scholarly journals Ultrasonographic detection, definition and quantification of soft tissue oedema in psoriatic dactylitis

2019 ◽  
Vol 21 (4) ◽  
pp. 414 ◽  
Author(s):  
Ilaria Tinazzi ◽  
Luca Idolazzi ◽  
Alen Zabotti ◽  
Luisa Arancio ◽  
Alberto Batticiotto ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Subcutaneous Tissue ◽  
Power Doppler ◽  
Tendon Sheath ◽  
Contralateral Side ◽  
Scanning Technique ◽  
Delphi Round ◽  
Volar Aspect ◽  
Definition Of ◽  
Tissue Oedema

Aim: To define and score finger soft tissue oedema in psoriatic dactylitis by ultrasound.Material and methods: A systematic literature review (SLR) on ultrasound-detected finger soft tissue oedema was performed. Subsequently, based on the SLR, a Delphi survey was developed and circulated among a group of 13 expert sonographers, in order to obtain agreement on detection, definition and scoring of finger oedema by B-mode and power Doppler ultrasound. Agreement was considered achieved when each statement was approved by >75% of participants.Results: At the first Delphi round, 91 % agreement was obtained for the scanning technique to adopt, including the most appropriate area to evaluate. At the second round, 76% agreement was achieved on the definition of soft tissue finger oedema. At the third round, 76% agreement was obtained for B-mode and power Doppler scores. The volar aspect of the finger and comparisons with the contralateral side were agreed to be the most appropriate in terms of scanning technique. Agreed ultrasound definition of finger soft tissue oedema was “abnormal hypoechoic/anechoic areas, diffused or localized within the subcutaneous tissue between the epidermidis and the tendon-related anatomic structures (i.e. flexor tendon sheath, peritenonium, tendon pulleys), with local thickening, with or without local abnormal Doppler signal, visualised in two perpendicular planes and not evident on the contralateral side”. Semiquantitative (0-3) scores for both B-mode and power Doppler were agreed to be the most appropriate to be used.Conclusion: Our work produced, for the first time, technical indications, definition and scoring for the ultrasound assessment of soft tissue oedema in psoriatic dactylitis

Ultrasound of the Wrist and Hand

2019 ◽  
pp. 360-363
Author(s):  
Corrie M. Yablon
Keyword(s):  
Soft Tissue ◽  
Tendon Sheath ◽  
Contralateral Side ◽  
Dynamic Imaging ◽  
Cell Tumor ◽  
Stener Lesion ◽  
Ganglion Cysts ◽  
Soft Tissue Masses ◽  
Joint Effusions ◽  
Annular Pulley

Chapter 122 covers US of the wrist and hand. US is gaining popularity as a useful modality for imaging wrist and hand pain, providing soft tissue resolution superior to MRI, with the additional benefits of real-time imaging, ease of comparison to the contralateral side, and dynamic imaging. US provides excellent visualization of tendons and the small joints of the hand. Peripheral nerves are easily identified and assessed with US with resolution surpassing MRI. Median nerve entrapment can be quickly and easily evaluated when carpal tunnel disease is suspected. Dynamic evaluation allows further assessment for the presence of Stener lesion, sagittal band and annular pulley injuries, and for tendon subluxation. US easily shows joint effusions, osteophytes, erosions, and synovial hypertrophy when arthritis is suspected. Soft tissue masses, such as ganglion cysts or giant cell tumor of the tendon sheath, are accurately imaged with US.

scholarly journals Improving Imaging Modalities in Early Psoriatic Arthritis: The Role of Ultrasound in Early Diagnosis of Psoriatic Arthritis

2022 ◽  
Vol 8 ◽  
Author(s):  
Tania Gudu ◽  
Beverly Ng ◽  
Hannah Jethwa ◽  
Catherine Graham ◽  
Veda Kudva ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Psoriatic Arthritis ◽  
Soft Tissue ◽  
Early Diagnosis ◽  
Flexor Tendon ◽  
Power Doppler ◽  
Us Findings ◽  
Early Psoriatic Arthritis ◽  
Tissue Oedema

