• Title/Summary/Keyword: musculoskeletal ultrasound

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Effects of Ultrasound, Laser and Exercises on Temporomandibular Joint Pain and Trismus Following Head and Neck Cancer

  • Elgohary, Hany Mohamed;Eladl, Hadaya Mosaad;Soliman, Ashraf Hassan;Soliman, Elsadat Saad
    • Annals of Rehabilitation Medicine
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    • v.42 no.6
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    • pp.846-853
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    • 2018
  • Objective To compare the effects of low intensity ultrasound (LIUS), traditional exercise therapy (TET), low level laser therapy (LLLT) and TET on temporomandibular joint (TMJ) pain and trismus following recovery from head and neck cancer (HNC). Methods Sixty participants following, who had experienced HNC, were randomly allocated to three groups of 20 people each. Each group received different therapy. Group A received LIUS and TET; group B received LLLT and TET; while group C received TET. All 60 participants were evaluated under the visual analog scale (VAS), the University of Washington Quality of Life questionnaire (UW-QOL) and the Vernier caliper scale (VCS) at the beginning of the therapies and after 4 weeks. Results ANOVA test revealed significant improvements across all three groups with outcomes of p<0.05. The results of the UW-QOL questionnaire showed a significant difference between groups A, B and C in favor of group A (p<0.05). The VAS results showed a more improvement in group A as compared to group B (p<0.05), while there was no statistical difference between groups B and C (p>0.05). The VCS results showed more improvement for the individuals in group B as compared to those in group C (p<0.05), while there was minimal difference between groups A and B (p>0.05). Conclusion The LIUS and TET are more effective than LLLT and/or TET in reducing TMJ pain and trismus following HNC.

A Method and Effect for Tibial Defect Treatment Using Interstitial Low Level Laser (경골 손상 치료에서의 침습형 저출력 레이저 치료법 및 효과)

  • Lee, Sangyeob;Hwang, Donghyun;Kim, Hansung;Jung, Byungjo
    • Journal of Biomedical Engineering Research
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    • v.37 no.4
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    • pp.147-151
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    • 2016
  • Tibial defect, or fracture is very routine musculoskeletal case which brings fully uncomfortable and painful situations to patient. Moreover, it has long hospitalization period because of its risk of non-union. There are many studies using ultrasound, vibration, and laser for bone regeneration to figure out fast bone healing. Among them, Low Level Laser Therapy (LLLT) is already known that it is very easy to treat and may have positive effect for bone regeneration. However, LLLT has uncertain energy dose because of scattering and absorption of laser in tissue. In this study, we used interstitial LLLT to treat tibial defect in animal study. The Interstitial LLLT can overcome some limitations caused by laser scattering or absorption in tissue medium. The results were evaluated using u-CT which can calculate X-ray attenuation coefficient and bone volume of bone defect area. These results showed that interstitial LLLT may affect fast bone healing process in early phase.

Extraction of Transverse Abdominis Muscle form Ultrasonographic Images (초음파 영상에서 복횡근 근육 추출)

  • Kim, Kwang-Baek
    • Journal of the Korean Institute of Intelligent Systems
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    • v.22 no.3
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    • pp.341-346
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    • 2012
  • In rehabilitation where ultrasonographic diagnosis is not popular, it could be subjective by medical expert's experience. Thus, it is necessary to develop an objective automative procedure in ultrasonic image analysis. A disadvantage of existing automative analytic procedure in musculoskeletal system is to designate an incorrect muscle area when the figure of fascia is vague. In this study, we propose a new procedure to extract more accurate muscle area in abdomen ultrasonic image for that purpose. After removing unnecessary noise from input image, we apply End-in Search algorithm to enhance the contrast between fascia and muscle area. Then after extracting initial muscle area by Up-Down search, we trace the fascia area with a mask based on morphological and directional information. By this tracing of mask movements, we can emphasize the fascia area to extract more accurate muscle area in result. This new procedure is proven to be more effective than existing methods in experiment using convex ultrasound images that are used in real world rehabilitation diagnosis.

