这项工作得到了中国浙江省教育厅普通科研项目（批准号：Y202249231）的支持。

这项研究得到了我院伦理和科学审查委员会的批准。从患者那里获得了书面知情同意。所有治疗程序均由具有10年肌肉骨骼超声干预经验的人员执行。操作员必须对肌肉骨骼解剖学有很好的了解。这里使用的超声波机器在 材料表中 提到，并有一个高频探头。
1. 器械设置和患者准备
<ol><li>输入ID号和患者姓名以保存图像。</li>
	<li>使用设备消毒湿巾对超声探头进行消毒。用外科手套覆盖探头执行所有程序。</li>
	<li>使用屏幕中间的 DBRN 设置图像。为此，请沿后旋肌进行横截面扫描以找到 DBRN。然后，旋转 90° 以获得长轴截面。在连续超声引导下，分离后旋肌周围组织和DBRN之间的粘附。</li>
	<li>要求患者坐下并将手臂弯曲 20° 放在检查床上。进行超声检查DBRN对周围组织的粘附（图1; 视频 1）。</li>
</ol>2.超声检查和治疗
<ol><li>使用复合碘对患者的皮肤进行三次消毒，然后将无菌手术毛巾放在患者的手臂上。</li>
	<li>使用10 mL等分试样的混合溶液（5 mL 2%利多卡因和5 mL 0.9%氯化钠）逐层提供局部麻醉，直到到达DBRN表面（图2）。麻醉的四层包括皮肤、皮下软组织、肱桡肌和浅表后肌。使用超声引导确认每层的麻醉，并检查针尖是否穿过每一层。</li>
	<li>通过在肱骨外上髁水平横向使用探头来识别桡神经。桡神经位于肱骨肌和肱肌之间。然后，将探头向远端移动，以找到桡神经的深分支，位于Supinator的深层和浅层之间。</li>
	<li>在连续超声引导下，使用5 mL注射器分离后旋肌肉周围组织与DBRN之间的粘附。从DBRN远端区域到近端区域进行针头释放。用尖端来回刺破粘附组织。当注射器和DBRN周围的组织之间存在阻力时停止。</li>
	<li>确保探头和针头得到精确控制，在整个操作过程中保持针尖可见，避免损坏DBRN。</li>
	<li>手术后，将 1 mL 皮质类固醇（倍他米松）和 2 mL 2% 利多卡因的混合物注射到 DBRN 的浅表区域。</li>
</ol>

超声引导下穿刺松解术联合皮质类固醇注射

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作者声明没有相互竞争的经济利益。

近年来，超声已成为评估周围神经卡压的宝贵工具。超声波可用于实时观察神经并提供动态可视化12。卡压的明显超声指标是卡压部位的神经CSA增加13，14。其他发现，如低回声质地、神经扁平化和血管增多，也见于卡压性神经病变15。
RN 卡压综合征约占非创伤性上肢病变的 0.7%。RN 卡压综合征与尺神经和正中神经卡压综合征相比较少见。在接受手术的患者中，RN 可以拉伸或压缩16。桡管综合征涉及由 DBRN 压缩损伤引起的前臂疼痛。家政职业、体育实践和专业活动都可能导致这些问题17.RN 中经历压迫的最常见解剖部分是后旋肌浅层的近端边缘，称为 Frohse 拱廊 （AF）。Frohse和Frankel在1908年首次描述了这种解剖学肌腱结构。前臂的旋前和旋后会增加由于纤维性AF 4，18 引起的 DBRN 压缩造成的伤害。
在这种情况下，我们发现在第一次手术后，当手指的关节完全伸直时，无名指和小指的背侧伸展有明显的局限性（无名指：-30°，小指：-40°）。超声检查显示，增厚的DBRN在出口处深深粘附在周围组织上。由于病人1个月前最后一次手术，他不愿意接受进一步的手术。因此，他两次接受了超声引导下DBRN的针头释放，并注射皮质类固醇，以缓解DBRN与周围组织之间的粘附。第二次治疗后1个月，当手指关节完全伸直时，患者无名指和小指的背侧伸展正常（无名指：0°，小指：0°）。 
在实时超声引导的帮助下，我们可以准确安全地观察神经及其周围组织。高频线性阵列换能器 （>10 MHz） 是可视化浅表组织和周围神经注射的最佳选择。本研究中的所有神经注射程序均采用无菌技术进行;例如，探头被外科手套覆盖，并使用复合碘对患者的皮肤进行消毒。有许多方案可用于神经水力解剖。例如，低浓度葡萄糖是区域麻醉期间第一个用于水定位的葡萄糖19。另一项研究表明，在超声20的引导下，使用生理盐水可以精确地对正中神经进行水解。在我们的研究中，我们使用5 mL 2%利多卡因和5 mL 0.9%氯化钠进行水力解剖。最近的一项研究报告称，5%葡萄糖和富血小板血浆注射是治疗腕管综合征的宝贵方案，治疗结果，包括症状缓解，优于盐水和皮质类固醇注射21。尽管富血小板血浆注射价格昂贵且制备过程复杂，但由于其潜在的效果更好，因此需要进一步研究。
创伤后肿胀和粘连逐渐减少，所需时间的长短取决于损伤的严重程度、损伤部位以及损伤的治疗效果。一般来说，轻伤引起的轻度肿胀通常会在几天到 1 周内消退。然而，重大伤害引起的更严重的肿胀可能会持续数周甚至数月。这一过程可以通过松针结合皮质类固醇注射来帮助。
从这个案例中可以学到几点。首先，操作人员应详细了解手的解剖结构，并在涉及周围神经松针的手术中具有出色的技术技能。其次，在进行周围神经治疗时，超声是术前、术中和术后研究中有用的观察工具。超声图像可以提供有关神经位置及其与周围组织关系的信息。第三，松针结合注射到周围神经有很大的挑战。粘附在周围组织的神经可能有模糊的边界。此外，周围神经很小，当身体轻微移动时很容易移动，因此注射到目标神经需要良好的操作技能。

