{"id":152712,"date":"2020-07-24T13:54:44","date_gmt":"2020-07-24T20:54:44","guid":{"rendered":"https:\/\/clarius.com\/blog\/echographie-msk-en-physiotherapie-integrite-osseuse\/"},"modified":"2026-09-06T08:19:58","modified_gmt":"2026-09-06T15:19:58","slug":"echographie-msk-en-physiotherapie-integrite-osseuse","status":"publish","type":"post","link":"https:\/\/clarius.com\/fr\/blog\/echographie-msk-en-physiotherapie-integrite-osseuse\/","title":{"rendered":"\u00c9chographie MSK en physioth\u00e9rapie &#8211; Int\u00e9grit\u00e9 osseuse"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Par Greg Fritz, PT, DPT, RMSK<\/p>\n\n<p class=\"wp-block-paragraph\">Lors de mon <a href=\"https:\/\/clarius.com\/fr\/blog\/imagerie-ultrasonore-de-lappareil-locomoteur-diagnostic-differentiel-des-resultats-ultrasonores\/\">dernier webinaire<\/a>, j&rsquo;ai abord\u00e9 les concepts de base de l&rsquo;utilisation des ultrasons dans les domaines de l&rsquo;orthop\u00e9die et de la kin\u00e9sith\u00e9rapie, ainsi que la mani\u00e8re d&rsquo;identifier la localisation des l\u00e9sions dans les structures de soutien (par exemple, les ligaments, les tendons). J&rsquo;ai \u00e9galement abord\u00e9 les signes d&rsquo;imagerie que vous devez rechercher sur l&rsquo;\u00e9chographie pour \u00e9valuer la vitesse et la phase du processus de gu\u00e9rison. <\/p>\n\n<p class=\"wp-block-paragraph\">Dans ce webinaire, je me concentre sur le r\u00f4le de l&rsquo;\u00e9chographie dans l&rsquo;\u00e9valuation des l\u00e9sions squelettiques et sur la mani\u00e8re dont l&rsquo;acquisition des bonnes comp\u00e9tences vous permet de mettre en \u00e9vidence des r\u00e9sultats cl\u00e9s qui n&rsquo;apparaissent pas sur d&rsquo;autres techniques d&rsquo;imagerie.<\/p>\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe title=\"MSK Ultrasound - Bone Integrity\" width=\"640\" height=\"360\" src=\"https:\/\/www.youtube.com\/embed\/jXnxOoX0fjU?feature=oembed&#038;modestbranding=1&#038;showinfo=0&#038;rel=0&#038;enablejsapi=1\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n<p class=\"wp-block-paragraph\">Les principales questions que nous devons nous poser lorsque nous r\u00e9alisons une \u00e9chographie sur une structure osseuse sont les suivantes :<\/p>\n\n<ul class=\"wp-block-list\"><li>Y a-t-il une l\u00e9sion ou une fracture de l&rsquo;os ?<\/li><li>Quel est le type de cette l\u00e9sion (par exemple, d\u00e9placement, avulsion, compression) ?<\/li><li>Le processus de cicatrisation se d\u00e9roule-t-il correctement ou sans union ?<\/li><li>Quel est l&rsquo;impact de la l\u00e9sion sur le mode de vie du patient ?<\/li><\/ul>\n\n<h2 class=\"wp-block-heading\">\u00c9tudes de cas d&rsquo;\u00e9chographie et de l\u00e9sions du squelette<\/h2>\n\n<p class=\"wp-block-paragraph\">Dans ces courtes \u00e9tudes de cas, j&rsquo;explore les donn\u00e9es recueillies aupr\u00e8s de chaque patient \u00e0 l&rsquo;aide de l&rsquo;\u00e9chographie pour souligner le r\u00f4le de cette technique d&rsquo;imagerie dans l&rsquo;identification des l\u00e9sions osseuses et d&rsquo;autres r\u00e9sultats importants.