Objective: Despite recent advances, early diagnosis of psoriatic arthritis (PsA) remains a challenge in clinical practice. Ultrasound (US) could be a useful tool for the diagnosis and management of PsA. The objective of this review was to determine the role of US in early diagnosis of PsA.Methods: We have performed a literature review aiming to evaluate studies on US findings in psoriasis and their predictive value of progression to PsA, as well as studies on US features specific for PsA in comparison with other conditions.Results: A total of 40 studies were included. Sixteen studies assessed US findings in psoriasis, of which only 3 prospectively evaluated the role of US in predicting progression to PsA. Patients with PsA had a greater frequency of US abnormalities, in particular enthesitis and Power Doppler(PD) signal compared to patients with psoriasis only. In the longitudinal studies, psoriatic patients with higher enthesopathy scores at baseline were more likely to progress to PsA. Twenty-four studies evaluated US abnormalities in PsA and compared them to other conditions. Most specific US features that distinguish PsA from psoriasis were PD signal and erosions in joints and entheses. Extra-synovial changes, including peri-tendinous dermal soft tissue oedema with associated PD signal and flexor tendon enthesopathy, as well as thickening of the pulleys in the flexor tendons were highly characteristic for PsA, as they were frequently found in PsA patients, but in none of the RA patients. US-detected entheseal abnormalities in particular erosions and PD signal were more frequent in patients with PsA compared to fibromyalgia.Conclusion: Despite the wide use of US in PsA, more research is needed to identify predictive factors of progression to PsA in patients with psoriasis, as well as to determine most specific US features that differentiate PsA from other conditions.

scholarly journals 451. High Rates of Hospitalization due to Skin and Soft-Tissue Infections in a Southwest American Indian Population

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S221-S222
Author(s):  
Anne M Davidson ◽  
Terry Burgess ◽  
Agafe Saguros ◽  
Chu Jian Ma ◽  
James McAuley ◽  
...  
Keyword(s):  
Risk Factors ◽  
Soft Tissue ◽  
American Indians ◽  
Subcutaneous Tissue ◽  
American Southwest ◽  
Soft Tissue Infections ◽  
Pathogenic Organism ◽  
Critical Access Hospital ◽  
Potential Risk Factors ◽  
Significant Health

Abstract Background Skin and soft-tissue infections (SSTIs) involve the skin, subcutaneous tissue, fascia, or muscle. Hospitalizations due to SSTIs represent a significant health disparity for American Indians (AI), but specific literature is limited. We characterized SSTI hospitalizations at our critical access hospital that exclusively serves an AI population in the American Southwest. Methods We identified patients hospitalized (admitted or transferred) with an SSTI from June 2017 to May 2018. Relevant cases underwent chart extraction for demographics, SSTI characteristics, laboratory and microbiologic data, relevant history and co-morbidities. All variables were summarized using descriptive statistics. Odds ratios and P-values with two-tailed tests were used to identify risk factors for multiple SSTI episodes. Results During the study period, 289 unique individuals comprised 343 SSTI hospitalizations / episodes (18% of the 1,883 total hospitalizations). The unadjusted annual rate of SSTI hospitalization was 2,018 per 100,000. There were 13 cases of necrotizing fasciitis (NF) with an unadjusted rate of 76 per 100,000 per year. Only 183 episodes (53%) had a wound culture performed, with 84% positive for a pathogenic organism, compared with 287 episodes (84%) with a blood culture performed, of which only 7% were positive for a pathogen. Methicillin-resistant Staphylococcus aureus (MRSA), methicillin-sensitive SA (MSSA)and/or Streptococcus pyogenes accounted for 74.9% (n = 125) and co-infection with these three organisms accounted for 22.2% (n = 37) of positive wound cultures (n = 167). An SSTI in the last year (49%), diabetes (41.9%), alcohol abuse (40%) and hypertension (39%) were common among all 289 individuals. Diabetes (OR 3.3, P < 0.01), hypertension (OR 2.8, P < 0.01), renal disease (OR 2.7, P < 0.05), previous SSTI (OR 3.0, P < 0.01) were associated with a higher risk of multiple SSTI hospitalizations. Conclusion The incidence rate of SSTI hospitalization in this Southwest AI population was 9-times greater than the general US population and 4-times greater than prior reports in Southwest AI. The NF rate was >10-times the general US population rate. We describe common co-morbidities among these SSTI episodes and potential risk factors for repeat hospitalization. Disclosures All authors: No reported disclosures.

scholarly journals Ultrasound and Doppler US in Evaluation of Superficial Soft-tissue Lesions

