Background: Wrist pain is prevalent. Activities such as dexterous sports, prolonged use of personal handheld devices, and extensive desktop keyboard usage are common contributors to wrist pain. Intersection syndrome, a form of inflammatory tenosynovitis, occurs at the intersection of the first and second dorsal compartments of the wrist. The first dorsal compartment is comprised of the tendons of abductor pollicis longus and extensor pollicis brevis, while the second dorsal compartment contains the tendons of extensor carpi radialis longus and extensor carpi radialis brevis. Intersection syndrome is diagnosed by pain localized to the dorsoradial forearm, approximately five cm proximal to the wrist joint, which worsens with resisted wrist and thumb extension. To date, the use of hydro dissection with 5% dextrose under ultrasoundguidance as a treatment for Intersection syndrome has not been reported. This case report presents the first report on ultrasound-guided hydro dissection as a therapeutic approach for intersection syndrome. Methods: A case report, with informed consent, involving a 32-year-old male athlete. The patient, a hurling player, presented with chronic right wrist pain diagnosed as intersection syndrome. The condition significantly affected his work, sporting activities, and daily living activities. Previous conservative management and physiotherapy had failed to alleviate his symptoms. To confirm the diagnosis, relevant imaging was performed, supplemented by dynamic ultrasound assessment. The procedure was performed aseptically. Continuous ultrasoundguidance was employed to ensure accurate needle placement. Once the needle tip position was confirmed, an initial injection of 5 mL of 0.25% chirocaine was administered. 10 mL of 5% dextrose was injected under ultrasoundguidance for hydro dissection, with good visualization of the solution’s distribution. Conclusion: Ultrasound-guided hydro dissection has not previously been documented as a treatment option for intersection syndrome. In this case,
Objective: To evaluate the application effect of ultrasound-guided central venous catheterization in the teaching of anesthesia residents. Methods: Forty anesthesia resident companions who received standardized residency training in our department from July 2018 to July 2020 were randomly divided into an ultrasound group and a control group, with 20 participants in each group. The ultrasound group was taught by ultrasound-guided central venipuncture, while the control group was taught by traditional anatomy. After ten training punctures, all trainees were assessed twice. Results: Both groups could master the technique of central venipuncture. The success rate of first puncture and the overall success rate of puncture in the ultrasound group were significantly higher than those in the control group (p p < 0.05). Conclusion: Compared with the traditional anatomical localization teaching, the use of ultrasound-guided technology can improve the success rate of puncture, save puncture time, reduce related complications, and have a better training effect.
In this letter we comment on the article by Zhang et al published in the recent issue of the World Journal of Gastrointestinal Endoscopy 2024.We focus specifically on the management of gastric varices(GV),which is a significant consequence of portal hypertension,is currently advised to include beta-blocker therapy for primary prophylaxis and transjugular intrahepatic portosystemic shunt for secondary prophylaxis or active bleeding.Although it has been studied,direct endoscopic injection of cyanoacrylate glue has limitations,such as the inability to fully characterize GV endoscopically and the potential for distant glue embolism.In order to achieve this,endoscopic ultrasound has been used to support GV characterization,real-time therapy imaging,and Doppler obliteration verification.
Background:We aimed to study physician attitudes toward ultrasound-guided procedures and possible improvements.We hypothesized that the usage of ultrasound in procedures may be limited by a high barrier of entry and that most physicians would choose to adopt software that provides real-time image guidance if accessible.Methods:A voluntary,cross-sectional survey of physicians at a single site was conducted using a five-point Likert scale.Data analysis included both descriptive and inferential statistical analyses and stratified by categorical descriptors,including variables of formal training,years of experience,and specialty of practice.Results:One hundred sixteen physicians responded to the survey.The majority disagreed that there was a steep learning curve(57.5%)and that they need more time to identify structures under ultrasound(85.0%).Overall attitudes were mixed about the use of additional software to improve ease of use,but most(55.4%)had positive opinions toward the addition of real-time 3D reconstruction.Respondents without formal training were significantly more likely to agree that additional software would improve ease of ultrasound-guided procedures(p=0.0389).Radiologists were significantly more likely to perceive a steeper learning curve and less likely to advocate for supplemental software compared to emergency medicine physicians,surgeons,or anesthesiologists.Conclusions:Surveyed physicians demonstrated comfort with ultrasound-guided procedures and a mixed stance toward the use of additional software to assist with procedures.Those without formal training had significantly more positive attitudes toward the use of additional technology to augment ultrasound-guided procedures,suggesting a knowledge gap that may benefit from such technology.
Emma BarrySanyukta DeshmukhVivian ZhangAntoan KosharHaider ButtKenneth RoweSiamak Moayedi
BACKGROUND Adrenocortical oncocytoma is a rare,mostly benign,nonfunctional tumor that is typically detected incidentally.Its diagnosis is challenging because of the absence of distinctive imaging characteristics,necessitating pathological validation.CASE SUMMARY We present a case report of a 35-year-old woman with an adrenal mass located on the left side,where endoscopic ultrasound-guided fine-needle aspiration(EUSFNA)was performed after comprehensive diagnostic assessment.Our results are consistent with those of previously documented cases regarding tumor demographics and anatomical location.Given the limited number of reports on this condition,long-term follow-up is crucial to enhance our understanding of its prognosis.CONCLUSION For patients with adrenocortical oncocytoma,EUS-FNA can enables collection of preoperative tissue specimens leading to suitable treatment strategies.
