2024 Workshop Handout Bundle-W18C Basic NM US Cartwright

W18C Basic NM US Cartwright
Pdf Summary
The provided document is an extensive guide on the use of neuromuscular ultrasound specifically for beginners, and a review for those familiar with the technique. The focus is on the hands-on application, interpretation, and safety protocols related to the ultrasound of muscles and nerves.<br /><br />**Key Points:**<br /><br />1. **Introduction and Basics:**<br />   - The guide assumes basic knowledge of nerve and muscle anatomy and electrodiagnostic (EDX) medicine.<br />   - It suggests additional resources for comprehensive information on pathology, reference values, anatomy, and new applications.<br /><br />2. **Ultrasound Safety:**<br />   - Ultrasound is considered safe with minimal risks, but caution is advised when imaging sensitive areas like the optic nerve.<br />   - Proper hygiene practices are emphasized to prevent the spread of microorganisms.<br />   - The transducer should be cleaned with alcohol-free disinfectants to avoid surface damage.<br /><br />3. **Materials and Procedure:**<br />   - The use of ultrasound gel is critical for optimal imaging.<br />   - Different types of transducers are used: wide fixed linear array and narrow 'hockey stick' probes, each suited for different anatomical structures.<br />   - Proper technique in holding and positioning the transducer is imperative for quality imaging.<br /><br />4. **Imaging Techniques:**<br />   - Importance of both cross-sectional (short axis) and sagittal (long axis) views for accurate imaging.<br />   - Provides detailed steps for standard imaging positions for common neuromuscular issues like carpal tunnel syndrome and ulnar nerve issues.<br /><br />5. **Ultrasound Physics:**<br />   - Explains the principles of sound transmission and reflection within tissues, which are fundamental to generating accurate images.<br />   - Discusses the trade-offs between resolution and depth of penetration with different ultrasound frequencies.<br /><br />6. **Instrumentation and Imaging Adjustments:**<br />   - Overview of complex ultrasound instrument controls and the significance of focus, depth, power/gain, and image centering in producing high-quality images.<br />   - Use of Doppler ultrasound to assess blood flow within nerves and muscles.<br /><br />7. **Imaging and Measurement:**<br />   - Detailed protocol for imaging muscles including their characteristic appearance, measurement of muscle size and brightness, and identification of pathology.<br />   - For nerves, standard procedures for measuring cross-sectional area (CSA) and assessing echogenicity are provided.<br />   - Techniques for imaging muscle pathologies are discussed, distinguishing between myopathic and neurogenic changes.<br /><br />8. **Clinical Observations:**<br />   - Muscle fasciculations are easily identifiable; tips are provided for enhancing the observation of these and other muscle movements.<br />   - Nerve pathologies generally present as enlargement and hypoechogenicity.<br />   - Increased intraneural blood flow is often a sign of pathology.<br /><br />9. **Reports and Documentation:**<br />   - Emphasizes the importance of capturing, storing, and documenting ultrasound images for accurate interpretation and audit purposes.<br />   - Ultrasound results should be included in comprehensive patient reports along with nerve conduction studies and needle electromyography (EMG) findings.<br /><br />Overall, the document serves as a comprehensive manual for performing and interpreting neuromuscular ultrasound, ensuring both beginner and experienced practitioners have a detailed and standardized approach to this diagnostic tool.
Keywords
neuromuscular ultrasound
beginners guide
hands-on application
ultrasound safety
imaging techniques
ultrasound physics
instrumentation adjustments
muscle pathology
nerve pathology
clinical observations