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1
المؤلفون: Eugene, Maida, Mary M, Chiavaras, Elena J, Jelsing, Shawn W, O'Driscoll, Wojciech, Pawlina, Jay, Smith
المصدر: Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. 36(8)
مصطلحات موضوعية: Aged, 80 and over, Male, Forearm, Cadaver, Humans, Reproducibility of Results, Female, Middle Aged, Ultrasonography, Interventional, Aged, Injections, Intra-Articular
الوصف: To determine the ability to sonographically identify the posterior cutaneous nerve of the forearm (PCNF) and its distal epicondylar branches using sonographically guided perineural injections in an unembalmed cadaveric model.A single experienced operator used a 12-3-MHz linear array transducer to identify the PCNF and its distal epicondylar region branches in 10 unembalmed cadaveric specimens (6 right and 4 left) obtained from 10 donors. Sonographically guided perineural PCNF injections were then completed with a 22-gauge, 38-mm stainless steel needle to deliver 0.25 mL of 50% diluted colored latex at 3 points along the PCNF. The latex location was then confirmed via dissection.The 10 donors included 4 male and 6 female cadavers aged 48 to 94 years (mean, 73 years) with body mass indices of 19 to 37 kg/mHigh-resolution sonography can identify the PCNF and its distal epicondylar branches. Sonographic evaluation of the PCNF should be included in the evaluation of patients presenting with refractory or atypical lateral elbow pain syndromes. Diagnostic and therapeutic sonographically guided procedures targeting the PCNF or its lateral epicondylar branches are feasible and warrant further investigation.
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المؤلفون: Elena J. Jelsing, Michael H. Silber, Ralitza H. Gavrilova, Neeraj Kumar, Bradley F. Boeve, Eoin P. Flanagan
المصدر: Neurology. 80:118-120
مصطلحات موضوعية: Male, Synucleinopathies, Pathology, medicine.medical_specialty, Pelizaeus-Merzbacher Disease, business.industry, Polysomnography, Leukodystrophy, REM Sleep Behavior Disorder, Parasomnia, Middle Aged, medicine.disease, Brain Waves, Magnetic Resonance Imaging, Sleep in non-human animals, REM sleep behavior disorder, Hyperintensity, White matter, medicine.anatomical_structure, medicine, Humans, Neurology (clinical), Brainstem, business
الوصف: Adult-onset autosomal dominant leukodystrophy (ADLD) is a slowly progressive hereditary disease of the white matter caused by duplication of the nuclear lamina protein lamin B1 on chromosome 5q23.2.1 Patients usually present in the 4th–5th decade with autonomic symptoms followed by pyramidal and cerebellar dysfunction.2 In ADLD, MRI head reveals symmetric T2-signal hyperintensities in the subcortical white matter, brainstem, and middle cerebellar peduncles.2 REM sleep behavior disorder (RBD) is a parasomnia characterized by dream enactment behavior and REM sleep without atonia.3 It has been reported most commonly with synucleinopathies such as Parkinson disease and may precede the diagnosis by decades.3 To our knowledge, RBD has not been reported with leukodystrophies. Herein we report a case of ADLD presenting with RBD as the initial symptom.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1ab4b5b4c30e12d3fee67d1e136f9698
https://doi.org/10.1212/wnl.0b013e31827b1b2a -
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المصدر: Musclenerve. 51(1)
مصطلحات موضوعية: Adult, Male, Forearm, Young Adult, Adolescent, Humans, Female, Middle Aged, Carpal Bones, Healthy Volunteers, Aged, Median Nerve, Ultrasonography
الوصف: The primary aim of this investigation was to determine whether use of write-zoom magnification affects sonographically determined cross-sectional area (CSA) of peripheral nerves.CSAs of the median (MN) and posterior interosseous (PIN) nerves were measured in 22 limbs from 11 asymptomatic volunteers using both standard imaging and write-zoom magnification. CSA measurements were repeated on the same images 1 week later.The average CSA of write-zoomed images for the MN was significantly larger at both measurement sessions (week 1: 11.1 mm(2) write-zoom vs. 10.0 mm(2) standard, P = 0.019; week 2: 11.8 mm(2) vs. 10.4 mm(2), P = 0.023). Similar differences were noted for the PIN (week 1: 2.3 mm(2) vs. 1.9 mm(2), P = 0.002; week 2: 2.5 mm(2) vs. 1.9 mm(2), P = 0.001).Write-zoom magnification may significantly increase the measured CSA of peripheral nerves. These changes appear to be more substantial when smaller nerves are measured.
