La semaine derni\u00e8re, nous avons pr\u00e9sent\u00e9 le mode d’imagerie \u00e9lastographique disponible sur notre plateforme Clarius Ultrasound. Greg Fritz PT, DPT, RMSK, physioth\u00e9rapeute dans l’\u00c9tat de Washington, a test\u00e9 l’\u00e9lastographie avec son scanner Clarius dans son petit cabinet. Voici un compte-rendu d\u00e9taill\u00e9 de son exp\u00e9rience avec cette fonctionnalit\u00e9 avanc\u00e9e de Clarius. <\/p>\n\n
\nLes physioth\u00e9rapeutes, qui identifient de mani\u00e8re critique les diagnostics musculo-squelettiques, b\u00e9n\u00e9ficient d’une compr\u00e9hension de la pathologie tissulaire au niveau cellulaire. Il existe des phases dans le processus de gu\u00e9rison des diff\u00e9rents types de tissus qui n\u00e9cessitent une p\u00e9riode d’attente afin d’initier et de g\u00e9rer de mani\u00e8re responsable la charge r\u00e9paratrice. Historiquement, nous d\u00e9terminons un calendrier pour les prochaines interventions de r\u00e9\u00e9ducation en fonction du temps \u00e9coul\u00e9 depuis la date de la blessure.
Aujourd’hui, gr\u00e2ce \u00e0 l’utilisation de l’imagerie ultrasonore en mode B \u00e0 haute r\u00e9solution, nous sommes en mesure de voir les signes avant-coureurs de la gu\u00e9rison (par exemple, la formation de callosit\u00e9s dans les fractures). Nous pouvons utiliser ces marqueurs pour d\u00e9cider d’un plan unique de progression de la charge pour chaque individu.
Avec l’\u00e9chographie MSK, le Doppler est un outil pr\u00e9cieux pour identifier l’\u00e9tat d’inflammation des tissus. \u00c9tant donn\u00e9 que la reconstruction des tissus r\u00e9actifs n\u00e9cessite une infrastructure de circulation des fluides pour faciliter le m\u00e9tabolisme de destruction des tissus endommag\u00e9s, la reconstruction de nouvelles matrices de soutien et l’\u00e9limination des d\u00e9chets associ\u00e9s, nous pouvons visualiser l’\u00e9tat de la circulation des fluides avec le Doppler couleur et le Doppler puissance.
Le d\u00e9veloppement de l’\u00e9lastographie (EUS) nous offre une nouvelle source d’informations pour \u00e9valuer de mani\u00e8re critique les caract\u00e9ristiques des maladies dans les tissus musculo-squelettiques. Par exemple, j’ai lu qu’il \u00e9tait possible d’identifier des profils d’\u00e9chos caract\u00e9ristiques dans les fibres de collag\u00e8ne qui montrent une augmentation marqu\u00e9e de la vuln\u00e9rabilit\u00e9 au d\u00e9veloppement de la d\u00e9gradation m\u00e9tabolique et de la n\u00e9ovascularisation de l’inflammation r\u00e9active dans les troubles li\u00e9s au surmenage cumulatif.
\u00c0 l’heure actuelle, il existe tr\u00e8s peu d’\u00e9tudes de qualit\u00e9 qui d\u00e9finissent clairement les r\u00e8gles d’interpr\u00e9tation des donn\u00e9es acquises avec ce nouvel outil. Cela s’explique en partie par le fait que, historiquement, l’\u00e9lastographie n’est disponible que sur les \u00e9quipements d’imagerie les plus co\u00fbteux. Comme ces syst\u00e8mes sont bien au-del\u00e0 de la port\u00e9e financi\u00e8re des cliniciens de la MSK, les r\u00e9sultats des quelques \u00e9tudes universitaires disponibles n’ont eu qu’une valeur pratique minime.
\u00c9tonnamment, Clarius Mobile Health est le premier \u00e0 proposer une option d’\u00e9lastographie de contrainte sur sa nouvelle gamme d’\u00e9chographes de poche abordables. \u00c0 mesure que l’\u00e9lastographie devient plus accessible, je pense qu’il est possible que nous commencions \u00e0 voir une forte augmentation de la valeur clinique de cet outil pour \u00e9valuer la sant\u00e9 des tissus et l’\u00e9tat de pr\u00e9paration aux progr\u00e8s des charges fonctionnelles.
