Table Of ContentLuca Maria Sconfi enza · Davide Orlandi
Enzo Silvestri Editors
Ultrasound-guided
Musculoskeletal
Procedures
The Lower Limb
123
Ultrasound-guided Musculoskeletal
Procedures
Luca Maria Sconfi enza
Davide Orlandi • E nzo Silvestri
Editors
Ultrasound-guided
Musculoskeletal
Procedures
The Lower Limb
Editors
Luca Maria Sconfi enza Davide Orlandi
Unit of Radiology Department of Internal Medicine
IRCCS Policlinico San Donato Università degli studi di Genova
San Donato Milanese, Milano Genova
Italy Italy
Department of Biomedical Sciences Enzo Silvestri
for Health Ospedale Evangelico Internazionale
Università degli Studi di Milano Unit of Radiology
Milano Genova
Italy Italy
ISBN 978-88-470-5763-0 ISBN 978-88-470-5764-7 (eBook)
DOI 10.1007/978-88-470-5764-7
Library of Congress Control Number: 2015947819
Springer Milan Heidelberg New York Dordrecht London
© Springer-Verlag Italia 2015
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or
part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of
illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way,
and transmission or information storage and retrieval, electronic adaptation, computer software,
or by similar or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a specifi c statement, that such names are
exempt from the relevant protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in
this book are believed to be true and accurate at the date of publication. Neither the publisher nor
the authors or the editors give a warranty, express or implied, with respect to the material
contained herein or for any errors or omissions that may have been made.
Printed on acid-free paper
Springer-Verlag Italia Srl. is part of Springer Science+Business Media (www.springer.com)
Foreword
The success encountered by the previous book entitled U ltrasound-Guided
Musculoskeletal Procedures: The Upper Limb witnessed the great interest of
our colleagues for ultrasonography of the musculoskeletal system and for the
related ultrasound-guided treatments. Thus, we propose this second book,
devoted to ultrasound-guided procedures to treat common and less common
pathology of the lower limb.
S ome therapeutic procedures, such as hip viscosupplementation, received
a great impulsion from the use of ultrasound guidance and currently represent
one of the central procedures that can be used to treat hip osteoarthritis,
mainly to delay total hip replacement. In the hip, ultrasound guidance is also
very useful to treat periarticular pathologic conditions, such as gluteal, rectus
femoris, and hamstring enthesopathy or iliopsoas bursitis.
The knee has always been regarded as an “easy” joint that could be treated
without any imaging guidance. However, ultrasound has been shown to
improve needle placement accuracy, especially in obese people in whom ana-
tomical references are poor, or in those patients affected by infl ammatory or
degenerative disease, which need a highly targeted treatment. Compression
neuropathies around the knee have also been addressed.
I n the ankle, this book has been focused on the treatment of common dis-
eases, such as plantar fasciitis, Morton’s neuroma, and periarticular ganglia,
including the principal indications to treatment, the most convenient access
routes, and the drugs to use.
In conclusion, this book represents a comprehensive and practical guide to
perform ultrasound-guided procedures of the musculoskeletal system in the
lower limb, both for beginners, who want to learn the basic principles, and
expert physicians, who want to implement new procedures in their clinical
practice. The procedures here reported derive mostly from the long-lasting
experience of our musculoskeletal interventional team and are only in small
part derived from literature, as evidence on large samples still missing in
some diseases. We also acknowledge the effort of our younger colleagues in
this volume, whose invaluable contribution revealed to be an excellent asset.
