Review of Ultrasound-guided Labeling: Exploring Its Potential in Teaching Cadaveric Ligaments During Anatomical Dissection Courses

Overview

Journal Int J Med Educ

Specialty Medical Education

Date 2024 Feb 3

PMID 38308861

Authors

Felix Margenfeld

Adib Zendehdel

Giorgio Tamborrini

Amelie Poilliot

Magdalena Muller-Gerbl

Affiliations

Soon will be listed here.

Abstract

Objectives: This scoping review aimed to give an overview of the existing literature about ultrasound-guided labeling techniques of human cadaver ligaments and tried to work out the possibilities of integrating ultrasound into dissection courses.

Methods: A literature review was carried out on the 3rd of January 2023, with relevant studies discovered in the following databases: MEDLINE, EMBASE, CENTRAL, BIOSIS Previews and Web of Science Core Collection. Grey literature was also considered. The reference lists of all relevant papers were scanned. Only ultrasound studies on human cadaver ligaments were included. The included studies' general characteristics and ultrasound-guided approaches to label the ligaments were taken from them and examined.

Results: The search found 8899 matches, but only 96 of them met the criteria. The transverse carpal ligament (15.62%) and the annular pulleys (19.79%) were the ligaments that had received the greatest research attention. Twenty-three studies are included in the methodological analysis. Both the marking substrate and the injected volume were diverse. Although 65% of the included studies achieved 100% accuracy using the ultrasound directed labeling approaches.

Conclusions: Ultrasound-guided labeling techniques achieve a high accuracy. Therefore, this methodology could be a potential teaching tool for students during the dissection course. But caution is advised in drawing general conclusions because of the small sample sizes and different methodologies in the studies. Future larger-scale research is necessary.

References

Petrover D, Richette P . Treatment of carpal tunnel syndrome : from ultrasonography to ultrasound guided carpal tunnel release. Joint Bone Spine. 2017; 85(5):545-552. DOI: 10.1016/j.jbspin.2017.11.003. View

Delforge S, Lecoq B, Hulet C, Marcelli C . Coracoacromial ligament section under ultrasonographic control: a cadaveric study on 20 cases. Orthop Traumatol Surg Res. 2014; 100(2):e167-70. DOI: 10.1016/j.otsr.2013.09.018. View

Stecco C, Macchi V, Lancerotto L, Tiengo C, Porzionato A, De Caro R . Comparison of transverse carpal ligament and flexor retinaculum terminology for the wrist. J Hand Surg Am. 2010; 35(5):746-53. DOI: 10.1016/j.jhsa.2010.01.031. View

Vance M, Tucker J, Harness N . The association of hemoglobin A1c with the prevalence of stenosing flexor tenosynovitis. J Hand Surg Am. 2012; 37(9):1765-9. DOI: 10.1016/j.jhsa.2012.06.007. View

Frank C . Ligament structure, physiology and function. J Musculoskelet Neuronal Interact. 2004; 4(2):199-201. View

Pape J, Boudier-Reveret M, Brismee J, Gilbert K, Grabs D, Sobczak S . Accuracy of unguided and ultrasound guided Coracohumeral ligament infiltrations - a feasibility cadaveric case series. BMC Musculoskelet Disord. 2020; 21(1):136. PMC: 7049223. DOI: 10.1186/s12891-020-3153-4. View

OKeeffe G, Davy S, Barry D . Radiologist's views on anatomical knowledge amongst junior doctors and the teaching of anatomy in medical curricula. Ann Anat. 2019; 223:70-76. DOI: 10.1016/j.aanat.2019.01.011. View

Chang K, Wu W, Hsu P, Lew H, Ozcakar L . Clinical Tests of the Shoulder: Accuracy and Extension Using Dynamic Ultrasound. Am J Phys Med Rehabil. 2019; 99(2):161-169. DOI: 10.1097/PHM.0000000000001311. View

Bledsoe A, Zimmerman J . Ultrasound: The New Stethoscope (Point-of-Care Ultrasound). Anesthesiol Clin. 2021; 39(3):537-553. DOI: 10.1016/j.anclin.2021.03.011. View

10.

Sehmbi H, Johnson M, Dhir S . Ultrasound-guided subomohyoid suprascapular nerve block and phrenic nerve involvement: a cadaveric dye study. Reg Anesth Pain Med. 2019; 44(5):561-564. DOI: 10.1136/rapm-2018-100075. View

11.

Rajeswaran G, Lee J, Eckersley R, Katsarma E, Healy J . Ultrasound-guided percutaneous release of the annular pulley in trigger digit. Eur Radiol. 2009; 19(9):2232-7. DOI: 10.1007/s00330-009-1397-3. View

12.

Wahezi S, Yerra S, Rivelis Y, Sitapara K, Gonzalez D, Downie S . Sonographically Guided Percutaneous Sectioning of the Coracohumeral Ligament for the Treatment of Refractory Adhesive Capsulitis: Proof of Concept. Pain Med. 2020; 21(12):3314-3319. DOI: 10.1093/pm/pnaa262. View

13.

Chiavaras M, Harish S, Oomen G, Popowich T, Wainman B, Bain J . Sonography of the anterior oblique ligament of the trapeziometacarpal joint: a study of cadavers and asymptomatic volunteers. AJR Am J Roentgenol. 2010; 195(6):W428-34. DOI: 10.2214/AJR.10.4403. View

14.

Carline L, McLeod G, Lamb C . A cadaver study comparing spread of dye and nerve involvement after three different quadratus lumborum blocks. Br J Anaesth. 2016; 117(3):387-94. DOI: 10.1093/bja/aew224. View

15.

So S, Patel R, Orebaugh S . Ultrasound imaging in medical student education: Impact on learning anatomy and physical diagnosis. Anat Sci Educ. 2016; 10(2):176-189. DOI: 10.1002/ase.1630. View

16.

Leveritt S, McKnight G, Edwards K, Pratten M, Merrick D . What anatomy is clinically useful and when should we be teaching it?. Anat Sci Educ. 2016; 9(5):468-75. DOI: 10.1002/ase.1596. View

17.

Nasu H, Nimura A, Yamaguchi K, Akita K . Morphology of the anterolateral ligament: a complex of fibrous tissues spread to the anterolateral aspect of the knee joint. Anat Sci Int. 2020; 95(4):470-477. PMC: 7381439. DOI: 10.1007/s12565-020-00543-1. View

18.

Bramer W, Giustini D, de Jonge G, Holland L, Bekhuis T . De-duplication of database search results for systematic reviews in EndNote. J Med Libr Assoc. 2016; 104(3):240-3. PMC: 4915647. DOI: 10.3163/1536-5050.104.3.014. View

19.

Stamenov N, Yordanova P, Dimitrov D, Telbiyska M, Stefanov M . The Epiligament: Structure, Postnatal Development and Role in Ligament Healing. Cureus. 2019; 11(6):e4836. PMC: 6682335. DOI: 10.7759/cureus.4836. View

20.

Le Goff B, Berthelot J, Maugars Y . Ultrasound assessment of the posterior sacroiliac ligaments. Clin Exp Rheumatol. 2011; 29(6):1014-7. View