UNASSIGNED: Tendinopathy is a disease state characterized by tendon disorder with pain or decreased function that can cause significant disability. Multiple treatment modalities exist; however, no single treatment is superior. Ultrasound-guided percutaneous needle tenotomy (PNT) and TENEX are emerging as promising treatment options for tendinopathy.
UNASSIGNED: To review the current literature of reported outcomes for PNT, TENEX, and TENJET, for the treatment of tendinopathy, including pain relief, change in function, and patient-reported outcomes.
UNASSIGNED: A comprehensive search was conducted from database inception to September 2023 in Ovid Medline, Ovid Embase, and Cochrane Library.
UNASSIGNED: Keywords and index terms related to tendon injury, ultrasound, and tenotomy were used in combination to identify relevant literature that included ultrasound-guidance, treatment of tendinopathy, and treatment with PNT, TENEX, or TENJET. Covidence Systematic Review Software used to screen for relevant studies. Only English-language studies were included.
UNASSIGNED: Systematic Review using PICO framework as defined and registered with the International Prospective Register of Systematic Reviews (PROSPERO ID CRD42022321307).
UNASSIGNED: Level 4 (evidence from a systematic review graded to the lowest level of study included).
UNASSIGNED: Articles meeting the inclusion criteria were reviewed. Type and region of tendinopathy studied, outcome measures, and complications were recorded. Clinical and self-reported outcomes data were compared across studies.
UNASSIGNED: A total of 10 studies, representing 11 tendon sites, were included. The studies overall report improvements in pain, function, and quality of life after undergoing PNT or TENEX, with minimal adverse effects. Mean risk of bias assessment scores were 8.35 out of 10 assessing internal and external validity for included studies.
UNASSIGNED: PNT and TENEX are safe, beneficial, and minimally invasive treatment option for patients, especially for conditions refractory to more conservative treatments options.

UNASSIGNED: The detection rate of benign thyroid nodules is increasing every year, with some affected patients experiencing symptoms. Ultrasound-guided thermal ablation can reduce the volume of nodules to alleviate symptoms. As the degree and speed of lesion absorption vary greatly between individuals, an effective model to predict curative effect after ablation is lacking. This study aims to predict the efficacy of ultrasound-guided thermal ablation for benign thyroid nodules using machine learning and explain the characteristics affecting the nodule volume reduction ratio (VRR).
UNASSIGNED: Prospective study.
UNASSIGNED: The clinical and ultrasonic characteristics of patients who underwent ultrasound-guided thermal ablation of benign thyroid nodules at our hospital between January 2020 and January 2023 were recorded.
UNASSIGNED: Six machine learning models (logistic regression, support vector machine, decision tree, random forest, eXtreme Gradient Boosting [XGBoost], and Light Gradient Boosting Machine [LGBM]) were constructed to predict efficacy; the effectiveness of each model was evaluated, and the optimal model selected. SHapley Additive exPlanations (SHAP) was used to visualize the decision process of the optimal model and analyze the characteristics affecting the VRR.
UNASSIGNED: In total, 518 benign thyroid nodules were included: 356 in the satisfactory group (VRR ≥70% 1 year after operation) and 162 in the unsatisfactory group. The optimal XGBoost model predicted satisfactory efficacy with 78.9% accuracy, 88.8% precision, 79.8% recall rate, an F1 value of 0.84 F1, and an area under the curve of 0.86. The top five characteristics that affected VRRs were the proportion of solid components < 20%, initial nodule volume, blood flow score, peripheral blood flow pattern, and proportion of solid components 50-80%.
UNASSIGNED: The models, based on interpretable machine learning, predicted the VRR after thermal ablation for benign thyroid nodules, which provided a reference for preoperative treatment decisions.

A 39-year-old man was admitted to our hospital with kidney stones after kidney transplantation. Kidney, ureter, and bladder radiographs showed multiple stones in the transplanted and orthotopic kidneys, which had not been reported previously. Owing to the larger size of the stones in the transplanted kidney, they needed to be removed. Percutaneous nephrolithotomy and ureteroscopy were performed under B-mode ultrasound guidance. The stone measured 1.9 × 1.6 cm and was located under the calyx of the kidney. A titanium laser fiber was used to dissolve the stones, which were subsequently removed. No adverse reactions occurred during or after the surgery. The causes of stone formation included dietary factors, related drugs, improper fluid intake, and urinary tract infections. As neither the donor nor the recipient had a history of kidney stones, we hypothesized that the stones were a new entity that either developed following transplantation or a long-term complication.