Pietra Ligure , Italy Giovanni Serafi ni , MD
May 2015
v
Contents
1 General Aspects of US-Guided Musculoskeletal
Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Luca Maria Sconfi enza, Davide Orlandi, Carmelo Messina,
and Enzo Silvestri
Part I The Hip
2 The Hip: Focused Ultrasound Anatomy and Examination
Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Emanuele Fabbro and Giulio Ferrero
3 Hip Intra-articular Injections . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Emanuele Fabbro and Giulio Ferrero
4 Hip Insertional Tendinopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Giulio Ferrero, Emanuele Fabbro, and Angelo Corazza
5 Periarticular Fluid Collections . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Luca Maria Sconfi enza and Alice Arcidiacono
6 Bursitis and Cysts Around the Hip . . . . . . . . . . . . . . . . . . . . . . . 41
Davide Orlandi and Silvia Perugin Bernardi
Part II The Knee
7 The Knee: Focused Ultrasound Anatomy and Examination
Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Riccardo Sartoris and Angelo Corazza
8 Knee Intra-articular Injections . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Giovanni Serafi ni and Francesca Lacelli
9 Bursitis and Cysts Around the Knee . . . . . . . . . . . . . . . . . . . . . . 65
Angelo Corazza and Riccardo Sartoris
10 Patellar Tendinopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Davide Orlandi, Francesca Lacelli, and Giovanni Serafi ni
vii
viii Contents
Part III The Ankle
11 The Ankle: Focused US Anatomy and Examination
Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Riccardo Sartoris and Angelo Corazza
12 Ankle Intra-articular Injections . . . . . . . . . . . . . . . . . . . . . . . . . 83
Angelo Corazza and Riccardo Sartoris
13 Achilles Tendinopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Davide Orlandi and Enzo Silvestri
14 Drainage of Articular Ganglia Around the Ankle . . . . . . . . . . . 91
Emanuele Fabbro and Giulio Ferrero
15 Deep Retrocalcaneal Bursa Injection . . . . . . . . . . . . . . . . . . . . . 95
Angelo Corazza and Silvia Perugin Bernardi
16 Treatment of Flexor and Extensor Tendon Sheath
Tenosynovitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Riccardo Sartoris and Alice Arcidiacono
Part IV The Foot
17 The Foot: Focused US Anatomy and Examination
Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Davide Orlandi and Francesca Lacelli
18 Plantar Fasciitis Dry-Needling Procedure . . . . . . . . . . . . . . . . . 107
Davide Orlandi and Luca Maria Sconfi enza
19 Treatment of Morton’s Neuroma and Intermetatarsal
Bursitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Angelo Corazza and Riccardo Sartoris
Contributors
Alice Arcidiacono Postgraduate School in Radiodiagnostics , University of
Genova, School of Medicine , Genova , Italy
Angelo Corazza Postgraduate School in Radiodiagnostics , University of
Genova, School of Medicine , Genova , Italy
Emanuele Fabbro Unit of Radiology , Ospedale Santa Corona,
ASL 2 Savonese , Pietra Ligure , Italy
Giulio Ferrero Unit of Radiology , Ospedale Santa Corona,
ASL 2 Savonese , Pietra Ligure , Italy
Francesca Lacelli Unit of Radiology , Ospedale Santa Corona,
ASL 2 Savonese , Pietra Ligure , Italy
Carmelo Messina Postgraduate School in Radiodiagnostics ,
University of Milano, School of Medicine , Milano , Italy
Davide Orlandi Department of Internal Medicine , University of Genova ,
Genova , Italy
Silvia Perugin Bernardi Postgraduate School in Radiodiagnostics ,
University of Genoa, School of Medicine , Genova , Italy
Riccardo Sartoris Postgraduate School in Radiodiagnostics , University of
Genoa, School of Medicine , Genova , Italy
Luca Maria Sconfi enza Unit of Radiology , IRCCS Policlinico San
Donato , Milano , Italy
Department of Biomedical Sciences for Health, University of Milano ,
Milano , Italy
Giovanni Serafi ni Unit of Radiology , Ospedale Santa Corona,
ASL 2 Savonese , Pietra Ligure , Italy
Enzo Silvestri Unit of Radiology , Ospedale Evangelico Internazionale ,
Genova , Italy
ix
