The Utility of Ultrasound for Diagnosing Purulent Infections of the Upper Extremity

Halim, Andrea; Shih, Yushane C.; Dodds, Seth D.

doi:10.1007/s11552-015-9771-x

Cited by 3 publications

(4 citation statements)

References 32 publications

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“…Previous studies have established the diagnostic strength of MSK-US for superficial soft tissue abscess formation. These studies showed different values, sensitivity 98% and specificity 88%, 18 96.7% and 85.7%, 19 97% and 83%, 20 and, 65.9% and 94%, 21 respectively. Comparing those with the study results, the calculated sensitivity of 92% (vs improved laboratory parameters) and 100% (vs intraoperative findings) was comparable with the sensitivity established by three of the four studies.…”

Section: Discussionmentioning

confidence: 89%

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The Utility of Musculoskeletal Ultrasonography in Diagnosing Pyomyositis: A Comparison With Surgically and Conservatively Treated Cases

Bionat

Ongchuan

2021

Journal of Diagnostic Medical Sonography

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Objective: The study aimed to determine the accuracy of sonography in diagnosing pyomyositis. Methods: A retrospective review of pyomyositis cases in a government hospital between January 1, 2016 and June 30, 2019 was done. All cases underwent a sonogram for the indication of pyomyositis. Positive purulence for surgical cases and improved laboratory parameters for conservative cases were confirmatory for pyomyositis. Comparison with sonographic results using a 2 × 2 contingency table was done to determine sensitivity and specificity. Results: A total of 122 cases were included. The sonographic results corresponded with 95% of surgical cases and 89% of conservative cases. A lack of false and true negatives for surgical cases resulted in a sensitivity of 100% (95% confidence interval [CI] = 93%–100%) and a specificity of 0% (95% CI = 0%–71%). In conservative cases, sonography had a sensitivity of 92% (95% CI = 82%–97%) and a specificity of 0% (95% CI = 0%–84%) due to a lack of true negatives. Conclusion: Sonography is not limited to primarily as a screening tool but a capable diagnostic imaging choice for pyomyositis, particularly in low-resource settings. The results show the strength of sonography, particularly in the suppurative stage of pyomyositis. [Box: see text]

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Section: Discussionmentioning

confidence: 89%

“…1,8 Previous studies have established the sensitivity and specificity of sonography in detecting skin and superficial soft tissue abscess formation. [18][19][20][21] However, the sensitivity and specificity of sonography for detecting abscesses in deeper soft tissues and muscle, particularly pyomyositis, have not been described.…”

mentioning

confidence: 99%

The Utility of Musculoskeletal Ultrasonography in Diagnosing Pyomyositis: A Comparison With Surgically and Conservatively Treated Cases

Bionat

Ongchuan

2021

Journal of Diagnostic Medical Sonography

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“…But B-mode ultrasound and duplex ultrasound have limitations: Evaluation can be difficult in cases when pus presents with the same echogenicity as lymphatic tissue and can therefore be hardly distinguished. It is also artifact-prone especially to movement or in the evaluation of structures in deep tissue regions, which is true especially concerning duplex ultrasound [4,5]. New ultrasound techniques like superb microvascular imaging (which has proven to be able to detect low-grade inflammation) or B-flow imaging have, to our knowledge, not yet been assessed for their suitability for the detection of peritonsillar abscess [6].…”