桡神经 （RN） 在肘部水平分裂为两个主要分支：深分支 （DBRN） 和浅分支 （SBRN）。DBRN 起源于 RN 的主干，位于肱骨1 的外上髁水平。DBRN绕桡骨颈部弯曲，然后穿过后旋肌浅缘的腱弓下方，这被称为Frohse2的拱廊。该解剖部位是前臂3，4 处 DBRN 最常见的卡压部位。在极少数情况下，DBRN 可以从supinator 5 的入口压缩到出口。DBRN的卡压可引起前臂外背近端疼痛和腕伸肌无力6，7，8。
当神经受伤时，神经传导检查（NCS）和肌电图（EMG）有时会显示异常结果，表明神经受损。尽管肌电图是一种成熟的方法，并提供有关神经疾病的功能信息，但它缺乏检测与神经相关的解剖学和形态学信息的能力9。除此之外，肌电图在神经损伤的早期阶段的敏感性和特异性不是很高。超声可以很容易地检测到周围神经，并在超声成像中显示它们。许多研究报告了高频超声在诊断周围神经卡压方面的价值5。它作为寻找周围神经的诊断方法具有巨大的潜力。Babaei-Ghazani等人在Frohse拱廊报告了DBRN的超声值，他们得出结论，年龄与DBRN的横截面积（CSA）有关，而身高或性别等其他特征不是1。一些研究报告说，皮质类固醇注射可有效治疗肌肉骨骼疾病10，11。然而，到目前为止，还没有关于超声引导下针头释放加在DBRN中注射皮质类固醇治疗粘连的报告。在这里，我们报告了一种无需开放手术即可分离粘连的方法。一名左手无名指和小指背屈受限的男性患者采用这种方法进行治疗。该患者在治疗前1个月左前臂受伤。前臂的多块肌肉（指伸肌、 小指 伸肌和尺 腕伸肌）在另一家医院缝合。他的DBRN有水肿并增厚，DBRN的出口点深深地粘附在周围组织上。使用US引导下放针和注射DBRN皮质类固醇治疗后，当手指关节完全伸直时，患者环和小指的背部伸展正常。

<table><tbody><tr><td>Betamethasone</td><td>MSD Merck Sharp &amp;amp; Dohme AG</td><td>B7005-100MG</td><td></td></tr><tr><td>Injection syringe</td><td>Hangzhou Minsheng Pharmaceutical Co., LTD</td><td></td><td>5 mL and 10 mL</td></tr><tr><td>Lidocaine</td><td>Shanghai Zhaohui Pharmaceutical Co., LTD</td><td>H41022244</td><td>7 mL</td></tr><tr><td>Sodium chloride</td><td>Hangzhou Minsheng Pharmaceutical Co., LTD</td><td>http://www.mspharm.com/pro_list.asp?PageNumber=3&amp;amp;info_kind=004001&lt;br/&gt; &amp;amp;d_add_date1=&amp;amp;d_add_date2=&amp;amp;&lt;br/&gt; skind=&amp;amp;p_keys=</td><td>5 mL</td></tr><tr><td>Ultrasonic diagnostic system</td><td>SIEMENS</td><td></td><td>Type:ACUSON Sequoia</td></tr></tbody></table>

ultrasound-guided needle release combined with corticosteroid injection for the treatment of supinator syndrome

