Ultrasonographic evaluation of the flexor pollicis longus tendon in frequent mobile phone texters.

OBJECTIVE: The aim of this study was to assess flexor pollicis longus tendon by using ultrasound imaging in frequent mobile phone texters. SUBJECTS: In total, 149 subjects, aged 18-40 yrs, were recruited as frequent mobile phone texters (n = 71) and infrequent texters (n = 78). METHODS: Demographic data and estimate frequency of texting were noted. Thumb pain during activity, range of motion for thumb joints, grip and pinch strengths, and Quick Disabilities of arm, shoulder, and hand were evaluated. Standardized bilateral ultrasound evaluations were performed using a linear array probe, and tendon area measurements were done with axial imaging at midthenar region and midproximal phalangeal region with manual trace technique. RESULTS: The groups were similar except for the mean estimate number of messages/month (P = 0.001). Whereas grip and pinch strength values were significantly higher (frequent texter group, P = 0.001; infrequent texter group, grip strength P = 0.018; pinch strengths, P = 0.001) on the texting side in both groups, flexor pollicis longus tendons were larger (P = 0.001) and the activity pain was higher (P = 0.005) on the texting sides only in the frequent texter group. Flexor pollicis longus thickness significantly correlated with messages/month only in the frequent texter group (r = 0.592, P = 0.001). CONCLUSIONS: Flexor pollicis longus tendons seem to be thicker at the midthenar level in subjects who frequently use mobile phone texting. Because this increase in thickness parallels the number of messages per day, the authors believe that further studies are needed to elucidate whether such changes become problematic later on in life.

Nineteen reasons why physiatrists should do musculoskeletal ultrasound: EURO-MUSCULUS/USPRM recommendations.

This article is an eventual consensus of experts from the European Musculoskeletal Ultrasound Study Group (EURO-MUSCULUS) and the Ultrasound Study Group in Physical and Rehabilitation Medicine (USPRM) pertaining to the use of musculoskeletal ultrasound in physical and rehabilitation medicine. Nineteen important reasons (as regards general advantages, specific conditions in physical and rehabilitation medicine, as well as comparisons with other imaging tools) have been highlighted to consolidate the scenario of how/why the probe of ultrasound needs to become the stethoscope, the extended hand, and the pen of physiatrists.

Precision of novice sonographers concerning median nerve and Achilles tendon measurements.

OBJECTIVE: The aim of this study was to quantify how precise the measurements of beginner sonographers (relative to an expert) are concerning small and large ellipsoid structures (median nerve and Achilles tendon). DESIGN: During a 4-day musculoskeletal ultrasonography course at a secondary-care center, 19 attendants and an expert physiatrist sonographer were enrolled. After the hand practice session, the physicians performed median nerve measurements (short axis, long axis, and cross-sectional area) at the level of carpal tunnel on the same subject. Repeat measurements were done at the end of the following day. Similarly, achilles tendon measurements were taken during 2 consecutive days (after the ankle-foot session). An expert sonographer also performed the same evaluations twice, together with the attendants. The mean values of the expert's measurements were used as the "test value" for each parameter. RESULTS: Median nerve long-axis values pertaining to the first trial were found to be smaller than that of the test value (P = 0.003), but those of the second trial were similar to the test value (P = 0.107). Median nerve short-axis and area measurements were not different from the test value in either trials (P > 0.05). Achilles tendon measurements were significantly larger than the test value (P < 0.05) at the first trial but were similar to the test value at the second trial (P > 0.05). Percentage deviations of the attendants' measurements (median nerve short and long axes) were negatively correlated with their sonography experience. CONCLUSIONS: We imply that novice sonographers tend to measure small structures smaller and large structures larger. Personal experience seems to play a role especially for small structures, and practice affects the precision of these measurements favorably.