<\/p>\n\n<h3 class=\"wp-block-heading\">\u00c9tude de cas num\u00e9ro 01 &#8211; douleur aux c\u00f4tes<\/h3>\n\n<p class=\"wp-block-paragraph\">Un chauffeur de bus de 55 ans se pr\u00e9sente avec une douleur localis\u00e9e dans la<sup>4e<\/sup> c\u00f4te qui a commenc\u00e9 il y a deux jours apr\u00e8s avoir senti un claquement de doigts. Le patient a not\u00e9 que la douleur \u00e9tait similaire \u00e0 celle qu&rsquo;il ressentait lorsqu&rsquo;il jouait au football au lyc\u00e9e. <\/p>\n\n<h4 class=\"wp-block-heading\">Discussion<\/h4>\n\n<p class=\"wp-block-paragraph\">Comme vous pouvez le voir sur la <em>figure 01<\/em>, l&rsquo;illustration en 3D de la cage thoracique montre la vue du grand axe (ligne bleue) vue \u00e0 l&rsquo;\u00e9chographie, ainsi que la vue du petit axe (ligne jaune).<\/p>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" data-src=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/07\/Screen-Shot-2020-07-22-at-5.29.45-PM.png\" alt=\"\" class=\"wp-image-10543 lazyload\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 794px; --smush-placeholder-aspect-ratio: 794\/788;\" \/><figcaption><em>Figure 01 &#8211; Illustration 3D de la cage thoracique<\/em><\/figcaption><\/figure><\/div>\n\n<p class=\"wp-block-paragraph\">La <em>vid\u00e9o 01<\/em> montre la vue du grand axe, qui met en \u00e9vidence une ligne claire discontinue associ\u00e9e \u00e0 la corticale de la c\u00f4te. Cette interruption du p\u00e9rioste est un signe \u00e9vident de fracture. <\/p>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/07\/1-LAX-Rib-Fracture.gif\" alt=\"\" class=\"wp-image-10541\" \/><figcaption><em>Vid\u00e9o 01 &#8211; Fractures de c\u00f4tes \u00e0 LAX<\/em><\/figcaption><\/figure><\/div>\n\n<p class=\"wp-block-paragraph\">Comme vous pouvez \u00e9galement le voir au-dessus du point de discontinuit\u00e9, il y a un d\u00f4me de noirceur<strong>(d\u00f4me effusif<\/strong>) qui refl\u00e8te la pr\u00e9sence d&rsquo;un \u00e9panchement juste au-dessus du site de la fracture.<\/p>\n\n<p class=\"wp-block-paragraph\">D&rsquo;autre part, la <em>vid\u00e9o 02<\/em> montre la vue du petit axe o\u00f9 l&rsquo;on observe une ligne hyper\u00e9chog\u00e8ne en forme de croissant.<\/p>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/07\/2-SAX-Rib-Fracture.gif\" alt=\"\" class=\"wp-image-10542\" \/><figcaption><em>Vid\u00e9o 02 &#8211; Fracture de c\u00f4te SAX<\/em><\/figcaption><\/figure><\/div>\n\n<p class=\"wp-block-paragraph\">Lorsque je fais glisser la sonde le long de l&rsquo;axe court, vous pouvez clairement voir le discontineum se d\u00e9placer d&rsquo;un c\u00f4t\u00e9 \u00e0 l&rsquo;autre.<\/p>\n\n<p class=\"wp-block-paragraph\"><strong>Cela prouve que la fracture n&rsquo;est pas parfaitement situ\u00e9e dans le plan de l&rsquo;axe court.<\/strong><\/p>\n\n<h3 class=\"wp-block-heading\">\u00c9tude de cas num\u00e9ro 02 &#8211; douleur aux doigts<\/h3>\n\n<p class=\"wp-block-paragraph\">Un jeune homme de 15 ans se plaint d&rsquo;une douleur \u00e0 la face externe de la main gauche depuis 3 jours. Le patient d\u00e9clare qu&rsquo;au cours d&rsquo;un match de football, son doigt s&rsquo;est pris dans le maillot d&rsquo;un adversaire. <\/p>\n\n<h4 class=\"wp-block-heading\">Discussion<\/h4>\n\n<p class=\"wp-block-paragraph\">Lorsque j&rsquo;ai commenc\u00e9 \u00e0 \u00e9valuer l&rsquo;int\u00e9grit\u00e9 osseuse du patient, j&rsquo;ai d&rsquo;abord plac\u00e9 la sonde dans le grand axe (ligne bleue), puis dans le petit axe (ligne jaune), comme vous pouvez le voir sur la <em>figure 02.