Abstract:
Background The elbow joint is essential in the human body, composed of the distal end of the humerus and the proximal end of the radius and ulna. The anatomy of this joint is complex, and it is prone to soft tissue injuries due to trauma. Children are a high-risk group for soft tissue injuries of the elbow joint. Due to their young age, immature physical development, and tendency to play and engage in activities such as climbing and running, children are more likely to experience soft tissue injuries of the elbow joint. Additionally, because children cannot clearly express their feelings of illness due to age, diagnosing these injuries can be more complex, and medical imaging techniques are often needed for accurate diagnosis. CT and MRI scans are commonly used for soft tissue injuries of the elbow joint, but CT scans have high radiation doses, and MRI scans have long scan times and high costs, so they are generally not used as routine screening methods. In recent years, with the continuous development of ultrasound imaging technology, musculoskeletal ultrasound has gradually been applied in diagnosing and treating various joint fractures and soft tissue injuries due to its convenience, precise imaging, and lack of radiation. Objective To investigate the application value of musculoskeletal high-frequency ultrasound in diagnosing elbow joint soft tissue injury.
Methods One hundred twenty patients with elbow joint trauma admitted to our hospital from January 2020 to January 2022 were selected as the research objects. All patients underwent musculoskeletal ultrasound exploration of the elbow joint. The detection of soft tissue injury of the elbow joint by musculoskeletal ultrasound was analyzed. MRI, ultrasound follow-up, remission of clinical symptoms, and surgical results were used as the gold diagnostic criteria. The sensitivity, specificity, and accuracy of musculoskeletal ultrasonography in diagnosing elbow joint soft tissue injury were calculated, and the Kappa test was used to analyze the consistency between musculoskeletal ultrasonography diagnosis results and gold standard examination results. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficacy of musculoskeletal ultrasound in elbow soft tissue injury.
Results Among the 120 patients, 110 (91.67%) were found to have soft tissue injuries of the elbow by gold standard examination, and 169 soft tissue injuries of the elbow were diagnosed. Tendon injury [30.77% (52/169) ], ligament injury [26.04% (44/169) ], and epiphyseal cartilage injury [18.34% (31/169) ] were the most common types of soft tissue injury of the elbow joint. Among the types of elbow soft tissue injury in different age groups (3-14 years old, >14 years old), epiphysis cartilage injury was mainly seen in children aged 3-14. The incidence of epiphysis cartilage injury was 37.50% (27/72) in children aged 3-14 years old and 8.33% (4/48) in children aged >14 years old. The difference was statistically significant (x2=12.787, P<0.05). The other types of soft tissue injury were distributed in both age groups, with no statistical significance (P>0.05). The sensitivity, specificity, and accuracy of musculoskeletal ultrasonography in the diagnosis of soft tissue injury of the elbow joint were 91.12% (154/169), 90.00% (9/10), and 91.06% (163/179). Kappa test results showed that the musculoskeletal ultrasound diagnosis of soft tissue injury around the elbow joint was in good agreement with the results of the gold standard examination (Kappa value =0.489). ROC curve analysis showed that the corresponding AUC was 0.906, indicating that musculoskeletal ultrasound has a high diagnostic value for soft tissue injuries around the elbow joint.
Conclusion Musculoskeletal ultrasound diagnosis of elbow joint soft tissue injury has high sensitivity, specificity, and accuracy can effectively reduce the occurrence of missed diagnosis and misdiagnosis, and can better meet the needs of clinical diagnosis.
Key words:
Musculoskeletal high-frequency ultrasound,
Elbow joint,
Occult fracture,
Soft tissue injury,
Diagnostic value
Liqing Liu, Fei Yang, Xinming Lu, Ziyu Zhao. Application value of musculoskeletal high-frequency ultrasound in the diagnosis of elbow joint soft tissue injury[J]. Chinese Journal of Shoulder and Elbow(Electronic Edition), 2023, 11(01): 24-29.