Ultrasound Panic Findings in the Urological Region

Little is known regarding the association between ultrasonographic (US) findings and biomarkers of bone and cartilage in individuals with knee osteoarthritis (OA). We investigated (1) US findings in early-stage knee OA and (2) the association between US findings and bone/cartilage biomarkers. A population cohort aged 35-55 years (n = 106) with early-stage knee OA was investigated. US examination was performed according to European League against Rheumatism (EULAR) guidelines using a 7.5-MHz probe. Biomarkers of bone resorption (CTx-I) and formation (PINP), cartilage resorption (U-CTx-II) and synthesis (S-PIIANP), and general bone and cartilage biomarkers (OC, COMP) were assessed. The most prevalent US findings were tendon calcification, synovial thickening, and suprapatellar effusion. In women, the presence of tendon calcification and Baker's cysts could predict 36% of the variability in U-CTx-II levels. The presence of osteophytes and tendon calcification predicted up to 38% of the variability of PIIANP concentration. Defects in subchondral bone, meniscal changes, and effusion predicted up to 29% of the variability in COMP levels. Tendon calcification was related to cartilage synthesis (based on PIIANP levels) in men and to cartilage degradation (based on U-CTx-II concentrations) in women. US signs of synovitis were reflected metabolically by markers of joint tissue metabolism. Tendon calcification, synovial thickening, and effusion were common US findings in early-stage knee OA. US-detectable findings were substantially responsible for the variability in bone and cartilage biomarkers, associations reflective of the active metabolism of soft tissues in early-stage OA.

BackgroundGiven the importance of diagnosing intra-abdominal injury (IAI) in children with blunt abdominal trauma (BAT) and preventing radiation exposure to children by avoiding CT scans, this study aimed to evaluate a scoring criterion based on ultrasound (US) findings and laboratory data in assessing the clinical risk of IAI in children with BAT.Materials and methodsIn this retrospective study, baseline and clinical information of 180 children (under 18 years of age) with BAT including physical examination, hemodynamic parameters, and laboratory data, were extracted from medical records. US findings were considered abnormal if any report of mild free fluid or solid organ injury was noted. The presence or absence of IAI was assessed through medical records or telephone interviews to inquire about the patients’ outcome within the two-week period post-discharge. The primary outcome was the identification of IAI, assessed through a combination of US findings, physical examination (abdominal tenderness), and laboratory parameters (WBC count and hematuria). The measurement methods included Chi-squared tests, Fisher’s exact test, independent samples t-test, logistic regression, and ROC analysis.ResultsThe current study showed that 153 (85%) and 27 (15%) patients were without and with IAI, respectively. The positive US finding with sensitivity and specificity of 92.59% and 44.44%, respectively, abdominal tenderness with sensitivity and specificity of 81.48% and 87.58%, respectively, hematuria with sensitivity and specificity of 62.96% and 50.33%, respectively, and high WBC level with sensitivity and specificity of 85.19% and 76.47%, had a significant diagnostic value in detecting the presence of IAI (P value < 0.001). A cutoff point ≥ 2 from the sum of the scores of these four criteria can predict the presence of IAI with a sensitivity of 81.48% and a specificity of 94.12% (AUC = 0.94; P value < 0.001).ConclusionThis study shows that a scoring system based on positive US findings, abdominal tenderness, hematuria, and high WBC levels effectively diagnoses IAI in BAT children. A score of 2 or more strongly indicates the presence of IAI, improving decision-making for further imaging and treatment. Implementing this system can reduce unnecessary CT scans and radiation exposure, enhancing pediatric trauma care.

Comparison of the diagnostic performances of ultrasonography, CT and fine needle aspiration cytology for the prediction of lymph node metastasis in patients with lymph node dissection of papillary thyroid carcinoma: A retrospective cohort study

HRQL and severity of brain ultrasound findings in a cohort of adolescents who were born preterm.

PurposeThe study aimed to investigate the utility of ultrasonographic (US) findings in predicting the subsequent radiographic parameters of developmental dysplasia of the hips.MethodsIn this 12-year retrospective cohort study, all new-born infants with a positive clinical examination or risk factors were included. They were scheduled for hip ultrasonography in the first 3 months, and subsequent radiographs at 1 year of life. The US images were evaluated using the Graf classification, Harcke’s dynamic screening method, and Terjesen’s femoral head coverage method. The radiographic images were evaluated using the acetabular index and femoral head position. The overall US or radiographic findings were considered abnormal if they were classified as abnormal for any of their respective parameters. The overall US and radiographic parameters were correlated.ResultsA total of 160 patients were included. The overall US and radiographic parameters showed no statistically significant difference (P=0.050). The sensitivity, specificity, and accuracy of the overall US parameters were 57.1%, 84.9%, and 81.3%, respectively. All three individual US parameters showed no statistically significant differences, with the overall radiographic findings and acetabular index (P>0.05). However, they showed a statistically significant difference, with the position of the femoral head (P<0.001), with the US parameters having an excellent negative predictive value of 100% for identifying an abnormal femoral head position.ConclusionThe current study suggests that US findings evaluated in the first 3 months of life showed no statistically significant difference with radiographic findings evaluated at 1 year of life. The US parameters showed an excellent negative predictive value for abnormal femoral head position on radiographs.

