Kamal Mezian

Charles University in Prague | CUNI · Department of Rehabilitation Medicine (1. LF)

Aim: To propose a standardized, high-resolution ultrasound (US) protocol to assess the patellar tendon–Hoffa fat pad interface (PTHFPI) in patients with (proximal) patellar tendinopathy (PPT). Methods: Using a high-frequency transducer and a high-level machine, we matched the cadaveric and histological microarchitecture of the PTHFPI with multiple...

Insertional Achilles tendinopathy is an umbrella medical term referring to pain and swelling on the posterior aspect of the calcaneus. High-resolution ultrasound imaging is commonly used in daily practice to assess the pathological changes of the Achilles tendon, cortical bone of the calcaneus, and soft tissues located inside the retrocalcaneal spa...

BACKGROUND: Fibromyalgia is a debilitating condition marked by persistent pain and reduced functionality. Various therapeutic methods have been suggested to alleviate symptoms in individuals with fibromyalgia, yet the impact of diverse rehabilitation strategies remains unclear. OBJECTIVE: This systematic review and meta-analysis aimed at assessing...

The paraspinal muscles of the cervical, thoracic, and lumbar spine are important pain generators because muscle strains or myofascial pain syndrome caused by trigger points are common during clinical practice. Ultrasonography is the most convenient imaging tool for evaluating these muscles due to its advantages, such as providing good delineation o...

Insomnia is commonplace in the general population. Poor sleep quality leads to various health dysfunctions and compromises the well-being of the affected individuals. Non-pharmacologic approaches should be considered the first-line treatment as suggested by various guidelines. Among others (e.g., sleep hygiene, cognitive-behavioral therapy, light t...

Assessment of the posterior lateral knee pain poses diagnostic challenges, requiring accurate evaluation of various structures in light of the medical history and physical examination. Despite substantial progress in the ultrasonographic diagnosis of musculoskeletal disorders, the current protocol (EURO-MUSCULUS/USPRM. Basic scanning protocols for...

Objective Injection of the tibiotalar (TT) joint is commonly performed in clinical practice under ultrasound (US) guidance using an anteromedial approach. However, in some patients, this approach may be technically challenging due to post-traumatic and/or degenerative bony changes. Therefore, the aim of this cadaveric investigation was to demonstra...

Background: Injections around the Achilles tendon (AT) are commonly performed in clinical practice to manage non-insertional Achilles tendinopathy, but the presence/distribution of the injectate with relation to its sheath has not been assessed specifically. Accordingly, the aim of this cadaveric investigation was to demonstrate the feasibility of...

Elucidating its dynamic interaction within the knee joint, this exploration delves into the awareness regarding the articularis genus muscle for ultrasound-guided suprapatellar recess injections. While injections into the infrapatellar recess may proceed without ultrasound guidance, we highlight concerns regarding the potential cartilage injury. In...

Background: Vertebral fragility fractures (VFFs) commonly result from low bone mass and microarchitecture deterioration of bone tissue. spinal orthoses are common non-pharmacological options for managing vertebral fracture pain. However, the effects of spinal orthoses on pain, physical functioning, and quality of life (QoL) are still debated. Obj...

Background: Impaired physical performance and muscle strength are recognized risk factors for fragility fractures, frequently associated with osteoporosis and sarcopenia. However, the integration of muscle strength and physical performance in the comprehensive assessment of fracture risk is still debated. Therefore, this cross-sectional study aime...

Background: Sleep hygiene habits and self-reported sleep quality of those who work from home have yet to be fully understood. As working from home was widely implemented during the COVID-19 pandemic, the period might be a convenient model for studying the measures, as mentioned earlier. Objective: This study aimed to assess sleep hygiene habits...

In this dynamic scanning protocol, ultrasound examination of the ankle is described using various maneuvers to assess different conditions. Real-time patient examination and scanning videos are used for better simulation of daily clinical practice. The protocol is prepared by several/international experts in the field of musculoskeletal ultrasound...

Objectives: Low back pain is a prevalent public health issue caused by superior cluneal nerve (SCN) entrapment. This study aimed to explore the course of SCN branches, cross-sectional area (CSA) of the nerves, and effects of ultrasound-guided SCN hydrodissection. Methods: SCN distance relative to the posterior superior iliac spines was measured...