Diagnostic Usefulness of Digital Infrared Thermal Image in Carpal Tunnel Syndrome (수근관 증후군에서 적외선 체열 검사의 진단적 유용성)

  • Park, Jihyun;Lee, Jang Woo;Lee, Sang Eok;Kim, Byung Hee;Park, Dougho
    • Clinical Pain
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    • v.18 no.2
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    • pp.70-75
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    • 2019
  • Objective: The purpose of this study is to evaluate the usefulness of infrared thermography in patients with carpal tunnel syndrome by comparing with electrodiagnostic and ultrasonographic findings. Method: From January 2014 to October 2017, electrodiagnosis, ultrasound, and digital infrared thermal image (DITI) of unilateral carpal tunnel syndrome diagnosed in a single hospital were retrospectively analyzed. The subjects with bilateral symptoms of carpal tunnel syndrome, peripheral vascular disease, diabetes, thyroid disease, fibromyalgia, rheumatic disease, systemic infection, inflammation, malignant tumor, and other musculoskeletal disorders such as finger osteoarthritis, peripheral neuropathy, cervical radiculopathy, and the previous history of surgery were excluded. Results: Of 53 patients diagnosed with carpal tunnel syndrome, 11 were male and 42 were female. The visual analogue scale was 4.9 ± 1.9, and the duration of symptom was 11.8 ± 12.5 months. There was no statistically significant difference in the body surface temperature between the unaffected and affected sides. The severity of symptoms, electrodiagnostic findings, and cross-sectional area of the median nerve significantly correlates to each other. The temperature difference between the second fingers of the affected and unaffected sides showed a weak correlation with the amplitude of sensory nerve action potential and onset latency of compound muscle action potential, when there was no significant correlation with the other parameters. Conclusion: The difference in temperature on the surface of the body, which can be confirmed by DITI, is little diagnostic value when DITI is performed in unilateral carpal tunnel syndrome patients, especially when compared with ultrasonography.

Changes of abdominal muscle thickness during stable and unstable surface bridging exercise in young people

  • Kim, Tae Hoon;Hahn, Joohee;Jeong, Ju-Ri;Lee, Changjoo;Kim, You Jin;Choi, Sung Min;Jeon, Da Young;Lee, Jin Hwa;Lim, In-Hyuk;Lee, Wan-Hee
    • Physical Therapy Rehabilitation Science
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    • v.5 no.4
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    • pp.210-214
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    • 2016
  • Objective: The aim of this study was to measure the muscle architectural parameters of abdominal muscles in healthy individuals by rehabilitative ultrasound imaging (RUSI) and to investigate their changes after bridging exercise in various environments. Design: Cross-sectional study. Methods: The study included 40 healthy participants (19 men, 21 women). Subjects were randomly allocated to a stable surface group (SG, n=20) or an unstable surface group (UG, n=20). The participants assumed three positions in rest, bridging exercise with knee flexion $60^{\circ}$, and bridging exercise with knee flexion $90^{\circ}$ for the measurement of abdominal muscle thickness by RUSI. For the resting position, the participants held the head neutral in a hook-lying position and the dominant side was measured. For contraction, the participants performed the bridging exercise with the knee joint in $60^{\circ}$ and $90^{\circ}$ of flexion for 10 seconds each. Results: For transversus abdominis, external oblique muscle thickness, within the stable surface group and the unstable surface group, no significant contraction difference was observed in both the $60^{\circ}$ and $90^{\circ}$ bridge exercise conditions. Contraction difference of internal oblique muscle was significantly larger at $90^{\circ}$ than at $60^{\circ}$ within the SG (p<0.05). But within the UG, no significant contraction difference was shown. There was no significant contraction difference between the surface group and the unstable SG at $60^{\circ}$ condition and at $90^{\circ}$ condition in all measured muscles. Conclusions: The contraction difference is different for each muscle during bridge exercise with knee flexion $60^{\circ}$ and bridging exercise with knee flexion $90^{\circ}$. Muscle contraction difference is generally large when exercised on an unstable surface than a stable surface, but these are not statistically significant when bridging exercise is performed using dynamic air cushion for unstable surface.

Extraction of Muscle Areas from Ultrasonographic Images using Information of Fascia (근막 정보를 이용한 초음파 영상에서의 근육 영역 추출)

  • Kim, Kwang-Baek
    • Journal of Korea Multimedia Society
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    • v.11 no.9
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    • pp.1296-1301
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    • 2008
  • Ultrasonography constructs pictures of areas inside the body needs in diagnosis by bouncing high-enorgy sound waves(ultrasound) off internal tissues or organs. In constructing an ultrasonographic image, the weakness of bounding signals induces noises and detailed differences of brightness, so that having a difficulty in detecting and diagnosing with the naked eyes in the analysis of ultrasonogram. Especially, the difficulty is extended when diagnosing muscle areas by using ultrasonographic images in the musculoskeletal test. In this paper, we propose a novel image processing method that computationally extracts a muscle area from an ultrasonographic image to assist in diagnosis. An ultrasonographic image consists of areas corresponding to various tissues and internal organs. The proposed method, based on features of intensity distribution, morphology and size of each area, extracts areas of the fascia, the subcutaneous fat and other internal organs, and then extracts a muscle area enclosed by areas of the fascia. In the extraction of areas of the fascia, a series of image processing methods such as histogram stretching, multiple operation, binarization and area connection by labeling is applied. A muscle area is extracted by using features on relative position and morphology of areas for the fascia and muscle areas. The performance evaluation using real ultrasonographic images and specialists' analysis show that the proposed method is able to extract target areas being approximate to real muscle areas.

