ULTRASONIDO EN REUMATOLOGÍA
Encuentro con EMIS-6 que están cursando la rotación de Reumatología y que quieren aprender algunas generalidades acerca de cómo el ultrasonido es una herramienta de gran ayuda diagnóstica para el reumatólogo.
TALLER DE HABILIDADES CLÍNICAS PARA APRENDER A DIAGNOSTICAR
EL SÍNDROME DEL TÚNEL CARPIANO
EL SÍNDROME DEL TÚNEL CARPIANO
Actividad # 1 : Ver este video
Actividad # 2 : Ver este video
Actividad # 3 : Ver este video
Actividad # 4 : Leer este artículo
| carpal_tunnel_syndrome_ultrasound_protocol_-_yin-ting_chen__2016.pdf |
Given its increasing availability, factors of patient comfort and preference, as well as its ability to predict electrodiagnostic outcomes, US should be considered a first-line screening tool when available. It can help detect the presence of anatomic anomalies that may contribute to therapeutic planning.
Although many variations in measurement locations have been proposed, the most commonly measured location is the pisiform, and the cross-sectional area is the most studied and validated measurement parameter. As the most optimal diagnostic cross-sectional area value has not been conclusively established, a cross-sectional area of greater than 14 mm2 can be used to rule in carpal tunnel syndrome, and a value of less than 8 mm2 can be used to rule it out.
The use of a Δ cross-sectional area of greater than 2 mm2 in a nonbifid median nerve and greater than 4 mm2 in a bifid median nerve allows simple clinical implementation of US with high diagnostic accuracy.
A wrist-to-forearm ratio of less than 1.4 has 99% sensitivity in predicting normal electrodiagnostic results and may be considered part of the screening test.
Although many variations in measurement locations have been proposed, the most commonly measured location is the pisiform, and the cross-sectional area is the most studied and validated measurement parameter. As the most optimal diagnostic cross-sectional area value has not been conclusively established, a cross-sectional area of greater than 14 mm2 can be used to rule in carpal tunnel syndrome, and a value of less than 8 mm2 can be used to rule it out.
The use of a Δ cross-sectional area of greater than 2 mm2 in a nonbifid median nerve and greater than 4 mm2 in a bifid median nerve allows simple clinical implementation of US with high diagnostic accuracy.
A wrist-to-forearm ratio of less than 1.4 has 99% sensitivity in predicting normal electrodiagnostic results and may be considered part of the screening test.
Actividad # 5 : Obtener por ultrasonido las imágenes y dimensiones del nervio mediano de una persona necesarias para apoyar o descartar el diagnóstico de Síndrome del Túnel Carpiano.
There are 6 key views:
(1) distal forearm in the transverse axis, for the baseline cross-sectional area
(2) carpal tunnel inlet in the transverse axis;
(3) tunnel to outlet in the transverse axis, for mass lesions;
(4) tunnel to outlet in the longitudinal axis, for deformation of the median nerve;
(5) dynamic test to evaluate dynamic compression of the median nerve; and
(6) assessment of accessory structures.
(1) distal forearm in the transverse axis, for the baseline cross-sectional area
(2) carpal tunnel inlet in the transverse axis;
(3) tunnel to outlet in the transverse axis, for mass lesions;
(4) tunnel to outlet in the longitudinal axis, for deformation of the median nerve;
(5) dynamic test to evaluate dynamic compression of the median nerve; and
(6) assessment of accessory structures.