<\/em><\/p>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" data-src=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/07\/Screen-Shot-2020-07-22-at-5.29.33-PM.png\" alt=\"\" class=\"wp-image-10544 lazyload\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 544px; --smush-placeholder-aspect-ratio: 544\/752;\" \/><figcaption><em>Figure 02 &#8211; \u00c9chographie de la phalange proximale<\/em><\/figcaption><\/figure><\/div>\n\n<p class=\"wp-block-paragraph\">La vue du grand axe pr\u00e9sent\u00e9e sur la <em>vid\u00e9o 03<\/em> montre l&rsquo;os de la phalange proximale avec un signe clair de discontinuit\u00e9 osseuse et d&rsquo;hyper\u00e9mie au-dessus du site de la fracture.<\/p>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/07\/3-capture_1.gif\" alt=\"\" class=\"wp-image-10545\" \/><figcaption><em>Vid\u00e9o 03 &#8211; L&rsquo;os de la phalange proximale<\/em><\/figcaption><\/figure><\/div>\n\n<p class=\"wp-block-paragraph\">La vue sur l&rsquo;axe court<em>(vid\u00e9o 04<\/em>) montre une structure brillante en forme d&rsquo;arche, avec plusieurs points saillants.<\/p>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/07\/4-capture_3.gif\" alt=\"\" class=\"wp-image-10546\" \/><figcaption><em>Vid\u00e9o 04 &#8211; Vue de l&rsquo;axe court<\/em><\/figcaption><\/figure><\/div>\n\n<p class=\"wp-block-paragraph\">Apr\u00e8s avoir examin\u00e9 les donn\u00e9es des deux clich\u00e9s, j&rsquo;ai recommand\u00e9 au patient de passer une radiographie, qui a finalement mis en \u00e9vidence une fracture en spirale o\u00f9 le composant distal de la phalange proximale a gliss\u00e9, r\u00e9duisant la longueur totale de l&rsquo;os<em>(figure 03).<\/em><\/p>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" data-src=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/07\/figure-3-1024x750.png\" alt=\"\" class=\"wp-image-10547 lazyload\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 1024px; --smush-placeholder-aspect-ratio: 1024\/750;\" \/><figcaption><em>Figure 03 &#8211; Radiographie montrant une fracture en spirale de la phalange proximale<\/em><\/figcaption><\/figure><\/div>\n\n<h3 class=\"wp-block-heading\">\u00c9tude de cas num\u00e9ro 03 &#8211; douleur au talon<\/h3>\n\n<p class=\"wp-block-paragraph\">Un marathonien de 45 ans, qui a termin\u00e9 une course de 250 miles une semaine avant de venir \u00e0 mon cabinet, se plaint de sensations douloureuses dans la face lat\u00e9rale de l&rsquo;ext\u00e9rieur du calcan\u00e9um.<\/p>\n\n<p class=\"wp-block-paragraph\"><strong>La patiente a pass\u00e9 des radiographies simples qui n&rsquo;ont r\u00e9v\u00e9l\u00e9 aucun signe de fracture de stress.<\/strong><\/p>\n\n<h4 class=\"wp-block-heading\">Discussion<\/h4>\n\n<p class=\"wp-block-paragraph\">En pla\u00e7ant la sonde sur la face sup\u00e9ro-externe du calcan\u00e9um<em>(figure 04)<\/em>, j&rsquo;ai obtenu l&rsquo;image suivante ( <em>figure 05)<\/em>.