Importance of US Findings in Access Planning during Jugular Vein Hemodialysis Catheter Placements

The Beighton score (BS) is widely used to evaluate generalized joint laxity. However, the association between the BS and lateral ankle laxity is unclear. This study compared the ultrasonographic (US) findings of the anterior talofibular ligament (ATFL) between high- (≥6) and low- (≤3) BS groups of healthy young women. The ATFL lengths of healthy young women were measured in the stress and nonstress positions using the previously reported technique from March 2021 to January 2022. The ATFL ratio (ratio of stress to nonstress ATFL length) was used as an indicator of lateral ankle laxity. The anterior drawer test (ADT) was performed. The correlation between the BS and US findings was also examined. A total of 20 (high-BS group) and 61 (low-BS group) subjects with a mean age of 23.8 ± 1.0 years were included. The high-BS group showed a higher grade of ADT than the low-BS group. No significant differences were found in the nonstress and stress ATFL lengths and ATFL ratio (1.10 ± 0.05 vs. 1.09 ± 0.05, p = 0.19) between the groups. No correlation was found between the BS and US findings. In conclusion, this study did not detect significant differences in the US findings of the ATFL between the high- and low-BS groups.

Scrotal ultrasounds are utilised in some primary care settings for suspected cryptorchidism, despite inaccuracies. We aim to identify the correlation between ultrasound and primary care provider (PCP) findings of undescended testicles (UDTs) as a potential source of confirmation bias. Males referred for suspected UDT by PCPs who underwent scrotal ultrasound and paediatric urologist examination from 2014 to 2019 were included. Correlation between PCP and ultrasound findings and diagnostic accuracy were evaluated. Logistic regression was utilised to determine associations between patient factors and UDT misdiagnosis. Out of 145 testes, ultrasound corroborated PCPs' UDT diagnoses 87.6% of the time, 49.6% of which were confirmed as UDT by paediatric urologists. Ultrasound had a false positivity rate of 81.0% and specificity of 19.0%. Ultrasound versus paediatric urologist findings regarding testicle location were significantly different (P < 0.0001). Patients aged ≥8 years old had 5.2 times greater odds of being misdiagnosed with UDT than patients <8 years old (95% confidence interval: 1.6-16.7; P < 0.002) by PCP and ultrasound. Scrotal ultrasound highly corroborated PCPs' UDT diagnoses. Older patients were more likely to be misdiagnosed with UDT by PCP and ultrasound. As ultrasounds rarely refute PCP examinations for suspected UDTs and are highly inaccurate, confirmation bias may explain the use of ultrasound in the workup of UDT.

To evaluate the ultrasound abdomen findings in patients having viral chronic liver disease (CLD) and build correlation of these findings with the duration of disease. Cross-sectional analytical study. Department of Medicine, Liaquat University Hospital, Hyderabad and Jamshoro, Pakistan, from February to July 2016. Known cases of CLD were inducted. Data was collected using a standardized form which included details of patients, duration of disease and their ultrasound abdomen findings, like liver size, echo pattern and echogenicity, nodularity, intrahepatic vessel (IHV) obliteration, ascites and splenomegaly. Data were analyzed using SPSS version 16. The association of duration of the disease on ultrasound findings was studied by means of chi-square test. A total of 193 subjects (92 males, 101 females; age range 14-80 years) were taken. The average measured liver span was 13.99 ±3.14 cm, with most coarse echo pattern. About a quarter, i.e. 26.94% of the cases, had no complications; 17.62% only had ascites and 16.06% presented with IHV obliteration, and ascites with splenomegaly. The duration had no significant association with liver size, echo pattern and echogenicity, and nodularity of the liver (p-values of 0.182, 0.331 and 0.268), respectively or complications (p=0.164). The duration of CLD had no significant association with the ultrasound findings of liver.

Introduction: In an ectopic pregnancy, most patients present with 5 to 9 weeks of amenorrhea, mild pelvic pain and vaginal spotting which triggers the evaluation of ectopic pregnancy. The presence of an extrauterine gestational sac containing a yolk sac or embryo is the most specific sonographic finding whereas an echogenic tubal ring in the adnexa is the most common finding.1 This study aimed to find the accuracy of ultrasound findings versus clinical presentation, intraoperative findings and histological findings. Methods: This is a retrospective study. All patients with histopathological diagnoses of ectopic pregnancy were included in the study and data regarding clinical diagnosis, ultrasound diagnosis and intraoperative diagnosis were retrieved and compared with their histopathological diagnosis. Result: There were 216 cases of ectopic pregnancy with an overall incidence of ectopic pregnancy was 0.88%. The sensitivity with ultrasound diagnosis was 99.52% and specificity 11.11% with positive and negative predictive values were 96.2 % and 50 % respectively and overall diagnostic accuracy of 95.83%. The sensitivity was 97.6% and specificity was 11.1% for clinical diagnosis of ectopic pregnancy. The sensitivity was 100% for intraoperative diagnosis of ectopic pregnancy with a positive predictive value is 95.83%. Conclusion: Clinical diagnosis, intraoperative findings and ultrasound findings were highly sensitive to detecting ectopic pregnancy in the study population. The overall diagnostic accuracy was highest for the ultrasound finding.

