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Nail unit ultrasound: a complete guide of the nail diseases

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Abstract

Introduction

The nails have a functional and esthetic importance for patients. Almost always, the nail disorders are diagnosed on the basis of clinical findings, but imaging methods may be required for a better assessment. These imaging methods, such as ultrasound and magnetic resonance, may help to establish an accurate diagnosis. Magnetic resonance imaging is not widely available and sometimes may be very expensive; that is why, ultrasound is an excellent imaging modality. Our objective is to expose the nail unit anatomy, the nail unit anatomy in ultrasound, and some of the frequent pathologies found in our daily practice.

Methods

A review of the literature was done to review the anatomy, technical aspects, and different findings in normal and abnormal nail unit ultrasound.

Results

Ultrasound offers an appropriate alternative for the evaluation of the nail unit, allows a real-time evaluation of each one of the components of the nail unit with an optimal visualization of these structures, and allows the evaluation of the thickness of the components, the vascularity, and blood flow by Doppler application. In addition, the nail unit disorder, such as infectious diseases, inflammatory and rheumatologic conditions, nail tumors, among others, may be assessed, not only in the diagnosis but also in the follow-up. Pre-surgical evaluation, surgical follow-up, and some procedures, such as biopsies, may be done by this technique.

Conclusions

Ultrasound is an excellent technique for evaluation of normal anatomy, diagnosis, and follow-up of patients with nail unit diseases. This is an alternative for other imaging methods and may be used for an accurate diagnosis approach.

Sommario

Oggetto

Le unghie hanno un’importanza funzionale e estetica per i pazienti. Quasi tutti i disturbi delle unghie sono diagnosticati sulla base di reperti clinici ma le metodiche di Imaging sono richieste per una migliore valutazione. Queste metodiche di Imaging, come l’ecografia e la RM, possono aiutare nell’ottenere una diagnosi più accurata. La RM è una metodica di Imaging non facilmente disponibile e rappresenta un costo aggiuntivo, per questo motivo l’ecografia è una metodica eccellente in questo campo. Il nostro obiettivo è mostrare l’anatomia normale, l’anatomia ecografica delle unghie e anche alcune delle patologie più frequenti nella pratica clinica quotidiana.

Metodi

E’ stata effettuata una review della Letteratura riguardo l’anatomia, gli aspetti tecnici e i reperti ecografici delle unghie normali e patologiche.

Risultati

L’ecografia offre un’alternativa valida nella valutazione delle unghie, permettendo una valutazione in tempo reale dello spessore dei componenti, della vascolarizzazione al color Doppler. Inoltre, la diagnosi e il follow-up dei disordini delle unghie, sia infettivi, infiammatori, reumatologici, tumorali, possono essere effettuati. Infatti, La valutazione pre-chirurgica, il follow-up e alcune procedure come le biopsie possono essere effettuate mediante questa metodica.

Conclusioni

L’ecografia è una tecnica eccellente per la valutazione dell’anatomia normale, la diagnosi e il follow-up delle malattie delle unghie. Essa è un’alternativa che sembra valida rispetto ad altre metodiche di Imaging per una diagnosi accurata.

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Abbreviations

US:

Ultrasound

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Authors and Affiliations

  1. Radiology Department, Country Scan LTDA, Carrera 16 # 84a- 09 Cons. 323, Bogotá, Colombia

    Felipe Aluja Jaramillo

  2. Dermatology Department, Instituto de Pós-graduação Médica Carlos Chagas-Policlínica Geral do Rio de Janeiro, Rio De Janeiro, Brazil

    Diana Carolina Quiasúa Mejía

  3. Carrera 21 No 122-87, Bogotá, Colombia

    Diana Carolina Quiasúa Mejía

  4. Radiology Department, Clínica Universitaria Colombia, Calle 23b # 66-46, Bogotá, Colombia

    Hector Mauricio Martínez Ordúz

  5. Dermatology Department, Clínica Universitaria Colombia, Calle 23b # 66-46, Bogotá, Colombia

    Cesar González Ardila

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  1. Felipe Aluja Jaramillo
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  2. Diana Carolina Quiasúa Mejía
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  3. Hector Mauricio Martínez Ordúz
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  4. Cesar González Ardila
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Correspondence to Felipe Aluja Jaramillo.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Aluja Jaramillo, F., Quiasúa Mejía, D.C., Martínez Ordúz, H.M. et al. Nail unit ultrasound: a complete guide of the nail diseases. J Ultrasound 20, 181–192 (2017). https://doi.org/10.1007/s40477-017-0253-6

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  • DOI: https://doi.org/10.1007/s40477-017-0253-6

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