In recent years, different classifications for muscle injuries have been proposed based on the topographic location of the injury within the bone-tendon-muscle chain. We hereby propose that in addition to the topographic classification of muscle injuries, a histoarchitectonic (description of the damage to connective tissue structures) definition of the injury be included within the nomenclature. Thus, the nomenclature should focus not only on the macroscopic anatomy but also on the histoarchitectonic features of the injury.

ObjectiveThe present work is aimed at analysing ultrasound findings in patients with distal biceps brachii tendon (DBBT) injuries to assess the sensitivity of ultrasound in detecting the different forms of injury, and to compare ultrasound results with magnetic resonance imaging (MRI) and surgical results.Materials and methodsA total of 120 patients with traumatic DBBT injuries examined between 2011 and 2015 were analysed. We compared ultrasound results with MRI results when surgery was not indicated and with MRI and surgical results when surgery was indicated.ResultsFor major DBBT injuries (complete tears and high-grade partial tears), the concordance study between exploration methods and surgical results found that ultrasound presented a slight statistically significant advantage over MRI (ultrasound: κ = 0.95—very good—95% CI 0.88 to 1.01, MRI: κ = 0.63—good—95% CI 0.42 to 0.84, kappa difference p < 0.01). Minor injuries, in which most tendon fibres remain intact (tendinopathies, elongations and low-grade partial tears), are the most difficult to interpret, as ultrasound and MRI reports disagreed in 12 out of 39 cases and no surgical confirmation could be obtained.ConclusionsBased on present results and previous MRI classifications, we establish a traumatic DBBT injury ultrasound classification. The sensitivity and ultrasound–surgery correlation results in the diagnosis of major DBBT injuries obtained in the present study support the recommendation that ultrasound can be used as a first-line imaging modality to evaluate DBBT injuries.

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The "tennis leg" (TL) concept was initially defined in 1883 by Powell 1 as an "acute and sharp pain in the region of the triceps surae" which the patient referred to as "a snapping sensation" or "as if someone had thrown him a stone." Historically, it was attributed to a plantaris muscle rupture. Several decades later in 1958, Arner and Lindholm's 2 surgical findings proposed that it was actually related to a medial head of the gastrocnemius rupture. In 1977, Miller 3 further described the TL concept as a rupture affecting the medial head of the gastrocnemius myoaponeurotic or myotedinous junction that usually occurred by either a sudden plantarflexion of the foot with the knee extended, or a sudden knee extension with a flexed ankle. TL is a common injury especially in amateur and professional athletes representing up to a 13% of all muscle injuries

Numbers of B.fragilis bacteriophages in comparison to coliphages, enteroviruses and rotaviruses were evaluated by different methods in sediments of a coastal area near Barcelona which receives substantial amounts of pollution of domestic origin. Phages infecting B.fragilis should be eluted from sediments prior to their enumeration, in the same way as solid-associated animal viruses have to.Phages infecting B.fragilis were better eluted by glycine buffer at alkaline pH than by a caotropic agent (beef extract-sodium nitrate). Such differences between glycine buffer and sodium nitrate were not evident when enteroviruses and rotaviruses were eluted from sediments. This suggests that elution with glycine buffer is preferable for bacteriophages, while the use of caotropic agents is advisable for animal viruses, because of the simplicity of the methodology. In the studied area, coliphages were the more abundant viruses. Also, B.fragilis phages outnumbered rotaviruses and enteroviruses by a factor of more than ten. The ratios between phages active against B.fragilis and either enteroviruses or rotaviruses in marine sediments were similar to the ratios found in sewage, thus indicating that they have a similar fate.

Purpose: To compare the clinical effectiveness of minimally invasive ultrasound (US)guided vs open release for carpal tunnel syndrome. Methods: In an open randomized controlled trial, 47 employed patients were allocated to US-guided carpal tunnel release (USCTR) and 42 to an open carpal tunnel release (OCTR) procedure. The main outcome was symptom severity measured by the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ-S). Secondary outcomes were hand functionality (BCTQ-F), nerve conduction, two-point discrimination, handgrip and pinch strength, pain (visual analog scale), work leave and complications. For BCTQ-S and BCTQ-F, minimal clinically important differences (MCID) were also considered. Follow-up duration was 12 months.Results: Mixed model analyses detected no significant differences between the two treatment arms in BCTQ-S (P = .098) while BCTQ-F scores were significantly better in the USCTR group (P = .007). This benefit was, however, not supported by the MCID data. Remaining variables were similar in the two groups except pain which was lower in USCTR at 3 months follow-up. All variables but two-point discrimination showed significant improvement after 3 months.Conclusions: Our findings reveal similar symptom relief benefits following OCTR or USCTR in these patients. The patients in our USCTR group, however, reported better hand functional status and less pain.carpal tunnel syndrome, hand, minimally invasive surgical procedures, musculoskeletal ultrasonography, nerves | INTRODUCTIONCarpal tunnel syndrome is the most frequent compression neuropathy among employed adults in the United States, with an incidence of 6.3 cases per 10 000 full-time equivalent 1 and a cost of $45 000 to $89 000 per patient. 2 Since it is accepted that open carpal tunnel release (OCTR) is better at relieving symptoms than non-surgical therapies, 3,4 open surgical procedures are most commonly used for this purpose. The goal of surgery is to divide the flexor retinaculum (FR) to decompress the median nerve at the level of the wrist. Complications associated with OCTR surgery are post-surgical pain, dysesthesia and reduced grip strength which could be explained by a

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Sonography of the iliopsoas tendon plays an important role in the diagnosis and preoperative and postoperative management for the increasing number of patients under consideration for arthroscopically guided hip interventions such as iliopsoas tenotomy in a variety of conditions, including arthropathy, periarticular calcifications, and cam-type deformities of the femoral head. The ability to visualize the iliopsoas tendon pre-operatively can be helpful diagnostically in patients presenting with hip pain and can aid in planning surgery, while evaluating the tendon postoperatively is important in the assessment of causes of postoperative pain and other potential complications. We present a novel technique for visualizing the distal iliopsoas tendon complex in the longitudinal axis at its insertion on the lesser trochanter on sonography.