Back pain is the leading cause of disability globally and results in a substantial medical and economic burden. Epidural steroid injections (ESIs) have been widely used as a treatment for back pain with radiculopathy of various etiologies. Ultrasound guidance (UG) for delivering ESIs can reduce costs and facilitate the procedure in resource-limited settings compared to the current standard technique of using fluoroscopic guidance (FG). This scoping review aimed to compare the clinical outcomes between UG and FG ESIs in the treatment of radicular pain. Systematic searches of Embase, Ovid Medline, Scopus, CENTRAL (Cochrane Central Register of Controlled Trials), CDSR (Cochrane Database of Systematic Reviews), and ClinicalTrials.gov were conducted in accordance with PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews) guidelines. Randomized controlled trials (RCTs) and comparative observational studies investigating the outcomes between UG and FG ESIs in the treatment of radicular pain were included. The risk of bias for included RCTs was assessed using the Cochrane Collaboration risk-of-bias tool. From 1,659 potentially relevant publications, eight studies (five RCTs and three retrospective comparative studies) were included. Five of the studies were conducted in the Republic of Korea, one in China, one in India, and one in Egypt. All studies reported no significant difference between UG and FG ESIs in success rate, pain index, and postoperative disability (p > 0.05). One study reported increased intravascular injections in the FG group, but this did not reach statistical significance (p > 0.05). One study reported decreased needle-placement time in the UG group (p < 0.001). One study reported decreased total operation time in the UG group (p < 0.05). Overall, treatment outcomes and adverse events profile are comparable between UG and FG ESIs for radicular pain. UG ESIs reduce costs, minimize radiation exposure, facilitate vessel identification, prevent injury, and potentially save intraoperative time while offering the same benefits as FG injections. Future studies should focus on long-term outcomes, cost-effectiveness, and the impact of UG ESIs on patient satisfaction and quality of life.

Background: This study aimed to summarize the current status of research on ultrasound-guided acupuncture and dry-needling treatment and the specific treatment methods applied to patients. Methods: A scoping review was conducted, surveying three English databases (PubMed, Embase, and the Cochrane Library) for studies published up to May 2024. All studies related to ultrasound-guided acupuncture and dry-needling treatment were considered. Literature was selected using selection and exclusion criteria, and extracted and organized using EndNote. Results: A total of 107 eligible studies were included. Among the 107 studies, non-comparative studies accounted for the largest proportion (n = 47, 43.9%), followed by randomized controlled trials (RCTs; n = 41, 38.3%). Diseases of the musculoskeletal system or connective tissue (15 diseases of the musculoskeletal system or connective tissue) accounted for most (n = 48, 55.8%) of the 86 diseases studied, followed by symptoms, signs, or clinical conditions not otherwise classified (n = 17, 19.8%). Conclusions: Ultrasound-guided acupuncture and dry-needling have been actively studied and applied for the treatment of various diseases. However, higher-quality studies are needed for further applications in research and clinical practice.

Oral clefts represent a significant craniofacial anomaly in neonates, presenting multifaceted challenges such as feeding difficulties, recurrent ear infections, speech impediments, poor growth, hearing impairments, and dental misalignments. These anomalies not only affect physical health but also have profound psychosocial implications for affected individuals and their families. Current management strategies aim to address these challenges comprehensively, and recent advancements in technology have offered innovative solutions. Among these, the integration of ultrasound-guided (USG) three-dimensional (3D)-constructed obturator devices has emerged as a promising approach to enhancing patient outcomes, particularly in achieving facial symmetry and facilitating early nutritional rehabilitation. This study presents a detailed case series of three term infants born to non-consanguineous parents with appropriate birth weights for their gestational age, each diagnosed with a unilateral cleft lip and palate (UCLP). The first infant also presented with left-hand polydactyly and a preauricular sinus, while the second was diagnosed with multicystic kidney disease based on kidney, ureter, and bladder (KUB) scan findings. Collaborating with the Smile Train organization and the maxillofacial surgery team, a comprehensive management plan was devised. In the initial phase, intraoral scanning (Medit Intraoral Scanner™, Seoul, South Korea; done at Saveetha Medical College and Hospitals, Chennai) and digital printing of the obturator plate were performed to capture precise anatomical details. Subsequently, 3D printing technology (Ender 3D Printer™, Creality, Shenzhen, China; done at Saveetha Medical College and Hospitals, Chennai) was employed to fabricate a customized obturator plate equipped with a nasal stent. This ultrasound (US)-guided 3D-constructed obturator device was designed to fit each infant\'s unique oral anatomy, providing optimal support and alignment. The implementation of this device within a week post birth played a pivotal role in expediting the initiation of direct breastfeeding and nutritional rehabilitation. Furthermore, one of the infants underwent cleft lip surgical repair at four months of age, showcasing the device\'s compatibility with subsequent surgical interventions. The utilization of US-guided 3D-constructed obturator devices in the management of cleft lip and palate (CLP) has demonstrated significant clinical benefits. These devices contribute to reduced facial deformities, mitigate nasal cartilage sagging, and foster enhanced weight gain. Additionally, they facilitate successful breastfeeding, thereby promoting early nutritional recovery. Moreover, the improved facial symmetry and cheek fullness resulting from this approach contribute to accelerated rehabilitation, thereby reducing the societal stigma often associated with craniofacial anomalies.

