Ultrasound Findings of Young and Traumatic Amputees With Lower Extremity Residual Limb Pain in Turkey

Am J Phys Med Rehabil. 2017 Aug;96(8):572-577. doi: 10.1097/PHM.0000000000000687.

Abstract

Objective: The current study was designed to document clinical and ultrasound (US) findings of patients with residual limb pain (RLP) after amputation and to investigate the relationship between these findings.

Materials and methods: A chart review was performed to identify demographic and clinical data including the age (current and at the time of injury), time since amputation, gender, reason for amputation, affected limb number, side and level of limb loss, and ultrasonographic findings of young and traumatic amputees with RLP.

Results: The study included a total of 147 patients. Inflammation and neuroma were the leading pathologies in 20-29 years and 30-39 years age groups, respectively. Inflammation/edema were detected significantly more in patients with <1 year since amputation (P = 0.001). Neuroma was found at a significantly high rate in patients at 1-5 years (P = 0.029) and infection/abscess was more common in patients at >5 years since amputation (P = 0.051). The percentage of neuromas in below-the-knee amputees was significantly higher than in non-below-the-knee amputees (45.8% vs. 28.6%). Neuroma formation was detected in 50% of the patients with land mine-related amputation and at 27% in patients with amputation secondary to other traumatic reasons. Regression analysis showed below-the-knee-level amputation to be an associated factor for US abnormality.

Conclusion: The leading US findings were inflammation/edema, neuroma, and infection/abscess in traumatic amputees with RLP. The US findings might be different in patients according to the time since amputation. Patient with land mine-related amputations may have different US findings.

MeSH terms

  • Adult
  • Amputation Stumps / diagnostic imaging*
  • Amputation Stumps / pathology
  • Amputation, Surgical / adverse effects*
  • Female
  • Humans
  • Lower Extremity / diagnostic imaging*
  • Lower Extremity / pathology
  • Lower Extremity / surgery
  • Male
  • Neuroma / diagnostic imaging
  • Neuroma / etiology
  • Neuroma / pathology
  • Phantom Limb / diagnostic imaging*
  • Phantom Limb / pathology
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / etiology
  • Postoperative Complications / pathology
  • Retrospective Studies
  • Turkey
  • Ultrasonography / methods
  • Young Adult