Evidence‐based guideline: Neuromuscular ultrasound for the diagnosis of carpal tunnel syndrome

Introduction: The purpose of this study was to develop an evidence‐based guideline for the use of neuromuscular ultrasound in the diagnosis of carpal tunnel syndrome (CTS). Methods: Two questions were asked: (1) What is the accuracy of median nerve cross‐sectional area enlargement as measured with ultrasound for the diagnosis of CTS? (2) What added value, if any, does neuromuscular ultrasound provide over electrodiagnostic studies alone for the diagnosis of CTS? A systematic review was performed, and studies were classified according to American Academy of Neurology criteria for rating articles of diagnostic accuracy (question 1) and for screening articles (question 2). Results: Neuromuscular ultrasound measurement of median nerve cross‐sectional area at the wrist is accurate and may be offered as a diagnostic test for CTS (Level A). Neuromuscular ultrasound probably adds value to electrodiagnostic studies when diagnosing CTS and should be considered in screening for structural abnormalities at the wrist in those with CTS (Level B). Muscle Nerve 46: 287–293, 2012Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/92446/1/23389_ftp.pd

Applications and Emerging Trends of Hyaluronic Acid in Tissue Engineering, as a Dermal Filler, and in Osteoarthritis Treatment

Hyaluronic acid (HA) is a naturally occurring biodegradable polymer with a variety of applications in medicine including scaffolding for tissue engineering, dermatological fillers, and viscosupplementation for osteoarthritis treatment. HA is available in most connective tissues in body fluids such as synovial fluid and the vitreous humor of the eye. HA is responsible for several structural properties of tissues as a component of extracellular matrix (ECM) and is involved in cellular signaling. Degradation of HA is a step-wise process that can occur via enzymatic or non-enzymatic reactions. A reduction in HA mass or molecular weight via degradation or slowing of synthesis affects physical and chemical properties such as tissue volume, viscosity, and elasticity. This review addresses the distribution, turnover, and tissue-specific properties of HA. This information is used as context for considering recent products and strategies for modifying the viscoelastic properties of HA in tissue engineering, as a dermal filler, and in osteoarthritis treatment

Efficacy of therapeutic ultrasound in treatment of adhesive capsulitis: A prospective double blind placebo-controlled randomized trial.

BACKGROUND: In treatment of adhesive capsulitis, deep heating agents have been shown to have positive effects on pain and function. OBJECTIVE: To evaluate if addition of ultrasound used in treatment of adhesive capsulitis will provide additional benefits. METHODS: Thirty patients with adhesive capsulitis were included in a prospective, double-blind, randomized controlled trial. Hotpack, TENS (Transcutaneus Electrical Nerve Stimulation), exercise and active ultrasound therapies were applied to the first group (n= 15), whereas sham ultrasound was applied to the second group (n= 15) in addition to hotpack, TENS and exercise. The patients were evaluated using joint range of motion, UCLA shoulder scale and Shoulder Disability Questionnaire scales at baseline and at 6th and 24th weeks post-treatment. RESULTS: When pain and the clinical and functional parameters were compared in both groups, significant improvement was found compared to baseline (p 0.05). CONCLUSION: Adding ultrasound treatment to a combination of physical therapy modalities did not provide any additional benefits for the treatment of adhesive capsulitis

A prospective double blind placebo-controlled randomized trial

BACKGROUND: In treatment of adhesive capsulitis, deep heating agents have been shown to have positive effects on pain and function