桡神经（RN）的两个主要分支是深分支（DBRN）和浅分支（SBRN）。RN在肘部分裂成两个主要分支。DBRN在supinator的深层和浅层之间运行。由于其解剖学特征，DBRN可以很容易地在Frohse（AF）的拱廊上压缩。这项工作的重点是1个月前左前臂受伤的42岁男性患者。前臂的多块肌肉（指伸肌、 小指 伸肌和尺 腕伸肌）在另一家医院缝合。之后，他的左手无名指和小指背屈受限。病人不愿再做手术，因为他在1个月前接受了多块肌肉的缝合手术。超声显示桡神经深支（DBRN）水肿并增厚。DBRN的出口点已经深深地粘附在周围的组织上。为了缓解这种情况，对DBRN进行了超声引导下针头松解加皮质类固醇注射。近3个月后，患者无名指和小指的背侧伸展明显改善（无名指：-10°，小指：-15°）。然后，第二次进行相同的治疗。近1个月后，当手指关节完全伸直时，戒指和小指的背侧伸展正常。超声可以评估DBRN的状况及其与周围组织的关系。超声引导下针头释放联合皮质类固醇注射是DBRN粘连的有效且安全的治疗方法。

治疗后1个月，手指关节完全伸直，无名指和小指背侧伸展明显改善（无名指：-15°，小指：-25°）。治疗后3个月，患者复诊DBRN。通过超声评估的DBRN粘连范围与治疗前相比显着减小。无名指和小指的背侧伸展也得到了改善（无名指：-10°，小指：-15°; 图3; 视频 2）。第二次进行相同治疗后1个月，当手指关节完全伸直时，戒指和小指的背部伸展正常（无名指：0°，小指：0°; 图4）。
<img alt="Figure 1" class="xfigimg" src="/files/ftp_upload/65256/65256fig01.jpg"> 图1：入院时的体格检查和超声检查结果。 （A）当患者的指关节完全伸直时，无名指和小指的背侧伸展有明显的限制（无名指：-30°，小指：-40°，白色箭头）。（B）长轴视图的超声显示，桡神经深支（DBRN）明显水肿和增厚（白色箭头）。DBRN的出口点粘附在周围组织上（白色虚线箭头）。 <a href="https://www.jove.com/files/ftp_upload/65256/65256fig01large.jpg" target="_blank">请点击此处查看此图的大图。</a>
<img alt="Figure 2" class="xfigimg" src="/files/ftp_upload/65256/65256fig02.jpg"> 图2：第一次治疗的超声图像。 我们使用针头释放分离周围组织之间的粘附。将 1 mL 皮质类固醇（倍他米松）和 2 mL 2% 利多卡因的混合物注射到 DBRN 的浅表区域。 <a href="https://www.jove.com/files/ftp_upload/65256/65256fig02large.jpg" target="_blank">请点击此处查看此图的大图。</a>
<img alt="Figure 3" class="xfigimg" src="/files/ftp_upload/65256/65256fig03.jpg"> 图3：第二次治疗的超声图像。 （A）第一次治疗后1个月，当手指关节完全伸直时，患者的无名指和小指背侧伸展明显改善（无名指：-15°，小指：-25°，白色箭头）。（B）3个月后，患者的无名指和小指背侧延伸进一步改善（无名指：-10°，小指：-15°，白色箭头）。（C）超声图像显示，第一次治疗后3个月，粘附在周围组织的DBRN区域显着减少（白色虚线箭头）。 <a href="https://www.jove.com/files/ftp_upload/65256/65256fig03large.jpg" target="_blank">请点击此处查看此图的大图。</a>
<img alt="Figure 4" class="xfigimg" src="/files/ftp_upload/65256/65256fig04.jpg"> 图4：后续处理。 第二次进行相同治疗后1个月，当手指关节完全伸直时，患者无名指和小指的背部伸展正常（无名指：0°，小指：0°，白色箭头）。 <a href="https://www.jove.com/files/ftp_upload/65256/65256fig04large.jpg" target="_blank">请点击此处查看此图的大图。</a>
视频1：治疗前的超声视频。<a href="https://www.jove.com/files/ftp_upload/65256/pre-treatment_Re.zip" target="_blank">请点击此处下载此视频。</a>
视频2：治疗后的超声视频。<a href="https://www.jove.com/files/ftp_upload/65256/post-treatment_RE.zip" target="_blank">请点击此处下载此视频。</a>