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4The source of fluid deep to the iliotibial band: documentation of a potential intra-articular source
المؤلفون: Jay Smith, Elena J. Jelsing, Eugene Maida, Jonathan T. Finnoff
المصدر: PMR : the journal of injury, function, and rehabilitation. 6(2)
مصطلحات موضوعية: musculoskeletal diseases, Male, Knee Joint, medicine.medical_treatment, Iliotibial Band Syndrome, Physical Therapy, Sports Therapy and Rehabilitation, Suprapatellar recess, Intra articular, Cadaver, medicine, Humans, Prospective Studies, Saline, Aged, Ultrasonography, Aged, 80 and over, business.industry, Rehabilitation, Anatomy, Exudates and Transudates, Middle Aged, musculoskeletal system, Knee pain, Neurology, Female, Neurology (clinical), medicine.symptom, Epicondyle, business, Cadaveric spasm, human activities
الوصف: Objective To determine whether there is a consistent extension of the lateral synovial recess under the iliotibial band (ITB) in an unembalmed cadaveric model. Design A prospective laboratory investigation. Setting A procedural skills laboratory of a tertiary medical center. Subjects Twelve unembalmed cadaveric knee specimens. Methods The suprapatellar recess, ITB, and region deep to the ITB were examined sonographically to document the absence of fluid in each knee. Thereafter, 60 mL of normal saline solution was injected into each knee to distend the joint recesses. Postinjection sonographic examination of the ITB at the level of the lateral femoral epicondyle was repeated at 0°, 25°, and 45° of knee flexion to detect and characterize any fluid visualized in the region of the ITB. The location of fluid in relation to the ITB was recorded as anterior, deep, posterior, or a combination of these positions. Results Fluid was observed anterior and deep to the ITB in 100% of 12 specimens. In 2 specimens, fluid also was noted posterior to the ITB. The presence and location of the fluid did not appear to change as a function of knee position. Using dynamic sonographic evaluation, we could track the fluid deep to the ITB back to the knee joint. Conclusions The lateral synovial recess appears to regularly extend beneath the anterior ITB. Fluid deep to the ITB should precipitate further evaluation of the knee joint when clinically indicated. Although distention of the lateral synovial recess is not always symptomatic, synovial irritation may be a pathoetiologic factor in the production of lateral knee pain syndromes, including ITB syndrome.
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المصدر: PMR : the journal of injury, function, and rehabilitation. 6(9)
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Weakness, Physical Therapy, Sports Therapy and Rehabilitation, Electromyography, Rotator Cuff Injuries, symbols.namesake, Young Adult, Risk Factors, Shoulder Pain, Tendon Injuries, Internal medicine, medicine, Brachial Plexus Neuritis, Humans, Cyst, Rotator cuff, Young adult, Fisher's exact test, Aged, Retrospective Studies, Rupture, medicine.diagnostic_test, business.industry, Rotator cuff injury, Nerve Compression Syndromes, Rehabilitation, Retrospective cohort study, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Surgery, medicine.anatomical_structure, Treatment Outcome, Neurology, symbols, Female, Neurology (clinical), medicine.symptom, business
الوصف: Objective To report our diagnostic and treatment experiences, and patient outcomes, in patients with suprascapular neuropathy (SSN). Design Retrospective cohort study. Setting A tertiary medical center. Patients 65 patients with electromyographically (EMG)-confirmed SSN. Methods A 5-year retrospective chart review of patients with EMG-confirmed SSN. Main Outcome Measures Descriptive statistics were used to summarize demographics, risk factors, causes, EMG findings, diagnostic evaluation, treatments, and self-reported outcomes. Exact Mantel-Haenszel χ 2 tests and Fisher exact tests were used to assess correlation between these measures. Results The 3 most common causes of SSN were trauma (32 patients), an inflammatory process (ie, brachial neuritis) (14), and the presence of a cyst (13). Remaining cases were related to a rotator cuff tear or were due to overuse. No cases were attributed to notch abnormalities. At the time of follow-up (a mean of 50 months [range, 15-84 months] after EMG), 50% of subjects returned to activity with no restrictions (excellent outcome) and 40% returned to activity with restrictions (good outcome), regardless of cause and treatment. EMG findings, specifically the presence/absence of fibrillation potentials, did not predict recovery. Conclusions SSN should be considered in patients with shoulder pain and weakness. Magnetic resonance imaging and ultrasound help to exclude a structural process. Identifying a structural cause, specifically a cyst or rotator cuff tear, is important because it appears that these patients have improved recovery with return to normal activities when treated surgically. Although EMG data did not have prognostic value in this study, the data were limited and further study is warranted. Regardless of cause or treatment, most patients with SSN returned to activities in some capacity.
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