2014 ◽  
Vol 4 ◽  
pp. 12 ◽  
Author(s):  
Huseyin Toprak ◽  
Erkan Kiliç ◽  
Asli Serter ◽  
Ercan Kocakoç ◽  
Salih Ozgocmen
Keyword(s):  
Soft Tissue ◽  
Imaging Modality ◽  
Power Doppler ◽  
Soft Tissue Lesions ◽  
Doppler Us ◽  
Size Number ◽  
Ultrasound Technology ◽  
Superficial Tissue ◽  
Superficial Soft Tissue

Improved developments in digital ultrasound technology and the use of high-frequency broadband transducers make ultrasound (US) imaging the first screening tool in investigating superficial tissue lesions. US is a safe (no ionizing radiation), portable, easily repeatable, and cheap form of imaging compared to other imaging modalities. US is an excellent imaging modality to determine the nature of a mass lesion (cystic or solid) and its anatomic relation to adjoining structures. Masses can be characterized in terms of their size, number, component, and vascularity with US and Doppler US especially with power Doppler US. US, however, is operator dependent and has a number of artifacts that can result in misinterpretation. In this review, we emphasize the role of ultrasound, particularly power Doppler, in superficial soft-tissue lesions.

NECROTISING SOFT TISSUE INFECTION OF BILATERAL UPPER LIMB CAUSED BY THE INJECTION OF ORAL BACTERIA: A CASE REPORT

Hand Surgery ◽  
2013 ◽  
Vol 18 (02) ◽  
pp. 243-246 ◽  
Author(s):  
Yuichi Yoshii ◽  
Tomoo Ishii ◽  
Shinsuke Sakai
Keyword(s):  
Soft Tissue ◽  
Upper Limb ◽  
Soft Tissue Infection ◽  
Soft Tissues ◽  
Biceps Brachii ◽  
Subcutaneous Tissue ◽  
Oral Bacteria ◽  
Tissue Infection ◽  
Left Elbow ◽  
The Right

Necrotising soft tissue infection is a rare and rapid process with devastating consequence. We report one case of necrotising soft tissue infection in a bilateral upper limb with uncommon oral bacteria. Radiological imaging revealed the presence of gas in upper limb soft tissues, and an MRI showed the localised signal changes in the biceps muscle of the right upper arm, and the subcutaneous tissue of the left elbow. The patient was treated with surgical resection of the infected muscle and wide debridement of the subcutaneous tissue. Antibiotics were initiated. The patient recovered immediately without functional deficit. The unique features of this patient were possible to observe in the progression of the necrotising soft tissue infection in the bilateral upper limb with intentional injection of oral bacteria, and the effect of biceps brachii resection in a prime age worker.

scholarly journals Concurrent Pseudomonas Periorbital Necrotizing Fasciitis and Endophthalmitis: A Case Report and Literature Review

Pathogens ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 854
Author(s):  
Yu-Kuei Lee ◽  
Chun-Chieh Lai
Keyword(s):  
Soft Tissue ◽  
Literature Review ◽  
Necrotizing Fasciitis ◽  
Subcutaneous Tissue ◽  
Superficial Fascia ◽  
Upper Eyelid ◽  
Case Presentation ◽  
Phthisis Bulbi ◽  
Eyelid Swelling ◽  
The Rich

(1) Background: Necrotizing fasciitis (NF) is an infection involving the superficial fascia and subcutaneous tissue. Endophthalmitis is an infection within the ocular ball. Herein we report a rare case of concurrent periorbital NF and endophthalmitis, caused by Pseudomonas aeruginosa (PA). We also conducted a literature review related to periorbital PA skin and soft-tissue infections. (2) Case presentation: A 62-year-old male had left upper eyelid swelling and redness; orbital cellulitis was diagnosed. During eyelid debridement, NF with the involvement of the upper Müller’s muscle and levator muscle was noted. The infection soon progressed to scleral ulcers and endophthalmitis. The eye developed phthisis bulbi, despite treatment with intravitreal antibiotics. (3) Conclusions: Immunocompromised individuals are more likely than immunocompetent hosts to be infected by PA. Although periorbital NF is uncommon due to the rich blood supply in the area, the possibility of PA infection should be considered in concurrent periorbital soft-tissue infection and endophthalmitis.