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Anterior Talofibular Ligament and Superior Extensor Ankle Retinaculum Thicknesses: Relationship with Balance

  • Malloy, Brooke;Furrow, David;Cook, Haily;Smoot, Elizabeth;Cash, Lindsey;Aron, Adrian;Jagger, Kristen;Harper, Brent
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.4
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    • pp.173-182
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    • 2019
  • Purpose: This study determined if anterior talofibular ligament (ATFL)/superior extensor ankle retinaculum (SEAR) thicknesses are related to dynamic balance in individuals with chronic ankle instability (CAI). Materials and Methods: The subjects were 14 males and 15 females (age=24.52±3.46 years). Ankle instability was assessed using the Cumberland Ankle Instability Tool (CAIT) with a cut off score of 25 to define two groups. SonoSite MTurbo (Fugifilm Sonosite, Inc.) musculoskeletal ultrasound (MSKUS) unit was used to assess ATFL and SEAR thicknesses. Dynamic balance was measured with the Y Balance Test (YBT) and two NeuroCom balance tests. Results: There were no significant differences in the average ATFL thickness between stable and unstable ankles in those subjects with CAI (0.25±0.03 cm and 0.21±0.05 cm, respectively) or in the SEAR thickness (0.09±0.04 cm and 0.10±0.03 cm, respectively). There were also no significant differences in the right and left ATFL thicknesses (0.23±0.07 cm and 0.21±0.04 cm, respectively) or the SEAR thicknesses (0.09±0.01 cm and 0.09±0.01 cm, respectively) in those without CAI. There were no differences between limbs in composite scores on YBT in those with CAI (p=0.35) and those without CAI (p=0.33). There was a moderate correlation between the left SEAR thickness and the large forward/backward perturbations on the NeuroCom (Natus) motor control test (r=0.51, p=0.006 and r=0.54, p=0.003, respectively). Conclusion: There were no differences in the ATFL/SEAR thicknesses or balance measures between or within the groups, likely because CAI is multi-factorial and related to mechanisms other than tissue changes alone. More sensitive technology and a better definition of the measurement process may provide more definitive results.

Diagnostic Approach to a Soft Tissue Mass (연부조직 종양의 진단적 접근)

  • Chun, Young Soo;Song, Seung Hyun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.4
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    • pp.293-301
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    • 2019
  • Soft tissue masses of the extremities and torso are a common problem encountered by orthopaedic surgeons. Although these soft tissue masses are often benign, orthopaedic surgeons need to recognize the key features differentiating benign and malignant masses. An understanding of the epidemiology and clinical presentation of soft tissue masses is needed to develop a practical approach for evaluation and surgical management. Size and depth are the two most important factors on which triage decisions should be based. In a differential diagnosis of a tumor, it is important to know the characteristics of the soft tissue mass through detailed history taking and physical examinations before the diagnostic procedures. A variety of imaging studies, such as simple radiography, ultrasound, magnetic resonance imaging, positron emission tomography, computed tomography, bone scan, and angiography can be used to diagnose tumors. Know the ledge of advantages and disadvantages of each imaging study is essential for confirming the characteristics of the tumor that can be observed in the image. In particular, ultrasonography is convenient because it can be performed easily in an outpatient clinic and its cost is lower than other image studies. On the other hand, the accuracy of the test is affected by the skill of the examiner. A biopsy should be performed to confirm the tumor and be performed after all imaging studies have been done but before the final treatment of soft tissue tumors. When a biopsy is to be performed, careful attention to detail with respect to multidisciplinary coordination beforehand, cautious execution of the procedure to minimize complications, and expedient follow-up and referral to a musculoskeletal oncologist when appropriate, are essential.

