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Objective: To aid emergent diagnosis of postoperative retropharyngeal hematoma in anterior cervical spine surgery patients, this study investigates ultrasonography's potential role by evaluating the visibility of retropharyngeal and prevertebral soft tissues in the neck using ultrasound and potential correlations with body habitus. Methods: The visibility of the anterior vertebral bodies and the prevertebral soft tissues in both sides of the neck was recorded and analyzed with 95% CI using the Wilson method. Body mass index, neck circumference, and neck length were measured. A point-biserial correlation was performed to compare body habitus with visibility of vertebrae and prevertebral tissues. Results: Longus colli muscle and C3 to C6 were successfully visualized in all 10 (100%) cases on both sides. C2 was only visible in 6 (60%) on both sides. C7 was visible in 9 (90%) on the right and 7 (70%) on the left. The esophagus was visible in 7 (70%) on the right and 10 (100%) on the left. There was a significant negative correlation with neck circumference and C2 visibility on the right side, r(8) = -0.76, P = 0.011. Conclusions: Ultrasonography was successful in visualizing prevertebral tissues, with a trend of obstructed visibility with wider and longer necks. Clinical Relevance: Ultrasonography has potential to aid early detection of postoperative retropharyngeal hematoma after cervical spine surgery. [ABSTRACT FROM AUTHOR]

Background: The high soft-tissue contrast of magnetic resonance imaging (MRI) makes it useful for evaluation of hand injuries, but its limitations include cost, imaging artifacts, and patient claustrophobia. Ultrasound is readily available, fast, noninvasive, and radiation free, but its utility for the evaluation of hand soft-tissue injury and pathology is less well known. Purpose: We sought to examine the accuracy of ultrasound for the evaluation of hand injury at a single institution. Methods: We queried a radiology information system for ultrasound cases between 2014 and 2020 at a tertiary care institution using the keyword "hand" and injury terms. We performed a retrospective chart review of cases found according to the type of injury detected on ultrasound. To evaluate the diagnostic accuracy of ultrasound in hand injury and pathology, we recorded postimaging clinical diagnoses and surgical findings. Results: We found 154 patients who underwent ultrasound for hand injuries and had confirmed surgical diagnosis and/or robust clinical follow-up. Tendon injury was the most commonly diagnosed condition on ultrasound (70/154); others detected were retained foreign body (31), mass (21), ligamentous injury (9), pulley injury (8), nerve injury (11), and traumatic arthropathy (4). Ultrasound correctly characterized hand injury in 150/154 cases (97.4%) based on surgical and/or clinical follow-up. Ultrasound failed to diagnose 3 cases of partial tendon tear and 1 case of digital nerve injury. Conclusion: In this retrospective, single-institution review, ultrasound was found to be highly accurate in the detection of soft tissue hand injury and pathology, demonstrating a high concordance rate with surgical and clinical findings. Further study is warranted. [ABSTRACT FROM AUTHOR]

Image‐guided prosthetic joint aspirations have been criticized in the literature as having poor sensitivity and specificity. Native fluid is typically analyzed for the presence of infection. Joint lavage during fluoroscopically guided aspiration of prosthetic joints is not routinely performed, and the lavage aspirate is not typically analyzed unless native fluid could not be aspirated for culture. This study aims to determine if concordance of culture results from native fluid and an additional joint lavage sample improves sensitivity and specificity in the diagnosis of prosthetic joint infection by fluoroscopically guided joint aspiration. A retrospective review of the fluoroscopically guided joint aspirations at our institution between December 2007 and December 2009 was performed. Data collected from the electronic medical record included culture results for both native fluid and lavage aspirate, histopathology results, final clinical diagnosis, as well as clinical/surgical management. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratio for infection were calculated for the following culture analysis scenarios: native fluid alone; lavage aspirate alone; native fluid; and lavage aspirate. Five hundred sixty‐three aspirations, mostly prosthetic joints, were identified in the reviewed time period, of which 397 were sent for both native fluid and lavage aspirate analysis. Concordance between positive culture results from native fluid and joint lavage aspirate markedly increased the likelihood ratio for infection from 23.8 to 138.7 and improved specificity and PPV of fluoroscopically guided joint aspiration, with similar sensitivity and NPV to that of native fluid culture alone. [ABSTRACT FROM AUTHOR]