A 31-year-old woman experienced sudden left neck pain during side plank exercise. Despite oral analgesics, her pain worsened especially when swallowing or speaking loudly.

Ultrasound has emerged as a highly valuable tool in imaging peripheral nerve lesions in the wrist region, particularly for common pathologies such as carpal tunnel and Guyon’s canal syndromes. Extensive research has demonstrated nerve swelling proximal to the entrapment site, an unclear border, and flattening as features of nerve entrapments. Howev...

Papillary thyroid carcinomas (PTC) are the most common type of thyroid malignancy that usually presents as a palpable or nonpalpable nodule. Some of these nodules may cause hoarseness, swallowing, and breathing problems. In this paper, we present a case of PTC with fatigue as the leading symptom. The suspicion for thyroid disease was made upon palp...

Background Several technological advances and digital solutions have been proposed in the recent years to face the emerging need for tele-monitoring older adults with Chronic Obstructive Pulmonary Disease (COPD). However, several challenges have negatively influenced an evidence-based approach to improve Health-Related Quality of Life (HR-QoL) in t...

This report aimed to present a case of wrist-tendon rupture and to discuss a rare complication after corticosteroid injection. A 67-year-old woman had difficulty extending her left-thumb interphalangeal joint several weeks after a palpation-guided local corticosteroid injection. Passive motions remained intact without sensory abnormalities. Ultraso...

Objectives: To describe a proximal to distal approach for ultrasound (US) guided intra-articular elbow injection. Design: Cadaveric study. Settings: Academic institution. Subjects: Single cadaveric specimen. Methods: Both elbows of a single cadaver were injected with green-colored water-diluted latex dye using the US-guided proximal to dis...

Cervical myofascial pain is a very common clinical condition in the daily practice of musculoskeletal physicians. Physical examination is currently the cornerstone for evaluating the cervical muscles and identifying the eventual presence of myofascial trigger points. Herein, the role of ultrasound assessment in precisely localizing them is progress...

Background: Spinal cord injury (SCI) leads to spinal nerve fiber tract damage resulting in functional impairments. Volumetric muscle loss (VML), a skeletal muscle volume abnormal reduction, is represented by atrophy below the injury level. The strategies for VML management included personalized approaches, and no definite indications are available...

Lateral epicondylitis (LE) is a very common and painful condition seen in the daily practice of musculoskeletal physicians. Ultrasound-guided (USG) injections are commonly performed to manage the pain, promote the healing phase, and plan a tailored rehabilitation treatment. In this aspect, several techniques were described to target specific pain g...

Shoulder pain is a common complaint over the paralytic side of stroke patients. We suggest that ultrasound examination should be arranged for hemiplegic shoulders in the presence of pain unresponsive to medication and physical therapy. Ultrasound-guided dual target corticosteroid injection can be introduced over the rotator cuff interval and subdel...

Neuropathic pain, affecting 6.9–10% of the general population, has a negative impact on patients’ quality of life and potentially leads to functional impairment and disability. Repetitive transcranial magnetic stimulation (rTMS)—a safe, indirect and non-invasive technique—has been increasingly applied for treating neuropathic pain. The mechanism un...

Background: Physicians who suffer from poor sleep quality are at an increased risk of mistakes and poor decision-making. We deemed it noteworthy to assess sleep quality in practicing physiatrists, previously reported to be at higher risk of physician burnout, which was documented associated with sleep deprivation. Objective: The aim was to estim...

Ischiofemoral impingement syndrome is a neglected cause of posterior hip pain which is derived from narrowing of the space between the lateral aspect of the ischium and the medial aspect of the lesser trochanter. Its diagnosis is challenging and requires the combination of physical tests and imaging studies. In the present narrative review, we foun...

In this dynamic scanning protocol, ultrasound examination of the knee is described using various maneuvers to assess different conditions. Real-time patient examination and scanning videos are used for better simulation of the daily clinical practice. The protocol is prepared by several/international experts in the field of musculoskeletal ultrasou...

Shoulder disorders are very common in clinical practice. Among several other pathologies, calcific tendinopathy of the rotator cuff tendons is frequently observed during the ultrasound examination of patients with painful shoulder. The deposition of hydroxyapatite calcium crystals should not be considered as a static process but rather a dynamic pa...