Watch this Scientific Journal Video about Ultrasound-Guided Needle Release Combined with Corticosteroid Injection for the Treatment of Supinator Syndrome at JoVE.com

作者聚焦： 超声引导下松针联合皮质类固醇注射治疗旋后综合征  

由于其解剖学特征，桡神经的深分支很容易在Frohse的拱廊中被压缩。超声引导下针头释放联合皮质类固醇注射是深支桡神经粘连的有效且安全的治疗方法。

超声引导下穿刺释放联合皮质类固醇注射治疗后导管综合征

The two main branches of the radial nerve (RN) are the deep branch (DBRN) and the superficial branch (SBRN). The RN splits into two main branches at the ...

我们的研究方向是皮质类固醇超声。因此协议表明我们的超声数据过程需要与皮质类固醇联合注射器性状中的几种综合征。在实时超声引导的帮助下，我们可以观察综合症及其周围。教师撰写的文章与会话综合症的安全性相比。整个治疗与后标综合征相结合。桡神经的深支由于其解剖学特征，很容易在霜冻拱廊处被压缩。超声引导下针头释放联合皮质类固醇注射对哈西姆深支放射神经具有感染性且安全的治疗方法。与开放手术相比，超声引导下针头松解加皮质类固醇注射治疗后插综合征的切口更小、成本更低、治疗时间更短、恢复更快。超声引导下针头释放加皮质类固醇注射更适合临床应用。在未来。我们将使用超声数据，针头释放，皮质类固醇注射后治疗更多的周围神经病变。

ultrasound-guided-needle-release-combined-with-corticosteroid

Nanyang Technological University

Research

JoVE Journal

Neuroscience

Ultrasound-Guided Needle Release Combined with Corticosteroid Injection for the Treatment of Supinator Syndrome

1.3K 次观看.  Hangzhou Medical College. 我们的研究方向是皮质类固醇超声。因此协议表明我们的超声数据过程需要与皮质类固醇联合注射器性状中的几种综合征。在实时超声引导的帮助下，我们可以观察综合症及其周围。教师撰写的文章与会话综合症的安全性相比。整个治疗与后标综合征相结合。桡神经的深支由于其解剖学特征，很容易在霜冻拱廊处被压缩。超声引导下针头释放联合皮质类固醇注射对...

视频: 作者聚焦： 超声引导下松针联合皮质类固醇注射治疗旋后综合征  

Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss

Sudden sensorineural hearing loss (SSHL) is characterized by acute, idiopathic hearing loss. The estimated incidence rate is 5-30 cases per 100,000 people per year. The causes of SSHL and the mechanisms underlying SSHL currently remain unknown. Based on several hypotheses such as a circulatory disturbance to the cochlea, viral infection, and autoimmune disease, pharmaco-therapeutic approaches have been applied to treat SSHL patients; however, the efficacy of the standard treatment, corticosteroid therapy, is still under debate. Exposure to intense sounds has been shown to cause permanent damage to the auditory system; however, exposure to a moderate level enriched acoustic environment after noise trauma may reduce hearing impairments. Several neuroimaging studies recently suggested that the onset of SSHL induced maladaptive cortical reorganization in the human auditory cortex, and that the degree of cortical reorganization in the acute SSHL phase negatively correlated with the recovery rate from hearing loss. This article reports the development of a novel neuro-rehabilitation approach for SSHL, &#34;constraint-induced sound therapy (CIST)&#34;. The aim of the CIST protocol is to prevent or reduce maladaptive cortical reorganization by using an enriched acoustic environment. The canal of the intact ear of SSHL patients is plugged in order to motivate them to actively use the affected ear and thereby prevent progress of maladaptive cortical reorganization. The affected ear is also exposed to music via a headphone for 6 hr per day during hospitalization. The CIST protocol appears to be a safe, easy, inexpensive, and effective treatment for SSHL.

