EURO-MUSCULUS/USPRM Dynamic Ultrasound Protocols for Shoulder

Background. The maximum duration of vascular access for hemodialysis functioning rarely exceeds 4 years. The main tool for diagnosing access dysfunction is duplex ultrasound. Dynamic ultrasound examination of vascular access is not included in the standard examination of patient undergoing hemodialysis in Russia.Objective. To study the structure of complications and changes in hemodynamics in the vascular access for hemodialysis and to determine the risk factors contributing to its development.Design and methods. Ultrasound, clinical and laboratory examination was performed in 550 patients undergoing program hemodialysis, 517 (94.0 %) of them had arteriovenous fistula, 33 (6.0 %) patients had arteriovenous graft.Results. Vascular access complications occurred in 26.7 % (147 patients), there was no significant difference in the detection rate of thrombosis (26.5 %), stenosis (23.8 %), and aneurysm (21.1 %). A combination of two complications was observed in 20.4 %, the steal syndrome — in 8.2 %. A correlation was established between the presence of significant stenosis, aneurysm of the outflow vein and the development of thrombosis, between the presence of concomitant diseases of the peripheral arteries and the development of steal syndrome and stenosis of the inflow artery and the anastomosis zone.Conclusion. Duplex ultrasound allows to diagnose complications of vascular access for hemodialysis and determine its causes.

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The Role of Dynamic Ultrasound in the Assessment of the Pathological Changes of Acromioclavicular and Sternoclavicular Joints

QJM ◽

10.1093/qjmed/hcab106.077 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Zeinab Yousif Ishag Abdelhafiz ◽

Khalid Ahmed Mohammed Ali ◽

Safaa Kamal Mohammed Badraldeen

Keyword(s):

Shoulder Pain ◽

Dynamic Assessment ◽

Cost Comparison ◽

University Hospital ◽

Patient Comfort ◽

Radiology Department ◽

Control Group ◽

Diagnostic Modality ◽

Presenting Symptoms ◽

Dynamic Ultrasound

Abstract Background Sonography is a useful imaging tool for the examination of musculoskeletal pathology. There are many advantages to this technique, including easy accessibility, low cost, comparison with the asymptomatic limb, and patient comfort. Unlike other available modalities, dynamic assessment is readily performed using sonography. Furthermore, the use of Doppler technique allows assessment of vascularity, inflammation, and anatomical relationships of the structure in question to adjacent vessels. Aim of Study This study investigates the value of dynamic ultrasound in the evaluation of AC and SC joints abnormality in comparison with the asymptomatic limb. Patients & Methods This prospective study included fifty cases, thirty patients were clinically positive for shoulder pain. Twenty healthy persons examined as control group. The patients were referred from Rheumatology and Immunology Department of Ain Shams University.US evaluation was performed at the Radiology Department of Ain –Shams University Hospital in period from January to June2018, to characterizing the AC and SC joints, their pathogenesis and sequelae. Dynamic US examination was also performed in all the cases. Results This study included 30 patients. The most common presenting symptoms in the primary care were shoulder pain which present in all 30 patients. Appropriate history and physical examination coupled with correct radiographs usually lead to an accurate diagnosis, we add that dynamic US which served a role in directing the management plan in 18 patients, this further confirmed with a positive clinical examination, in contrast to the other 12 patients for whom there was negative clinical findings. Conclusion High-resolution US technology, coupled with good anatomical knowledge and proper technique, has become valuable in the assessment of ACJ pathology as can be a useful initial diagnostic modality in SCJ osteoarthritis. Using US as a first line investigative tool can eliminate the need for further more expensive investigation like CT/ MRI and serve as a guide for further imaging and management.

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