Department of Radiology, Dr. M.K. Shah Medical College and Research Center, Ahmedabad, India.
Dhruv Healthcare Multi-speciality Hospital, Ahmedabad, India.
Curr Med Imaging. 2021;17(4):459-463. doi: 10.2174/1573405616666201005114406.
High-frequency ultrasound (HFUS) is a mobile, radiation-free imaging tool for the diagnosis of musculoskeletal disorders. We aim to demonstrate the diagnostic value of dynamic HFUS for undiagnosed lower chest, upper abdomen, and loin pain with this case series.
A cricketer presented with long-standing left-sided dull ache lower chest and upper abdominal pain, aggravated on exertion and leaning forward. His previous laboratory and previous imaging tests were unrevealing. Dynamic HFUS of his left ribs during hooking maneuver demonstrated slipping of the eighth rib over the seventh rib associated with clicking. He also reported tenderness over this region. He was diagnosed with slipping rib syndrome (SRS), and was treated with the eighth nerve block under the HFUS guidance. The second and third cases presented with chronic undiagnosed waxing and waning loin pain despite extensive laboratory and radiological workup. Both patients demonstrated twelfth rib HFUS probe tenderness in a sitting position with a specific movement that reproduced the pain during the dynamic HFUS study. The diagnosis of twelfth rib syndrome (TRS) was confirmed and treated successfully with a local intercostal nerve block.
HFUS is the most underutilized imaging tool for the diagnosis of unexplained upper abdominal and lower chest pain syndromes. We identified only a few such reported cases managed with the help of HFUS.
The dynamic HFUS is a valuable imaging modality for the undiagnosed lower chest, upper abdominal, or loin pain.
高频超声（HFUS）是一种用于诊断肌肉骨骼疾病的移动、无辐射成像工具。我们旨在通过本病例系列展示动态 HFUS 对不明原因的下胸部、上腹部和腰部疼痛的诊断价值。
一名板球运动员出现长期左侧下胸部隐痛和上腹部疼痛，劳累和前倾时加重。他之前的实验室和影像学检查均无异常。在钩状动作中对其左侧肋骨进行动态 HFUS 检查时，显示第八肋骨在第七肋骨上滑动，并伴有弹响。他还报告该区域有压痛。他被诊断为滑动肋骨综合征（SRS），并在 HFUS 引导下接受第八神经阻滞治疗。第二例和第三例患者均出现慢性不明原因的腰痛，尽管进行了广泛的实验室和影像学检查。两名患者在坐位时，第十二肋骨 HFUS 探头在特定运动时出现压痛，该运动在动态 HFUS 研究中再现了疼痛。第十二肋骨综合征（TRS）的诊断得到确认，并成功接受局部肋间神经阻滞治疗。
HFUS 是诊断不明原因上腹部和下胸部疼痛综合征最未被充分利用的影像学工具。我们仅发现少数此类报道病例在 HFUS 的帮助下得到了治疗。
动态 HFUS 是一种用于诊断不明原因的下胸部、上腹部或腰部疼痛的有价值的影像学方法。