<\/p>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" data-src=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/07\/figure-4-1024x781.png\" alt=\"\" class=\"wp-image-10548 lazyload\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 1024px; --smush-placeholder-aspect-ratio: 1024\/781;\" \/><figcaption><em>Figure 04 &#8211; Mod\u00e8le de la face externe du calcan\u00e9um<\/em><\/figcaption><\/figure><\/div>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" data-src=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/07\/figure-5.png\" alt=\"\" class=\"wp-image-10549 lazyload\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 888px; --smush-placeholder-aspect-ratio: 888\/608;\" \/><figcaption><em>Figure 05 &#8211; Image \u00e9chographique montrant un d\u00f4me effusif au-dessus du site d&rsquo;une fracture de stress<\/em><\/figcaption><\/figure><\/div>\n\n<p class=\"wp-block-paragraph\">Lorsque vous suivez la ligne hyper\u00e9chog\u00e8ne, vous pouvez remarquer une zone sombre pr\u00e9sentant un d\u00f4me effusif situ\u00e9 exactement \u00e0 l&rsquo;endroit de la douleur maximale.<\/p>\n\n<p class=\"wp-block-paragraph\">Ce signe m&rsquo;a confort\u00e9 dans l&rsquo;id\u00e9e qu&rsquo;il y avait une fracture de stress dans l&rsquo;axe de ce d\u00f4me, ce qui a \u00e9t\u00e9 confirm\u00e9 10 jours apr\u00e8s cette consultation par une autre radiographie simple qui montrait des signes de formation d&rsquo;un cal.<\/p>\n\n<h3 class=\"wp-block-heading\">\u00c9tude de cas num\u00e9ro 04 &#8211; douleur au genou<\/h3>\n\n<p class=\"wp-block-paragraph\">Un constructeur de bateaux de 54 ans s&rsquo;est pr\u00e9sent\u00e9 avec une douleur au genou droit apr\u00e8s avoir ressenti un \u00ab\u00a0pop\u00a0\u00bb en glissant sur la glace et en atterrissant lourdement sur sa jambe droite. L&rsquo;incident s&rsquo;est produit trois ou quatre heures avant qu&rsquo;il ne se rende \u00e0 mon cabinet apr\u00e8s avoir pr\u00e9sent\u00e9 des signes d&rsquo;inflammation locale (par exemple, un gonflement) et une g\u00eane g\u00e9n\u00e9rale dans la r\u00e9gion du genou. <\/p>\n\n<h4 class=\"wp-block-heading\">Discussion<\/h4>\n\n<p class=\"wp-block-paragraph\">La <em>figure 06<\/em> est une illustration d&rsquo;une coupe sagittale de la jambe pour montrer les diff\u00e9rentes structures impliqu\u00e9es, y compris la poche suprapatellaire et les tendons du quadriceps.<\/p>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" data-src=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/07\/figure-6-1024x395.png\" alt=\"\" class=\"wp-image-10550 lazyload\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 1024px; --smush-placeholder-aspect-ratio: 1024\/395;\" \/><figcaption><em>Figure 06 &#8211; Illustration de la jambe dans le plan sagittal<\/em><\/figcaption><\/figure><\/div>\n\n<p class=\"wp-block-paragraph\">L&rsquo;image de la <em>figure 07<\/em> repr\u00e9sente le genou gauche du patient, o\u00f9 la poche suprapatellaire et les fibres qui composent l&rsquo;extr\u00e9mit\u00e9 distale du muscle quadriceps sont visibles. En outre, la ligne claire et arqu\u00e9e repr\u00e9sente la rotule. <\/p>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" data-src=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/07\/figure-7-1024x765.png\" alt=\"\" class=\"wp-image-10551 lazyload\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 1024px; --smush-placeholder-aspect-ratio: 1024\/765;\" \/><figcaption><em>Figure 07 &#8211; Image \u00e9chographique d&rsquo;un genou sain<\/em><\/figcaption><\/figure><\/div>\n\n<p class=\"wp-block-paragraph\">En pla\u00e7ant la sonde au-dessus du genou affect\u00e9, j&rsquo;ai obtenu l&rsquo;image \u00e9chographique de la <em>figure 08<\/em> qui montre clairement une texture hyper\u00e9chog\u00e8ne anormale de la vo\u00fbte de la rotule, consid\u00e9rablement en dessous de l&#8217;emplacement normal.