Upper Limb Interventions

Sconfienza, Luca Maria; Chianca, Vito; Messina, Carmelo; Albano, Domenico; Pozzi, G; Bazzocchi, Alberto

doi:10.1016/j.rcl.2019.05.002

Cited by 24 publications

(39 citation statements)

References 58 publications

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“…The use of small syringe needles associated with 10 mL local anesthetics seems to be sufficient to perform the procedure with minimal discomfort. This is what generally reported in literature, although no specific data on the topic have ever been reported [22][23][24]. Our data show that 70% of patients did not report any pain during the lavage.…”

supporting

confidence: 68%

“…Further studies may be performed during longer follow-up to explore how satisfaction may change over time. Indeed, for instance, it has been demonstrated that the differences in clinical outcome between patients subjected to US-PICT and those treated by subacromial injections of corticosteroids are evident only six months after treatment [24]. Then, we do not have a control group which was treated in a different way or with patients who were not fully aware of the procedure.…”

mentioning

confidence: 99%

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Ultrasound-Guided Percutaneous Irrigation of Rotator Cuff Calcific Tendinopathy (US-PICT): Patient Experience

Albano

Gambino

Messina

et al. 2020

BioMed Research International

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Purpose. To assess patients’ experience of ultrasound-guided percutaneous irrigation of rotator cuff calcific tendinopathy (US-PICT). Methods. Ninety-one patients (58 females; mean age: 50.5±8.3 years) treated by US-PICT (local anesthesia, single-needle lavage, and intrabursal steroid injection) answered to a list of questions regarding their experience of the procedure before treatment, immediately after treatment, and three months later. The Borg CR10 scale was used to evaluate perceived pain, discomfort during anesthetic injection, and anxiety. The Wilcoxon, Spearman’s rho, linear regression, and chi-square statistics were used. Results. 81/91 patients complained mild discomfort during the injection of anesthetics (2, 1-2). Pain scores during US-PICT were very low (0, 0-1), with 70% patients having not experienced pain. After treatment, we found a significant reduction of pain (before: 8, 7-8; 3-month: 3, 1-6; p<.001) and anxiety (before: 5, 2-7; during treatment: 2, 1-7; p=0.010), with high overall satisfaction (immediately after: 10, 9-10; 3-month: 9, 7-10) and confidence in the possibility of recovery (immediately after: 9, 8-10; 3-month: 10, 8-10), respectively. Treatments performed before US-PICT were not statistically associated with pain relief (p=0.389) and clinical improvement (p=0.937). We found a correlation between satisfaction immediately postprocedure and confidence in the possibility of recovery (p=0.002) and between satisfaction three months after treatment and clinical improvement (p<0.001) and patients’ reminds about the description of the procedure (p=0.005) and of the potential complications (p=0.035). Conclusions. US-PICT is a mildly painful, comfortable, and well-tolerated procedure, regardless of any previous treatments. Patients’ satisfaction is correlated with clinical benefit and full explanation of the procedure and its complications.

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supporting

confidence: 68%

mentioning

confidence: 99%

Ultrasound-Guided Percutaneous Irrigation of Rotator Cuff Calcific Tendinopathy (US-PICT): Patient Experience

Albano

Gambino

Messina

et al. 2020

BioMed Research International

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“…The adjustment of ultrasound settings should also be considered for ultrasound-guided interventional procedures to enhance needle visibility for an accurate injection of drugs or contrast media. [23][24][25][26][27] Dedicated software may improve the depiction of the needle, mainly with compound imaging, because harmonic imaging is not always helpful for this purpose. 28 Finally, artificial intelligence will undoubtedly play a role in further improving all these capabilities in the very near future, although nothing is available on the market at present.…”

Section: Ultrasound Technologymentioning

confidence: 99%

High-Frequency and Ultra-High Frequency Ultrasound: Musculoskeletal Imaging up to 70 MHz

Albano

Aringhieri

Messina

et al. 2020

Semin Musculoskelet Radiol

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Musculoskeletal (MSK) ultrasound has well-established advantages, able to investigate very small structures with high resolution and a quick and real-time dynamic evaluation with the possibility of contralateral comparison. Thus ultrasound has kept its own almost exclusive fields of application in daily clinical practice, and it is considered the first-level imaging technique to assess tendons, bursae, and capsuloligamentous structures of small peripheral joints as well as peripheral nerves. Up to now, however, clinical MSK ultrasound imaging could not go beyond the first 1 to 2 cm under the skin, using high-frequency probes up to 18 to 20 MHz with spatial resolution just below millimeters. We present the impressive technical advancements leading to image resolution as low as 30 µm using ultra-high frequency ultrasound (UHFUS) probes up to 70 MHz. High-frequency ultrasound and UHFUS, with frequencies ranging from 22 to 70 MHz, are promising tools to evaluate very superficial structures. In the MSK system, only two articles have assessed its value in limited case series. Future developments may be aimed to better assess ultrastructural changes of very superficial peripheral nerves and other thin structures such as pulleys, retinacula, and tendons.

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“…Overall, US may serve as a useful method to guide percutaneous aspiration in most of these conditions. [13][14][15][16][17]…”

Section: Skin and Subcutaneous Tissuesmentioning

confidence: 99%

Musculoskeletal Ultrasound in the Emergency Department

Chianca

Pietto

Zappia

et al. 2020

Semin Musculoskelet Radiol

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The skin, nerves, and tendons are superficial anatomical structures that can easily be investigated with an ultrasound (US) examination in the emergency department (ED). US evaluation is relatively underused in musculoskeletal evaluation when compared with other emergency applications, such as abdominal trauma, possible aortic aneurysm, and in the cardiovascular system. The aim of this article is to revise the main bone and soft tissue conditions that can be assessed using US in the ED.

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Upper Limb Interventions

Cited by 24 publications

References 58 publications

Ultrasound-Guided Percutaneous Irrigation of Rotator Cuff Calcific Tendinopathy (US-PICT): Patient Experience

Ultrasound-Guided Percutaneous Irrigation of Rotator Cuff Calcific Tendinopathy (US-PICT): Patient Experience

High-Frequency and Ultra-High Frequency Ultrasound: Musculoskeletal Imaging up to 70 MHz

Musculoskeletal Ultrasound in the Emergency Department

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