Musc uloske le ta l (MSK) Outline T e c hno lo g y Ove rvie w - - PowerPoint PPT Presentation

Musc uloske le ta l (MSK)

Outline

• T

e c hno lo g y Ove rvie w

• I

ma g ing De ta ile d Ana to my

– Me dia n Ne rve – Me ta c a rpo pha la ng e a l Jo int – Dig ita l Pulle ys – Ra dia l Arte ry – T

e mpo ro ma ndib ula r Jo int

– Uppe r T

ra pe zius

– Ac hille s Ca lc a ne a l I

nse rtio n

– T

a rsa l T unne l

http://anatomy-diagram.net/wp-content/uploads/2015/11/human-anatomy- muscle-skeleton-human-skeletal-system-free-picture.jpg

T e c hnology Ove r vie w

Transducers

T e c hnology Ove r vie w

System Features

Softw are

B-Mode



M-Mode



Color Doppler



Applications

Customer Segments Clinical

Transducers

Models Available UHF22 (15 MHz) UHF48 (30 MHz) UHF70 (50 MHz)

Regulatory

Patient Management



FDA Power Management



DICOM Connectivity

 I m age Processing ( Vevo HD)

Speckle Reduction



Spatial Compounding 

Me dian Ne r ve

• T

he me dia n ne rve is de rive d fro m the b ra c hia l ple xus a nd is o ne o f 3 ma jo r ne rve s tha t supply tha t ha nd

• Clinic a l Re le va nc e : Pa ssing unde r the c a rpa l tunne l (fle xo r re tina c ulum) the

me dia n ne rve c a n b e c o mpre sse d = c a rpa l tunne l syndro me

Anatomy

http://emedicine.medscape.com/article/1369028-overview

E epineurium; F fascicle; P perineurium; V vessel.

https://studentconsult.inkling.com/read/wheaters-functional-histology-atlas-young-5th/chapter- 7/figure-7-13

Anatomy of a Peripheral Nerve

Me dian Ne r ve

Imaging

6-15 MHz 50 MHz

Vevo MD Ultra High Frequency Conventional Ultrasound

Me tac ar pophalange al (MCP) Joint

• T

he MCP jo ints a re fo und in the ha nd b e twe e n e a c h me ta c a rpa l a nd pro xima l pha la nx

• MCP jo ints a llo w a ra ng e o f mo ve me nt in the fing e r
• Clinic a l Re le va nc e : T

he MCP jo int typic a lly b e c o me s a rthritic with Rhe uma to id Arthritis

Anatomy

Me tac ar pophalange al Joint imaging

Vevo MD Ultra High Frequency Conventional Ultrasound

Imaging

Digital Pulle ys

• T

he a nnula r lig a me nts o f the fing e r (A pulle ys) a re lo c a te d o n the pa lma r a spe c ts o f the fing e rs

• T

he A1pulle y o rig ina te s fro m the MCP jo int

• T

he A1 pulle ys c a n disrupt the a c tio n o f the fle xo r te ndo ns c a using pa in a nd limiting mo ve me nt = trig g e r fing e r

Anatomy

http://www.reumatologiaclinica.org/en/clinical- anatomy-hand/articulo/S1699258X12002422/ http://www.iowahand.com/trigger.html

Digital Pulle ys

Imaging

Conventional Ultrasound Vevo MD Ultra High Frequency

Radial Ar te r y

• T

he ra dia l a rte ry is a b ra nc h o ff the b ra c hia l a rte ry in the fo re a rm

• I

n the ha nd it c o ntrib ute s to the supe rfic ia l a nd de e p pa lma r a rc he s

• Clinic a l Re le va nc e : T

he ra dia l pulse is de te c te d a s the ra dia l a rte ry pa sse s o ve r the dista l ra dius.

Anatomy

Byrne, R. A. et al. (2012) Vascular access and closure in coronary angiography and percutaneous intervention

• Nat. Rev. Cardiol. doi:10.1038/nrcardio.2012.160

http://teachmeanatomy.info/upper-limb/vessels/arteries/

Radial Ar te r y

Imaging

Conventional Ultrasound Vevo MD Ultra High Frequency

Radial Ar te r y

Imaging (within the anatomical snuffbox)

Drake: Gray’s Anatomy for Students; 2nd Edition

T e mpor

• mandibular

Joint

• T

he te mpo ro ma ndib ula r jo int (T MJ) is a b ila te ra l a rtic ula tio n b e twe e n the ma ndib le a nd te mpo ra l b o ne s, whic h fo rm the ja w

• An a rtic ula r disc se pa ra te s the jo int into 2 c o mpa rtme nts
• T

his disc c a n b e c o me displa c e d whic h c a n le a d to limite d ja w mo ve me nt a nd pa in

Anatomy

http://www.mdguidelines.com/temporomandibular-joint-syndrome

T e mpor

• mandibular

Joint

Imaging

Conventional Ultrasound Vevo MD Ultra High Frequency

Uppe r T r ape zius Musc le

• T

he tra pe zius is a b ila te ra l, wide , fla t musc le in the uppe r b a c k

• F

unc tio ns: mo ve , ro ta te a nd sta b ilize sc a pula ; e xte nd he a d a nd ne c k

• E

xist a s thre e se ts o f fib e rs o n e a c h side (lo we r, middle , uppe r)

– I

mb a la nc e s in the se fib e rs c a n a ffe c t po sture

Anatomy

Uppe r T r ape zius Musc le F ibe r s

Imaging

Conventional Ultrasound Vevo MD Ultra High Frequency

Ac hille s Calc ane al Inse r tion

• T

he Ac hille s is a te ndo n in the po ste rio r a nkle tha t a tta c he s the le g musc le s to the c a lc a ne us (he e l)

• I

t is the thic ke st te ndo n in the b o dy a nd func tio ns inc lude pla nta r fle xio n o f the fo o t a nd kne e fle xio n

• T

he Ac hille s c a n b e to rn, rupture d, o r b e c o me infla me d

Anatomy

http://www.aafp.org/afp/2002/0501/p1805.html

Ac hille s T e ndon

Imaging

Conventional Ultrasound Vevo MD Ultra High Frequency

Achilles-Calcaneal Insertion

T ar sal T unne l

• Sma ll a re a o n the a nkle , po ste rio r

to me dia l ma lle o lus

• Co ve re d b y the fle xo r

re tina c ulum

• Co nta ins: po ste rio r tib ia l a rte ry

a nd ve in, tib ia l ne rve , se ve ra l te ndo ns

• Ne rve e ntra pme nt c a n o c c ur

(ta rsa l tunne l syndro me ) c a use s pa in a nd we a kne ss in fo o t musc le s

Anatomy

Tarsal Tunnel

T ar sal T unne l

Imaging

Conventional Ultrasound Vevo MD Ultra High Frequency

Flexor Retinaculum Tibial Nerve Tibial Artery and Vein

Ove r vie w

• Hig h-fre q ue nc y ultra so und a llo ws visua liza tio n o f sma ll a na to my no t

visib le with c o nve ntio na l ultra so und (do wn to 30µm)

• Cutting e dg e te c hno lo g y c a n le a d to ne w me dic a l disc o ve rie s
• T
• uc h-sc re e n, c usto miza b le inte rfa c e le a ds to impro ve d wo rkflo w

a nd re duc e d e xa mina tio n time s

• Hig hly a dva nc e d tra nsduc e rs de sig ne d fo r the sma lle st pa tie nts

Same size as grain of rice!