BACKGROUND: To evaluate the utilization of point-of-care ultrasound(POCUS) for the assessment of emergency department(ED) patients with musculoskeletal symptoms and the impact of musculoskeletal POCUS on medical decis...BACKGROUND: To evaluate the utilization of point-of-care ultrasound(POCUS) for the assessment of emergency department(ED) patients with musculoskeletal symptoms and the impact of musculoskeletal POCUS on medical decision-making and patient management in the ED.METHODS: This was a retrospective review of ED patients presenting with musculoskeletal symptoms who received a POCUS over a 3.5-year period. An ED POCUS database was reviewed for musculoskeletal POCUS examinations used for medical decision-making. Electronic medical records were then reviewed for demographic characteristics, history, physical examination findings, ED course, additional imaging studies, and impact of musculoskeletal POCUS on patient management in ED. RESULTS: A total of 264 subjects(92 females, 172 males) and 292 musculoskeletal POCUS examinations were included in the fi nal analysis. Most common symptomatic sites were knee(31.8%) and ankle(16.3%). Joint effusion was the most common fi nding on musculoskeletal POCUS, noted in 33.7% of the patients, and subcutaneous edema/cobblestoning was found in 10.2% of the patients. Muscle or tendon rupture was found in 2.3% of the patients, and 1.9% of the patients had joint dislocation. Bursitis or bursa fluid was found in 3.4% of patients, and tendonitis/tendinopathy was found in 2.3%. Twenty percent of them were ultrasound-guided musculoskeletal procedures, and most of them(73.3%) were arthrocentesis. Of the included studies, all except three either changed or helped guide patient management as documented in the patients' medical records.CONCLUSION: Our study fi ndings illustrate the utility of POCUS in the evaluation of a variety of musculoskeletal pathologies in the ED.展开更多
Objective:To explore the application effect and clinical value of musculoskeletal ultrasound in the rehabilitation of hand function after flexor tendon rupture repair.Methods:In this study,72 patients were selected fr...Objective:To explore the application effect and clinical value of musculoskeletal ultrasound in the rehabilitation of hand function after flexor tendon rupture repair.Methods:In this study,72 patients were selected from among patients who underwent flexor tendon rupture repair of the hand in Yancheng Third People’s Hospital from May 2018 to May 2020;the patients were randomly divided into the control group(routine hand rehabilitation training)and the experimental group(musculoskeletal ultrasound and targeted hand rehabilitation training based on examination results)by die roll,with 34 cases in each group;the hand rehabilitation of the two groups were compared.Results:The excellent and good rate of the total active motion(TAM)of the experimental group(94.44%)was significantly higher than that of the control group(69.44%)(P<0.05);before treatment,there was no significant difference in the diameter and degree of stenosis of the artery in the finger between the two groups(P>0.05);after treatment,the degree of stenosis and the diameter of the artery of the experimental group were significantly better than those of the control group(P<0.05).Conclusion:For patients treated with flexor tendon rupture repair of the hand,the use of musculoskeletal ultrasound in the rehabilitation process can significantly improve the functional recovery of the hand;therefore,it is worthy of in-depth research,promotion,and application in clinical rehabilitation.展开更多
Objective:To observe the ultrasonographic characteristics of conjoined tendon repair in direct anterior approach for total hip arthroplasty(DAA-THA),and to evaluate the efficacy of musculoskeletal ultrasound in determ...Objective:To observe the ultrasonographic characteristics of conjoined tendon repair in direct anterior approach for total hip arthroplasty(DAA-THA),and to evaluate the efficacy of musculoskeletal ultrasound in determining the healing after joint tendon repair.Methods:A total of 60 patients who required primary total hip arthroplasty in Yulin Orthopedic Hospital of Chinese and Western Medicine from July 2020 to July 2021 were selected;the patients were divided into two groups,an observation group,group A(n=30),and a control group,group B(n=30),according to different intraoperative methods.There was no significant difference in gender,age,and diagnosis between the two groups.Direct anterior approach was used for both the groups.For group A,the joint capsule and conjoined tendon(superior gemellus,obturator internus,and inferior gemellus)were repaired in situ,whereas for group B,only the joint capsule was repaired in situ,while the conjoined tendon was not repaired.The healing of the tendon was observed.Results:(1)in terms