Musculoskeletal Sonography of the Postoperative Orthopedic Patient

Jon A. Jacobson; Matthew J. Lax

doi:10.1055/s-2002-23165

Seminars in Musculoskeletal Radiology, Table of Contents

Semin Musculoskelet Radiol 2002; 06(1): 067-078
DOI: 10.1055/s-2002-23165

Musculoskeletal Sonography of the Postoperative Orthopedic Patient

Jon A. Jacobson¹ , Matthew J. Lax²

¹Department of Radiology, University of Michigan, Ann Arbor, MI
²Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada

Abstract

ABSTRACT

Musculoskeletal sonography has an important role in the evaluation of the postoperative orthopedic patient. One major advantage of sonography over magnetic resonance imaging and computed tomography is that artifact from metal, which is common after orthopedic surgery, is relatively limited. This allows a clear assessment of the soft tissues for abnormalities such as tendon tear, tenosynovitis, joint effusion, and soft tissue infection. Sonography also has a role in evaluation of recurrent soft tissue tumor, bone healing, and limb amputation. This article first discusses the basic technical aspects of musculoskeletal sonography and is followed by sonographic examples of normal anatomy. Common applications of musculoskeletal sonography in evaluation of the postoperative orthopedic patient are reviewed, including sonography after tendon surgery, assessment of soft tissues adjacent to orthopedic hardware, recurrent musculoskeletal soft tissue tumors, sonography of bone healing, and evaluation of limb amputation. Guidelines and pitfalls of these applications are reviewed.

KEYWORD

Ultrasound - soft tissues - surgery - complications

Full Text

References

REFERENCES

1 Erickson S J. High-resolution imaging of the musculoskeletal system. Radiology . 1997; 205 593-618
2 Jacobson J A. Musculoskeletal sonography and MR imaging. A role for both imaging methods. Radiol Clin North Am . 1999; 37 713-735
3 Shapiro R S, Wagreich J, Parsons R B, Stancato-Pasik A, Yeh H C, Lao R. Tissue harmonic imaging sonography: evaluation of image quality compared with conventional sonography. Am J Roentgenol . 1998; 171 1203-1206
4 Bude R O, Rubin J M. Power Doppler sonography. Radiology . 1996; 200 21-23
5 Crass J R, van de Vegte L G, Harkavy L A. Tendon echogenicity: ex vivo study. Radiology . 1988; 167 499-501
6 Craig J G, Jacobson J A, Moed B R. Ultrasound of fracture and bone healing. Radiol Clin North Am . 1999; 37 737-751
7 Jacobson J A, van Holsbeeck T M. Musculoskeletal ultrasonography. Orthop Clin North Am . 1998; 29 135-167
8 Silvestri E, Martinoli C, Derchi L E, Bertolotto M, Chiaramondia M, Rosenberg I. Echotexture of peripheral nerves: correlation between US and histologic findings and criteria to differentiate tendons. Radiology . 1995; 197 291-296
9 Jamadar J D, Jacobson J A, Hayes C W. Sonographic evaluation of the median nerve at the wrist. J Ultrasound Med . 2001; 20 1011-1014
10 Crass J R, Craig E V, Feinberg S B. Sonography of the postoperative rotator cuff. Am J Roentgenol . 1986; 146 561-564
11 Mack L A, Nyberg D A, Matsen F R, Kilcoyne R F, Harvey D. Sonography of the postoperative shoulder. Am J Roentgenol . 1988; 150 1089-1093
12 Winter T C, Richardson M L, Matsen F A. Ultrasound of the shoulder. RSNA Radiogr Electr J . 1997; 1
13 Khoury N J, El-Khoury G Y, Saltzman C L, Brandser E A. MR imaging of posterior tibial tendon dysfunction. Am J Roentgenol . 1996; 167 675-682
14 Fessell D P, Jacobson J A, Craig J. Using sonography to reveal and aspirate joint effusions. Am J Roentgenol . 2000; 174 1353-1362
15 van Holsbeeck T M, Eyler W R, Sherman L S. Detection of infection in loosened hip prostheses: efficacy of sonography. Am J Roentgenol . 1994; 163 381-384
16 Bureau N J, Chhem R K, Cardinal E. Musculoskeletal infections: US manifestations. Radiographics . 1999; 19 1585-1592
17 Pino G, Conzi G F, Murolo C. Sonographic evaluation of local recurrences of soft tissue sarcoma. J Ultrasound Med . 1993; 12 23-26
18 Choi H, Varma D GK, Fornage B D, Kim E E, Johnston D A. Soft-tissue sarcoma: MR imaging vs sonography for detection of local recurrence after surgery. Am J Roentgenol . 1991; 157 353-358
19 Arya S, Nagarkatti D G, Dudhat S B, Nadkarni K S, Joshi M S, Shinde S R. Soft tissue sarcomas: ultrasonographic evaluation of local recurrences. Clin Radiol . 2000; 55 193-197
20 Alexander A A, Nazarian L N, Feld R I. Superficial soft-tissue masses suggestive of recurrent malignancy: sonographic localization and biopsy. Am J Roentgenol . 1997; 169 1449-1451
21 Jacobson J A, Starok M, Pathria M, Garfin S R. Pseudarthrosis: US evaluation after posterolateral spinal fusion. Radiology . 1997; 204 853-858
22 Thomas A J, Bull M J, Howard A C, Saleh M. Peri operative ultrasound guided needle localization of amputation stump neuroma. Injury . 1999; 30 689-691
23 Provost N, Bonaldi V M, Sarazin L, Cho K H, Chhem R K. Amputation stump neuroma: ultrasound features. J Clin Ultrasound . 1997; 25 85-89