expansion.
| S-EPMC5323294 | biostudies-literature
Project description:Simulating the locomotion of insects is beneficial to many areas such as experimental biology, computer animation and robotics. This work proposes a neuro-musculo-skeletal model, which integrates the biological inspirations from real insects and reproduces the gait pattern on virtual insects. The neural system is a network of spiking neurons, whose spiking patterns are controlled by the input currents. The spiking pattern provides a uniform representation of sensory information, high-level commands and control strategy. The muscle models are designed following the characteristic Hill-type muscle with customized force-length and force-velocity relationships. The model parameters, including both the neural and muscular components, are optimized via an approach of evolutionary optimization, with the data captured from real insects. The results show that the simulated gait pattern, including joint trajectories, matches the experimental data collected from real ants walking in the free mode. The simulated character is capable of moving at different directions and traversing uneven terrains.
| S-EPMC5795013 | biostudies-literature
Project description:Untethered miniature robots have significant poten-tial and promise in diverse minimally invasive medical applications inside the human body. For drug delivery and physical contra-ception applications inside tubular structures, it is desirable to have a miniature anchoring robot with self-locking mechanism at a target tubular region. Moreover, the behavior of this robot should be tracked and feedback-controlled by a medical imaging-based system. While such a system is unavailable, we report a reversible untethered anchoring robot design based on remote magnetic actuation. The current robot prototype's dimension is 7.5 mm in diameter, 17.8 mm in length, and made of soft polyurethane elastomer, photopolymer, and two tiny permanent magnets. Its relaxation and anchoring states can be maintained in a stable manner without supplying any control and actuation input. To control the robot's locomotion, we implement a two-dimensional (2D) ultrasound imaging-based tracking and control system, which automatically sweeps locally and updates the robot's position. With such a system, we demonstrate that the robot can be controlled to follow a pre-defined 1D path with the maximal position error of 0.53 ± 0.05 mm inside a tubular phantom, where the reversible anchoring could be achieved under the monitoring of ultrasound imaging.
| S-EPMC7610639 | biostudies-literature
Project description:The aim of the study was to investigate the curative effect of botulinum toxin type A (BTX-A) injection into stellate ganglion under ultrasound guidance in patients suffering from insomnia. From October 2015 to April 2016, 48 patients suffering from insomnia were enrolled in this study. Patients were divided into 2 groups using a random digital grouping method: i) Control group (24 cases), and ii) treatment group (24 cases). Patients in the control group received 1 mg oral estazolam 30 min before sleep every night, while patients in the treatment group received BTX-A injection in bilateral stellate ganglions under ultrasound guidance. Curative effect evaluation was carried out after treatment. The international Pittsburgh Sleep Quality Index (PSQI) and polysomnogram (PSG) were evaluated in the two groups before and after treatment. The total effective rate was obviously higher in the treatment group. The PSQI score and the results of the PSG indicated that the insomnia situation improved in both groups. However, compared with the control group, the treatment group had a more significant improvement. In conclusion, BTX-A injection in stellate ganglion was a relatively easy and effective way to treat insomnia without any notable adverse reactions.
| S-EPMC5525588 | biostudies-other
Project description:BackgroundSickle cell anemia (SCA) is a common genetic disease in Nigeria. Past studies from West Africa focused on isolated aspects of its medical and surgical presentations. To the best of our knowledge, the musculo-skeletal presentations amongst Nigerians with SCA have not been documented in a single all encompassing study. This work aims to prospectively document the musculo-skeletal disease burden among SCA patients.MethodsIn a prospective study of 318 consecutive patients with genotype-confirmed SCA at the Lagos University Teaching Hospital (LUTH), the musculo-skeletal pathologies, anatomic sites, grade of disease, age at presentation and management outcome were recorded over a one-year period. Data obtained were analyzed using Epi-Info software version 6.0. Data are presented as frequencies (%) and mean values (SD) as appropriate.ResultsThe HbSS genotype occurred in 296 (93.0%), while 22 (7.0%) were HbSC. 100 (31.4%) patients with average presenting haemoglobin concentration of 8.2 g/100 ml in the study group, presented with 131 musculo-skeletal pathologies in 118 anatomic sites. Osteomyelitis 31 (31%) and septic arthritis 19 (19%) were most commonly observed in children less than 10 years. Skin ulcers and avascular necrosis (AVN) occurred predominantly in the older age groups, with frequencies of 13 (13.0%) and 26 (26.0%) respectively. 20 (71.5%) of diagnosed cases of AVN presented with radiological grade 4 disease. The lower limbs were involved in 84 (71.1%) of sites affected. Lesions involving the spine were rare 11 (0.9%). Multiple presentations occurred in 89 (28.0%) of patients; 62 (69.7%) of which were children below 10 years.ConclusionsMusculo-skeletal complications are common features of sickle cell anaemia seen in 31.4%. Infectious aetiologies predominate with long bones and joints of lower limbs more commonly affected by osteomyelitis and septic arthritis. Healthcare providers managing SCA should be aware of the potential morbidity and mortality of these conditions to ensure early diagnosis and adequate management.
| S-EPMC2821293 | biostudies-literature
Project description:This meta-analysis compares change in wrist pain following ultrasound-guided (US-guided) intra-articular glucocorticoid injections with change in pain after palpation-guided injections in persons with inflammatory arthritis or osteoarthritis.Data sources included MEDLINE, Cochrane, BIOSIS, CINAHL, ACR/AHRP abstracts, and ClinicalTrials.gov. Studies that assessed change in wrist pain with direct comparison of US-guided and palpation-guided injections were included in the meta-analysis. Subject-level data was sought from authors of all relevant studies. Primary outcome was mean change in wrist pain from baseline to 1-6 week follow-up by visual analog scale (VAS). Mean difference in VAS was calculated for comparative studies. Secondary outcome was proportion attaining Minimal Clinically Important Improvement (MCII), defined as VAS reduction ? 20%. Odds ratios (ORs) of MCII were calculated for comparative studies. Mean differences in VAS and ORs for MCII for comparative studies were combined using fixed and random effects meta-analysis.Ten studies were eligible, and adequate data was available from 4 studies with direct comparison of US-guided and palpation-guided treatment arms. The difference in mean VAS reduction (US-guided minus palpation-guided) ranged from-0.2 to 1.3, with a combined estimate of 1.0 (95% CI 0.3, 1.7). OR for MCII in comparative studies ranged from 1.0 to 12.4, with a combined OR of 3.2 (95% CI 1.2, 8.5) in favor of ultrasound.US-guided glucocorticoid injections to the wrist result in greater reductions in pain, and greater likelihood of attaining MCII than palpation-guided injections at 1-6 weeks follow-up.
| S-EPMC4146403 | biostudies-literature