Description

Hand complaints are some of the most common issues patients present to musculoskeletal physicians. In particular; carpal tunnel syndrome, trigger fingers and de quervain's tenosynovitis can be debilitating to individuals. These conditions can interfere with activities of daily living, ability to work and overall quality of life. Traditionally, when these patients fail non-surgical treatment the next option is some form of an open procedure provided by hand surgeons. Though the majority of patients are relieved of their symptoms there is still portion of patients who either continue to have complaints, have complications and are afraid of the intervention completed because of the recovery time.

Recently, sports medicine physicians with expertise in ultrasound have been performing soft tissue releases to address these issues. The current literature has suggested that these approaches have resulted in minimal complications and quicker recovery time.

Beyond upper extremity issues; distal Achilles with increased bony prominence of the calcaneus (haglunds deformity) pathology has been a difficult issue to address non-surgically. From a surgical perspective when patients are symptomatic despite nonoperative management they can be offered an open (or mini open) procedure where the Achilles tendon is debrided with detachment/reattachment along with excision of the bony prominence. This procedure is useful to patients, however, there are inherent risks and a prolonged recovery course. Within the last decades there has been an increased use of percutaneous interventions to address tendon pathologies with promising outcomes. This success has lead to the utilization of a ultrasound guided percutaneous technique to address haglund's syndrome with reduced recovery time and decreased complication rate. These topics would be of great use to our membership as they encounter these conditions on a daily basis and likely already utilizing ultrasound perform interventions. Having an improved understanding of these pathologies and how to provide advanced services could improve patient outcomes and expand our skill set.

Learning Objectives

• Learning Objective 1: Demonstrate how to perform ultrasound guided percutaneous trigger finger and first dorsal compartment releases
• Learning Objective 2: Review the relevant anatomy for haglund's deformity and achilles tendinopathy
• Learning Objective 3: Review the ultrasound guided percutaneous haglund's resection technique

Sports Medicine

Faculty
Ricardo Colberg, MD: Disclosed no relevant financial relationships.
Walter Sussman, DO: Disclosed no relevant financial relationships.

AAPM&R Medical Education Committee
John C. Cianca, MD: Ownership or partnership with Musculoskeletal Ultrasound Consultants, LLC.
Karen P. Barr, MD: Disclosed no relevant financial relationships.
Rachel A. Brakke Holman, MD: Disclosed no relevant financial relationships.
Joseph E. Burris, MD: Serves on the Speakers Bureau for, and received clinical research grants from Allergan.
David S. Cheng, MD: Disclosed no relevant financial relationships.
Theresa A. Gillis, MD: Disclosed no relevant financial relationships.
Kevin N. Hakimi, MD: Disclosed no relevant financial relationships.
Matthew T. Haas, MD: Disclosed no relevant financial relationships.
R.Samuel Mayer, MD: Royalties from Demos Medical Publishing.
Ameet S. Nagpal, MD MS MEd: Disclosed no relevant financial relationships.
Sunil Sabharwal, MD: Royalities from Demos Publishing; board member, American Board of Physical Medicine and Rehabilitation.
Sarah M. Smith, MD: Disclosed no relevant financial relationships.
Stephanie Tow, MD: Disclosed no relevant financial relationships.
Kevin R. VIncent, MD, PhD: Disclosed no relevant financial relationships.

AAPM&R CME Committee
Karen P. Barr, MD: Disclosed no relevant financial relationships.
Cherry C. Junn, MD: Disclosed no relevant financial relationships.
Sheryl R. Levin, MD: Disclosed no relevant financial relationships.
Kentaro Onishi, DO: Disclosed no relevant financial relationships.
Evan R. Peck, MD: Disclosed no relevant financial relationships.
Cynthia G. Pineda, MD: Disclosed no relevant financial relationships.
Patricia T. Tan, MD: Disclosed no relevant financial relationships.
Brionn K. Tonkin, MD: Disclosed no relevant financial relationships.
Kristin A. Wong, MD: Disclosed no relevant financial relationships.

No other planners, faculty or other individuals in control of content disclosed any relevant financial relationships.

FDA Disclosures
All faculty members for this activity have disclosed they do not intend to discuss or demonstrate any pharmaceutical or medical device for which FDA clearance has not been approved.