BackgroundBreast cancer ranks globally as the most prevalent cause of female deaths. Papillary breast carcinoma (PBC), a rare subtype of breast cancer, presents distinct challenges in diagnosis and management because of its unique histopathological features.ObjectivesThis study aims to determine the prevalence and main imaging findings of PBC in women attending a tertiary breast imaging centre.MethodA retrospective review of mammography and ultrasound imaging findings of female patients with histologically proven PBC, referred to a tertiary breast imaging centre over a 5-year period, was conducted.ResultsThe study included 102 female patients with a mean age of 53.8. Mammography detected masses in 93.02%, with calcifications in 41.2% and abnormal borders in 56.8%. Architectural distortion and asymmetry occurred in 27.5% and 28.4% respectively, both showing moderate correlation with PBC (r = 0.50, p = 0.009; r = 0.51, p = 0.0057). Ultrasound findings indicated irregular mass shapes (mean = 1.53), with hypoechoic patterns significantly associated with PBC (r = 0.40, p = 0.0013). Correlation analysis revealed strong associations between PBC and breast pain (r = 0.74, p < 0.0001), and erythema (r = 0.62, p < 0.0001). There was no significant association between the mammography and ultrasound findings (p = 0.495).ConclusionThe findings underscore the value of using mammography and ultrasound in the diagnosis of PBC, as the two modalities offer complementary information.ContributionThere is a paucity of data on the radiological findings of PBC in Africa. The current study prevalence mirrors global trends, highlighting the importance of ongoing surveillance and diagnostic accuracy.

Introduction British Hernia Society (BHS) 2013 guidelines1 suggest that groin hernia diagnostic investigation should not be done at the primary care level. Nevertheless, General Practitioners refer patients with a positive ultrasound finding of groin hernia to secondary care. As a result, patients have false hopes that their symptoms would resolve if the ultrasound finding is addressed. The study aims to find the positive predictive value (PPV) for groin ultrasound for hernia and should the primary care physicians request the scan before referral to secondary care. Method A retrospective audit of outcome of patients referred to a general surgical department for groin hernia treatment. The study looked at elective groin hernia referrals for the period between June and August 2019. Results 127 patients were electively treated for groin hernia in secondary care. 40% of the patients had ultrasounds before treatment. The GP requested 78% of the ultrasounds. A positive finding was the reason for the referral. Two patients (5%) in this group had negative operative findings. 24 herniograms over 57 months for patients referred with positive ultrasound and negative clinical findings showed only 2 had positive findings (8%). None of the negative patients returned to the same hospital for groin hernia treatment until date. Conclusions It is recommended that the diagnostic tests for groin hernia be requested by the operating surgeon as per the BHS guidelines. Patients should not be subjected to hernia operations based on ultrasound findings as the PPV for this investigation is very low for patients who have negative clinical findings.2

Utility of combined gray-scale and perflubutane contrast-enhanced ultrasound for diagnosing early hepatocellular carcinomas: Comparison of well differentiated and distinctly nodular types.

The purpose of this study is to describe the ultrasonographic (US), computed tomographic (CT), and magnetic resonance imaging (MRI) findings in fascioliasis and to emphasize the impact of radiology in diagnosis. Radiologic findings in 23 consecutive patients with fascioliasis were prospectively recorded. All patients had at least one US and CT examination, and 10 of them were studied by MRI. All diagnoses were confirmed by serologic methods. In the first three cases, initial diagnosis was reached by microscopic demonstration of the parasites' eggs in bile obtained by US-guided gallbladder aspiration. In the hepatic phase of fascioliasis, multiple, confluent, linear, tractlike, hypodense, nonenhancing hepatic lesions were detected by CT. On US, the parasites could be clearly identified in the gallbladder or common bile duct as floating and nonshadowing echogenic particles. MRI showed the lesions as hypo- or isointense on T1-weighted images and as hyperintense on T2-weighted images. CT findings in the hepatic phase and US findings in the biliary phase are characteristic of fascioliasis. Because clinical and laboratory findings of fascioliasis may easily be confused with several diseases, radiologists should be familiar with the specific radiologic findings of the disease to shorten the usual long-lasting diagnostic process.

PurposeThe purpose of this article is to provide a practical review of common ultrasound (US) findings in patients presenting with acute scrotal pain.MethodsWe performed a literature search and reviewed numerous US cases archived in the radiology department of a large university hospital to find examples that illustrate the common US findings encountered in acute scrotal pain.ResultsWe reviewed the literature and provided several practical examples of common US findings in patients presenting with acute scrotal pain.ConclusionScrotal US plays a pivotal role in the evaluation of acute scrotal pain and allows proper triage of patients for conservative, medical, or surgical management due to its ability to rapidly differentiate intra versus extratesticular pathology, determine extent of trauma, and assess parenchymal perfusion.