Ultrasound Imaging of the Superficial Fascia in the Upper Limb: Arm and Forearm

Carmelo Pirri, Nina Pirri, Diego Guidolin, Veronica Macchi, Raffaele De Caro, Carla Stecco, Carmelo Pirri, Nina Pirri, Diego Guidolin, Veronica Macchi, Raffaele De Caro, Carla Stecco

Abstract

The superficial fascia has received much attention in recent years due to its important role of compartmentalizing the subcutaneous tissue. Ultrasound (US) imaging, owing to its high definition, provides the possibility of better visualizing and measuring its thickness. The aim of this study was to measure and compare, with US imaging, the thickness of superficial fascia in the arm and forearm in different regions/levels. An observational study has been performed using US imaging to measure superficial fascia thickness in the anterior and posterior regions at different levels in a sample of 30 healthy volunteers. The results for superficial fascia thickness revealed statistically significant differences (p < 0.0001) in the arm between the anterior and posterior regions; in terms of forearm, some statistically significant differences were found between regions/levels. However, in the posterior region/levels of the arm, the superficial fascia was thicker (0.53 ± 0.10 mm) than in the forearm (0.41 ± 0.10 mm); regarding the anterior regions/levels, the superficial fascia of the arm (0.40 ± 0.10 mm) was not statistically different than the forearm (0.40 ± 0.12 mm). In addition, the intra-rater reliability was good (ICC2,k: 0.88). US helps to visualize and assess the superficial fascia inside the subcutaneous tissue, improving the diagnosis of fascial dysfunction, and one of the Us parameters to reliably assess is the thickness in different regions and levels.

Keywords: reliability; subcutaneous tissue; superficial fascia; thickness; ultrasonography.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The probe position during the ultrasound (US) imaging assessment of the superficial fascia. (A): the anterior region of the forearm (Ant 1); (B) for adequate scans and to reduce surface pressure on the skin, the ultra-sonographer used suitable amounts of gel (*), and the US beam was kept perpendicular to the fascial layers.
Figure 2
Figure 2
Ultrasound (US) images of the superficial fascia of: the anterior region of the arm (A) and of the forearm (C); the posterior region of the arm (B) and of the forearm (D). Anterior regions (A,C) at levels Ant 1 (a,e) and Ant 2 (b,f). Posterior regions (B,D) at levels Post 1 (c,g) and Post 2 (d,h). Probe: black rectangle; Red dashes: superficial fascia.
Figure 3
Figure 3
Ultrasound thickness measurements of the superficial fascia of the arm.
Figure 4
Figure 4
Ultrasound thickness measurements of the superficial fascia of the forearm.
Figure 5
Figure 5
Ultrasound thickness measurements of the superficial fascia of the arm and forearm at different regions/levels.

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