DYNAMIC ULTRASOUND - AN EFFICIENT EVALUATION TECHNIQUE 

Dr. Bureau concentrated her study on the use of dynamic ultrasound in the evaluation of acromiohumeral syndrome. This technique held the promise of making it possible to observe a larger range of anomalies associated with this disorder as well as helping to diagnose the syndrome at an earlier stage. The goal of the study was to compare dynamic ultrasound to other, more generally used techniques, in particular magnetic resonance imaging (MRI). Ultrasound does not rely on radiation and does not lead to harmful side effects. It also makes it possible to observe structures during active shoulder motion, in contrast with MRI, which can only produce a static image.

“Most people think that ultrasound is used primarily to study the foetus. However, it also has many other clinical applications,” notes Dr. Bureau. The results of the study on 13 patients were conclusive. Not only does dynamic ultrasound provide direct observation of the various joint structures in motion, it also provides important information about the possible intrinsic and extrinsic causes of this syndrome, which facilitates a more accurate diagnosis. Ultimately, dynamic ultrasound may serve as a valuable tool for the development of more appropriate and more effective treatment strategies.

TOWARDS BETTER PREDICTION

Dr. Bureau is currently collaborating with the CRCHUM’s Imaging and Orthopaedics Laboratory (LIO), in particular with Nicola Hagemeister and Jacques de Guise of the CRCHUM and the Ecole de technologie supérieure, and their team of biomedical engineers, as well as with other orthopaedists and a physiatrist (Drs Patrice Tétreault, Dominique Rouleau, and André Roy). They are working on the development of reliable radiological indicators to better predict the risk for developing chronic shoulder disability among workers. The goal of this multidisciplinary team is to identify the cause of loss of shoulder function and eventually to be able to predict the outcome of a given treatment strategy. Some patients have torn shoulder tendons but still retain good upper-arm movements, whereas others, with less serious lesions, experience greater limitations. “We are looking to identify ways of distinguishing patients in this regard so we can gain a better understanding of the pathology,” notes Dr. Bureau. The information obtained will not only improve injury assessment and patient treatment in hospitals and in outside clinics, but will also help in optimizing rehabilitation strategies.

BENCH TO BEDSIDE

In addition to advancing patient care, the current project exemplifies the importance of creating closer ties between clinical researchers, physicians and basic researchers. “It is a unique collaborative effort between basic researchers and clinicians, one that is generating extremely interesting work and that broadens clinical research in a very positive way. This type of research model should be encouraged,” notes Dr. Bureau.