Australasian Journal of Ultrasound in Medicine最新文献

{"title":"Changes in Intrauterine Device Position From Initial Insertion to Check Up","authors":"Grace Swain, Karen Mizia, Elizabeth Luxford","doi":"10.1002/ajum.70035","DOIUrl":"10.1002/ajum.70035","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There is some evidence of intrauterine contraceptive devices (IUDs) migrating after insertion; however, these studies had small sample sizes and have not been performed with an Australian population. Furthermore, current guidelines for IUDs provide ambiguous recommendations for post-procedure check-ups 5–8 weeks after insertion. In some cases, it is unclear if a pelvic ultrasound should be used to ascertain IUD position. The clinical usefulness of ultrasound as the primary post-procedure investigation has not been fully elucidated, nor has the migration and position change in an Australian population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the migration or change in position of IUDs in an Australian population, and the clinical usefulness of a post-procedure check with an ultrasound following insertion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study over 3 years across eight Sydney sites by multiple practitioners.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>645 cases were referred for insertion or IUD exchange under ultrasound. In 5% of cases the device was sub-optimally positioned at the time of insertion. On post-procedure follow-up, of the IUDs in the optimal position, 98.5% remained unchanged. 1.3% changed to a suboptimal position, but of these 75% had an underlying uterine anomaly. Of the devices that were sub-optimally positioned at time of insertion, 84% migrated to the optimal fundal position; those unchanged from suboptimal (16%) had anomalies or other causes identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Once an IUD is inserted into an appropriate position in the fundus, it is extremely unlikely to change position unless the patient has an underlying structural anomaly or a previous hysterotomy. Fundal positioning at the initial insertion was 95%, which on post-procedure check-up improved to 98.7% of cases. Reassuringly, of the IUDs which were sub-optimally positioned, 84% improved their position to an appropriate location 5–8 weeks later. This also suggests migration of devices into an optimal position. With this evidence that most IUDs will migrate to a more appropriate position, we suggest all guidelines remove the 4–8 week check, and that to perform an ultrasound only if symptomatic or if unable to palpate the IUD strings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Impact Statement</h3>\u0000 \u0000 <p>This study evaluates the migration or change in position of intrauterine contraceptio","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Accuracy of Ultrasound-Generated Inferior Vena Cava Collapsibility Index in the Prediction of Post-Induction Hypotension During General Anaesthesia: A Systematic Review and Meta-Analysis","authors":"Mitchell Kitchin Gordon,&nbsp;Aharon Golod,&nbsp;Renee Rostolis,&nbsp;Tim Outhred,&nbsp; Rebecca Caragata,&nbsp;Raymond Hu","doi":"10.1002/ajum.70033","DOIUrl":"10.1002/ajum.70033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Post-induction hypotension (PIH) is a common complication following anaesthetic induction and is associated with adverse perioperative outcomes. Ultrasound-generated inferior vena cava collapsibility index (IVC-CI) is a non-invasive measure of volume status that may predict PIH. This systematic review and meta-analysis evaluated the diagnostic accuracy of IVC-CI in predicting PIH in adult, non-obstetric patients undergoing general anaesthesia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of PubMed, Embase, and Cochrane Library (up to June 2024) identified studies reporting IVC-CI as a predictor of PIH. Prospective and retrospective observational studies were included, while studies involving paediatric, obstetric, or hypotensive patients pre-induction were excluded. The QUADAS-2 tool assessed risk of bias and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework was utilised to assess certainty of evidence. Pooled diagnostic performance was measured via area under the receiver operating characteristic curve (AUROC). Meta-regression explored heterogeneity across studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-three studies (<i>n</i> = 1973) were included, with 16 studies (<i>n</i> = 1585) providing AUROC data. The pooled AUROC for IVC-CI in predicting PIH was 0.72 (95% CI, 0.64–0.80), indicating moderate diagnostic accuracy. High heterogeneity was observed (<i>I</i>² = 94.4%). Meta-regression showed no significant associations between AUROC and age, sex, American Society of Anesthesiologists status, or induction agents. Publication bias was identified (Egger's test, <i>p</i> &lt; 0.001). The quality of evidence, as evaluated using the GRADE approach, was ‘very low’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>IVC-CI shows potential as a predictive tool for PIH; however, significant heterogeneity, inconsistent protocols, and publication bias limit its robustness. Standardised measurement methods and larger studies are needed to confirm its clinical utility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Ultrasound-generated IVC-CI demonstrates moderate accuracy in predicting PIH and may assist in guiding pre-induction management strategies, such as fluid administration or vasopressor use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Ultrasound Training: A Scoping Review of Educational Interventions and Outcomes","authors":"Patrick Lavoie,&nbsp;Maude Crétaz,&nbsp;Élisabeth Quesnel,&nbsp;Jessica Van Tassel,&nbsp;Claudie Roussy,&nbsp;Christina Dagher,&nbsp;André Denault,&nbsp;Tanya Mailhot","doi":"10.1002/ajum.70031","DOIUrl":"10.1002/ajum.70031","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lung ultrasound (LUS) is increasingly recognised as an essential diagnostic and monitoring tool in acute and critical care. As its use grows, understanding how LUS education is designed, delivered, and evaluated for practicing healthcare professionals has become essential.