2023 Workshop Handout Bundle-Basic US of the Lower Limb Nerves (Dr. Duplechan)

Basic US of the Lower Limb Nerves (Dr. Duplechan)

Pdf Summary

The document is an instructional guide on the basics of Musculoskeletal (MSK) Ultrasound, authored by Dr. Lester Duplechan and presented at the 2023 AANEM Annual Meeting. MSK Ultrasound employs sound waves to diagnose pathologies in tendons, ligaments, joints, muscles, and nerves, focusing on orthopedic disorders. This technique, offering advantages like high spatial resolution, lower cost, no radiation risk, and dynamic real-time evaluation, is contrasted with the Neuromuscular Ultrasound (NMUS) which targets peripheral nervous system disorders.<br /><br />The guide addresses key components necessary for effective MSK ultrasound imaging. High-frequency linear array transducers are preferred for optimal imaging, requiring specific handling techniques involving fine motor control and stabilization. The sonographic appearance of tissues varies, classified as hypoechoic, hyperechoic, and anechoic, and recognizing these patterns is essential for accurate diagnosis. Anisotropy, a significant artifact resulting from the non-perpendicular placement of the transducer, is discussed—highlighting its impact on visualizing tendons and ligaments compared to nerves and muscles.<br /><br />The document delineates the identification of common tendon pathologies such as tendon tears, tendinosis, and the broader term tendonopathy. Tendon pathologies are identified using characteristics like echogenicity, structural integrity, and Doppler imaging signals. Examples and figures are provided to illustrate these features.<br /><br />Detailed checklists for both upper and lower limb imaging guide practitioners through the scanning processes for various anatomical structures, outlining appropriate patient positioning and pointing out significant landmarks for efficient and comprehensive evaluation.<br /><br />Overall, the guide emphasizes the importance of a systematic approach to using MSK ultrasound, practice in recognizing tissue patterns, and the critical role of transducer handling in achieving diagnostic accuracy. Various tables, figures, and references are included to support and elaborate on the principles mentioned.

Keywords

Musculoskeletal Ultrasound

MSK Ultrasound

Dr. Lester Duplechan

2023 AANEM Annual Meeting

tendon pathologies

high-frequency linear array transducers

anisotropy

echogenicity

patient positioning

dynamic real-time evaluation