The description is apt because both electromyography (EMG) and ultrasound, discoveries of the twentieth century, are hands-on techniques (arts) that lead to a better understanding of science. Of course, the better one understands the science of these techniques (arts), the more enterprising an individual becomes with them. This description of how real advances occur in the world is somewhat at odds with the notion of hypothesis planned research, which some see as a critical antecedent of meaningful discovery. This idea fails to capture the implicit real-time reasoning and motor skill involved in most innovations, particularly in the incremental discovery that characterizes much of the technologic advances routinely available today. In fact, it is the real-time aspects of physiologic investigations, such as ultrasound and EMG, that make them so engaging for the practitioner. These techniques encourage problem solving by integrating complex findings on interview, physical examination, electrodiagnostic testing, and real-time ultrasonography. The process of integration, or more commonly failed integration, stimulates curiosity and enhances discovery in this field.
This book is written for those who want to further develop the art and science of neuromuscular medicine with the use of ultrasonography. Our interests in this field began, as many things do in clinical medicine, with the help of an enthusiastic mentor, Dr. William McKinney, a former president of the American Institute of Ultrasound in Medicine and a pioneer in carotid ultrasonography. He encouraged F.W. 25 years ago to follow up on studies by Heckmatt and colleagues demonstrating the utility of ultrasonography in the evaluation of muscular dystrophy. Casual use of the technique verified its sensitivity for detecting chronic muscle disease, but because this alone did little to add to clinical care, use of the technique was limited primarily to research. However, over the next 15 years with significant enhancement in available resolution, the technique became useful for studying nerves and the routine evaluation of entrapment neuropathies. About 10 years ago, M.C. became involved in neuromuscular discovery with ultrasonography. Since then, we have been joined by a number of others in the United States and abroad, some who have had experience predating ours. The encouragement these pioneers have provided us by their unexpected discoveries and elegant research has led us to put together this introductory textbook of neuromuscular ultrasonography. We have tried to credit as many of these remarkable individuals as possible either by inviting them to contribute chapters or by generous citations of their work. We look forward to finding more colleagues and collaborators in the future who will further advance this promising field.
- The Authors -
Key Features
- Diagnose and manage your patients more quickly and easily by visualizing muscles and nerves without painful testing.
- Master the nuances of using ultrasound through the visual instruction of clear images and illustrations.
- Minimize patient discomfort while maximizing optimal patient evaluation with a practical focus that covers using ultrasound as a screening tool, provides clinical pearls, and includes comparisons to electrodiagnosis.
- Apply the full range of ultrasound applications, including interventional uses (such as ultrasound-guided botulinum toxin and steroid injections), ultrasound of polyneuropathies (often found in diabetics), and more.
Website Features
- Consult the book from any computer at home, in your office, or at any practice location.
- Instantly locate the answers to your clinical questions via a simple search query.
- Quickly find out more about any bibliographical citation by linking to its MEDLINE abstract.
- Master cutting-edge techniques through online videos that demonstrate each procedure.