Objectives: The aim of the present study was to propose a methodologically innovative sonographic approach for optimal evaluation of synovial tissues (starting from histopathology). Methods: Using high-frequency ultrasound probes and high-level ultrasound machines, we matched the histological microarchitecture of synovial tissues with multiple sono...

Objectives To describe and report a ′lateral′ (lateral to medial) approach for ultrasound (US) guided intra articular hip injection. Design Cadaveric investigation. Settings Academic institution, department of anatomy. Subjects One cadaveric specimen. Methods Both hips of a single cadaver were injected using the US-guided lateral approach. In t...

Chronic obstructive pulmonary disease (COPD) is a burdensome condition affecting a growing number of people worldwide, frequently related to major comorbidities and functional impairment. In these patients, several factors might have a role in promoting both bone and muscle loss, including systemic inflammation, corticosteroid therapies, sedentary...

A 3-year-old boy was found to have a painless mass over his right anterior lateral knee for the previous 6 months. The mass was hardly identified during knee extension and became visible upon squatting. There was no specific finding on ultrasound imaging over his right knee at the supine extended position. During squatting, ultrasound imaging showe...

Musculoskeletal ultrasound identifies a broad range of pathologies. Typical sonographic images of certain pathological/abnormal conditions can be rendered and 'highlighted' for the daily practice/language of musculoskeletal sonographers. The following text and accompanying figures/videos represent a collection of findings pertaining to commonplace...

Myofascial pain is a very common disorder in the daily practice of musculoskeletal physicians whereby trapezius is one of the most commonly affected muscles in this clinical scenario. Nowadays, physical examination can be promptly coupled with the sonographic assessment to optimize the identification/injection of multiple pain generators potentiall...

Objective: To define a standardized comprehensive sonographic approach for evaluating the different histo-anatomical compartments of the lateral elbow. Design: Using high-frequency US probes, we tried to match the anatomical features of the lateral elbow and its different sonographic patterns in patients with the diagnosis of lateral epicondylit...

Musculoskeletal ultrasonography, despite various advantages, is a user-dependent modality. There are several approaches to facilitate the learning process of novice sonographers, e.g., on-site courses, textbooks, and online lectures. However, the need for specific (sono)anatomy knowledge can be an obstacle, particularly in the beginning. With the a...

The facial and submental regions are supplied by complicated neurovascular networks; therefore, facial aesthetic injections may be associated with serious adverse events such as skin necrosis and blindness. Pre-injection localization of neurovascular structures using high-resolution ultrasound can theoretically prevent unexpected complications. The...

Being able to reveal (with high resolution) a broad range of pathologies pertaining to various structures, ultrasound (US) imaging has already a well-established role/contribution in musculoskeletal medicine. Herewith, in contrast to its several advantages (handy, convenient, cost-effective, does not contain radiation, etc.), there is still one dis...

Background Previous evidence showed that cellular aging is a multifactorial process that is associated with decline in mitochondrial function. Physical exercise has been proposed as an effective and safe therapeutical intervention to improve the mitochondria network in the adult myocytes. Aims The aim of this systematic review of randomized contro...

Background: In clinical practice, ultrasound assessment of the skin and superficial tissues is progressively becoming a valuable diagnostic tool to support physical examination in the outpatient setting. Objectives: The aim of this study was to define a standardized sonographic approach to (layer-by-layer) accurately evaluate multiple histological...

Background: Axillary web syndrome (AWS) is one of the most prevalent and underrecognized disorders affecting breast cancer (BC) women. However, the optimal therapeutic strategy to manage AWS is far from being fully characterized. Therefore, this systematic review aims to provide a broad overview of the available rehabilitation treatments in this b...

Background: Ultrasound (US) has been widely used for the diagnosis and guided interventions of peripheral nerve disorders. Although superior cluneal nerve (SCN) entrapment is an important cause of lower back pain, a relevant review as to how US can be used for imaging and guided intervention for cases of SCN entrapment is still lacking. Objective...

In this dynamic scanning protocol, ultrasound assessment of the adult hip is described using different maneuvers for various conditions. Real-time patient examination and ultrasound scanning videos are coupled for convenience as well as for better insight. The text covers the common conditions around the hip where especially dynamic ultrasound scan...

