Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
-
Randomized Controlled Trial Comparative Study
Comparison of Two Injection Techniques for Intra-articular Hip Injections.
Intra-articular hip joint injections have traditionally relied on the use of image guidance to confirm intra-articular needle placement. Musculoskeletal ultrasound (US) has emerged as a popular tool to aid the clinician in performing intra-articular hip injections. Modern automated injection delivery systems are commercially available and may offer the potential to optimize clinical efficiency while limiting procedural morbidity. The purpose of this study was to compare patient-reported outcomes and clinical efficiency between two US-guided intra-articular hip injection techniques. The hypothesis was that the use of an automated delivery system for US-guided intra-articular hip joint injections would show superiority in clinical efficiency over traditional syringe injections. ⋯ Use of an automated delivery system for US-guided intra-articular hip injections did not show superior efficiency or patient comfort over traditional syringe injections. Intra-articular corticosteroid injections led to clinically and statistically significant improvements in pain and function for patients with intra-articular hip pain, irrespective of the delivery method. Smoking history and female sex were independent predictors of increased pain associated with intra-articular hip joint injections.
-
A few studies have evaluated real-time shear wave elastography (SWE) for assessing liver fibrosis by measuring liver stiffness in patients with chronic hepatitis C virus (HCV) infection, but they excluded human immunodeficiency virus/HCV-coinfected patients. We investigated the diagnostic performance of liver stiffness measured by SWE as a noninvasive predictor of liver fibrosis in HCV using liver biopsy as a reference standard, including monoinfected and coinfected patients. ⋯ Shear wave elastography of the liver is an effective noninvasive predictor of liver fibrosis in patients with HCV. There was no significant difference between monoinfected and coinfected patients; hence, the same cutoff values can be used for both groups. Combination of SWE with the fibrosis-4 score leads to higher accuracy, although at the expense of inconclusive results in some patients.
-
Ultrasound phantoms are invaluable as training tools for vascular access procedures. We developed ultrasound phantoms with wall-less vessels using 3-dimensional printed chambers. ⋯ Several variations on this design are presented, which include branched and stenotic vessels. The results show that 3-dimensional printing can be well suited to the construction of wall-less ultrasound phantoms, with designs that can be readily customized and shared electronically.
-
To evaluate the feasibility of ultrasound (US)-guided cervical facet injections and to identify the potential obstacles to routine use of this technique. ⋯ Although US-guided cervical facet joint injections are feasible, substantial obstacles may prevent their routine use. The main obstacle is to effectively identify and target the correct cervical level in a prone position.
-
Ultrasound (US)-guided fine-needle aspiration cytology (FNAC) is able to identify patients with extensive node involvement before surgery. In this study, we aimed to establish the optimal US criterion to identify abnormal lymph nodes on US-guided FNAC for detection of patients with 3 or more metastatic axillary nodes. ⋯ Cortical thickness of greater than 3.5 mm in the most suspicious nodes is appropriately predictive of patients with 3 or more tumor-involved axillary nodes. When this criterion for US-guided FNAC was adopted, a group of patients with 1 or 2 metastatic nodes could be spared unnecessary 1-step axillary lymph node dissection.