scholarly journals Diagnostic Value of Muscle Ultrasound for Myopathies and Myositis

2020 ◽  
Vol 22 (11) ◽  
Author(s):  
Jemima Albayda ◽  
Nens van Alfen
Keyword(s):  
Imaging Modality ◽  
Neuromuscular Disorders ◽  
Diagnostic Value ◽  
Inflammatory Myopathies ◽  
Muscle Disorders ◽  
Muscle Edema ◽  
Specific Muscle ◽  
Muscle Groups ◽  
Muscle Ultrasound ◽  
Screening And Diagnosis

Abstract Purpose of Review The purpose of this review is to critically discuss the use of ultrasound in the evaluation of muscle disorders with a particular focus on the emerging use in inflammatory myopathies. Recent Findings In myopathies, pathologic muscle shows an increase in echogenicity. Muscle echogenicity can be assessed visually, semi-quantitatively, or quantitatively using grayscale analysis. The involvement of specific muscle groups and the pattern of increase in echogenicity can further point to specific diseases. In pediatric neuromuscular disorders, the value of muscle ultrasound for screening and diagnosis is well-established. It has also been found to be a responsive measure of disease change in muscular dystrophies. In chronic forms of myositis like inclusion body myositis, ultrasound is very suitable for detecting markedly increased echogenicity and atrophy in affected muscles. Acute cases of muscle edema show only a mild increase in echogenicity, which can also reverse with successful treatment. Summary Muscle ultrasound is an important imaging modality that is highly adaptable to study various muscle conditions. Although its diagnostic value for neuromuscular disorders is high, the evidence in myositis has only begun to accrue in earnest. Further systematic studies are needed, especially in its role for detecting muscle edema.

Simulate and sense force exertions during virtual patient transfer tasks

2020 ◽  
Vol 64 (1) ◽  
pp. 2092-2096
Author(s):  
Ken Chen ◽  
Rebecca Widmayer ◽  
Karen B. Chen
Keyword(s):  
Muscle Activity ◽  
Fine Tuning ◽  
Activity Levels ◽  
Patient Lifting ◽  
Perceived Workload ◽  
Specific Muscle ◽  
Muscle Groups ◽  
Forceful Exertion ◽  
Lifting Task ◽  
Transfer Tasks

Virtual reality (VR) is commonplace for training, yet simulated physical activities in VR do not require trainees to engage and contract the muscle groups normally engaged in physical lifting. This paper presents a muscle activity-driven interface to elicit the sensation of forceful, physical exertions when lifting virtual objects. Users contracted and attained predefined muscle activity levels that were calibrated to user-specific muscle activity when lifting the physical counterpart. The overarching goal is to engage the appropriate muscles, and thereby encourage and elicit behaviors normally seen in the physical environment. Activities of 12 key muscles were monitored using electromyography (EMG) sensors while they performed a three-part patient lifting task in a Cave Automatic Virtual Environment. Participants reported higher task mental loads and less physical loads for the virtual lift than the physical lift. Findings suggest the potential to elicit sensation of forceful exertion via EMG feedback but needed fine-tuning to offset perceived workload.

scholarly journals MiRNAs and Muscle Regeneration: Therapeutic Targets in Duchenne Muscular Dystrophy

2021 ◽  
Vol 22 (8) ◽  
pp. 4236
Author(s):  
Amelia Eva Aránega ◽  
Estefanía Lozano-Velasco ◽  
Lara Rodriguez-Outeiriño ◽  
Felicitas Ramírez de Acuña ◽  
Diego Franco ◽  
...  
Keyword(s):  
Stem Cell ◽  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Muscle Regeneration ◽  
Transcriptional Control ◽  
Neuromuscular Disorders ◽  
Critical Role ◽  
Gene Replacement ◽  
Control Of Gene Expression ◽  
Muscle Disorders

microRNAs (miRNAs) are small non-coding RNAs required for the post-transcriptional control of gene expression. MicroRNAs play a critical role in modulating muscle regeneration and stem cell behavior. Muscle regeneration is affected in muscular dystrophies, and a critical point for the development of effective strategies for treating muscle disorders is optimizing approaches to target muscle stem cells in order to increase the ability to regenerate lost tissue. Within this framework, miRNAs are emerging as implicated in muscle stem cell response in neuromuscular disorders and new methodologies to regulate the expression of key microRNAs are coming up. In this review, we summarize recent advances highlighting the potential of miRNAs to be used in conjunction with gene replacement therapies, in order to improve muscle regeneration in the context of Duchenne Muscular Dystrophy (DMD).