<\/p>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" data-src=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/07\/figure-8.png\" alt=\"\" class=\"wp-image-10552 lazyload\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 864px; --smush-placeholder-aspect-ratio: 864\/584;\" \/><figcaption>Figure 08 Image \u00e9chographique d&rsquo;une l\u00e9sion du genou<\/figcaption><\/figure><\/div>\n\n<p class=\"wp-block-paragraph\">C&rsquo;est le signe que des morceaux des structures osseuses de la rotule se sont avuls\u00e9s sous la tension provoqu\u00e9e par les fibres du quadriceps. L&rsquo;ombre \u00e9cho\u00efque (r\u00e9gion sombre) sous la ligne claire constitue un \u00e9l\u00e9ment de preuve suppl\u00e9mentaire. <\/p>\n\n<h3 class=\"wp-block-heading\">\u00c9tude de cas num\u00e9ro 05 &#8211; douleur \u00e0 la cheville<\/h3>\n\n<p class=\"wp-block-paragraph\">Un homme de 72 ans, golfeur \u00e0 la retraite, a pr\u00e9sent\u00e9 une douleur aigu\u00eb dans la r\u00e9gion de la cheville, exacerb\u00e9e en position debout. \u00c0 l&rsquo;exception de certaines positions, les patients ont fait \u00e9tat d&rsquo;activit\u00e9s quotidiennes normales sans aucune sensation d&rsquo;inconfort. <\/p>\n\n<h4 class=\"wp-block-heading\">Discussion<\/h4>\n\n<p class=\"wp-block-paragraph\">La <em>figure 09<\/em> illustre l&rsquo;articulation entre le tibia distal, le p\u00e9ron\u00e9 distal et l&rsquo;astragale. Notez que la ligne bleue repr\u00e9sente le cartilage articulaire, o\u00f9 l&rsquo;on devrait voir des zones sombres refl\u00e9tant l&rsquo;<strong>armure articulaire<\/strong> sur l&rsquo;astragale. <\/p>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" data-src=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/07\/figure-9-1024x716.png\" alt=\"Encadr\u00e9 : Figure 09 Illustration 3D de l&apos;articulation de la cheville\" class=\"wp-image-10553 lazyload\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 1024px; --smush-placeholder-aspect-ratio: 1024\/716;\" \/><figcaption><em>Figure 09 &#8211; Illustration en 3D de l&rsquo;articulation de la cheville<\/em><\/figcaption><\/figure><\/div>\n\n<p class=\"wp-block-paragraph\">Lorsque je place la sonde d&rsquo;\u00e9chographie au-dessus de l&rsquo;articulation, vous pouvez voir l&rsquo;armure articulaire (ligne sombre) qui court d&rsquo;un c\u00f4t\u00e9 \u00e0 l&rsquo;autre<em>(vid\u00e9o 05<\/em>).