Learning objectives
The aim of this educational exhibit is to:
1.
review the US-guided percutaneous procedures aimed to the treatment of lower limb musculoskeletal pathologies;
2.
show technical aspects,
precautions and tricks that may help to improve the outcome of such treatments;
3.
report anatomical schemes with didactic purpose and show correlations both with US static images and procedural US videos.
Background
Ultrasound is very helpful in the guidance of percutanous musculoskeletal procedures on the lower limb either to the relatively deep location of some joint structures,
such as the hip (where free-hand techniques are affected by a low level of accuracy) or to the superficial location of other structures that are too small or very close to neurovascular structures.
Diagnostic and subsequent interventional procedures of upper limb are performed using high frequency broadband (7-15MHz) linear transducers,
depending on the depth of the target and the local...
Findings and procedure details
HIP OSTEOARTHRITIS
Hip osteoarthritis affect 4.4% of adults over 55 years.
Primary hip OA is found as a degenerative joint disease frequently associated with increased loads on this weight-bearing joint,
such as in the case of various grades obesity.
Secondary hip OA can be found in patients with untreated FAI (femoracetabular impingement) or hip dysplasia,
in which the altered biomechanics usually leads to joint damage.
Clinical presentation
The main symptom is joint stiffness that occurs as they are getting out of bed or after sitting...
Conclusion
Ultrasound has emerged as a low-cost,
radiation-free,
real-time guidance and effective imaging technique to detect joint abnormalities and to guide percutaneous procedures.
The knowledge of technical aspects and tips is essential to act in the most accurate way on target tissues that could haverelatively deep location,
be very small and/orclose to neurovascular structures.
References
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Survival of the Charnley low-friction arthroplasty.
A 12–24 year follow-up of 276 cases.
Acta Orthop Scand 1997; 68:27–9.
Hoaglund FT,
Steinbach L.
Primary osteoarthritis of the hip: Etiology and epidemiology.
J Am Acad Orthop Surg 2001;9:320–7.
Kellgren JH,
Lawrence JS.
Osteoarthritis as seen in random samples of the population.
J Bone Joint Surg Br 1961;43-B:601....