scholarly journals Diagnostic value of research methods in diagnostics of chronic pancreatitis

2021 ◽  
Vol 102 (4) ◽  
pp. 528-536
Author(s):  
G R Aliyeva
Keyword(s):  
Chronic Pancreatitis ◽  
Early Stage ◽  
Imaging Modality ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Clinical History ◽  
Diagnostic Value ◽  
Diagnostic Tools ◽  
Invasive Approach ◽  
Pancreas Function ◽  
Function Testing

Chronic pancreatitis remains an unsolved problem for clinicians. One of the biggest dilemmas is to establish a clear diagnosis. Diagnosis can be particularly elusive in patients with early chronic pancreatitis. Many studies have been undertaken to improve diagnostics in chronic pancreatitis, but this has been significantly limited by the lack of a gold standard. The evaluation of patients with suspected chronic pancreatitis should follow a progressively non-invasive to more invasive approach. Computed tomography is the best primary imaging modality to obtain as it has good sensitivity for severe chronic pancreatitis and may exclude the need for other diagnostic tests. When ambiguous results are obtained, a magnetic resonance cholangiopancreatography may require for a more detailed evaluation of both the pancreatic parenchyma and ducts. If the diagnosis remains in doubt, endoscopic ultrasound with or without pancreas function testing becomes the preferred method. Endoscopic retrograde cholangiopancreatography remains a last line diagnostic test and generally should be used only for diagnostic purposes. Future researches in the field of diagnosis of early-stage chronic pancreatitis should purpose optimizing current diagnostic tools. A definitive diagnosis of chronic pancreatitis may not be made simply by clinical history, imaging or function testing alone, but rather by the data gathered by a combination of these diagnostic tools.

scholarly journals Comparison of Urinary Adiponectin in the Presence of Metabolic Syndrome in Peri- and Postmenopausal Women

2021 ◽  
Author(s):  
Patsama Vichinsartvichai ◽  
Rattana Teeramara ◽  
Titima Jirasawas ◽  
Prirayapak Sakoonwatanyoo
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Postmenopausal Women ◽  
Demographic Data ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Screening And Diagnosis ◽  
Baseline Demographic

Abstract Objectives To find the association between urinary adiponectin and metabolic syndrome (MetS) in peri- and postmenopausal women and its potential application as a noninvasive screening for MetS. Methods A cross-sectional study was conducted in healthy peri- and postmenopausal women (defined by STRAW+10 staging) age at least 40 years who attended annual checkup or menopause clinic were recruited. Baseline demographic data, MENQOL, anthropometric measurements, blood pressure, laboratory (FBS, total cholesterol, HDL-C, LDL-C, TG) and urinary adiponectin were collected. The MetS was diagnosed according to JIS 2009. Results 290 peri- and postmenopausal women had participated. The prevalence of Mets among our participants was 18%. Urinary adiponectin levels were similar in peri- and postmenopausal women with and without MetS (2.6±2.2 vs 2.3±1.9 ng/mL, respectively, P = 0.55). Urinary adiponectin provides no diagnostic value for MetS (AUC = 0.516). Conclusions Urinary adiponectin has no role in screening and diagnosis of MetS in peri- and postmenopausal women. The quest toward noninvasive screening for MetS is still going on.

scholarly journals Imaging in Inflammatory Bowel Diseases - Magnetic Resonance Imaging

2015 ◽  
Vol 33 (Suppl. 1) ◽  
pp. 26-31
Author(s):  
Hans Herfarth ◽  
Andreas G. Schreyer
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Intestinal Inflammation ◽  
Imaging Modality ◽  
Imaging Techniques ◽  
Magnetization Transfer ◽  
Diagnostic Value ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Line Imaging ◽  
Sensitivity Specificity

Diagnostic imaging techniques play an important role in the diagnosis and management of patients with inflammatory bowel diseases (IBDs). The approach should be guided by considerations of diagnostic accuracy, concerns about patient exposure to ionizing radiation, local expertise and tolerance of the endoscopic and/or imaging technique. In regard to the clinical diagnostic value (sensitivity, specificity and accuracy), no significant differences exist between CT and MRI for the evaluation of the extent of inflammation, stricturing, penetrating disease or extraluminal complications such as abscesses. Due to the absence of radiation exposure, MRI of the intestine is recommended as the first-line imaging modality in patients with suspected or established IBD. The focus of this review is the latest developments in MRI techniques to detect IBDs. Specifically, the use of new indices for the grading of inflammation or assessing bowel damage as well as innovative experimental approaches such as diffusion-weighted imaging or magnetization-transfer MRI to evaluate and quantify the degree of intestinal inflammation and fibrosis in stricturing Crohn's disease are discussed.