<\/p>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/07\/5-OCD-DJD.gif\" alt=\"\" class=\"wp-image-10554\" \/><figcaption><em>Vid\u00e9o 05 &#8211; Aspect lat\u00e9ral de l&rsquo;armure articulaire<\/em><\/figcaption><\/figure><\/div>\n\n<p class=\"wp-block-paragraph\">La <em>vid\u00e9o 05<\/em> montre une ligne relativement floue dans la partie lat\u00e9rale de l&rsquo;armure articulaire. Elle montre \u00e9galement une \u00e9rosion du sommet de l&rsquo;astragale, ce qui indique un d\u00e9faut ost\u00e9ochondral (OCD) qui ne peut pas \u00eatre vu sur une radiographie ordinaire et n\u00e9cessite une IRM pour un diagnostic positif. <\/p>\n\n<p class=\"wp-block-paragraph\">Cependant, selon les recherches que j&rsquo;ai examin\u00e9es, le champ de vision obtenu \u00e0 partir de l&rsquo;\u00e9chographie lorsque vous demandez au patient de faire une flexion dorsale et plantaire couvre environ 90 % des zones communes susceptibles d&rsquo;\u00eatre touch\u00e9es par les TOC.<\/p>\n\n<h3 class=\"wp-block-heading\">\u00c9tude de cas num\u00e9ro 06 &#8211; douleur aux orteils<\/h3>\n\n<p class=\"wp-block-paragraph\">Une femme de 57 ans s&rsquo;est plainte d&rsquo;une douleur aigu\u00eb persistante \u00e0 l&rsquo;orteil apr\u00e8s avoir subi une oignonectomie. Inqui\u00e8te de l&rsquo;intensit\u00e9 de la douleur pendant sa convalescence, elle est retourn\u00e9e voir son m\u00e9decin, qui lui a recommand\u00e9 de suivre une th\u00e9rapie physique pour acc\u00e9l\u00e9rer le processus de gu\u00e9rison. <\/p>\n\n<h4 class=\"wp-block-heading\">Discussion<\/h4>\n\n<p class=\"wp-block-paragraph\">Les figures suivantes<em>(figure 10, figure 11<\/em>) montrent des images aux rayons X des vis utilis\u00e9es, la ligne bleue \u00e9tant l&rsquo;axe que j&rsquo;ai suivi pour produire la <em>vid\u00e9o 06.<\/em><\/p>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" data-src=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/07\/figure-10-682x1024.png\" alt=\"\" class=\"wp-image-10555 lazyload\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 682px; --smush-placeholder-aspect-ratio: 682\/1024;\" \/><figcaption><em>Figure 10 &#8211; Radiographie du pied du patient<\/em><\/figcaption><\/figure><\/div>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" data-src=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/07\/figure-11-1024x581.png\" alt=\"\" class=\"wp-image-10557 lazyload\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 1024px; --smush-placeholder-aspect-ratio: 1024\/581;\" \/><figcaption><em>Figure 11 &#8211; Radiographie du pied du patient<\/em><\/figcaption><\/figure><\/div>\n\n<p class=\"wp-block-paragraph\">Comme le montre clairement la vid\u00e9o, les instruments m\u00e9talliques utilis\u00e9s dans la proc\u00e9dure sont tr\u00e8s visibles, cr\u00e9ant un \u00ab\u00a0<strong>effet de cascade<\/strong>\u00ab\u00a0.<\/p>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/07\/6-2d6753f2-962e-4632-8cfd-3581655c3af7.gif\" alt=\"\" class=\"wp-image-10556\" \/><figcaption>Vid\u00e9o 06 &#8211; \u00ab\u00a0Effet de cascade\u00a0\u00bb<\/figcaption><\/figure><\/div>\n\n<p class=\"wp-block-paragraph\">L&rsquo;\u00e9chographie montre les agrafes utilis\u00e9es et l&rsquo;\u00e9panchement autour d&rsquo;elles, la formation d&rsquo;ost\u00e9ophytes et de l\u00e9g\u00e8res traces de formation de callosit\u00e9s en cours.<\/p>\n\n<p class=\"wp-block-paragraph\">Pour \u00e9valuer la phase de cicatrisation, je mets le doppler pour visualiser le flux sanguin autour de l&rsquo;endroit de l&rsquo;intervention<em>(vid\u00e9o 07<\/em>).