De nombreux mod\u00e8les de r\u00e9cup\u00e9ration des tissus admettent des changements dans la texture des tissus lorsque notre collag\u00e8ne se ramollit avec la maladie et la surutilisation ou se raidit avec l’inactivit\u00e9, la cicatrisation de la reconstruction et les sch\u00e9mas douloureux de tension musculaire. Les points de d\u00e9clenchement musculaires et l’\u00e9paississement fibrotique classique associ\u00e9s \u00e0 divers syndromes musculo-squelettiques nous offrent une toile vierge pour tester \u00ab\u00a0en pratique\u00a0\u00bb l’applicabilit\u00e9 de ces informations dans nos pratiques.
J’ai eu la chance de pouvoir tester la fonction d’\u00e9lastographie sur mon scanner Clarius HD. Dans mon cabinet de kin\u00e9sith\u00e9rapie de petite ville, j’ai pu observer l’adoucissement des \u00ab\u00a0\u00e9chosignatures\u00a0\u00bb dans les tendons d’ancrage des extenseurs du poignet au coude (Tennis Elbow) et le profil de couleur de la d\u00e9gradation interfibrillaire dans les tendinopathies d’insertion du tendon d’Achille.
J’esp\u00e8re qu’avec chaque exposition \u00e0 ces donn\u00e9es sur la rigidit\u00e9, je d\u00e9velopperai une meilleure compr\u00e9hension clinique de leur valeur pour les d\u00e9cisions que je dois prendre dans les options d’intervention pour mes patients.
Je suis reconnaissant \u00e0 Clarius d’avoir apport\u00e9 ce niveau de qualit\u00e9 d’imagerie avanc\u00e9e \u00e0 un appareil d’\u00e9chographie abordable pour les cliniciens comme moi. Je souhaite que l’avenir soit fait d’informations diagnostiques tissulaires plus nombreuses et plus pertinentes, \u00e0 la port\u00e9e d’un nombre croissant de cliniciens POC. <\/p>\n<\/blockquote>\n\nGreg est l’un des trois kin\u00e9sith\u00e9rapeutes du pays \u00e0 avoir obtenu un certificat de pionnier en imagerie ultrasonore musculo-squelettique (RMSK) dans l’\u00c9tat de Washington. Son \u00e9quipe \u00e0 Anacortes Physiotherapy se consacre \u00e0 l’utilisation de techniques \u00e9prouv\u00e9es et \u00e9mergentes bas\u00e9es sur des principes scientifiques solides et des recherches fond\u00e9es sur des preuves, tout en mettant l’accent sur les diagnostics cliniques et la th\u00e9rapie manuelle orthop\u00e9dique. <\/p>\n\n
Pour plus d’informations sur l’\u00e9chographie portable pour MSK, visitez notre page web sur le scanner Clarius L15 HD.<\/a> <\/p>\n\n
\n\nD\u00e9couvrez ce cas de Greg Fritz, PT, DPT, RMSK post\u00e9 sur Clarius Cases @clariusmhealth<\/a> https:\/\/t.co\/916p8SPMjO #UltrasoundAnywhere<\/a><\/p>– Greg Fritz, PT, DPT, RMSK (@gregfritzpt) 30 novembre 2018<\/a><\/blockquote> \n","protected":false},"excerpt":{"rendered":"
La semaine derni\u00e8re, nous avons pr\u00e9sent\u00e9 le mode d’imagerie \u00e9lastographique disponible sur notre plateforme Clarius Ultrasound. Greg Fritz PT, DPT, RMSK, physioth\u00e9rapeute dans l’\u00c9tat de Washington, a test\u00e9 l’\u00e9lastographie avec son scanner Clarius dans son petit cabinet. Voici un compte-rendu d\u00e9taill\u00e9 de son exp\u00e9rience avec cette fonctionnalit\u00e9 avanc\u00e9e de Clarius. Les physioth\u00e9rapeutes, qui identifient de…<\/p>\n","protected":false},"author":4,"featured_media":30956,"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":[1031,929,990],"tags":[],"specialities":[66],"class_list":["post-153030","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-commentaires","category-education","category-perspectives","specialities-msk"],"acf":[],"yoast_head":"\n
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