BACKGROUND: This survey was aimed to obtain the characteristics of physicians operating in mass vaccination sites (MVS), emphasizing their motivation to work there. METHOD: We conducted a nationwide cross-sectional internet-based survey involving physicians operating in MVS during the COVID-19 pandemic. The questionnaire comprised demographic char...

Objective: To investigate the relationship between sarcopenia and RAS-related disorders and to explore the effects of angiotensin converting enzyme inhibitors (ACEIs) and angiotensin-II receptor blockers (ARBs) on muscle mass/function and physical performance. Design: This multi-center, cross-sectional study was performed using ISarcoPRM algorit...

In this dynamic protocol, ultrasound evaluation of the wrist and hand is described using various maneuvers for relevant conditions. Scanning videos are coupled with real-time patient examination videos. The authors believe that this practical guide - prepared by the international consensus of several experts - will help musculoskeletal physicians p...

Medial knee pain is commonplace in clinical practice and ultrasound assessment of the tibial collateral ligament‐medial meniscus complex is increasingly becoming a valuable examination tool in the outpatient setting. In the pertinent literature, basic sonographic protocols have been proposed to evaluate the medial compartment of the knee joint. Usi...

Background: Sacro-iliac joint (SIJ) pain is an often-misdiagnosed cause (up to 30% cases) of atypical low back pain (LBP) that might be treated with a wide range of conservative interventions. However, Platelet-Rich-Plasma (PRP) ultrasound-guided injections at SIJ level in subjects with mitochondrial disorders have not yet been investigated. Case...

Ultrasound imaging has become an important topic of study in physical medicine and rehabilitation. In a recent issue of the American Journal of Physical Medicine and Rehabilitation, we started a series of 6 articles on this topic. The authors have revised and updated the ultrasound protocols of the European Musculoskeletal Ultrasound Study Group in...

In this dynamic protocol, ultrasound examination of the shoulder using different maneuvers is described for several/relevant shoulder problems. Scanning videos are coupled with real-time patient examination videos for better understanding. The authors believe that this practical guide prepared by an international consensus of several experts (EURO-...

In this dynamic protocol, ultrasound examination of the elbow using different maneuvers is described for several/relevant elbow problems. Scanning videos are coupled with real-time patient examination videos for better understanding. The authors believe that this practical guide-prepared by an international consensus of several experts (EURO-MUSCUL...

Ultrasound has been extensively applied to the diagnosis of and guided interventions for knee disorders. However, although it is commonly affected during sports injuries, the anterior cruciate ligament (ACL) is not usually incorporated in the majority of ultrasound scanning protocols. In the past, because of its oblique trajectory and deeper locati...

In the pertinent literature, standardized sonographic protocols have been widely described to evaluate the different compartments of the shoulder. However, the subcoracoid space is a complex anatomical region—usually not included/described in basic ultrasound approaches. Accordingly, starting from its anatomy, we describe a two-phase dynamic ultras...

In this article, an ultrasound-guided technique for sacroiliac joint (SIJ) injection is described. The SIJ was repeatedly identified as a possible pain generator in patients with low back pain. In cases where other (noninvasive) treatment options fail, SIJ injection might provide pain relief. The described procedure can also be used to perform a di...

Herein, we describe a 46-year-old woman with persistent pain and weakness in her left ankle/foot one year after surgical repair of all three ankle extensor tendons following a penetrating injury. This report presents a unique case whereby US imaging played a paramount role in the diagnosis and surgical management of a previous nonanatomic repair of...

This guide to ultrasound examination of the wrist and hand describes the basic scanning planes and contains corresponding high-resolution ultrasound images. The patient and probe positionings are explained in a simplified step-by-step manner using schematic drawings. This standard and simple examination technique seems to be an appropriate way to i...

This guide to ultrasound imaging of the knee describes the basic scanning planes and contains corresponding high-resolution ultrasound images. The patient and probe positionings are explained in a simplified step-by-step manner using schematic drawings. This standard and simple examination technique seems to be an appropriate way to improve the lea...

This guide to ultrasound imaging of the ankle and foot describes the basic scanning planes and contains corresponding high-resolution ultrasound images. The patient and probe positionings are explained in a simplified step-by-step manner using schematic drawings. This standard and simple examination technique seems to be an appropriate way to impro...