Reliability and Precision of Stress Sonography of the Ulnar Collateral Ligament

Bica, David; Armen, Joseph; Kulas, Anthony S.; Youngs, Kevin; Womack, Zachary

doi:10.7863/ultra.34.3.371

Cited by 36 publications

(23 citation statements)

References 19 publications

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“…8,20,28 In addition, Bica et al showed that medial elbow stress sonography is a reliable and precise method for detecting changes in ulnohumeral joint space gapping. 6 In addition, we compared medial elbow joint space gapping before and after 100 pitches in the throwers with and without an elbow brace in 2017. 20 In that crossover design study with 1 week washout period, there was no significant difference in medial elbow joint space gapping before pitching in the 2 groups, and it is clear that medial elbow joint space gapping increases as the number of throws increase.…”

Section: Resultsmentioning

confidence: 99%

The effect of repetitive baseball pitching on medial elbow joint space gapping associated with 2 elbow valgus stressors in high school baseball players

Hattori

Akasaka

Otsudo

et al. 2018

Journal of Shoulder and Elbow Surgery

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Gravity stress and 30 N valgus stress may produce different effects with respect to medial elbow joint space gapping before pitching; however, 30 N valgus stress appears to induce greater mechanical stress, which may be preferable when assessing joint instability but also has the potential to be more aggressive. The present results may indicate that constraining factors to medial elbow joint valgus stress matched typical viscoelastic properties of cyclic creep.

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Section: Resultsmentioning

confidence: 99%

The effect of repetitive baseball pitching on medial elbow joint space gapping associated with 2 elbow valgus stressors in high school baseball players

Hattori

Akasaka

Otsudo

et al. 2018

Journal of Shoulder and Elbow Surgery

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“…Although further studies are necessary to standardize and test these 4 diagnostic steps, their proposed use is feasible. Ultrasound machines are available in most emergency departments and orthopedic offices and, with the proper training, can be used to examine potential Lisfranc injuries . This would be beneficial to both the patient and physician: quick visualization of the ligament promotes rapid treatment, and the patient does not need to bear weight on an injured joint complex for diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound as a Diagnostic Tool in the Assessment of Lisfranc Joint Injuries

DeLuca

Walrod

Boucher

2019

J of Ultrasound Medicine

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Objectives Ligamentous Lisfranc injuries are frequently overlooked because of subtle clinical presentations and diagnostic difficulties. The dorsal Lisfranc ligament (DLL) is easily visualized with ultrasound (US), which can provide quick, cost‐effective diagnoses of disorders but is not considered standard clinical practice. This study sought to compare DLL measurement accuracy between US and cadaveric dissection. Methods Ultrasound images of 22 embalmed cadaveric feet were obtained with an M‐Turbo US machine and a 6–13‐MHz linear array (FUJIFILM SonoSite, Inc, Bothell, WA). Images were measured in the US unit and again with ImageJ software (National Institutes of Health, Bethesda, MD). Specimens were dissected, and DLL morphologic characteristics were recorded. Results Twenty‐two specimens were scanned, however 4 were excluded, leaving a sample of 11 male and 7 female cadaveric specimens (mean age ± SD, 80.3 ± 14.03 years). The DLL length differences between SonoSite (8.39 ± 1.27 mm) and ImageJ (8.25 ± 1.84 mm) were not significant (P > .05). Both US DLL measurements significantly differed from the gross dissection measurement (10.8 ± 1.85 mm; P < .001). The morphologic characteristics of the DLL at dissection were consistent. Overall, 70% to 80% of the ligament length was represented by US compared to dissection. The dorsal joint space did not differ significantly between SonoSite (2.19 ± 0.49 mm) and ImageJ (2.05 ± 0.52; P > .05). Both US measurements were also significantly larger than dissection measurements (1.04 ± 0.24; P < .001). Intraclass correlation coefficients indicated good reliability for the DLL length (0.835) and moderate reliability for the dorsal joint space (0.714). Conclusions The DLL is underrepresented but easily distinguished by US, demonstrating its utility in Lisfranc injury diagnosis. Thus, we propose a 4‐component assessment involving US, which may provide more rapid, cost‐effective diagnoses of subtle Lisfranc injuries.

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“…Studies have shown an increase in the width of the medial joint space of the dominant arm. 1,2,14 Our study chose to use the nondominant arms of those who were not overhead throwing athletes. Using these participants ensured that the differences found in this study were not due to anatomic adaptations associated with repeated valgus loading but, rather, anatomic changes associated with changes in the flexion angle.…”

Section: Discussionmentioning

confidence: 99%