Ultrasound: Joint: Difference between revisions
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==Background== | ==Background== | ||
* | *US can demonstrate joint effusions and aid in diagnostic procedures such as joint aspiration and hematoma blocks | ||
*Shoulder | *Common joints that are amenable to ultrasound includes glenohumeral, elbow, wrist, hip, knee, and ankle joint | ||
*[[Shoulder dislocation]]s can be found with SN and SP nearing 100% in both diagnosis and assessing reduction<ref>Abbasi, S, et al. Diagnostic Accuracy of Ultrasonographic Examination in the Management of Shoulder Dislocation in the Emergency Department. Annals of Emergency Medicine. 2013; 62(2):170–175.</ref> | |||
==Joint Effusion== | ==Joint Effusion== | ||
===Images=== | ===Images=== | ||
====Normal==== | |||
====Abnormal==== | |||
[[File:Joint effusion.png|300px|Joint effusion]] | |||
===Instructions=== | ===Instructions=== | ||
#Select linear probe (high frequency probe) for smaller joints such as elbow, wrist, ankle, or knee | |||
#Select curvelinear probe (low frequency probe) for larger joints such as shoulder or hip joint | |||
#Scan joint longitudinally to identify the joint space and adjacent bones | |||
#Rotate 90° over area of concern | |||
===Findings=== | ===Findings=== | ||
*Positive | |||
**Substantial quantity of anechoic fluid (in comparison to contralateral side) | |||
*Negative | |||
**Trace or no effusion | |||
==Shoulder Dislocation== | ===Pearls and Pitfalls=== | ||
*Compare contralateral joint | |||
==[[Shoulder Dislocation]]== | |||
===Images=== | ===Images=== | ||
====Normal==== | |||
[[File:Reduced shoulder.png|300px|Reduced shoulder]] | |||
====Abnormal==== | |||
[[File:Shoulder dislocation humerus right of screen.png|300px|Dislocation]] | |||
====Reduction==== | |||
[[File:In-Vivo Shoulder Reduction Rutz.gif|300px|In-Vivo Shoulder Reduction<ref>http://www.thepocusatlas.com/musculoskeletal/</ref>]] | |||
===Instructions=== | ===Instructions=== | ||
====Posterior Approach==== | |||
#Select curvilinear probe (low frequency probe) | |||
#Place probe to the posterior chest parallel above the scapular spine | |||
#Identify the glenoid and humeral head | |||
====Anterior Approach==== | |||
#Select curvilinear probe (low frequency probe) | |||
#Place probe to the anterior chest parallel to the glenohumeral joint | |||
#Identify the glenoid and humeral head | |||
===Findings=== | ===Findings=== | ||
*In anterior and posterior shoulder dislocations, the humeral head is displaced anterior or posterior to the glenoid fossa, respectively | |||
*Hematoma may be present and appear hyperechoic next to the glenoid fossa | |||
===Pearls and Pitfalls=== | |||
*Always compare findings with the unaffected joint | |||
==See Also== | |||
*[[Ultrasound: MSK]] | |||
*[[Ultrasound: Bone]] | |||
==External Links== | ==External Links== | ||
== | ==References== | ||
<references/> | <references/> | ||
[[Category:Radiology]] | |||
[[Category:Orthopedics]] | |||
Latest revision as of 18:49, 28 September 2019
Background
- US can demonstrate joint effusions and aid in diagnostic procedures such as joint aspiration and hematoma blocks
- Common joints that are amenable to ultrasound includes glenohumeral, elbow, wrist, hip, knee, and ankle joint
- Shoulder dislocations can be found with SN and SP nearing 100% in both diagnosis and assessing reduction[1]
Joint Effusion
Images
Normal
Abnormal
Instructions
- Select linear probe (high frequency probe) for smaller joints such as elbow, wrist, ankle, or knee
- Select curvelinear probe (low frequency probe) for larger joints such as shoulder or hip joint
- Scan joint longitudinally to identify the joint space and adjacent bones
- Rotate 90° over area of concern
Findings
- Positive
- Substantial quantity of anechoic fluid (in comparison to contralateral side)
- Negative
- Trace or no effusion
Pearls and Pitfalls
- Compare contralateral joint
Shoulder Dislocation
Images
Normal
Abnormal
Reduction
![In-Vivo Shoulder Reduction[2]](/wiki/File:In-Vivo_Shoulder_Reduction_Rutz.gif)
Instructions
Posterior Approach
- Select curvilinear probe (low frequency probe)
- Place probe to the posterior chest parallel above the scapular spine
- Identify the glenoid and humeral head
Anterior Approach
- Select curvilinear probe (low frequency probe)
- Place probe to the anterior chest parallel to the glenohumeral joint
- Identify the glenoid and humeral head
Findings
- In anterior and posterior shoulder dislocations, the humeral head is displaced anterior or posterior to the glenoid fossa, respectively
- Hematoma may be present and appear hyperechoic next to the glenoid fossa
Pearls and Pitfalls
- Always compare findings with the unaffected joint
See Also
External Links
References
- ↑ Abbasi, S, et al. Diagnostic Accuracy of Ultrasonographic Examination in the Management of Shoulder Dislocation in the Emergency Department. Annals of Emergency Medicine. 2013; 62(2):170–175.
- ↑ http://www.thepocusatlas.com/musculoskeletal/