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New technologies applied to ultrasound diagnosis of sports injuries

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Abstract

Introduction

The aim of this study was to compare the ultrasound images of different soft tissue lesions from two different portable sonography devices: a conventional portable sonography device (ultrasound [US]-A, Micromaxx model; Sonosite Inc., Bothell, WA, USA), and a recently marketed compact device (US-B, Logiq e; General Electric Healthcare, Wauwatosa, WI, USA). The US-B device uses the new technologies of tissue harmonic imaging, real-time compound ultrasound, panoramic view, three-dimensional imaging, and virtual convex imaging.

Methods

We compared ultrasound images of six different types of soft tissue lesions (muscle contusion, muscle strain, patellar tendinosis, calcifying patellar tendinosis, rupture of the lateral internal ligament of the knee, and deep infrapatellar synovial bursa), from six different subjects. Analysis of images was performed by the same ultrasound specialist. In accordance with the classical criteria for ultrasound studies, the following quantitative indicators and parameters of ultrasound quality were used to evaluate the images: degree of echogenicity, size of the lesion area, aspect, shape, borders, and overall visualization.

Results

In muscle lesions due to contusion, not only is the edematous area better visualized with the new system, but definition of hemorrhagic area borders and their content is especially increased. In lesions of the tendons, the new system affords better definition of the borders of the hypoechogenic area of tendinous degeneration and perfect visualization of the extension of the damaged area using a panoramic study. Sonographic study of ligaments with chronic lesions permits visualization of scar areas. Finally, use of the new system with a small synovial bursa shows the content of the bursa and thickness of the walls more clearly.

Conclusion

Overall, the quantitative indicators and parameters of image quality performed in this study of common sports lesions demonstrate the improvement in visualization of damaged soft tissues with the new technologies now incorporated into portable sonography devices.

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References

  1. Strobel K, Zanetti M, Nagy L, Hodler J. Suspected rotator cuff lesions: tissue harmonic imaging versus conventional US of the shoulder. Radiology. 2004;230:243–249.

    Article  PubMed  Google Scholar 

  2. Oktar SO, Yücel C, Özdemir H, Ulutürk A, Isik S. Comparison of conventional sonography, real-time compound sonography, tissue harmonic sonography, and tissue harmonic compound sonography of abdominal and pelvic lesions. AJR Am J Roentgenol. 2003;181:1341–1347.

    PubMed  Google Scholar 

  3. Barberie JE, Wong AD, Cooperberg PL, Carson BW. Extended field-of-view sonography in musculoskeletal disorders. AJR Am J Roentgenol. 1998;171:751–757.

    PubMed  CAS  Google Scholar 

  4. Weng L, Tirumalai AP. Method and apparatus for generating large compound ultrasound images. U.S. Patent 5575286; 1996. Available at: www.freepatentsonline. com/5575286.html. Accessed October 2008.

  5. Fornage BD. The hypoechoic normal tendon: a pitfall. J Ultrasound Med. 1987;6:19–22.

    PubMed  CAS  Google Scholar 

  6. Alvarez G, Alvarez I, Jiménez F, Cobián C. El Power Doppler como ayuda en el diagnóstico ecográfico de lesiones músculo esqueléticas. In: Ponencias del III Curso Internacional de Medicina y Traumatología del Deporte y II Jornadas Regionales de Promoción de la Salud y Ejercicio Físico. Toledo: Consejería de Sanidad de la Junta de Comunidades de Castilla la Mancha; 2003:195–200.

    Google Scholar 

  7. Laraudogoitia, E. Ecocardiografía. Impacto de las nuevas tecnologías. Rev Esp Cardiol. 2005;5(suppl. A):45–54.

    Google Scholar 

  8. Stiskal M, Steinbach R, Obholzer G, Frank W, Fischer H, Czembirek H. Tissue harmonic imaging sonography: is the image quality in routine abdominal ultrasound improved? Rofo. 2000;172:1006–1010.

    PubMed  CAS  Google Scholar 

  9. Tranquart F, Grenier N, Eder V, Pourcelot L. Clinical use of ultrasound tissue harmonic imaging. Ultrasound Med Biol. 1999;25:889–894.