of diagnosis,after conjoined tendon repair,26 cases in group A showed good tendon continuity,good tension,and a small amount of effusion echo around,three cases showed partial interruption of tendon echo,low echo,or no echo inside with insufficient structural clarity,and a case showed complete interruption;in group B,all 30 cases had continuous interruption,poor tension,tendon retraction,and thickening;the healing rate of group A’s conjoined tendon repair was 96.67%;(2)in terms of prognostic assessment,one month after the surgery,the Harris score of group A was significantly higher than that of group B(P<0.05);however,there was no significant difference in the terms of the Harris score between the two groups 3-6 months after surgery(P>0.05);the effective tension of conjoined tendon and the effective muscle strength of group A were significantly higher than those of group B(P<0.05).Conclusion:Musculoskeletal ultrasound has high diagnostic value in the healing of conjoined tendon and provides dynamic clinical observation after conjoined tendon repair in DAA-THA;it is proven that DAA-THA with conjoined tendon repair on the premise of reconstructing the joint capsule can well restore its tension,enhance its muscle strength,significantly improve early joint stability and joint function,as well as facilitate the rapid recovery of patients.展开更多
Background: To evaluate the effect of treatment on musculoskeletal ultrasound (MSUS) and explore whether MSUS are associated with therapeutic response in rheumatoid arthritis (RA) patients treated with Tofacitinib in ...Background: To evaluate the effect of treatment on musculoskeletal ultrasound (MSUS) and explore whether MSUS are associated with therapeutic response in rheumatoid arthritis (RA) patients treated with Tofacitinib in combination with methotrexate (MTX). Methods: We enrolled 102 RA patients treated with Tofacitinib in combination with MTX from a multicenter, exploratory, short-term, prospective and observational ultrasound cohort study of patients who received biologic or targeted synthetic disease-modifying antirheumatic drug (DMARD) therapy. We evaluated the patients’ clinical disease activity and musculoskeletal ultrasound (MSUS) scores. The serum concentrations of two venous blood inflammatory indicators were evaluated (c-reactive protein [CRP], erythrocyte sedimentation rate [ESR]) by multiplex bead assays at baseline, 3, and 6?months: the change over 6?months was defined as the P value. Before MSUS score treatment, an associate chief physician tested the wrist joints of each patient at the first treatment, and the attending physician with 3 years of MSUS experience and 7 years of work experience also performed semi-quantitative scores on the same RA patients and tested the consistency of the results. Results: Tofacitinib in combination with MTX significantly improved the clinical disease activity and MSUS score over 6?months. Serum ESR and CRP were significantly elevated at 6?months after the Tofacitinib in combination with MTX introduction (P P P Conclusions: MSUS scores may be useful for predicting RA patients’ therapeutic responses to abatacept.展开更多
文摘BACKGROUND: To evaluate the utilization of point-of-care ultrasound(POCUS) for the assessment of emergency department(ED) patients with musculoskeletal symptoms and the impact of musculoskeletal POCUS on medical decision-making and patient management in the ED.METHODS: This was a retrospective review of ED patients presenting with musculoskeletal symptoms who received a POCUS over a 3.5-year period. An ED POCUS database was reviewed for musculoskeletal POCUS examinations used for medical decision-making. Electronic medical records were then reviewed for demographic characteristics, history, physical examination findings, ED course, additional imaging studies, and impact of musculoskeletal POCUS on patient management in ED. RESULTS: A total of 264 subjects(92 females, 172 males) and 292 musculoskeletal POCUS examinations were included in the fi nal analysis. Most common symptomatic sites were knee(31.8%) and ankle(16.3%). Joint effusion was the most common fi nding on musculoskeletal POCUS, noted in 33.7% of the patients, and subcutaneous edema/cobblestoning was found in 10.2% of the patients. Muscle or tendon rupture was found in 2.3% of the patients, and 1.9% of the patients had joint dislocation. Bursitis or bursa fluid was found in 3.4% of patients, and tendonitis/tendinopathy was found in 2.3%. Twenty percent of them were ultrasound-guided musculoskeletal procedures, and most of them(73.3%) were arthrocentesis. Of the included studies, all except three either changed or helped guide patient management as documented in the patients' medical records.CONCLUSION: Our study fi ndings illustrate the utility of POCUS in the evaluation of a variety of musculoskeletal pathologies in the ED.