<\/p>\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img decoding=\"async\" src=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/07\/7-fcf40c31-47a4-4c67-91ab-f4d2c7177be1-crop.gif\" alt=\"\" class=\"wp-image-10559\" \/><figcaption>Vid\u00e9o 07 &#8211; Doppler puissance<\/figcaption><\/figure><\/div>\n\n<p class=\"wp-block-paragraph\">Comme vous pouvez le voir sur les r\u00e9sultats du doppler, il y a une r\u00e9action inflammatoire qui intervient dans le processus de cicatrisation. Par cons\u00e9quent, la patiente a d\u00fb passer un certain temps dans une botte d&rsquo;immobilisation pour permettre \u00e0 la l\u00e9sion de gu\u00e9rir compl\u00e8tement avant de reprendre une vie normale. <\/p>\n\n<h2 class=\"wp-block-heading\">Les questions auxquelles l&rsquo;\u00e9chographie permet de r\u00e9pondre<\/h2>\n\n<p class=\"wp-block-paragraph\">Comme d\u00e9montr\u00e9 ci-dessus, je peux affirmer en toute confiance que l&rsquo;\u00e9chographie est un outil extr\u00eamement utile pour \u00e9valuer l&rsquo;int\u00e9grit\u00e9 des os et les fractures.<\/p>\n\n<p class=\"wp-block-paragraph\">Vous trouverez ci-dessous les questions auxquelles nous pouvons r\u00e9pondre uniquement par \u00e9chographie.<\/p>\n\n<ul class=\"wp-block-list\"><li><strong>Voyez-vous des fractures ?<\/strong><\/li><\/ul>\n\n<p class=\"wp-block-paragraph\">Oui, vous pouvez visualiser des images haute r\u00e9solution de la fracture, qui sont souvent meilleures que des radiographies simples.<\/p>\n\n<ul class=\"wp-block-list\"><li><strong>Pouvez-vous \u00e9valuer le processus de gu\u00e9rison ?<\/strong><\/li><\/ul>\n\n<p class=\"wp-block-paragraph\">Oui, vous pouvez voir les modifications tissulaires et les changements m\u00e9taboliques qui se produisent \u00e0 l&rsquo;endroit de la l\u00e9sion.<\/p>\n\n<ul class=\"wp-block-list\"><li><strong>Pouvez-vous constater des fractures de stress ou de surmenage ?<\/strong><\/li><\/ul>\n\n<p class=\"wp-block-paragraph\">Oui, et en fait, les signes de fractures de stress apparaissent plus t\u00f4t \u00e0 l&rsquo;\u00e9chographie qu&rsquo;\u00e0 la radiographie.<\/p>\n\n<ul class=\"wp-block-list\"><li><strong>Pouvez-vous visualiser les l\u00e9sions autour du mat\u00e9riel ?<\/strong><\/li><\/ul>\n\n<p class=\"wp-block-paragraph\">Oui, avec une r\u00e9solution particuli\u00e8rement \u00e9lev\u00e9e.<\/p>\n\n<h2 class=\"wp-block-heading\">Message \u00e0 emporter<\/h2>\n\n<p class=\"wp-block-paragraph\">Malgr\u00e9 l&rsquo;id\u00e9e re\u00e7ue selon laquelle l&rsquo;\u00e9chographie n&rsquo;est pas aussi utile pour identifier et \u00e9valuer les l\u00e9sions osseuses, les experts en physioth\u00e9rapie savent que l&rsquo;utilisation correcte de cet outil peut donner des r\u00e9sultats impressionnants qui rivalisent avec d&rsquo;autres techniques d&rsquo;imagerie sophistiqu\u00e9es.<\/p>\n\n<p class=\"wp-block-paragraph\">Nous esp\u00e9rons que vous avez trouv\u00e9 ce webinaire instructif. Pour en savoir plus sur le scanner Clarius HD qui convient le mieux \u00e0 votre cabinet de m\u00e9decine nucl\u00e9aire, visitez notre page sur les \u00e9chographes portatifs pour la m\u00e9decine nucl\u00e9aire ou parlez \u00e0 un expert en \u00e9chographie ci-dessous. <\/p>\n","protected":false},"excerpt":{"rendered":"<p>Par Greg Fritz, PT, DPT, RMSK Lors de mon dernier webinaire, j&rsquo;ai abord\u00e9 