This article reports the development of a neuro-rehabilitation approach, "constraint-induced sound therapy (CIST)" for sudden sensorineural hearing loss. The aim of CIST is to prevent maladaptive cortical reorganization by using an enriched acoustic environment. CIST represents a safe, easy, inexpensive, and effective approach to treat sudden sensorineural hearing loss.

对于突发性耳聋神经康复治疗方法

Sudden sensorineural hearing loss (SSHL) is characterized by acute, idiopathic hearing loss. The estimated incidence rate is 5-30 cases per 100,000 people ...

科研

行为学

Analyzing Satellite Cell Function During Skeletal Muscle Regeneration by Cardiotoxin Injury and Injection of Self-delivering siRNA In Vivo

Skeletal muscle possesses an enormous capacity to regenerate after injury. This process is mainly driven by muscle stem cells, also termed satellite cells. Satellite cells are characterized by the expression of the transcription factor Pax7 and their location underneath the basal lamina in the resting skeletal muscle. Upon injury, satellite cells get activated, undergo self-renewal or differentiation to either form new myofibers or to fuse with damaged ones. The functionality of satellite cells in vivo can be investigated using a cardiotoxin based injury model of skeletal muscle. To study the function of one gene during the regeneration of skeletal muscle, transgenic mouse models are mostly used. Here, we present an alternative method to transgenic mice, to investigate the gene function in satellite cells during regeneration, e.g., in cases where transgenic mice are not available. We combine the cardiotoxin mediated injury of a specific skeletal muscle with the injection of a self-delivering siRNA into the regenerating muscle which is then taken up by satellite cells among other cells. Thereby, we provide a method to analyze gene function in satellite cells during regeneration under physiological conditions without the need for transgenic mice.

We describe an in vivo method to investigate the functional loss of a specific gene in satellite cells by using a combination of cardiotoxin mediated injury of skeletal muscle and the injection of a self-delivering siRNA.

通过心肌毒素损伤和在 Vivo 中注射自传递 siRNA 在骨骼肌再生过程中的卫星细胞功能分析

Skeletal muscle possesses an enormous capacity to regenerate after injury. This process is mainly driven by muscle stem cells, also termed satellite ...

遗传学

An Ultrasonic Tool for Nerve Conduction Block in Diabetic Rat Models

Nerve conduction block with a high intensity-focused ultrasound (HIFU) transducer has been performed in normal and diabetic animal models recently. HIFU can reversibly block the conduction of peripheral nerves without damaging the nerves while using an appropriate ultrasonic parameter. Temporary and partial block of the action potentials of nerves shows that HIFU has the potential to be a useful clinical treatment for pain relief. This work demonstrates the procedures for suppressing the action potentials of neuropathic nerves in diabetic rats in vivo using an HIFU transducer. The first step is to generate adult male diabetic neuropathic rats by streptozotocin (STZ) injection. The second step is to evaluate the peripheral diabetic neuropathy in STZ-induced diabetic rats by an electronic von Frey probe and a hot plate. The final step is to record in vivo extracellular action potentials of the nerve exposed to HIFU sonication. The method showed here may benefit the study of ultrasound analgesic applications.

This work presents the methodology of applying high intensity-focused ultrasound to block the action potentials of diabetic neuropathic nerves.

糖尿病大鼠模型神经传导阻滞的超声工具

Nerve conduction block with a high intensity-focused ultrasound (HIFU) transducer has been performed in normal and diabetic animal models recently. HIFU ...

生物工程

Screening of Axonal Degeneration in Carpal Tunnel Syndrome Using Ultrasonography and Nerve Conduction Studies

Axonal degeneration, indicative of surgical decompression, may coexist in carpal tunnel syndrome (CTS) as the disease progresses. However, the current diagnostic and severity gradation system cannot clearly indicate its coexistence, resulting in&#160;confusion of appropriate treatment prescription. There are also constraints in conventional methods for&#160;differentiation as well. This study aims at introducing an innovative, efficient, and quick screening protocol to differentiate axonal degeneration associated with CTS, using ultrasound and nerve conduction studies (NCS). It starts by using NCS to perform orthodromic stimulation at the wrist, to obtain the sensory conduction of the median and the ulnar nerves respectively. Meanwhile, the motor conduction&#160;of the median nerve is collected by stimulating the palm, wrist, and elbow, followed by the stimulation of the ulnar nerve at the wrist,&#160;below and above the elbow. Then, an ultrasound assessment is performed, using a linear array transducer, with cross-sectional area (CSA) and perimeter (P) at the wrist and at the one-third distal forearm calipered. Ratios (R-CSA, R-P) and changes from wrist to one-third distal forearm (&#916;CSA and &#916;P) are calculated according to a standard format. Potential axonal degeneration coexisting in CTS will be screened according to the criteria of NCS and cut-off values of ultrasound measurements established in a previous study. In terms of its noninvasiveness, low cost, convenience, and efficiency, it is easy to apply ultrasound complimentarily in clinical practice to prescreen patients with potential coexisting axonal degeneration. Nevertheless, the ultrasonographic imaging cannot directly reflect axonal degeneration. It still relies on conventional but invasive methods&#160;such as electromyography (EMG) and biopsy&#160;for confirmation if needed.