Contents
Chapter 1 - Basic Principles of Ultrasound
- Overview
- Getting Started: Obtaining an Image
- The Transducer
- Sound Pulse Technology
- Sound: Fundamental Principles and Its Behavior in Tissue
- The Relationship Between Propagation and Harmonics
- Ultrasound Instrument Function: Driving the Transducer and Image Display
- Quantifying Ultrasound Findings
- Artifacts
- Practical Considerations Regarding Neuromuscular Ultrasound
- Conclusion
- References
Chapter 2 - Ultrasound of Peripheral Nerves
- Principles of Neuromuscular Ultrasonography
- Advanced Ultrasonographic Techniques
- High-Resolution Ultrasound of Peripheral Nerves
- Spectrum of Nerve Abnormalities
- Ultrasonographic Techniques: Probe Placement and Views
- References
Chapter 3 - Ultrasound of Muscle
- Basics of Ultrasound Physics in Relation to Muscle Ultrasound Imaging
- Normal Muscle
- Muscle Ultrasound in Neuromuscular Disorders
- Muscle Ultrasound in Clinical Practice: Measurement Protocol
- Quantifying Muscle Ultrasound
- Dynamic Muscle Ultrasound
- Dynamic Ultrasound in Clinical Practice
- References
Chapter 4 - Basic Approach to Ultrasound of Other Structures in the Extremities
- Cystic or Partially Cystic Soft-Tissue Masses
- Solid Soft-Tissue Masses of the Extremities
- Disorders of Peripheral Veins and Arteries
- Miscellaneous Findings and Artifacts That May Simulate Disease
- Conclusion
- References
Chapter 5 - Ultrasound of Focal Neuropathies
- Median Nerve
- Ulnar Nerve
- Radial Nerve
- Other Upper Extremity Nerves
- Sciatic Nerve
- Peroneal Nerve
- Tibial Nerve
- Other Lower Extremity Nerves
- Conclusion
- References
Chapter 6 - Ultrasound of the Brachial Plexus
- Equipment, Terminology, and Limitations of Ultrasound
- Ultrasound Appearance of Tissues
- Solution Injection and Effects on Imaging and Stimulation
- Indications for Ultrasound Imaging of the Brachial Plexus
- Ultrasound for Evaluation of Brachial Plexus Pathology
- Conclusion
- References
Chapter 7 - Ultrasound of Polyneuropathies
- A Few Words on Getting Started
- Immune-Mediated Neuropathies
- Hereditary Neuropathies
- Other Acquired Neuropathies
- Conclusion
- References
Chapter 8 - Ultrasound of Motor Neuron Disease
- Imaging in Motor Neuron Disease
- Surrogate Marker of Disease Progression
- Conclusion
- References
Chapter 9 - Ultrasound of Inflammatory Myopathies
- B-Mode Ultrasound Dynamic Evaluation of Muscle Weakness in Myositis
- Standard B-Mode Ultrasound in Inflammatory Myopathy
- Doppler Ultrasound in Inflammatory Myopathies
- Contrast-Enhanced Ultrasound
- Disease-Specific Findings
- Conclusion
- References
Chapter 10 - Ultrasound of Muscular Dystrophies, Myopathies, and Muscle Pathology
- The Normal Examination
- Muscle Pathology Seen with Ultrasound in Neuromuscular Disease
- Neuromuscular Ultrasound as a Diagnostic Tool
- Ultrasound Abnormalities in Inherited Myopathies
- Conclusion
- References
Chapter 11 - Interventional Ultrasound
- General Principles of Ultrasound-Guided Interventions
- Ultrasound Guidance for Steroid Injections for Carpal Tunnel Syndrome
- Ultrasound Guidance for Botulinum Toxin Injections
- Ultrasound-Guided Botulinum Toxin for Sialorrhea
- Ultrasound Guidance for Regional Anesthesia
- Ultrasound for Biopsy Guidance
- Ultrasound for Presurgical Screening
- Intraoperative Use of Ultrasound
- Other Interventional Applications of Ultrasound
- Conclusion
- References
Chapter 12 - Ultrasound as a Complement to Electrodiagnostic Studies
- The Role of Ultrasound in Nerve Conduction Studies
- Imaging of Nerve
- The Role of Ultrasound in Needle EMG
- Risk of Needle EMG in Anticoagulated Patients
- Imaging of Muscle
- The Role of Ultrasound in Education
- Conclusion
- References
Chapter 13 - Future Directions in Neuromuscular Ultrasound
- Muscle Ultrasound
- Nerve Ultrasound
- Musculoskeletal Mimics of Neuromuscular Disease
- Small Fiber and Autonomic Nerves
- Emerging Ultrasound Technologies
- Practice Issues
- Conclusion
- References
Appendices
- Appendix A: Neuromuscular Ultrasound Scanning Protocols
- Appendix B: Neuromuscular Ultrasound Videos
About the Authors
- Francis O. Walker, MD, Professor, Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
- Michael S. Cartwright, MD, Assistant Professor, Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
Product Details
- Hardcover: 208 pages
- Publisher: Saunders; 1 Har/Psc edition (2011)
- Language: English
- ISBN-10: 1437715273
- ISBN-13: 978-1437715279
- Product Dimensions: 11.1 x 8.7 x 0.5 inches
List Price: $149.00