Ultrasound-guided clavipectoral fascial plane block (CPB) and intermediate cervical plexus block (ICPB) have been used as novel approaches for clavicular fracture surgery in adults. However, there are few reports of ultrasound-guided CPB combined with ICPB for clavicular surgery in children under 18 years of age. A 16-year-old male baseball player (weight, 57 kg; height, 160 cm) was scheduled to undergo open reduction and internal fixation with superior plate placement for a left-sided displaced midshaft clavicular fracture. We performed ultrasound-guided CPB using 0.25% ropivacaine (10 mL each) on the medial and lateral sides of the clavicle fracture between the periosteum of the clavicle and the clavipectoral fascia and ICPB using 0.25% ropivacaine (5 mL) under general anesthesia. The surgery proceeded smoothly, and the postoperative pain was minimal. In this case, ultrasound-guided CPB combined with ICPB was used effectively and safely to treat clavicular fractures in an adolescent athlete.

To study a new method for establishing animal models of prenatal bronchopulmonary dysplasia (BPD), we used lung ultrasound score (LUS) to semi-quantitatively assess the severity of lung lesions in model rats. Lipopolysaccharide (LPS) was injected into the right lung of the fetus of the rat under ultrasound-guided, and the right lung of the neonates were scanning for LUS. Specimens were collected for pathological scoring and detection of pulmonary surfactant-associated glycoprotein (SP)-C and vascular endothelial growth factor (VEGF) expression quantity. The correlation between LUS and pathological scores was analyzed. (1) The animal models were consistent with the pathological manifestations of BPD. (2) It showed a strong positive correlation between LUS and pathological scores in animal models (r = 0.84, P < 0.005), and the expression quantity of SP-C and VEGF in lung tissue were decreased (both P < 0.05). Animal models established by ultrasound-guided puncture of the lung of rats and injection of LPS were consistent with the manifestation of BPD. This method could be used to establish animal models of BPD before birth, and the severity of BPD could be assessed by using LUS.

UNASSIGNED: To compare the effectiveness of ultrasound (US)-guided radiofrequency ablation (RFA) and conventional open thyroidectomy (OT) in the treatment of benign thyroid nodules (BTN).
UNASSIGNED: Medical records of 103 patients with BTN undergoing surgical treatment at The Affiliated Jiangning Hospital of Nanjing Medical University from March 2019 to March 2022 were retrospectively analyzed. Records show that 53 patients underwent US-guided RFA (observation group) and 50 patients underwent conventional OT (control group). Perioperative indicators (operation duration, intraoperative blood loss, postoperative hospital stay, incision length, and VAS score 12h and 24h after surgery), complications, thyroid function, and nodule recurrence in both groups were compared and analyzed.
UNASSIGNED: Perioperative indicators of patients in the observation group were better, and the visual analogue scale (VAS) scores at 12 and 24 hours after the surgery were lower than those of the control group (p<0.05). The incidence of complications in the observation group was significantly lower than that in the control group (p<0.05). There was no statistically significant difference in the preoperative levels of thyroid-stimulating hormone (TSH), serum free thyroxine (FT4) and serum free triiodothyronine (FT3) between the two groups (p>0.05). The postoperative TSH levels in the observation group increased compared to the preoperative levels and were higher than those in the control group, while FT4 and FT3 levels decreased after surgery and were lower than those in the control group (p<0.05).
UNASSIGNED: Compared to conventional open thyroidectomy, US-guided RFA is associated with less trauma, faster recovery, fewer complications, and less impact on thyroid function in the treatment of patients with BTN.

BACKGROUND: Surgery of the goat stifle joint requires good perioperative analgesia, ideally without affecting motor function in the postoperative period.  The objective of this study was to describe an ultrasound-guided technique for saphenous nerve block in goats. Eleven fresh female goat cadavers from two different age groups were used: seven of them were four years old with a mean ± SD body weight of 65.9 ± 7.3 kg. Four animals were six months old and their mean ± SD body weight was 20.1 ± 3.1 kg. The cadavers were positioned in lateral recumbency with the limb to be blocked lowermost. A high-frequency linear transducer (6-12 MHz) was used to localise the interfascial plane between the sartorius and the vastus medialis muscles and to identify the saphenous nerve on the medial aspect of the thigh, caudal to the femur, at the level of the femoral triangle. In 22 pelvic limbs 0.1 mL/kg of methylene blue was injected around the saphenous nerve under ultrasound guidance, followed by gross anatomical dissection. The length of circumferentially stained nerve was measured, and the success rate of achieving at least 1 cm of staining is presented with a 95% confidence interval (CI).
RESULTS: Although not all saphenous nerves were sonographically identified, their boundaries were defined as cranial to the femoral artery, lateral to the sartorius muscle, and medial to the vastus medialis and rectus femoris muscles, within the perivascular fat. During anatomical dissection, the overall dye solution distribution was graded as complete in 17/22 limbs indicating a 77.3% success rate [95% CI (0.598, 0.948)], partial in 3/22 limbs and failed in 2/22 limbs.
CONCLUSIONS: The success rate of this study indicates the feasibility of employing the ultrasound-guided technique to perform saphenous nerve block in goats. However, further in-vivo studies are recommended to assess the block\'s clinical efficacy before implementation on clinical patients.