Genetic and electrodiagnostic testing have long been standard diagnostic testing methods for peripheral nerve lesions. Ultrasound examination can be considered as a complementary test and has the advantage of obtaining detailed morphological information about peripheral nerves. Morphological information such as peripheral nerve cross sectional area (CSA), which can be obtained using ultrasound, is useful in evaluating peripheral nerve lesions such as entrapment neuropathy and inflammatory polyneuropathy. In this paper, I would like to briefly introduce existing meta-analysis studies on the normal value of peripheral nerve CSA to provide information for standardization of nerve examination on ultrasound.

Extracorporeal shock wave therapy (ESWT) is a non-invasive treatment method that uses mechanical energy to help restore biological tissue. Recently, the treatment targets have expanded to include not only musculoskeletal injuries such as plantar fasciitis and lateral epicondylitis, which are typical treatment targets, but also peripheral nerve damage, diabetic foot ulcers, and osteoarthritis. However, the therapeutic effect of ESWT has not yet been proven even for lateral epicondylitis. The purpose of this article is to review recent literature on ESWT for lateral epicondylitis and to suggest more effective treatment options.

To perform effective nerve hydrodissection on the upper extremities, it is essential to first select the target site through subjective and objective examinations based on basic anatomical knowledge of the nerve pathways and sites prone to entrapment. In ultrasound scanning, if the proximal diameter of the nerve increases compared to the distal one or the cross-sectional area of the nerve fascicle within the main nerve increases, it may be confirmed as a lesion site. If necessary, symptoms can be induced directly through stimulation using a nerve stimulator under ultrasound guidance for selection. When approaching the nearby nerve that triggers symptoms, it is important to confirm sufficient separation of surrounding structures that compress and irritate the main nerve through pressure after positioning the needle bevel with a tangential approach to target nerve.

When treating rotator cuff disease, it is crucial to understand the natural course and classification of the condition. It is necessary to distinguish whether the injury is acute, chronic, or an acute on chronic tear. From an anatomical perspective, it’s also essential to check for full thickness or partial thickness tears, and to identify any accompanying issues such as muscular atrophy or fat infiltration. Although the size of the rupture may increase over time, it is inappropriate to determine the treatment method solely based on the size or extent of the lesion, as the degree of damage and symptoms often do not align. Some studies have shown that the outcomes of surgical repairs can be similar to those of conservative treatments. Both surgical and conservative treatments can be effective depending on the case. Therefore, a careful analysis of patients and their specific lesions is required to achieve more effective treatment outcomes. What is important is to establish evidence and guidelines to determine which therapeutic approaches would be more effective for each patient.

Shoulder pain is one of the common symptoms that pain physicians frequently encounter in outpatient settings. Historically, the diagnosis of shoulder pain relied on clinical presentation and physical examination. However, with the advancement of ultrasound technology, physicians can now better diagnose and treat shoulder pain. When administering injection therapy for shoulder pain, the target may vary depending on the structure causing the pain. Furthermore, even when injecting the same structure, different approaches can be employed based on the practitioner’s preference, patient’s anatomical variations, or capability of maintaining specific positions for intervention. This review describes various ultrasound-guided injection techniques used in the treatment of shoulder pain.

Objective: The nationwide rehabilitation at-home care pilot program aims to provide medical services such as education, counseling, and remote management to patients who require continuous medical management after surgery. This study aims to retrospectively analyze the medical records of patients who participated in the project after knee arthroplasty to investigate the effectiveness of rehabilitation education in home-based care. Method: Data for analysis were collected from the evaluation form which is completed by the physician immediately after surgery and outpatient follow-up. The collected data included the patient’s sex, age, pre-operative functional level, surgical site, and scores on the berg balance scale (BBS) and visual analogue scale (VAS) for evaluating pain. If patients were re-admitted to other medical institutions for rehabilitation, data on the duration of their stay were collected for further analysis. Results: A total of 234 patients were selected and their data were analyzed. The average change in the BBS (ΔBBS) between immediately after surgery and outpatient follow-up was 43.34 ± 5.51, while the average change in the VAS (ΔVAS) was −0.77 ± 2.27. A significant positive correlation (p=0.001) was found between pre-operative functional level and ΔBBS or ΔVAS. However, no significant correlation (p=0.554) was observed between the duration of stay in other medical institutions and ΔBBS or ΔVAS. Conclusion: The home care pilot program is effective in promoting functional recovery and pain relief after knee arthroplasty. It is expected that appropriate rehabilitation education, remote management, and follow-up observation for up to 6 months will sufficiently replace long-term inpatient treatment after knee arthroplasty.

Severe neck pain, worsened by head rotation, may signal atlantoaxial joint involvement, prompting differentiation between inflammatory and mechanical causes. This study challenges conventions by presenting three cases where inflammatory diseases, typically associated with extremities, affect the atlantoaxial joint. Cases involve a 64-year-old woman with crowned dens syndrome (CDS) due to calcium pyrophosphate crystals, a 69-year-old male with septic arthritis at the C1-2 level and an 82-year-old female with rheumatoid arthritis (RA). Despite shared severe neck pain, patients with CDS and septic arthritis show notable neck rotation limitations, while the RA patient experiences joint pain without such constraints. Diagnostic methods include cervical computed tomography (CT) for CDS, and various imaging and blood tests for septic arthritis, and American College of Rheumatology/European League Against Rheumatism criteria (ACR/EULAR) for RA. These cases highlight atypical inflammatory manifestations at the atlantoaxial joint, urging consideration in severe neck pain scenarios.