Section: Introductionmentioning

confidence: 99%

Use of CEUS for Imaging Evaluation of Pediatric Peritonsillar Abscess

et al. 2023

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Purpose: Peritonsillar abscess can be diagnosed by B-mode ultrasound and cross-sectional imaging. The latter (with MRI being the modality of first choice in children) is associated with higher effort and risk for pediatric patients due to the administration of X-rays and/or the need of sedation. The purpose of this study is to evaluate whether the introduction of CEUS into the diagnostic algorithm for suspected pediatric peritonsillar abscess is suitable and advantageous. Materials and methods: Single-institution retrospective review of data of pediatric patients who were presented to the department of pediatric radiology for sonographic evaluation under the suspicion of peritonsillar abscess. Diagnostic performance of CEUS was evaluated by using surgical exploration or clinical follow-up as the reference standard. Results: 284 children included in the study underwent B-mode ultrasound. Mean age of all patients was 6,23 years. Peritonsillar abscess was the diagnosis in 42 patients. Diagnosis of peritonsillar abscess was made by B-mode ultrasound alone in 13 of 42 patients (31 %). In 17 of 42 patients (40 %), diagnosis was made by a combination of B-mode ultrasound and CEUS. Sensitivity rose from 37 % to 86 % in cases where B-mode ultrasound remained unclear and CEUS was used. Conclusion: Contrast-enhanced ultrasound (CEUS) is suitable and efficient for the diagnosis of peritonsillar abscess in pediatric patients. It increases the sensitivity for the diagnosis of peritonsillar abscess and thereby reduces the need of additional cross-sectional imaging for the pediatric patients. Zusammenfassung (German Version) Ziel: Peritonsillärabszesse können mittels B-Bild-Ultraschall und Schnittbildgebung diagnostiziert werden (mit MRT als Modalität der ersten Wahl). Schnittbildgebung ist aufwändiger und birgt mit der Anwendung von Röntgenstrahlen bzw. der Notwendigkeit einer Sedierung für pädiatrische Patienten Risiken. Mit der vorliegenden Arbeit soll evaluiert warden, , ob die Einführung von CEUS in den diagnostischen Algorithmus bei Verdacht auf Peritonsillärabszess hierfür geeignet und vorteilhaft ist. Material und Methode: Monozentrische, retrospektive Auswertung von Daten von pädiatrischen Patienten, die in der Kinderradiologie zur Sonographie unter dem Verdacht auf einen Peritonsillärabszess vorgestellt wurden. Die diagnostische Wertigkeit des CEUS wurde unter Verwendung eines Referenzstandards evaluiert. Ergebnisse: In die Studie wurden 284 Kinder (mittleres Alter 6,23 Jahre) eingeschlossen, die mittels B-Bild-Ultraschall untersucht wurden. Ein Peritonsillärabszess wurde in 42 Fällen diagnostiziert. Bei 13 der 42 Patienten (31 %) wurde die Diagnose allein mittels B-Bild-Ultraschall gestellt, bei 17 der 42 Patienten (40 %) durch eine Kombination aus B-Bild-Ultraschall und CEUS. Die Sensitivität stieg in den Fällen, in denen der B-Bild-Ultraschall ein unklares Ergebnis zeigte und CEUS zum Einsatz kam, von 37 % auf 86 % an. Schlussfolgerungen: Kontrastmittel-Ultraschall (CEUS) ist für die Diagnostik des Peritonsillärabszesses bei pädiatrischen Patienten geeignet und vorteilhaft. Er erhöht die Sensitivität für die Diagnosestellung des Peritonsillärabszesses und reduziert hierdurch die Notwendigkeit einer Anwendung von Schnittbildgebung bei den pädiatrischen Patienten.

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“…For example, Focused Abdominal Series for Trauma (FAST) has revolutionized the manner in which abdominal trauma is safely and noninvasively identified and rapidly screened for possible operative intervention 4 . Within orthopaedics, ultrasound has already been successfully used to aid diagnosis of upper extremity abscesses 5, 6 as well as identify rotator cuff tears 7, 8 .…”

Section: Introductionmentioning

confidence: 99%

Preclinical Evaluation of Photoacoustic Imaging as a Novel Noninvasive Approach to Detect an Orthopaedic Implant Infection

Wang

Thompson

Ashbaugh

et al. 2017

J Am Acad Orthop Surg

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Introduction Diagnosing prosthetic joint infection (PJI) poses significant challenges, and current modalities are fraught with low sensitivity and/or potential morbidity. Photoacoustic imaging (PAI) is a novel ultrasound-based modality with potential for diagnosing PJI safely and noninvasively. Materials In an established preclinical mouse model of bioluminescent Staphylococcus aureus PJI, fluorescent indocyanine green (ICG) was conjugated to β-cyclodextrin (CDX-ICG) or teicoplanin (Teic-ICG) and injected intravenously 1-week postoperatively. Daily fluorescent imaging (FLI) and PAI were used to localize and quantify tracer signals. Results were analyzed with 2-way ANOVA. Results Fluorescence clearly localized to the site of infection and was significantly higher with Teic-ICG compared to CDX-ICG (P=0.046) and ICG-alone (P=0.0087). With PAI, the photoacoustic signal per volumetric analysis was substantially higher and better visualized with Teic-ICG compared to CDX-ICG and ICG-alone, and co-localized well with BLI /FLI. Conclusion Photoacoustic imaging can successfully localize PJI in this proof-of-concept study and has shown potential for clinical translation in orthopaedics.

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The Utility of Ultrasound for Diagnosing Purulent Infections of the Upper Extremity

Abstract: Diagnostic study, Level II.

Cited by 3 publications

References 32 publications

The Utility of Musculoskeletal Ultrasonography in Diagnosing Pyomyositis: A Comparison With Surgically and Conservatively Treated Cases

The Utility of Musculoskeletal Ultrasonography in Diagnosing Pyomyositis: A Comparison With Surgically and Conservatively Treated Cases

Use of CEUS for Imaging Evaluation of Pediatric Peritonsillar Abscess

Preclinical Evaluation of Photoacoustic Imaging as a Novel Noninvasive Approach to Detect an Orthopaedic Implant Infection

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