    Article  PubMed  CAS  Google Scholar 

  10. Rosenthal SJ, Jones PH, Wetzel LH. Phase inversion tissue harmonic sonographic imaging: a clinical utility study. AJR Am J Roentgenol. 2001;176:1393–1398.

    PubMed  CAS  Google Scholar 

  11. Shapiro RS, Wagreich J, Parsons RB, Stancato-Pasik A, Yeh HC, Lao R. Tissue harmonic imaging sonography: evaluation of image quality compared with conventional sonography. AJR Am J Roentgenol. 1998;171:1203–1206.

    PubMed  CAS  Google Scholar 

  12. Lin DC, Nazarian LN, O’Kane PL, McShane JM, Parker L, Merritt CR. Advantages of real-time spatial compound sonography of the musculoskeletal system versus conventional sonography. AJR Am J Roentgenol. 2002;179:1629–1631.

    PubMed  Google Scholar 

  13. Carroll BA. Three-dimensional ultrasound. AJR Am J Roentgenol. 2000;175:666.

    Google Scholar 

  14. Harcke HT, Grissom LE, Finkelstein MS. Evaluation of the musculoskeletal system with sonography. AJR Am J Roentgenol. 1988;150:1253–1261.

    PubMed  CAS  Google Scholar 

  15. Beggs I. Sonography of muscle hernias. AJR Am J Roentgenol. 2003;180:395–399.

    PubMed  Google Scholar 

  16. Barceló P. Nomenclatura ecográfica. In: Jiménez F, ed. Diagnóstico Clínico y Ecográfico de las Lesiones en el Deporte. Murcia: Universidad Católica de Murcia; 2003;59–64.

    Google Scholar 

  17. Jacobson JA. Ultrasound in sports medicine. Radiol Clin North Am. 2002;40:363–386.

    Article  PubMed  Google Scholar 

  18. Garrett WE. Muscle strain injuries: clinical and basic aspects. Med Sci Sports Exerc. 1990;22:436–443.

    PubMed  Google Scholar 

  19. Clancy WGJ. Tendon trauma and overuse injuries. In: Leadbetter WB, Buckwalter JA, Gordon SL, eds. Sports-Induced Inflammation: Clinical and Basic Science Concepts Sports-Induced Inflammation: Clinical and Basic Science Concepts. Park Ridge, IL: American Academy of Orthopaedic Surgeons; 1990:609–618.

    Google Scholar 

  20. Martinoli C, Derchi LE, Pastorino C, Bertolotto M, Silvestri E. Analysis of echotexture of tendons with US. Radiology. 1993;186:839–843.

    PubMed  CAS  Google Scholar 

  21. Maffulli N, Khan KM, Paddu G. Overuse tendon conditions: time to change a confusing terminology. Arthroscopy. 1998;14:840–843.

    Article  PubMed  CAS  Google Scholar 

  22. Lin J, Fessell DP, Jacobson JA, Weadock WJ, Hayes CW. An illustrated tutorial of musculoskeletal sonography: part I, introduction and general principles. AJR Am J Roentgenol. 2000;175:637–645.

    PubMed  CAS  Google Scholar 

  23. van Dijk CN, Mol BW, Lim LS, Marti RK, Bossuyt PM. Diagnosis of ligament rupture of the ankle joint. Physical examination, arthrography, stress radiography and sonography compared in 160 patients after inversion trauma. Acta Orthop Scand. 1996;67:566–570.

    PubMed  Google Scholar 

  24. Alvarez G, Jimenez JF, Balius R. Ecografía músculo esquelética aplicada a la medicina del deporte. MD Revista Cientifica de Medicina del Deporte. 2006;4:3–36.

    Google Scholar 

  25. Campbell DG, Menz A, Isaacs J. Dynamic ankle ultrasonography: a new imaging technique for acute ankle ligament injuries. Am J Sports Med. 1994;22:855–858.

    Article  PubMed  CAS  Google Scholar 

  26. Jiménez F, ed. Diagnóstico Clínico y Ecográfico de las Lesiones en el Deporte. Murcia: Universidad Católica de Murcia; 2003.

    Google Scholar 

  27. Balius R, Rius M, Combalia A, eds. Ecografía Muscular de la Extremidad Inferior. Sistemática de Exploración y Lesiones en el Deporte. Barcelona: Masson; 2005.