Hand-held dynamometry for assessment of muscle strength in patients with inflammatory myopathies

Rheumatology ◽  
2020 ◽  
Author(s):  
Didem Saygin ◽  
Chester V Oddis ◽  
Siamak Moghadam-Kia ◽  
Bonny Rockette-Wagner ◽  
Nicole Neiman ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Disease Activity ◽  
Neuromuscular Disorders ◽  
Strong Association ◽  
External Validation ◽  
Manual Muscle Testing ◽  
Inflammatory Myopathies ◽  
University Of Pittsburgh ◽  
Muscle Testing ◽  
The University

Abstract Objectives Muscle weakness in idiopathic inflammatory myopathies (IIMs) is conventionally assessed using manual muscle testing (MMT). However, more objective tools must be developed to accurately and reliably quantify muscle strength in myositis patients. Hand-held dynamometry (HHD) is a quantitative, portable device with reported reliability in neuromuscular disorders. Our aim was to assess the reliability, validity and responsiveness of HHD in myositis. Methods Myositis patients [DM, necrotizing myopathy (NM), PM and anti-synthetase syndrome] evaluated at the University of Pittsburgh myositis centre were prospectively enrolled. Each patient was assessed at 0, 3 and 6 months for validated outcome measures of myositis disease activity and physical function. At each visit, muscle strength was assessed using both MMT and HHD (Micro FET2, Hoggan Health Industries, Draper, UT, USA). The reliability, validity and responsiveness of the HHD was assessed using standard statistical methods. Results Fifty IIM patients (60% female; mean age 51.6 years; 6 PM, 9 NM, 24 DM and 11 anti-synthetase syndrome) were enrolled. HHD showed strong test–retest intrarater reliability (r = 0.96) and interrater reliability (r = 0.98). HHD correlated significantly with the MMT score (r = 0.48, P = 0.0006) and myositis disease activity and functional measures. Longitudinal analysis showed a significant and strong association between the HHD and MMT as well as 2016 ACR/EULAR myositis response criteria (r = 0.8, P < 0.0001) demonstrating responsiveness. The mean effect size and standardized response mean of HHD was large: 0.95 and 1.03, respectively. MMT had a high ceiling effect compared with HHD. Conclusion HHD demonstrated strong reliability, construct validity and responsiveness in myositis patients. External validation studies are required to confirm these findings.

scholarly journals Diagnostic value of additional histopathological fascia examination in idiopathic inflammatory myopathies

2019 ◽  
Vol 26 (12) ◽  
pp. 1494-1496
Author(s):  
J. Lim ◽  
F. Eftimov ◽  
J. Raaphorst ◽  
E. Aronica ◽  
A. J. Kooi
Keyword(s):  
Diagnostic Value ◽  
Idiopathic Inflammatory Myopathies ◽  
Inflammatory Myopathies

Outcome assessment in the idiopathic inflammatory myopathies

2018 ◽  
Author(s):  
Lisa G. Rider ◽  
Frederick W. Miller
Keyword(s):  
Disease Activity ◽  
Endothelial Activation ◽  
Inactive Disease ◽  
Idiopathic Inflammatory Myopathies ◽  
Inflammatory Myopathies ◽  
Muscle Enzyme ◽  
Activation Markers ◽  
Core Set ◽  
Trial Endpoints ◽  
Muscle Ultrasound

Due to their rarity, heterogeneity, and multispecialty nature, the myositis syndromes have limited data-driven consensus on appropriate outcome measures. Recently, two international, multispecialty consortia developed new tools and consensus on core set measures of myositis disease activity and damage, as well as response criteria that are now recommended for use as clinical trial endpoints but will also be useful in clinical practice. Magnetic resonance imaging, muscle ultrasound, selected laboratory tests, and immunological biomarkers—including cytokines, chemokines, lymphocyte flow cytometry, and endothelial activation markers—can all be helpful adjuncts to serum muscle enzyme levels in assessing disease activity and damage, but these have not yet been fully validated. Definitions of clinically inactive disease, complete clinical response, and remission have also been proposed but require further validation. These advances should enhance the development of therapies by standardizing our ability to demonstrate their efficacy in treating the idiopathic inflammatory myopathies.