Clinical Outcome of Treatment for Stage IIA, IIB and III Osteosarcomas (Comparative Studies between Invasive Surgical Treatment and Non-invasive HIFU Technique) (진행된 장관골 골육종의 수술 및 비수술적 강력 집속 초음파 치료의 장기 추적 결과)

  • Wenzhi, Chen;Wei, Wang;Zhibiao, Wang;Hui, Zhu;Kequan, Li;Hao, Piao Xiang;Haibing, Su;Chengbing, Jin;Feng, Wu;Jin, Bai;Rhee, Seung-Koo;Kang, Yong-Koo;Bahk, Won-Jong;Chung, Yang-Guk;Huh, Sung-Woo;Lee, Eun-Sang
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.1
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    • pp.37-46
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    • 2006
  • Purpose: To evaluate the end results between the surgical treatment with neo-adjuvant chemotherapy in Korea and non-invasive high intensity focused ultrasound (HIFU) technique in China for osteogenic sarcomas. Materials and Methods: The surgical treatment with neoadjuvant chemotherapy for total 67 cases (4 IIA, 58 IIB, and 5 III) in Korea since 1993 and the HIFU therapy for total 71 cases (57 II and 14 III) in China since 1997 was performed. In Korea, neo-adjuvant chemotherapy in 66 cases out of total 67 patients, but the adjuvant chemotherapy in only one case was done. On the contrary, in China, full chemotherapy for more than 9 times for 37 patients with stage II out of total 71 cases, but for less than 8 times of partial chemotherapy for 23 patients (stage II) and 14 patients (stage III) was done. The surgical treatment in total 67 Korean patients was done with wide resection and reconstruction for 56 patients, but wide resection without reconstruction for 5 patients and amputation for 6 patients. In china, total 71 patients was treated with average 1.5 times (1~4 times) of HIFU, and if there are some evidences of residual tumor after HIFU with following MRI, the second HIFU therapy was given 2~4 weeks later. After then, the bony defect was in no touch, keep bracing for long time expecting regeneration. All of them were followed for average 46 Mo (12~150 Mo) in Korea, but followed for average 22 Mo (9 years~8 months) in China. Results: The 5 year survival rate (stage II), was average 92.7% (IIA 100%, IIB 85.5%) in Korea series, and average 78.7% (full chemotherapy 91.8%, part chemotherapy 56.6%) in China series. The 3 year survival rate (stage III) was 20% in Korea and 7.1% in China. So, the final overall survival rate was 65.2% in Korea and 51.8% in China. The overall functional outcome score by ISOLS was 24.3 (81%) in Korea and 19.8 (73%) in China. There are 25.4% (17/67 cases) of complications in Korea and 31% (27 complications in 22 patients out of total 71 cases) in China after each treatment. Conclusions: The end results of Korea series which was treated with neoadjuvant chemo- and surgical methods are better than that of non-invasive thermal ablation in china. But we also believe the HIFU, as one of, was also effective to decrease the local recurrence and symptomatic releaf for stage II or even in III of osteogenic sarcomas.

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Association of Metabolic Syndrome and Biochemical Examination of the Gallbladder Polyp (담낭 용종의 대사성 증후군 및 생화학적 검사의 연관성)

  • Park, Young-Joon
    • Journal of radiological science and technology
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    • v.38 no.3
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    • pp.267-276
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    • 2015
  • The gallbladder(GB) polyps have malignant potential and nowadays are increasing due to the extended use of ultrasonography. Even though there are various reports on the risk of GB polyps, there is few study on the relationship between the presence of metabolic syndrome including serum biochemistry, lifestyle and the development of gallbladder polyps in korean population. The aim of this study is to establish a relationship between the presence of metabolic syndrome including serum biochemistry and the development of gallbladder polyps in korean population. This study conducted on 151 men and 167 women who visited a musculoskeletal hospital in Gyeonggido to have an ultrasound scan of the abdomen from November 2, 2012 to January 31, 2014. They are randomly selected to evaluate the prevalence risk factors were analyzed by comparing various variables between the GB polyp positive and negative. The collected data were analyzed using the personal computer program SPSS version 20.0 for windows. The mean size of the GB polyps was 3.92mm in diameter. Size of GB polyps were less than 10mm in diameter. As to frequency in the people with the GB polyps, the number of patients with the GB polyps was 184(57.9%): the number of metabolic syndrome of them was 114(26.4%); these results showed that risk of the GB polyps got higher at patients with metabolic syndrome. As to the risk of the GB polyps, people with the GB polyps had significantly higher risk than those without the GB polyps, as follows: The risk was significantly 1.061 times higher by weight; 1.186 by BMI; 1.060 by systolic blood pressure; 1.030 by diastolic blood pressure; 1,009 by Total cholesterol; 2.736 by metabolic syndrome; 1.011 by blood sugar on an empty stomach; 1.064 by ESR. The risk factors of GB polyps were found to be weight, BMI, total cholesterol, Triglycerol, Glucose, systolic blood pressure, diastolic blood pressure, ESR and metabolic syndrome. This study has a possibility to be used an indicator to identify the GB polyps, and in the future larger-scale study will have to be conducted to objectify it.