Introduction: In this study we tested the hypothesis that fascicular constrictions (FCs) of the median nerve proximal to the elbow joint characterize anterior interosseous nerve syndrome (AINS).Methods: Magnetic resonance neurography (MRN) and ultrasound (US) examinations were evaluated in 45 patients with clinically suspected AINS. All 22 patients at site 1 underwent MRN and 8 underwent US; all 23 patients at site 2 underwent US.Results: Median nerve FCs were identified in all MRN cases; FCs and/or fascicular enlargements were identified in 88% of US cases. Most FCs were in the mediannerve posterior/posteromedial region and were proximal to the elbow joint line (mean distance: MRN, 5.4 cm; US, 7.5 cm), with the exception of a single FC (located 1 cm distal). No extrinsic compression of median or anterior interosseous nerves was identified in the arm or forearm.Discussion: AINS is a noncompressive neuropathy characterized by median nerve FCs in the arm. [ABSTRACT FROM AUTHOR]

Various clinical tests are used to evaluate the palmaris longus tendon, but their accuracy is unknown. We assessed the accuracy of clinical tests (Schaeffer's, Thompson's, Mishra-I, Mishra-II) against ultrasound as the reference standard. We hypothesized that Schaeffer's was most accurate and that examination can reliably assess the palmaris longus tendon's length. Ninety-six wrists were examined clinically and evaluated with ultrasound by radiologists who were blinded to examination results. We calculated diagnostic accuracy and agreement between length measurements. Sensitivity values were as follows: Schaeffer's 94%, Mishra-I 100%, Mishra-II 100%, Thompson's 72%. Specificity values were as follows: Schaeffer's 94%, Mishra-I 83%, Mishra-II 89%, Thompson's 91%. Intraclass correlation coefficient between palmaris longus tendon length measurement on examination and ultrasound was 0.54. Schaeffer's test accurately detected this tendon with >90% sensitivity and specificity, but clinical examination less reliably measured palmaris longus tendon length. Ultrasound may be a useful adjunct to assess potential graft length preoperatively. Level of evidence: I [ABSTRACT FROM AUTHOR]

Objective: Although the tarsometatarsal joints are separated into three distinct synovial compartments, communications between adjacent compartments are often noted during image-guided injections. This study aims to determine whether abnormal inter-compartment tarsometatarsal joint communication is associated with patient age or degree of tarsometatarsal osteoarthritis.Materials and Methods: One hundred forty tarsometatarsal injections were retrospectively reviewed by two radiologists. Extent of inter-compartment communication and degree of osteoarthritis were independently scored. Univariate and multivariable analyses were performed to assess whether the presence of and number of abnormal joint communications were related to age and degree of osteoarthritis.Results: Forty out of 140 tarsometatarsal joints showed abnormal communication with a separate synovial compartment, and 3 of the 40 showed abnormal communication with two separate compartments. On univariate analysis, higher grade osteoarthritis (p < 0.001) and older age (p = 0.014) were associated with an increased likelihood of abnormal inter-compartment tarsometatarsal communication and a greater number of these abnormal communications. On multivariate analysis, the degree of osteoarthritis remained a significant predictor of the presence of (p < 0.001) and number of (p < 0.001) abnormal communications, while the association of age was not statistically significant. There was significant correlation between age and degree of osteoarthritis (p < 0.001).Conclusion: Higher grade osteoarthritis increases the likelihood of abnormal inter-compartment tarsometatarsal joint communication and is associated with a greater number of abnormal communications. Diagnostic injection to localize a symptomatic tarsometatarsal joint may be less reliable in the setting of advanced osteoarthritis. [ABSTRACT FROM AUTHOR]