Femoro-acetabular impingement (FAI) is a common condition in young active subjects, which can lead to the development of early osteoarthritis if not correctly diagnosed. Imaging evaluation of FAI, mainly based on plain film and magnetic resonance evaluation, must be performed according to precise guidelines and is fundamental for reaching a final diagnosis. The purpose of this paper is to provide a clinical and radiological overview of FAI by describing the most common clinical tests, the imaging techniques used in the diagnosis, and the main radiological signs that may be encountered.
Aim: To assess the ultrasound features in patients with plantar fasciopathy before and after extracorporeal shock waves therapy (ESWT), using conventional grey-scale imaging and both strain (SE) and shear wave (SWE) elastosonographic evaluation.Material and method: Consecutive patients of both sexes attending our outpatient’s clinic, with diagnosis of unilateral plantar fasciopathy, were enrolled. Patients were treated with 3 sessions of ESWT once a week, and underwent clinical and ultrasound evaluation at baseline and at one and three months after treatment. Roles and Maudsley score (RM), visual analog scale (VAS) and 17-Italian Foot Function Index (FFI), were used to assess pain and functional improvement.Results: Twenty patients (11 female and 9 male) were enrolled in the study. Contralateral asymptomatic healthy plantar fascia was used as a control. At baseline, SWE velocity (SWEv) showed statistically significant difference between affected 3.8 (1.5; 5.1) m/s and healthy side 4.7 (4.07; 7.04) m/s, (p=0.006); no significant difference was found for strain ratio values (p=0.656). SWEv post hoc test results showed a significant difference from baseline 3.8 (1.5-5.1) m/s and three month 5.23 (4.55-6.74) m/s follow up visit (p=0.003). Significant statistical negative correlation was found between the SWEv and VAS (p=0.001) and positive correlation between the SWEv and FFI (p=0.012).Conclusion: SWE was effective in assessing plantar fascia elasticity and its alteration in fasciopathy. Furthermore, on the basis of the correlation with pain and functional scales, this technique appears to be a useful additional technique to conventional ultrasound for monitoring the efficacy of treatment
Objectives-In recent years, an increasing need to use imaging to assess normal and adaptive muscle function, in addition to its anatomy and structure, has emerged. We evaluated the myotendinous junction's elastosonographic behavior in light of the most recent literature on its physiologic behavior. The elastosonographic studies were compared with the results obtained from a standard measurement system to ensure a correlation with maximal muscle contraction.Methods-Nineteen male professional soccer players were assessed during functional tests. The participants performed 5 repetitions at 608/s to assess muscle strength and 3 repetitions at 308/s to assess the maximum force peak of thigh muscles. The participants were monitored by a strength-power measurement system and an ultrasound machine equipped with multifrequency (18-6-MHz) linear array transducers.Results-The 19 soccer players were aged between 19 and 34 years (mean age, 28 years). For the right rectus femoris, the results of the elastosonographic studies showed a mean elasticity value 6 SD of 30.75% 6 10.05% with the muscle relaxed and a value of 13.75% 6 8.44% during contraction (mean decrease, 17.00% 6 11.71%). Elasticity values were 36.48% 6 8.39% before contraction and 8.77% 6 6.55% during contraction of the left rectus femoris muscle (mean decrease, 27.71% 6 11.95%). For 308 eccentric contraction of the left leg, correlation with the standard measurement system showed Pearson r values of 20.53 and 20.51 when comparing force peak and mean work, respectively, with elasticity values.Conclusions-Our study shows that strain elastosonographic quantification of muscle elasticity seems to match the expected physiologic and biomechanical behavior of the myotendinous junction.
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