[Scanning Technique in Shoulder Ultrasonography]. / Sonografické vysetrení ramena.

This guide to ultrasound examination of the shoulder describes the basic scanning planes and contains corresponding high-resolution ultrasound images. The patient and probe positionings are explained in a simplified step-by-step manner using schematic drawings. This standard and simple examination technique seems to be an appropriate way to improve the learning curve of novice musculoskeletal sonographers. In this manuscript, an emphasis is placed on the rotator cuff, biceps tendon, subacromial-subdeltoid bursa, and joint recesses evaluation. This article also describes some common pitfalls to avoid when starting with shoulder ultrasonography (e.g. always determine the relevance of ultrasound findings in the context of clinical examination). Key words: tendons, bursa, synovial, shoulder, musculoskeletal, protocol, examination, ultrasound imaging, sonography, rotator cuff, acromioclavicular joint, shoulder impingement syndrome, learning curve.

[Scanning Technique in Elbow Ultrasonography]. / Sonografické vysetrení lokte.

This introduction to ultrasound evaluation of the elbow describes the basic scanning planes and contains corresponding high-resolution ultrasound images. The patient and probe positionings are explained in a simplified step-by-step manner using schematic drawings. This standard and simple examination technique seems to be an appropriate way to improve the learning curve of novice musculoskeletal sonographers. In this manuscript, an emphasis is placed on effusion detection, ulnar nerve imaging, and commonly injured tendons assessment. This article also describes some common pitfalls to avoid when starting with musculoskeletal ultrasonography (e.g. positioning issues, unsolicited artifacts). Key words: tendons, elbow tendinopathy, golfer's elbow, tennis elbow, musculoskeletal, protocol, ultrasound, common extensor tendon, common flexor tendon, ulnar nerve.

[Scanning Technique in Hip Ultrasonography]. / Sonografické vysetrení kycle.

This guide to ultrasound imaging of the hip describes the basic scanning planes and contains corresponding highresolution ultrasound images. The patient and probe positionings are explained in a simplified step-by-step manner using schematic drawings. This standard and simple examination technique seems to be an appropriate way to improve the learning curve of novice musculoskeletal sonographers. In this manuscript, an emphasis is put on hip effusion detection and on how to diagnose tendon and muscle injuries. Key words: tendons, hip tendinopathy, hip joint, athletic injuries, musculoskeletal, protocol, ultrasound, adductor tendon, trochanteric bursa, sciatic nerve.

[Scanning Technique in Wrist and Hand Ultrasonography]. / Sonografické vysetrení zápestí a ruky.

This guide to ultrasound examination of the wrist and hand describes the basic scanning planes and contains corresponding high-resolution ultrasound images. The patient and probe positionings are explained in a simplified step-by-step manner using schematic drawings. This standard and simple examination technique seems to be an appropriate way to improve the learning curve of novice musculoskeletal sonographers. In wrist section, an emphasis is placed on the carpal tunnel and extensor tendons evaluation. In the hand region, the scanning of the flexor pulley system and the flexor pollicis longus is described. Key words: hand, wrist joint, ultrasound, tendons, carpal tunnel syndrome, De Quervain disease, trigger finger disorder, hand injuries, musculoskeletal, protocol.

[Scanning Technique in Knee Ultrasonography]. / Sonografické vysetrení kolena.

This guide to ultrasound imaging of the knee describes the basic scanning planes and contains corresponding high-resolution ultrasound images. The patient and probe positionings are explained in a simplified step-by-step manner using schematic drawings. This standard and simple examination technique seems to be an appropriate way to improve the learning curve of novice musculoskeletal sonographers. In this manuscript, an emphasis is placed on Baker's cyst and knee effusion detection and on how to diagnose collateral ligament injuries. Key words: tendons, knee joint, tendinopathy, Baker's cyst, popliteal cyst, menisci, tibial, medial collateral ligament, musculoskeletal, protocol, ultrasound.

[Scanning Technique in Ankle nad Foot Ultrasonography]. / Sonografické vysetrení hlezna a nohy.

This guide to ultrasound imaging of the ankle and foot describes the basic scanning planes and contains corresponding high-resolution ultrasound images. The patient and probe positionings are explained in a simplified step-by-step manner using schematic drawings. This standard and simple examination technique seems to be an appropriate way to improve the learning curve of novice musculoskeletal sonographers. In this manuscript, an emphasis is placed on joint effusion detection, plantar fasciitis, Achilles tendinopathy, and ligamentous injuries around the ankle. Key words: tendons, ankle joint, tendinopathy, Achilles tendon, fasciitis, plantar, anterior talofibular ligament, musculoskeletal, protocol, ultrasound.

Acute pain: a multifaceted challenge - the role of nimesulide.

