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Objectives: This study aimed to evaluate the accuracy of four clinical tests confirmed by ultrasonography (USG) and to evaluate the role of age, sex, handedness, subcutaneous tissue thickness (STT), tendon thickness (TT), and STT/TT in determining the absence of the palmaris longus muscle. Patients and methods: In this descriptive study, 282 wrists of 141 healthy individuals (71 females, 70 males; mean age: 29±9.6 years; range, 21 to 55 years) were included between September 2021 and November 2022. The palmaris longus muscle tendon was identified by Schaeffer's test, Mishra's test I, Thompson's test, and Pushpakumar's test and then evaluated with USG. Before the tests, age, sex, and dominant hand information of the individuals were obtained. The STT and TT were measured with USG. Results: Sensitivity values by side were as follows (right/left respectively): Schaeffer's 92%/73%, Mishra's I 91%/93%, Thompson's 84%/87%, and Pushpakumar's 86%/91%. Specificity values by side were as follows (right/left respectively): Schaeffer's 87%/95%, Mishra's I 78%/82%, Thompson's 78%/79%, and Pushpakumar's 84%/82%. Sensitivity values by sex were as follows (female/male respectively): Schaeffer's 81%/96%, Mishra's I 92%/94%, Thompson's 85%/90%, and Pushpakumar's 91%/92%. Specificity values by sex were as follows (female/male respectively): Schaeffer's 68%/90%, Mishra's I 72%/90%, Thompson's 72%/85%, and Pushpakumar's 78%/85%. The intraclass correlation coefficient between clinical tests and USG was 0.94 for the left side and 0.95 for the right side. Conclusion: Mishra's test I and Pushpakumar's test can be used in females, while Schaeffer's test and Mishra's test I can be used in males as a mutually supportive clinical test. Furthermore, while there may be false negative and false positive test results due to muscle variations, it should be noted that STT/TT is also effective, particularly on the right side. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to clinically and ultrasonographically evaluate enthesitis in patients with spondyloarthritis (SpA) and to determine enthesitis response to anti-tumor necrosis factor (TNF) treatment. Patients and methods: Thirty-one SpA patients (22 males, 9 females; mean age: 39.4±10.9 years; range, 22 to 60 years) who started anti-TNF treatment due to their high disease activity were included in the cross-sectional prospective study between May 2017 and January 2018. Ankylosing Spondylitis Disease Activity Score, Bath Ankylosing Spondylitis Disease Activity Index, Ankylosing Spondylitis Quality of Life Questionnaire, Bath Ankylosing Spondylitis Functional Index, and Bath Ankylosing Spondylitis Metrology Index were recorded. Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) and Spondyloarthritis Research Consortium of Canada (SPARCC) Enthesitis Score were utilized for clinical enthesitis evaluation. Patients were ultrasonographically evaluated in accordance with the Madrid Sonographic Enthesitis Index (MASEI) by a blinded sonographer. Patients were clinically and ultrasonographically assessed at baseline and in the third month after the treatment. Results: In the initial evaluation, 24 (77.42%) of the patients had clinical enthesitis, and 30 (96.77%) of the patients had ultrasonographic enthesitis. After anti-TNF treatment, MASES, SPARCC, MASEI-structure, MASEI-thickness, MASEI-bursitis, MASEI-Doppler, MASEI-inflammatory, and MASEI-total scores significantly decreased (p<0.05). There was no significant change in MASEI-damage, MASEI-erosion, and MASEI-calcification scores following the therapy (p>0.05). Conclusion: Anti-TNF treatment may improve clinical and ultrasonographic enthesitis, particularly inflammatory changes. Erosions and calcifications may not ameliorate after three months of anti-TNF treatment. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to assess the relationship between ultrasonographic hand muscle thickness measurements and hand muscle strength in patients who underwent median or ulnar nerve reconstruction. Methods: In this prospective, cross‐sectional study, intrinsic hand muscle thicknesses were measured using ultrasound with a 4‐ to 13‐MHz linear‐array probe. Measurements of hand strength were performed using a dynamometer and a pinchmeter. Results: In the median nerve group (n = 11), a moderate correlation (r = 0.694; P =.018) was observed between lateral pinch strength and transverse thenar thickness. In the ulnar nerve group (n = 11), longitudinal thenar thickness below the flexor pollicis longus tendon was moderate to highly correlated with pinch and handgrip strengths (r = 0.726‐0.893; P <.05); whole transverse thenar thickness was moderate to highly correlated with pinch strengths (r = 0.724‐0.836; P <.05). Discussion: Sonographic measurements of intrinsic hand muscle thickness may be a useful tool for the assessment and follow‐up of patients with median or ulnar nerve injury. [ABSTRACT FROM AUTHOR]

Background: Pectoralis minor syndrome (PMS) develops when the neurovascular bundle compression occurs at the retropectoralis minor space. It may occur due to repetitive overhead activities, traumatic incident, structural causes, myofascial pain syndrome in the pectoralis minor muscle, as well as spasticity of the pectoralis minor muscle. In patients with hemiplegia, adductor muscles along with pectoralis minor muscle spasticity may be present in the upper extremity.Objective: We report a 19-year-old male patient with spastic hemiparesis who was diagnosed with PMS due to spasticity of the pectoralis minor muscle.Method: Diagnosis of PMS was confirmed by Ultrasound-guided 4 cc 1% lidocaine injection to the right pectoralis minor muscle and Ultrasound-guided onabotulinum toxin A injection was performed. Stretching exercises to the pectoral muscles were also added to the rehabilitation program.Result: Complaints of the patient were controlled by botulinum toxin injections at 3-month intervals.Conclusion: It should be kept in mind that spasticity in the upper extremity may develop in the pectoralis minor muscle, and may cause pressure on the neurovascular structures. Ultrasound-guided botulinum toxin injections can be a safe and effective treatment for PMS in a patent with post stroke spastic hemiparesis. [ABSTRACT FROM AUTHOR]

Objective: Adhesive capsulitis (AC) is a pathology that characterizes with shoulder pain and progressive restriction in active and passive range of motion of the shoulder joint. In recent years, ultrasonography has been widely used in the evaluation of shoulder pathologies. The diagnostic value of ultrasonography in AC has been researched but not fully explained. Materials and Methods: We retrospectively evaluated patients aged between 30 and 65 years who were admitted to our Physical Medicine and Rehabilitation Department with complaints of shoulder pain, restriction of shoulder movements and who were followed up with the diagnosis of AC and evaluated as stage 2 and 3. Patients were assessed with ultrasonography in terms of presence of effusion around the biceps tendon, presence of subdeltoid bursitis, presence of intraarticular effusion at the posterior region, appearance of rotator interval, coracohumeral ligament thickness, presence of rupture or calcified lesions in rotator cuff tendons. Results: A total of 33 patients (17 females, 16 males) were included in the study who were diagnosed as AC. 57.57% of the patients had effusion around the biceps tendon, 63.63% had subdeltoid bursitis, and 69.69% had intraarticular effusion. A total of 4 patients had appearance of partial tear at the rotator cuff tendons. In three patients, calcific lesions were detected in rotator cuff tendons (supraspinatus tendon in 2 patients, subscapulars tendon in 1 patient). Conclusion: Ultrasonography is valuable both in terms of the diagnosis of AC and the detection of secondary causes of AC. [ABSTRACT FROM AUTHOR]