Browse > Article
http://dx.doi.org/10.5397/cise.2019.22.1.40

Focal Bone Marrow Lesions: A Complication of Ultrasound Diathermy  

Kim, Seung Jae J. (Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine)
Kang, Yusuhn (Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine)
Kim, Dae Ha (Department of Orthopedics and Sports Medicine, CM General Hospital)
Lim, Jae Young (Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine)
Park, Joo Hyun (Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine)
Oh, Joo Han (Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine)
Publication Information
Clinics in Shoulder and Elbow / v.22, no.1, 2019 , pp. 40-45 More about this Journal
Abstract
Ultrasound diathermy is widely used for the treatment of musculoskeletal disorders and other soft tissue injuries. Its use as a therapeutic modality is believed to be safe, with very few reported complications. Here, we report two patients who developed focal bone marrow abnormalities after receiving ultrasound diathermy. Both patients' magnetic resonance (MR) evaluations revealed linear subchondral bone lesions of the superolateral humeral head similar to those in osteonecrosis. The patients' symptoms subsequently improved, and available follow-up MR evaluation revealed near complete resolution of bone lesions. These findings suggest that ultrasound diathermy, and its interaction with bone tissue through thermal mechanisms, can cause focal bone marrow abnormalities. Furthermore, the bone marrow abnormalities seem to be transient, resolving upon cessation of ultrasound diathermy, therefore osteonecrosis should be differentiated from this temporal lesion.
Keywords
Bone marrow lesion; Osteonecrosis; Magnetic resonance imaging; Complications; Diathermy;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Ebenbichler GR, Erdogmus CB, Resch KL, et al. Ultrasound therapy for calcific tendinitis of the shoulder. N Engl J Med. 1999;340(20):1533-8. doi: 10.1056/NEJM199905203402002.   DOI
2 Yeh LR, Chen CK, Tsai MY, Teng HC, Lin KL. Focal bone abnormality as a complication of ultrasound diathermy: a report of eight cases. Radiology. 2011;260(1):192-8. doi: 10.1148/radiol.11101301.   DOI
3 de Brito Vieira WH, Aguiar KA, da Silva KM, Canela PM, da Silva FS, Abreu BJ. Overview of ultrasound usage trends in orthopedic and sports physiotherapy. Crit Ultrasound J. 2012;4(1):11. doi: 10.1186/2036-7902-4-11.   DOI
4 ter Haar G. Therapeutic applications of ultrasound. Prog Biophys Mol Biol. 2007;93(1-3):111-29. doi: 10.1016/j.pbiomolbio.2006.07.005.   DOI
5 Draper DO, Castel JC, Castel D. Rate of temperature increase in human muscle during 1 MHz and 3 MHz continuous ultrasound. J Orthop Sports Phys Ther. 1995;22(4):142-50. doi: 10.2519/jospt.1995.22.4.142.   DOI
6 Smith NB, Temkin JM, Shapiro F, Hynynen K. Thermal effects of focused ultrasound energy on bone tissue. Ultrasound Med Biol. 2001;27(10):1427-33. doi: 10.1016/S0301-5629(01)00454-9.   DOI
7 Liu HM, Chao CM, Hsieh JY, Jiang CC. Humeral head osteonecrosis after extracorporeal shock-wave treatment for rotator cuff tendinopathy. A case report. J Bone Joint Surg Am. 2006;88(6):1353-6. doi: 10.2106/JBJS.E.00868.   DOI
8 Sugano N. Osteonecrosis of the humeral head. In: Koo KH, Mont MA, Jones LC, eds. Osteonecrosis. Berlin: Springer; 2014. 389-94.
9 Dalecki D. Mechanical bioeffects of ultrasound. Annu Rev Biomed Eng. 2004;6:229-48. doi: 10.1016/j.jos.2016.12.028.   DOI
10 Chen WS, Annaswamy TM, Yang W, Wang TG. Physical agent modalities. In: Cifu DX, ed. Braddom's physical medicine and rehabilitation. 5th ed. Philadelphia (PA): Elsevier; 2016. 378-81.