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Biomedical subjects

Michael S Cartwright

Publications and source records attributed to Michael S Cartwright.

10 recordsLinked to original sources
PubMed2006

Ultrasound in the diagnosis of ulnar neuropathy at the cubital tunnel.

PURPOSE: Ulnar neuropathy at the cubital tunnel (UCT) is diagnosed on the basis of history, physical examination, and nerve conduction studies (NCSs); however, the wide spectrum of findings often makes the diagnosis difficult. The purpose of this study was to document the ultrasonographic differences in ulnar nerve size between patients with UCT and control subjects, and to correlate those differences with clinical examination findings and NCS abnormalities, thereby testing the validity of ultrasound (US) as an additional adjunct diagnostic modality for UCT. METHODS: Fifteen elbows in 14 patients with symptoms, clinical examination, and NCS findings consistent with UCT had US of the ulnar nerve. Patients were excluded if they had a history of polyneuropathy, acute trauma involving the upper extremity, previous trauma in the region of the elbow (including previous surgery), or brachial plexus injury. The control group consisted of 60 elbows from 30 normal volunteers that also had US. Maximal cross-sectional areas (CSAs) were measured and compared for the 2 groups and a correlation analysis was performed between nerve size and NCS findings. RESULTS: The average CSA of the ulnar nerve was 0.065 cm(2) in the control group, whereas in the UCT group it was 0.19 cm(2), indicating a significant statistical difference in ulnar nerve size between the 2 groups. The Pearson correlation coefficient between motor nerve conduction velocity of the ulnar nerve and the CSA was 0.80. CONCLUSIONS: High-resolution US is a noninvasive, safe, and reliable modality for imaging the ulnar nerve at the elbow and it may provide a valuable adjunct to NCS in the diagnosis of UCT.

Adolescent↗
PubMed2004

Ultrasound of nerve and muscle.

Over the last two decades, ultrasound has developed into a useful technology for the evaluation of diseases of nerve and muscle. Since it is currently not used at by the majority of clinicians involved in diagnosis or care of patients with neuromuscular disorders, this review briefly describes the technical aspects of ultrasound and its physical principles. It relates normal muscle anatomy and movement to ultrasound images in the axial and sagittal planes and follows with a discussion of ultrasound findings in chronic muscle disease. These include evident atrophy and the loss of the hypoechoic architecture of normal muscle tissue. It highlights evolving uses of the technique to measure other pathologic changes in disease including altered muscle dynamics. With high-resolution instruments nerve imaging has now become standard, and the relationships of median nerve anatomy and observations of static and dynamic images from ultrasound are reviewed. Changes seen in carpal tunnel syndrome include significant increases in the cross-sectional area of the nerve just proximal to the site of compression, loss of hyperechoic intensities within nerve, and reduced mobility. Preliminary use of the technique for the study of other nerves is reviewed as well. Ultrasound is an ideal tool for the clinical and research investigation of normal and diseased nerve and muscle complementary to existing diagnostic techniques. As the technology continues to evolve, it will likely assume a more significant role in these areas as those most able to exploit its potential, clinical neurophysiologists and neuromuscular clinicians, incorporate its use at the bedside.

Carpal Tunnel Syndrome↗
PubMed2003

The clinical features of 16 cases of stroke associated with administration of IVIg.

This report characterizes the clinical features of 16 cases of stroke associated with IV immunoglobulin infusions. Fourteen of the strokes occurred within 24 hours of an infusion and 50% of the patients were receiving IV immunoglobulin for the first time. Nine patients had multifocal infarctions. All but one of the patients had stroke risk factors.

Adult↗
PubMedDate not supplied

The use of diagnostic ultrasound in carpal tunnel syndrome.

PURPOSE: Traditional evaluation of suspected carpal tunnel syndrome (CTS) involves a thorough history, physical examination, and nerve conduction velocity studies (NCS). Ultrasound is used widely in Europe and has gained acceptance in the United States in the diagnosis of various musculoskeletal disorders. The purpose of this study was to document the ultrasonographic measurement difference in median nerve size between patients with CTS and controls and to correlate these findings with NCS findings, thereby allowing us to test the validity of ultrasound as a diagnostic modality for CTS. METHODS: Forty-four wrists in 26 CTS patients and 86 wrists in 43 asymptomatic volunteers were imaged using a real-time ultrasound scanner with a 12/5 MHz linear-array transducer. The cross-sectional area of the median nerve was measured at the level of the distal wrist crease in both CTS patients and controls. All CTS patients had NCS. The ultrasonographic median nerve area was compared for the 2 groups and correlation analysis between ultrasonographic nerve sizes and NCS findings was performed. RESULTS: The average cross-sectional area of the median nerve at the distal wrist crease was 9 mm(2) in asymptomatic volunteers and 14 mm(2) in CTS patients. For the CTS patients the Pearson correlation coefficient between ultrasound nerve measurement and NCS values was 0.37, suggesting that higher values of ultrasound measurements are associated with abnormal NCS findings. CONCLUSIONS: Our results indicate that high-resolution ultrasound is informative in the evaluation of CTS and shows enlargement of the median nerve at the distal wrist crease in symptomatic patients. Therefore it is a reliable modality for imaging the wrist in patients with CTS. In addition ultrasound is well tolerated and safe. TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic, Level I.

Adult↗