文摘Objective:To explore the application effect and clinical value of musculoskeletal ultrasound in the rehabilitation of hand function after flexor tendon rupture repair.Methods:In this study,72 patients were selected from among patients who underwent flexor tendon rupture repair of the hand in Yancheng Third People’s Hospital from May 2018 to May 2020;the patients were randomly divided into the control group(routine hand rehabilitation training)and the experimental group(musculoskeletal ultrasound and targeted hand rehabilitation training based on examination results)by die roll,with 34 cases in each group;the hand rehabilitation of the two groups were compared.Results:The excellent and good rate of the total active motion(TAM)of the experimental group(94.44%)was significantly higher than that of the control group(69.44%)(P<0.05);before treatment,there was no significant difference in the diameter and degree of stenosis of the artery in the finger between the two groups(P>0.05);after treatment,the degree of stenosis and the diameter of the artery of the experimental group were significantly better than those of the control group(P<0.05).Conclusion:For patients treated with flexor tendon rupture repair of the hand,the use of musculoskeletal ultrasound in the rehabilitation process can significantly improve the functional recovery of the hand;therefore,it is worthy of in-depth research,promotion,and application in clinical rehabilitation.
文摘Objective:To observe the ultrasonographic characteristics of conjoined tendon repair in direct anterior approach for total hip arthroplasty(DAA-THA),and to evaluate the efficacy of musculoskeletal ultrasound in determining the healing after joint tendon repair.Methods:A total of 60 patients who required primary total hip arthroplasty in Yulin Orthopedic Hospital of Chinese and Western Medicine from July 2020 to July 2021 were selected;the patients were divided into two groups,an observation group,group A(n=30),and a control group,group B(n=30),according to different intraoperative methods.There was no significant difference in gender,age,and diagnosis between the two groups.Direct anterior approach was used for both the groups.For group A,the joint capsule and conjoined tendon(superior gemellus,obturator internus,and inferior gemellus)were repaired in situ,whereas for group B,only the joint capsule was repaired in situ,while the conjoined tendon was not repaired.The healing of the tendon was observed.Results:(1)in terms of diagnosis,after conjoined tendon repair,26 cases in group A showed good tendon continuity,good tension,and a small amount of effusion echo around,three cases showed partial interruption of tendon echo,low echo,or no echo inside with insufficient structural clarity,and a case showed complete interruption;in group B,all 30 cases had continuous interruption,poor tension,tendon retraction,and thickening;the healing rate of group A’s conjoined tendon repair was 96.67%;(2)in terms of prognostic assessment,one month after the surgery,the Harris score of group A was significantly higher than that of group B(P<0.05);however,there was no significant difference in the terms of the Harris score between the two groups 3-6 months after surgery(P>0.05);the effective tension of conjoined tendon and the effective muscle strength of group A were significantly higher than those of group B(P<0.05).Conclusion:Musculoskeletal ultrasound has high diagnostic value in the healing of conjoined tendon and provides dynamic clinical observation after conjoined tendon repair in DAA-THA;it is proven that DAA-THA with conjoined tendon repair on the premise of reconstructing the joint capsule can well restore its tension,enhance its muscle strength,significantly improve early joint stability and joint function,as well as facilitate the rapid recovery of patients.
文摘Background: To evaluate the effect of treatment on musculoskeletal ultrasound (MSUS) and explore whether MSUS are associated with therapeutic response in rheumatoid arthritis (RA) patients treated with Tofacitinib in combination with methotrexate (MTX). Methods: We enrolled 102 RA patients treated with Tofacitinib in combination with MTX from a multicenter, exploratory, short-term, prospective and observational ultrasound cohort study of patients who received biologic or targeted synthetic disease-modifying antirheumatic drug (DMARD) therapy. We evaluated the patients’ clinical disease activity and musculoskeletal ultrasound (MSUS) scores. The serum concentrations of two venous blood inflammatory indicators were evaluated (c-reactive protein [CRP], erythrocyte sedimentation rate [ESR]) by multiplex bead assays at baseline, 3, and 6?months: the change over 6?months was defined as the P value. Before MSUS score treatment, an associate chief physician tested the wrist joints of each patient at the first treatment, and the attending physician with 3 years of MSUS experience and 7 years of work experience also performed semi-quantitative scores on the same RA patients and tested the consistency of the results. Results: Tofacitinib in combination with MTX significantly improved the clinical disease activity and MSUS score over 6?months. Serum ESR and CRP were significantly elevated at 6?months after the Tofacitinib in combination with MTX introduction (P P P Conclusions: MSUS scores may be useful for predicting RA patients’ therapeutic responses to abatacept.
