Article

Ultrasound-guided procedures: Techniques and usefulness in controlling inflammation and disease progression

Rheumatology (Impact Factor: 4.44). 12/2012; 51(suppl 7):vii31-vii35. DOI: 10.1093/rheumatology/kes331

ABSTRACT US allows us to detect joint alterations and to perform procedures such as aspiration of fluid as well as therapeutic injections; it helps in placing the needle correctly, greatly improving the outcome. Tissue biopsies (of, for example, synovium, muscle or salivary glands) can be performed with US guidance, and this method may be of significant importance in diagnostic examinations. Other imaging methods may be fused with US, and thus detailed maps are available to navigate in soft tissues. The new era in rheumatology will include US as an important part of its armament. © The Author 2012. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.

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    ABSTRACT: Ultrasound has emerged as a low-cost, radiation-free and effective imaging technique to detect joint abnormalities and to guide percutaneous procedures. Being superficial, wrist and hand tendons and joints represents a good target to perform such procedures using ultrasound guidance. This kind of approach allows for a clear and real-time visualization of the needles during their whole path. In this setting, the knowledge of technical aspects and tips is essential to act in the most accurate way on target tissues that can be as small as a few millimetres. The aim of this review is to summarize the local treatments of inflammatory and degenerative disease described in literature (such as treatment of De Quervain's tenosynovitis, trigger finger, trapezio-metacarpal joint osteoarthritis, etc.), emphasizing precautions and tricks based on day-by-day experience that may help to improve the outcome of percutaneous ultrasound-guided procedures around the wrist and hand.
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