Aim of work
The type of traumatic peripheral nerve injury is a key factor for determining optimal treatment. Proper assessment of peripheral nerve injury facilitates appropriate treatment, significantly affects prognosis, and reduces disabilities. This study evaluated ultrasonography (US) to assess upper limb traumatic nerve injuries and compared the US with electrodiagnostic studies as the gold standard.
Materials and Methods
Participants were 69 adults (57 [83%] men, 12 [17%] women; mean age 36.3 ± 13.5 years) with a total of 96 peripheral nerve injuries (duration of 1 month–3 years). High-frequency US examinations and electro-physiologic studies confirmed upper limb peripheral nerve injury.
Results
Nerve discontinuation was diagnosed in 15 (15.6%) nerves; the cross-sectional area was increased in 33 (34.4%) nerves. Of 96 injuries, 54 (56.3%) were median, 24 (25%) were ulnar, and 18 (18.8%) were radial nerves. No statistically significant difference was found between US and electro-physiologic studies for nerve injury diagnosis (p = 0.054).
Conclusion
No significant differences were found between US and electro-physiologic studies for diagnosis of nerve injuries; however, US was valuable to assess surrounding tissue and supplied muscles. The capabilities to detect nerve injury and associated distal muscular, vascular, and other regional structures position the US as a complementary diagnostic tool.
Background: Musculoskeletal disorders are one of the most common complications in diabetic patients. The most common complaints are shoulder pain and limitation of movement.
Aim of Study:The aim of this study is to evaluate the diagnostic performance of high-resolution ultrasound in the diagnosis of shoulder joint pain in diabetic patients.
Material and Methods:This study was performed on 48 adult type 2 diabetic patients who were complaining of shoulder pain and/or limitation of shoulder movement. Greyscale sonography was done, comparing the results with fifty control subjects.Results: Supraspinatus tendon thickness (SST) was significantly greater in diabetics than in controls (p<0.001). There was no significant correlation between shoulder pain, clinical limitation of movement of the shoulder joint, and ultrasound findings in the diabetic group (p-value >0.05). However, there were significant SST tears, subacromial bursitis, and limitation of movement of SST ultrasound findings in older diabetic patients than in younger ones with a p-value (<0.05). In the diabetic patients, ultrasound revealed a sensitivity of 82.6% in detecting the underlying cause of shoulder pain. Also, it showed a 67.4% sensitivity and 50% specificity in the detection of the underlying cause of shoulder limitation of movement.
Conclusion:Ultrasound may be a high-quality diagnostic tool for diabetes individuals with shoulder joint disorders.
Background:
Rheumatoid arthritis (RA) is a common progressive chronic inflammatory
autoimmune disease which affects mostly small joints, causing pain, swelling, deformity, and
disability. Although progress has been made in exploring RA nature, still there is a lot to know
about the disease pathogenesis, diagnosis, and treatment.
Aim of the Work:
To investigate the role of serum anti-carbamylated protein antibodies and 14-3-3η in the diagnosis of RA compared to rheumatoid factor (RF), anti-CCP antibodies, and highfrequency
musculoskeletal ultrasound used to assess the disease activity and joint damage.
Methods:
Serum anti-carbamylated protein antibodies and 14-3-3η were measured using ELISA
in 61 RA patients and 26 normal controls. RA Disease Activity Score (DAS 28), X-ray and musculoskeletal
ultrasound (hands and feet), carotid ultrasound (Intima-Media Thickness IMT)
were used in assessing the RA disease.
Results:
Anti-carbamylated protein antibodies were significantly elevated in RA patients 4.5 (4.1-
8.9 U⁄ml) compared to the control 3.2(1.9- 4.3 U⁄ml) (p< 0.001) but 14-3-3η showed no significant
difference. There was a significant positive correlation between anti-carbamylated protein antibodies,
14-3-3η levels and disease activity score assessed by DAS 28, increased IMT measured by
carotid duplex, total synovitis and total erosion score were assessed by musculoskeletal ultrasound.
There was no correlation between RF and anti-CCP antibodies. Anti-carbamylated protein
antibodies were found to have 66.7% sensitivity and 85.2% specificity in RA diagnosis, while 14-
3-3η had 51.9% sensitivity and 72.1% specificity.
Conclusion:
Anti-carbamylated protein antibodies and 14-3-3η have a high sensitivity and specificity
in RA diagnosis and had a correlation with the disease activity and joint damage.
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