les concepts de base de l&rsquo;utilisation des ultrasons dans les domaines de l&rsquo;orthop\u00e9die et de la kin\u00e9sith\u00e9rapie, ainsi que la mani\u00e8re d&rsquo;identifier la localisation des l\u00e9sions dans les structures de soutien (par exemple, les ligaments, les tendons). J&rsquo;ai \u00e9galement abord\u00e9 les signes&#8230;<\/p>\n","protected":false},"author":4,"featured_media":33456,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","inline_featured_image":false,"footnotes":""},"categories":[146,142],"tags":[],"specialities":[66],"class_list":["post-152712","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-education","category-insights","specialities-msk"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.6 (Yoast SEO v28.6) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>\u00c9chographie MSK en physioth\u00e9rapie - Int\u00e9grit\u00e9 osseuse | Clarius | Blog Post<\/title>\n<meta name=\"description\" content=\"Par Greg Fritz, PT, DPT, RMSK Lors de mon dernier webinaire, j&#039;ai abord\u00e9 les concepts de base de l&#039;utilisation des ultrasons dans les domaines de\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/clarius.com\/fr\/blog\/echographie-msk-en-physiotherapie-integrite-osseuse\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"\u00c9chographie MSK en physioth\u00e9rapie - Int\u00e9grit\u00e9 osseuse\" \/>\n<meta property=\"og:description\" content=\"Par Greg Fritz, PT, DPT, RMSK Lors de mon dernier webinaire, j&#039;ai abord\u00e9 les concepts de base de l&#039;utilisation des ultrasons dans les domaines de\" \/>\n<meta property=\"og:url\" content=\"https:\/\/clarius.com\/fr\/blog\/echographie-msk-en-physiotherapie-integrite-osseuse\/\" \/>\n<meta property=\"og:site_name\" content=\"Clarius\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/clariusmhealth\/\" \/>\n<meta property=\"article:published_time\" content=\"2020-07-24T20:54:44+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-09-06T15:19:58+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/clarius.com\/wp-content\/uploads\/2020\/07\/2020.07.24-MSK-Ultrasound-in-Physiotherapy-\u2013-Bone-Integrity.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1920\" \/>\n\t<meta property=\"og:image:height\" content=\"1080\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Roderick\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@clariusmhealth\" \/>\n<meta name=\"twitter:site\" content=\"@clariusmhealth\" \/>\n<meta name=\"twitter:label1\" content=\"\u00c9crit par\" \/>\n\t<meta name=\"twitter:data1\" content=\"Roderick\" \/>\n\t<meta name=\"twitter:label2\" content=\"Dur\u00e9e de lecture estim\u00e9e\" \/>\n\t<meta name=\"twitter:data2\" content=\"9 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/clarius.com\\\/fr\\\/blog\\\/echographie-msk-en-physiotherapie-integrite-osseuse\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/clarius.com\\\/fr\\\/blog\\\/echographie-msk-en-physiotherapie-integrite-osseuse\\\/\"},\"author\":{\"name\":\"Roderick\",\"@id\":\"https:\\\/\\\/clarius.com\\\/fr\\\/#\\\/schema\\\/person\\\/f8d9e2692e9e347c679efc89b669dc11\"},\"headline\":\"\u00c9chographie MSK en physioth\u00e9rapie &#8211; 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