scholarly journals Ultrasonography for diagnosis of peri-implant diseases and conditions: a detailed scanning protocol and case demonstration

2020 ◽  
Vol 49 (7) ◽  
pp. 20190445 ◽  
Author(s):  
Hsun-Liang Chan ◽  
Oliver D. Kripfgans
Keyword(s):  
Imaging Modality ◽  
Research Work ◽  
Diagnostic Value ◽  
Tissue Imaging ◽  
European Federation ◽  
Postoperative Phase ◽  
Ultrasound Images ◽  
Cross Sectional ◽  
Color Flow ◽  
Scanning Protocol

Objectives: Ultrasonography has shown its promising diagnostic value in dental implant imaging research in the three treatment phases, namely, planning, intraoperative, and postoperative phase. With increasing awareness of peri-implant diseases and a lack of an efficient diagnostic method, the aim is to propose ultrasound imaging as a potential solution by providing a detailed scanning protocol and case demonstration. Methods: Ultrasound device specification and the setup for optimizing peri-implant tissue imaging was described. Two useful imaging modes, viz. B-mode and color flow, were introduced. Important anatomical structures for accurate diagnosis of peri-implant diseases were illustrated. Finally, a detailed scanning sequence was proposed. Results: Ultrasound images were acquired on live humans to exemplify the four peri-implant diseases and conditions, endorsed by the 2017 World Workshop organized by the American Academy of Periodontology and the European Federation of Periodontology. Ultrasound can provide not only cross-sectional anatomical images but also functional images (color flow images) that may be useful for evaluating the degree of peri-implant tissue inflammation. Conclusions: High-frequency ultrasonography could be another cross-sectional imaging modality in adjunct to radiographs for diagnosing imminent peri-implant diseases and conditions that negatively influence quality of life of millions of patients with implants. This case study provides a framework for future related research work and clinical scanning guidelines.

scholarly journals Diagnostic Value of Ultrasonography in Patients Suspected Acute Appendicitis

2013 ◽  
Vol 2 (2) ◽  
pp. 13-19
Author(s):  
MA Elahifar ◽  
H Taheri ◽  
A Bighamian
Keyword(s):  
Acute Appendicitis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Histopathological Examination ◽  
Imaging Modality ◽  
Diagnostic Value ◽  
Preoperative Imaging ◽  
Outpatient Basis ◽  
Abdominal Ultrasonography ◽  
Cell Counts

Introduction: Appendectomy is one of the most frequently performed abdominal operations in surgical practice. Preoperative imaging has been demonstrated to improve diagnostic accuracy in appendicitis. Abdominal ultrasonography (US) is the most commonly and first-line imaging modality used for diagnosing acute appendicitis (AA).The aim of this study was to demonstrate the diagnostic value of abdominal ultrasonography for diagnosing acute appendicitis. Methods: In a retrospective study, we analyzed 200 consecutive patients with abdominal pain that undergoing appendectomy, from June 2009 to April 2012. Patient characteristics, preoperative ultrasonography (US) and laboratory assessment including WBC were collected. Final diagnosis of appendicitis was confirmed by histopathological examination. Results were compared with US. Results: Two hundred patients were admitted to this study that undergoing appendectomy. Mean age was 24 years (range: 1 to 91 years), and 57% were females. Patient White blood cell counts were found to be high in 78% while it was 86% for AA group and 64% for NA group (p < 0.05). One hundred sixty-six of these patients (83%) were diagnosed as acute appendicitis on pathology, and 34 (17%) were diagnosed differently. 157 of patients underwent US, eighty two of this patients diagnosed as acute appendicitis on US examinations and in 78 of them were also reported as acute appendicitis on histopathological examination. The sensitivity and specificity of abdominal US for diagnosing appendicitis were 70% and 90.2% respectively. Positive predictive value (PPV) was 93% and negative predictive value (NPV) was reported 62%. Conclusion: Ultrasonography has a high PPV and specificity, so as a diagnostic tool, positive US strongly suggests the diagnosis of AA. A low negative predictive value recommends that negative US is not sufficient to exclude the diagnosis of AA and patients could not be managed on an outpatient basis following a negative scan. Nepalese Journal of Radiology; Vol. 2; Issue 2; July-Dec. 2012; 13-19 DOI: http://dx.doi.org/10.3126/njr.v2i2.7680

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