Here we present a protocol using nerve conduction studies and ultrasound to screen potential axonal degeneration associated with carpal tunnel syndrome. The criteria for differentiation are established. Compared to conventional approaches, this method is noninvasive, convenient, and efficient, with an overall satisfactory accuracy, sensitivity, and specificity.

超声和神经传导研究对腕管综合征轴突变性的筛查

Axonal degeneration, indicative of surgical decompression, may coexist in carpal tunnel syndrome (CTS) as the disease progresses. However, the current ...

神经科学

Neuromuscular Ultrasound of the Median Nerve at the Carpal Tunnel

The use of neuromuscular ultrasound greatly enhances the evaluation of carpal tunnel syndrome as an adjunct diagnostic tool as it provides dynamic and structural information about the median nerve and its surrounding anatomy.&#8239;Neuromuscular ultrasound aids in diagnostic accuracy (when used with electrodiagnostic testing) and offers etiologic information as a non-invasive, painless, cost-effective, and radiation-free imaging technology that can be easily carried out at the bedside for immediate interpretation. Neuromuscular ultrasound has the limitation of subjectivity, and the need for training and experience will affect the interpretation of results. This article describes a basic practical guide to visualizing the median nerve using neuromuscular ultrasound in a step-by-step manner to aid in the evaluation of carpal tunnel syndrome. Even though the use of ultrasound in the assessment of median nerve entrapment has been long established, there has been no recognized standard protocol. The present protocol aims to provide clear and concise instructions to describe a standard technique to visualize the median nerve through diagnostic ultrasound.

<meta charset="utf8"></head><body>腕管正中神经的神经肌肉超声

The present protocol describes a technique for the standardization of median nerve ultrasound in cases of suspected carpal tunnel syndrome.

腕管正中神经的神经肌肉超声

The use of neuromuscular ultrasound greatly enhances the evaluation of carpal tunnel syndrome as an adjunct diagnostic tool as it provides dynamic and ...

医学

Treatment Protocol for Rotator Cuff Calcific Tendinitis Using a Single-Crystal Piezoelectric Focused Shock Wave Source

Focused shock waves have emerged as a highly effective noninvasive therapeutic option for the treatment of calcific tendinitis of the shoulder. There are three types of focused shock wave generators: electrohydraulic, electromagnetic, and piezoelectric. According to our literature search, there are no reports of results with the use of single-crystal piezoelectric generators in calcific tendinitis of the shoulder. In a consecutive retrospective series of 23 patients with G&#228;rtner type I and II calcifications of the rotator cuff, we performed three applications of high-energy piezoelectric focused waves (4,000 pulses per session with a frequency of 6 Hz). At the final follow-up (average of 14 months), 82.6% of the cases showed complete resorption of the calcification in radiographic controls. In 8.7% of the cases, partial disappearance of the calcification was achieved, and in the remaining 8.7% there were no significant changes. Single-crystal piezoelectric generators have a success rate comparable to those already reported with electrohydraulic and electromagnetic devices.

Calcific tendinitis of the shoulder is a relatively common condition with numerous treatment options. Here, we discuss the indications of focused shock waves generated by a single-crystal piezoelectric device, describe a treatment protocol, and present the preliminary results.

使用单晶压电聚焦冲击波源治疗肩袖钙化性肌腱炎的方案

Focused shock waves have emerged as a highly effective noninvasive therapeutic option for the treatment of calcific tendinitis of the shoulder. There are ...

