Download Subtitle: Ex. MSK

Musculoskeletal (MSK)
Outline
• Technology Overview
• Imaging Detailed Anatomy
– Median Nerve
– Metacarpophalangeal Joint
– Digital Pulleys
– Radial Artery
– Temporomandibular Joint
– Upper Trapezius
– Achilles Calcaneal Insertion
– Tarsal Tunnel
http://anatomy-diagram.net/wp-content/uploads/2015/11/human-anatomymuscle-skeleton-human-skeletal-system-free-picture.jpg
Technology Overview
Transducers
Technology Overview
System Features
Software
B-Mode

M-Mode

Color Doppler

Applications
Customer
Segments
Clinical
Transducers
Models
Available
UHF22 (15 MHz)
UHF48 (30 MHz)
UHF70 (50 MHz)
Regulatory
Patient Management

FDA Power
Management

DICOM Connectivity

Image Processing (Vevo HD)
Speckle Reduction

Spatial Compounding

Median Nerve
Anatomy
•
•
The median nerve is derived from the brachial plexus and is one of 3 major
nerves that supply that hand
Clinical Relevance: Passing under the carpal tunnel (flexor retinaculum) the
median nerve can be compressed = carpal tunnel syndrome
Anatomy of a Peripheral Nerve
E epineurium; F fascicle; P perineurium; V vessel.
http://emedicine.medscape.com/article/1369028-overview
https://studentconsult.inkling.com/read/wheaters-functional-histology-atlas-young-5th/chapter7/figure-7-13
Median Nerve
Imaging
50 MHz
Vevo MD Ultra High Frequency
6-15 MHz
Conventional Ultrasound
Metacarpophalangeal (MCP) Joint
Anatomy
•
•
•
The MCP joints are found in the hand between each metacarpal
and proximal phalanx
MCP joints allow a range of movement in the finger
Clinical Relevance: The MCP joint typically becomes arthritic with
Rheumatoid Arthritis
Metacarpophalangeal Joint imaging
Imaging
Conventional Ultrasound
Vevo MD Ultra High Frequency
Digital Pulleys
Anatomy
•
•
•
The annular ligaments of the finger (A pulleys) are located on the palmar
aspects of the fingers
The A1pulley originates from the MCP joint
The A1 pulleys can disrupt the action of the flexor tendons causing pain and
limiting movement = trigger finger
http://www.reumatologiaclinica.org/en/clinicalanatomy-hand/articulo/S1699258X12002422/
http://www.iowahand.com/trigger.html
Digital Pulleys
Imaging
Conventional Ultrasound
Vevo MD Ultra High Frequency
Radial Artery
Anatomy
•
•
•
The radial artery is a branch off the brachial artery in the forearm
In the hand it contributes to the superficial and deep palmar arches
Clinical Relevance: The radial pulse is detected as the radial artery
passes over the distal radius.
Byrne, R. A. et al. (2012) Vascular access and closure in coronary angiography and percutaneous
intervention
Nat. Rev. Cardiol. doi:10.1038/nrcardio.2012.160
http://teachmeanatomy.info/upper-limb/vessels/arteries/
Radial Artery
Imaging
Conventional Ultrasound
Vevo MD Ultra High Frequency
Radial Artery
Imaging (within the anatomical snuffbox)
Drake: Gray’s Anatomy for Students; 2nd Edition
Temporomandibular Joint
Anatomy
• The temporomandibular joint (TMJ) is a bilateral articulation
between the mandible and temporal bones, which form the jaw
• An articular disc separates the joint into 2 compartments
• This disc can become displaced which can lead to limited jaw
movement and pain
http://www.mdguidelines.com/temporomandibular-joint-syndrome
Temporomandibular Joint
Imaging
Conventional Ultrasound
Vevo MD Ultra High Frequency
Upper Trapezius Muscle
Anatomy
• The trapezius is a bilateral, wide, flat muscle in the upper back
• Functions: move, rotate and stabilize scapula; extend head and neck
• Exist as three sets of fibers on each side (lower, middle, upper)
– Imbalances in these fibers can affect posture
Upper Trapezius Muscle Fibers
Imaging
Conventional Ultrasound
Vevo MD Ultra High Frequency
Achilles Calcaneal Insertion
Anatomy
• The Achilles is a tendon in the posterior ankle that attaches the
leg muscles to the calcaneus (heel)
• It is the thickest tendon in the body and functions include plantar
flexion of the foot and knee flexion
• The Achilles can be torn, ruptured, or become inflamed
http://www.aafp.org/afp/2002/0501/p1805.html
Achilles Tendon
Imaging
Conventional Ultrasound
Achilles-Calcaneal Insertion
Vevo MD Ultra High Frequency
Tarsal Tunnel
Anatomy
• Small area on the ankle, posterior
to medial malleolus
• Covered by the flexor
retinaculum
• Contains: posterior tibial artery
and vein, tibial nerve, several
tendons
• Nerve entrapment can occur
(tarsal tunnel syndrome) causes
pain and weakness in foot
muscles
Tarsal
Tunnel
Tarsal Tunnel
Imaging
Flexor Retinaculum
Tibial Artery and Vein
Tibial Nerve
Conventional Ultrasound
Vevo MD Ultra High Frequency
Overview
• High-frequency ultrasound allows visualization of small anatomy not
visible with conventional ultrasound (down to 30µm)
• Cutting edge technology can lead to new medical discoveries
• Touch-screen, customizable interface leads to improved workflow
and reduced examination times
• Highly advanced transducers designed for the smallest patients
Same size
as grain of
rice!