Noma and Necrotizing Fasciitis of the Face and Neck

2021 ◽  
Author(s):  
Lauren E. Miller ◽  
David A. Shaye
Keyword(s):  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Head And Neck ◽  
Subcutaneous Tissue ◽  
Neck Region ◽  
Superficial Fascia ◽  
Soft Tissue Infections ◽  
Head And Neck Region ◽  
Necrotizing Soft Tissue Infections ◽  
The Face

AbstractNecrotizing fasciitis (NF) is part of the class of necrotizing soft tissue infections characterized by rapid fascial spread and necrosis of the skin, subcutaneous tissue, and superficial fascia. If left untreated, NF can rapidly deteriorate into multiorgan shock and systemic failure. NF most commonly infects the trunk and lower extremities, although it can sometimes present in the head and neck region. This review provides an overview of NF as it relates specifically to the head and neck region, including its associated clinical features and options for treatment. Noma, a related but relatively unknown disease, is then described along with its relationship with severe poverty.

SUBUNGUAL GLOMUS TUMOUR: THE ENIGMATIC CAUSE OF CHRONIC PAINFUL FINGER PULP - A CASE REPORT

2021 ◽  
pp. 11-12
Author(s):  
Mohit Naren Kondapalli ◽  
Kishore Babu EP ◽  
Affee Asma
Keyword(s):  
Soft Tissue ◽  
Subcutaneous Tissue ◽  
Soft Tissue Tumors ◽  
Glomus Tumour ◽  
Connective Tissue Capsule ◽  
Venous Shunt ◽  
Fourth Decade ◽  
Tissue Capsule ◽  
Dermis Layer ◽  
Glomus Body

Glomus tumour, also referred to as Barré–Masson syndrome is an enigmatic, rare, painful tumour that is that represents a proliferation of the normal capsular-neural glomus apparatus. These are rare hamartomas that arise from the traditional glomus apparatus, located in subcutaneous tissue These are benign soft tissue neoplasms presenting usually within the second to fourth decade of life, originating from the glomus body. It accounts for 1-5% of all upper limb soft tissue tumors . It's a component of the dermis layer of the [1] skin, involved in thermoregulation. It structurally consists of an arterio-venous shunt which is surrounded by a connective tissue capsule and is found in increased amounts in the ngers and toes.

Reconstruction of Large Palmar Defects of the Hand Using Free Flaps

1997 ◽  
Vol 22 (5) ◽  
pp. 623-630 ◽  
Author(s):  
M. M. NINKOVÍC ◽  
A. H. SCHWABEGGER ◽  
G. WECHSELBERGER ◽  
H. ANDERL
Keyword(s):  
Soft Tissue ◽  
Free Flap ◽  
Subcutaneous Tissue ◽  
Free Flaps ◽  
Difficult Problem ◽  
Glabrous Skin ◽  
Soft Tissue Reconstruction ◽  
Anatomical Structures ◽  
Tissue Reconstruction ◽  
Restoration Of Sensibility

The reconstruction of large palmar defects of the hand remains a difficult problem due to the specific anatomical structures and highly sophisticated function of the palm. The glabrous skin and subcutaneous tissue in the palm are perfectly adapted to serve the prehensile function. The particular aim must be that repairs to this functional structure are similar in texture and colour and are aesthetically acceptable. Restoration of sensibility is desirable. For smaller defects a great variety of local pedicled or island flaps can be applied. However, for larger defects with exposed tendons, nerves or other essential structures, free flaps remain as a reliable alternative. This paper reviews our approach of soft tissue reconstruction in 16 patients with large palmar defects using various kinds of free flaps. The advantages, disadvantages and current indications for free flap resurfacing of the palm are discussed.

scholarly journals Femoral sheath lipoma causing venous obstruction syndrome

2010 ◽  
Vol 92 (6) ◽  
pp. e21-e22 ◽  
Author(s):  
Andrew Day ◽  
Paul Thomas
Keyword(s):  
Soft Tissue ◽  
Subcutaneous Tissue ◽  
Venous Obstruction ◽  
Soft Tissue Tumours ◽  
Venous Flow ◽  
Well Differentiated

Lipomas are benign, encapsulated, soft-tissue tumours composed of well-differentiated adipocytes. They arise in the subcutaneous tissue typically on the back, shoulder and neck. Lipomas have been known to cause symptomatic obstruction to venous flow by compression. We report a case of venous obstruction syndrome due to a small lipoma within the femoral sheath.

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