    Google Scholar 

  28. Balius R, Rius M, Struch A, Garcia R. Ecografía de las lesiones musculares en el fútbol. In: Ponencias del IV Curso Internacional de Medicina y Traumatología del Deporte y III Jornadas Regionales de Promoción de la Salud y Ejercicio Físico. Toledo: Consejería de Sanidad de la Junta de Comunidades de Castilla la Mancha; 2004:119–128.

    Google Scholar 

  29. Balius R. Lesión del recto femoral. In: Balius R, Rius M, Combalia A, eds. Ecografía Muscular de la Extremidad Inferior. Sistemática de Exploración y Lesiones en el Deporte. Barcelona: Masson; 2005:121–129.

    Google Scholar 

  30. McNamara MT, Greco A: Miscellaneous muscle lesions. In: Fleckenstein JL, Crues JV III, Reimers CD, eds. Muscle Imaging in Health and Disease. New York: Springer-Verlag; 1996:425–449.

    Google Scholar 

  31. Silvestri E, Martinoli C, Derchi LE, Bertolotto M, Chiaramondia M, Rosenberg I. Echotexture of peripheral nerves: correlation between US and histologic findings and criteria to differentiate tendons. Radiology. 1995;197;291–296.

    PubMed  CAS  Google Scholar 

  32. Van Holsbeeck MT, Introcaso JH. Sonography of tendons. In: Van Holsbeeck MT, Introcaso JH, eds. Musculoskeletal Ultrasound. St. Louis, MO: Mosby; 2001:77–129.

    Google Scholar 

  33. Almekinders LC, Vellema JH, Weinhold PS. Strain patterns in the patellar tendon and the implications for patellar tendinopathy. Knee Surg Sports Traumatol Arthrosc. 2002;10:2–5.

    Article  PubMed  Google Scholar 

  34. Cook JL, Khan KM, Harcourt PR, et al. Patellar tendon ultrasonography in asymptomatic active athletes reveals hypoechoic regions: a study of 320 tendons. Victorian Institute of Sport Tendon Study Group. Clin J Sport Med. 1998;8:73–77.

    Article  PubMed  CAS  Google Scholar 

  35. Öhberg L, Lorentzon R, Alfredson H. Neovascularisation in Achilles tendons with painful tendinosis but not in normal tendons: an ultrasonographic investigation. Knee Surg Sports Traumatol Arthrosc. 2001;9:233–238.

    Article  PubMed  Google Scholar 

  36. Rasmussen OS. Sonography of tendons. Scand J Med Sci Sports. 2000;10:360–364.

    Article  PubMed  CAS  Google Scholar 

  37. De Maeseneer M, Vanderdood K, Marcelis S, Shabana W, Osteaux M. Sonography of the medial and lateral tendons and ligaments of the knee: the use of bony landmarks as an easy method for identification. AJR Am J Roentgenol. 2002;178:1437–1444.

    PubMed  Google Scholar 

  38. Cook JL, Malliaras P, De Luca J, Ptasznik R, Morris M. Vascularity and pain in the patellar tendon of adult jumping athletes: a 5 month longitudinal study. Br J Sports Med. 2005;39:458–461.

    Article  PubMed  CAS  Google Scholar 

  39. Fessell DP, Jacobson JA, Craig J, et al. Using sonography to reveal and aspirate joint effusions. AJR Am J Roentgenol. 2000;74:1353–1362.

    Google Scholar 

  40. Robinson P, Bollen SR. Posterior ankle impingement in professional soccer players: efectiveness of sonographically guided therapy. AJR Am J Roentgenol. 2006;87:W53–W58.

    Article  Google Scholar 

  41. Jiménez Díaz JF, Álvarez Rey G, Balius Matas R, Villa Vicente JG. Avenços tècnics aplicats a l’ecografia musculosquelètica de la lesió esportiva. Apunts Medicina de l’Esport. 2007;154:66–75.

    Google Scholar 

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Correspondence to José Fernando Jiménez Díaz.

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Jiménez Díaz, J.F., Alvarez Rey, G., Balius Matas, R. et al. New technologies applied to ultrasound diagnosis of sports injuries. Adv Therapy 25, 1315–1330 (2008). https://doi.org/10.1007/s12325-008-0122-y

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