BACKGROUND: This article summarizes the outcome from an international consensus meeting, which took place in Vienna on 4 November 2014. SCOPE: The aim of the meeting was to provide the state of the art on the pathophysiology and treatment of acute pain with special emphasis on nimesulide, a non-steroidal anti-inflammatory drug (NSAID) indicated for the treatment of acute pain and primary dysmenorrhea. Besides the data on the mechanisms of acute inflammatory pain and on the efficacy and safety of nimesulide in patients affected by different forms of acute pain, the clinical experience of attending experts was discussed based on selected case reports. RESULTS: The members of this consensus group recognized that nimesulide is a NSAID highly effective in the treatment of several painful situations with an acute inflammatory component including primary dysmenorrhea. Although safety concerns regarding nimesulide have emerged in recent years, both robust new epidemiological data and clinical experience confirm a positive benefit/risk profile of nimesulide in the treatment of several forms of acute pain. CONCLUSIONS: The members of this international consensus group concluded that nimesulide, when used appropriately, remains a particularly valuable and safe option for the treatment of several conditions characterized by the presence of acute inflammatory pain because of the rapid onset of the analgesic action, and the positive evidence-based benefit/risk profile.

[3D ultrasonography for examination of the musculoskeletal system]. / 3D ultrasonografické vysetrování pohybového aparátu.

Three-dimensional (3D) sonography is the next logical step in diagnostic ultrasound examination. The true value of 3D ultrasonography, however, becomes evident only if 3D structures can be assessed without preconceptions ensuing from 2D interpretations. 3D ultrasonography can greatly improve our understanding of locomotor apparatus anatomy and pathology. The authors used spatial analysis to evaluate the data obtained by examination of patients with orthopedic diagnoses. The Voluson 530 MT and SONOReal system were used for examination. The Voluson permits a choice of either a 2D or a 3D imaging program for musculoskeletal system examination. The SONOReal, owing to a positional sensor of the probe, can be attached to any ultrasound transducer. In the period from 1990 to 2004, a total of 19 000 patients were examined by ultrasonography and, in 6 500 of them, the diagnosis was verified by another method, which showed a 99 % reliability of ultrasound examination. In 350 patients 2D imaging was followed by 3D examination; in 53 of them, 3D coronal and multiplanar imaging made the diagnosis based on 2D imaging more accurate and, in 12 patients, it provided new information on the patient's diagnosis. 3D reconstructions were made in 101 patients, of these 40 had been examined by other imaging methods (magnetic resonance, computer-assisted tomography) or arthroscopy. The results of examination showed a 100% correlation. Spatial reconstruction is based on the volume rendering method. This is an extension of the planar reconstruction method. Additional image processing techniques are used for a region of interest within a 3D volume data set. 3D ultrasound revealed a spatial relationship between lesions and their surfaces. The surface mode requires that the interface between tissues with different acoustic impedances should be a start line of 3D rendering. The acoustic threshold is a condition that restricts imaging circumstances in which surface rendering will be successful. Exploring 3D reconstructions with power Doppler scanning, which is more sensitive for tracking vessels, is a unique technique that can hardly be compared with any other imaging modality. 3D-volume imaging gives the examiner freedom to generate anatomical views from an infinite number of perspectives and allows us to explore anatomic relationships in the ways not available in any conventional 2D imaging. A spatial reconstruction presents a nearly perfect anatomical model. The possibility of storing volume data is considered a further progressive trend. It greatly contributes to enhancement of the scope of follow-up examinations, permits comparisons of expert conclusions and can serve educational purposes. The digital technology offers various networking solutions and plays a role in the development of 3D telemedicine. Although the diagnostic efficacy of 3D imaging is not greatly enhanced when compared with a 2D examination done by a well-trained specialist, the features of coronary sections and spatial reconstructions represent great progress of this imaging technology.

[Intra-articular treatment with Hyalgan in osteoarthrosis of the knee joint: experience in clinical practice in the Czech Republic]. / Intraartikulární lécba osteoartrózy kolenních kloubu Hyalganem: zkusenosti z klinické praxe v Ceské republice.

PURPOSE OF THE STUDY: To evaluate safety and efficacy of intraarticular (IA) hyaluronic acid (HA; Hyalgan in current medical practice. MATERIAL AND METHODS: Multicenter, prospective, opened, observational study included 601 patients in 35 centers in Czech Republic. Patients had analgesics and NSAIDs on demand as rescue analgesia, but i. a. corticosteroids were not allowed. Patients received 1 series of 5 IA injectious of HA into one knee. Outcome measures were: pain at rest and on walking, patients global and assessment of therapy, Lequesne's index, consumption of NSAIDs. The patients were followed for 17 weeks (12 weeks after the last injection). RESULTS: Patients improved in all outcome measures in week 5 (1 week after the last injection) and this improvement remained constant till week 17 (p < 0.001). The patients judged activity level as better or much better for 78% of treated kness in week 5 and 85.7% in week 17. The mean consumption of rescue NSAIDs dropped fom 4 days/1 week before treatment to 1 day/week during and after Hyalgan therapy. There were no severe side effects reported. Injection site pain occurred in 6.8% patients and in 1.45% for injection, and resulted in 1.4% in withdrawal. CONCLUSION: Hyalgan provided good clinical benefits and acceptable safety profile in current medical practise. The consumption of NSAIDs dropped considerably and therefore contributed to favourable cost/benefit ratio of Hyalgan therapy.