Musc uloske le ta l (MSK) Outline T e c hno lo g y Ove rvie w - PowerPoint PPT Presentation

Musc uloske le ta l (MSK)

Outline • T e c hno lo g y Ove rvie w • I ma g ing De ta ile d Ana to my – Me dia n Ne rve – Me ta c a rpo pha la ng e a l Jo int – Dig ita l Pulle ys – Ra dia l Arte ry – T e mpo ro ma ndib ula r Jo int – Uppe r T ra pe zius – Ac hille s Ca lc a ne a l I nse rtio n – T a rsa l T unne l http://anatomy-diagram.net/wp-content/uploads/2015/11/human-anatomy- muscle-skeleton-human-skeletal-system-free-picture.jpg

T e c hnology Ove r vie w Transducers

T e c hnology Ove r vie w System Features Softw are  B-Mode  M-Mode  Color Doppler Applications Customer Clinical Segments Transducers UHF22 (15 MHz) Models UHF48 (30 MHz) Available UHF70 (50 MHz) Regulatory  Patient Management FDA Power  Management  DICOM Connectivity I m age Processing ( Vevo HD)  Speckle Reduction  Spatial Compounding

Me dian Ne r ve Anatomy • T he me dia n ne rve is de rive d fro m the b ra c hia l ple xus a nd is o ne o f 3 ma jo r ne rve s tha t supply tha t ha nd • Clinic a l Re le va nc e : Pa ssing unde r the c a rpa l tunne l (fle xo r re tina c ulum) the me dia n ne rve c a n b e c o mpre sse d = c a rpa l tunne l syndro me Anatomy of a Peripheral Nerve E epineurium; F fascicle; P perineurium; V vessel. http://emedicine.medscape.com/article/1369028-overview https://studentconsult.inkling.com/read/wheaters-functional-histology-atlas-young-5th/chapter- 7/figure-7-13

Me dian Ne r ve Imaging 50 MHz Vevo MD Ultra High Frequency 6-15 MHz Conventional Ultrasound

Me tac ar pophalange al (MCP) Joint Anatomy • T he MCP jo ints a re fo und in the ha nd b e twe e n e a c h me ta c a rpa l a nd pro xima l pha la nx • MCP jo ints a llo w a ra ng e o f mo ve me nt in the fing e r • Clinic a l Re le va nc e : T he MCP jo int typic a lly b e c o me s a rthritic with Rhe uma to id Arthritis

Me tac ar pophalange al Joint imaging Imaging Conventional Ultrasound Vevo MD Ultra High Frequency

Digital Pulle ys Anatomy • T he a nnula r lig a me nts o f the fing e r (A pulle ys) a re lo c a te d o n the pa lma r a spe c ts o f the fing e rs • T he A1pulle y o rig ina te s fro m the MCP jo int • T he A1 pulle ys c a n disrupt the a c tio n o f the fle xo r te ndo ns c a using pa in a nd limiting mo ve me nt = trig g e r fing e r http://www.reumatologiaclinica.org/en/clinical- http://www.iowahand.com/trigger.html anatomy-hand/articulo/S1699258X12002422/

Digital Pulle ys Imaging Conventional Ultrasound Vevo MD Ultra High Frequency

Radial Ar te r y Anatomy • T he ra dia l a rte ry is a b ra nc h o ff the b ra c hia l a rte ry in the fo re a rm • I n the ha nd it c o ntrib ute s to the supe rfic ia l a nd de e p pa lma r a rc he s • Clinic a l Re le va nc e : T he ra dia l pulse is de te c te d a s the ra dia l a rte ry pa sse s o ve r the dista l ra dius. Byrne, R. A. et al. (2012) Vascular access and closure in coronary angiography and percutaneous intervention Nat. Rev. Cardiol. doi:10.1038/nrcardio.2012.160 http://teachmeanatomy.info/upper-limb/vessels/arteries/

Radial Ar te r y Imaging Conventional Ultrasound Vevo MD Ultra High Frequency

Radial Ar te r y Imaging (within the anatomical snuffbox) Drake: Gray’s Anatomy for Students; 2 nd Edition

T e mpor omandibular Joint Anatomy • T he te mpo ro ma ndib ula r jo int (T MJ) is a b ila te ra l a rtic ula tio n b e twe e n the ma ndib le a nd te mpo ra l b o ne s, whic h fo rm the ja w • An a rtic ula r disc se pa ra te s the jo int into 2 c o mpa rtme nts • T his disc c a n b e c o me displa c e d whic h c a n le a d to limite d ja w mo ve me nt a nd pa in http://www.mdguidelines.com/temporomandibular-joint-syndrome

T e mpor omandibular Joint Imaging Conventional Ultrasound Vevo MD Ultra High Frequency

Uppe r T r ape zius Musc le Anatomy • T he tra pe zius is a b ila te ra l, wide , fla t musc le in the uppe r b a c k • F unc tio ns: mo ve , ro ta te a nd sta b ilize sc a pula ; e xte nd he a d a nd ne c k • E xist a s thre e se ts o f fib e rs o n e a c h side (lo we r, middle , uppe r) – I mb a la nc e s in the se fib e rs c a n a ffe c t po sture

Uppe r T r ape zius Musc le F ibe r s Imaging Conventional Ultrasound Vevo MD Ultra High Frequency

Ac hille s Calc ane al Inse r tion Anatomy • T he Ac hille s is a te ndo n in the po ste rio r a nkle tha t a tta c he s the le g musc le s to the c a lc a ne us (he e l) • I t is the thic ke st te ndo n in the b o dy a nd func tio ns inc lude pla nta r fle xio n o f the fo o t a nd kne e fle xio n • T he Ac hille s c a n b e to rn, rupture d, o r b e c o me infla me d http://www.aafp.org/afp/2002/0501/p1805.html

Ac hille s T e ndon Imaging Conventional Ultrasound Achilles-Calcaneal Insertion Vevo MD Ultra High Frequency

T ar sal T unne l Anatomy • Sma ll a re a o n the a nkle , po ste rio r to me dia l ma lle o lus • Co ve re d b y the fle xo r re tina c ulum • Co nta ins: po ste rio r tib ia l a rte ry a nd ve in, tib ia l ne rve , se ve ra l te ndo ns Tarsal • Ne rve e ntra pme nt c a n o c c ur Tunnel (ta rsa l tunne l syndro me ) c a use s pa in a nd we a kne ss in fo o t musc le s

T ar sal T unne l Imaging Flexor Retinaculum Tibial Artery and Vein Tibial Nerve Conventional Ultrasound Vevo MD Ultra High Frequency

Ove r vie w • Hig h-fre q ue nc y ultra so und a llo ws visua liza tio n o f sma ll a na to my no t visib le with c o nve ntio na l ultra so und (do wn to 30µm) • Cutting e dg e te c hno lo g y c a n le a d to ne w me dic a l disc o ve rie s • T o uc h-sc re e n, c usto miza b le inte rfa c e le a ds to impro ve d wo rkflo w a nd re duc e d e xa mina tio n time s • Hig hly a dva nc e d tra nsduc e rs de sig ne d fo r the sma lle st pa tie nts Same size as grain of rice!