Ultrasound Scanning Protocol in the Assessment of Ulnar Neuropathy at the Elbow

Ulnar neuropathy at the elbow is commonly encountered in clinical practice and is the second most common entrapment neuropathy. Left untreated, ulnar neuropathy at the elbow can result in significant disability due to loss of dexterity and grip strength secondary to the weakness of intrinsic hand muscles. Precisely localizing a lesion in ulnar neuropathy can be challenging with electrodiagnostic testing alone. Ultrasound is a relatively quick and useful adjunctive diagnostic modality in overcoming this limitation, as an increase in the cross-sectional area (CSA) of the nerve is a common and validated finding in ulnar neuropathies at the elbow. Sonographic assessment of the nerve's echotexture and vascularity can provide additional diagnostic clues. Ultrasound also offers the unique benefit of detecting ulnar nerve subluxation or dislocation out of the retroepicondylar groove during dynamic assessment, although the clinical significance of this is controversial. Finally, ultrasound can also identify structural abnormalities leading to nerve compressions, such as the presence of bony abnormalities, scar tissue, and space-occupying lesions. These findings may influence management strategies and surgical planning. This protocol aims to illustrate the technique of static and dynamic sonographic imaging of the ulnar nerve around the elbow as a complement to electrodiagnostic testing in the assessment of ulnar neuropathy at the elbow.

<meta charset="utf8"></head><body>评估肘部尺神经病变的超声扫描方案

This is a standardized protocol for evaluating the ulnar nerve at the elbow using ultrasound.

评估肘部尺神经病变的超声扫描方案

Ulnar neuropathy at the elbow is commonly encountered in clinical practice and is the second most common entrapment neuropathy. Left untreated, ulnar ...

小针刀治疗肩周炎的疗效

Clinical Efficacy of Small Needle Knife Therapy on Stage I-II Frozen Shoulder

Frozen shoulder is a kind of aseptic inflammatory disease of the shoulder caused by strain, trauma, and other reasons, resulting in shoulder joint pain and limited function. The protocol presented here demonstrates the operation of a small needle knife in treating frozen shoulders, including patient management, material preparation, positioning, operation, and postoperative care. The purpose of this protocol is to relieve the pain and functional limitations and improve the living ability of patients with frozen shoulders. In our study, 76 stage I-II frozen shoulder patients who met the inclusion criteria were randomly divided into a control group and a treatment group (n=38). Patients in the control group received functional exercise, while the treatment group received small needle knife therapy with functional exercise. The visual analogue scores (VAS), the Constant and Murley scores (CMS), and the thickness of the coracohumeral ligament (CHL) under ultrasound were evaluated. After small needle knife therapy, the VAS score was significantly lower in the treatment group (5.11 &plusmn; 0.89) than in the control group (5.49 &plusmn; 0.65; t=-2.065, p&lt;0.05); the CMS score was significantly higher in the treatment group (64.72 &plusmn; 4.78) than in the control group (60.97 &plusmn; 6.00; t=2.947, p&lt;0.05); the CHL thickness was significantly decreased in the treatment group (2.38 &plusmn; 0.36) than in the control group (2.57 &plusmn; 0.42; t=-2.117, p&lt;0.05). These results indicate that the small needle knife significantly relieved the pain symptoms, improved the shoulder function, reduced the CHL thickness, and improved the quality of life and, therefore, had significant therapeutic efficacy in stage I-II frozen shoulder patients.

作者聚焦：用小针刀疗法治疗肩周炎 

The protocol presented here describes the detailed operation method and proves the effectiveness of a small needle knife in the treatment of frozen shoulders.

小针刀治疗I-II期肩周炎的临床疗效

Frozen shoulder is a kind of aseptic inflammatory disease of the shoulder caused by strain, trauma, and other reasons, resulting in shoulder joint pain ...

超声引导下穿刺释放联合皮质类固醇注射治疗后导管综合征

副本

摘要

探索更多视频

对于突发性耳聋神经康复治疗方法

通过心肌毒素损伤和在 Vivo 中注射自传递 siRNA 在骨骼肌再生过程中的卫星细胞功能分析

糖尿病大鼠模型神经传导阻滞的超声工具

超声和神经传导研究对腕管综合征轴突变性的筛查

腕管正中神经的神经肌肉超声

腕管正中神经的神经肌肉超声

使用单晶压电聚焦冲击波源治疗肩袖钙化性肌腱炎的方案

评估肘部尺神经病变的超声扫描方案

评估肘部尺神经病变的超声扫描方案

小针刀治疗I-II期肩周炎的临床疗效