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To map the evidence on educational interventions for LUS training, focusing on study characteristics, instructional strategies, and learning outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This scoping review followed the Joanna Briggs Institute methodology and PRISMA-ScR reporting guidelines. It identified and charted studies on LUS training for practicing healthcare professionals. Data extraction covered study characteristics, learner profiles, instructional strategies, instructor credentials, training duration and setting, and learning outcomes, categorised using the New World Kirkpatrick Model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty eight studies involving physicians, paramedics, respiratory therapists, physiotherapists, and nurses met inclusion criteria. Most interventions combined didactic teaching with hands-on practice, including supervised scanning and simulation. Training was typically brief (median duration = 3.5 h). Outcomes focused mainly on learning (Level 2: 86.8%) and less often on behaviour (Level 3: 47.4%). Considerable variation in educational designs and outcome measures limited cross-study comparisons, and few studies assessed long-term retention or clinical impact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Current LUS training uses multimodal approaches that integrate theory with supervised practice. However, programs and assessments remain heterogeneous and rarely theory-informed. Future research should strengthen pedagogical foundations, align evaluation with competency frameworks, and examine learning sustainability, interprofessional training, and patient-centred outcomes to support effective and scalable LUS education.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12771659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurement of Supraspinatus Tear Size Using Previously Acquired Ultrasound Images Obtained by Multiple Examiners","authors":"Christopher M. Gibbs,&nbsp;Luke T. Mattar,&nbsp;Satoshi Takeuchi,&nbsp;Robert T. Tisherman,&nbsp;Adam J. Popchak,&nbsp;Andrew C. Cordle,&nbsp;James J. Irrgang,&nbsp;Volker Musahl,&nbsp;Richard E. Debski","doi":"10.1002/ajum.70029","DOIUrl":"10.1002/ajum.70029","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction/Purpose</h3>\u0000 \u0000 <p>One examiner might not be able to acquire and interpret every image when examining rotator cuff tears in large cohort studies due to logistical issues. The aim of this study was to determine the repeatability of supraspinatus tear size measurements performed by multiple observers using previously acquired ultrasound images by a separate set of examiners.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seventy-two ultrasound examinations of individuals with symptomatic isolated supraspinatus tears were performed by five ultrasound examiners. Fifteen examinations were randomly chosen to be evaluated by three observers with varying amounts of ultrasound experience using repeated measurements. The maximum anterior–posterior tear size using these previously acquired ultrasound examinations was assessed and the repeatability and minimal detectable change were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The intra-observer repeatability was improved with greater experience to 0.87 (95% confidence interval [CI] 0.72–0.95) but was 0.51 (95% CI 0.20–0.77) and 0.75 (95% CI 0.51–0.90) for observers with low experience. For all observers, the inter-observer repeatability was 0.32 (95% CI 0.00–0.65). For all observers, the minimal detectable change was 4.6 mm and was lower in observers with more experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Changes in supraspinatus tear size of 4.6 mm can be detected using previously acquired ultrasound images. This is comparable to ultrasound examinations performed and measured by the same individual as previously reported in the literature. Repeatability is poor among examiners with less experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Clinical studies that cannot utilise measurements by a single examiner can be performed within current thresholds for determining changes in tear size of the supraspinatus tendon.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145828766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paramedic Echocardiography in Pulseless Electrical Activity Cardiac Arrest: An Education and Simulation Study","authors":"Hannah E. Latta,&nbsp;Andrew H. Swain,&nbsp;Nick Garrett,&nbsp;Bronwyn Tunnage","doi":"10.1002/ajum.70032","DOIUrl":"10.1002/ajum.70032","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients presenting with pulseless electrical activity (PEA) in out-of-hospital cardiac arrest (OHCA) may receive inappropriate care if a manual pulse check is relied upon to determine pulselessness. This study aimed to investigate whether ultrasound-naïve paramedics could acquire an ultrasound image within a 10-s pause during a pulse check in a simulated cardiac arrest environment and interpret ultrasound-detectable pathology. Secondary aims focus on the quality of ultrasound image acquisition and the retention of learned knowledge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Thirty paramedics participated in three sequential phases. Phase I involved a self-directed e-learning program covering an overview of ultrasound applications, including cultural considerations for indigenous New Zealand Māori in cardiac arrest. Phase II included face-to-face education, simulation assessments, and a knowledge quiz. Phase III included simulation assessments and a knowledge quiz. Ultrasound images were scored against the cardiac ultrasound structural assessment score (CUSAS) for quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During simulated cardiac arrest scenarios, the mean time to acquire an ultrasound scan was 9.6 s (SD = 2.9, 95% CI [9.3, 10.0]). Forty-seven per cent of study scans were captured within the 10-s pulse check pause. Of the acquired images, 73% (95% CI [67.8, 79.4]) of scans scored a CUSAS of ≥ 3, demonstrating adequate image quality. Participants correctly interpreted 91% (95% CI [88.5, 94.5]) of 243 pathological scans during the simulations. In Phase II, 83 of 87 interpretations were correct (95%, 95% CI [91.0, 99.7]), while in Phase III, 140 of 156 interpretations were correct (90%, 95% CI [84.9, 94.4]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>During cardiac arrest simulations, paramedics on average took 9.6 s to acquire an ultrasound scan, with 47% of scans completed within the 10-s pulse-check pause.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Research Aims</h3>\u0000 \u0000 <p>To determine if paramedics can acquire an ultrasound image within the 10-s pulse check pause in simulated pulseless electrical activity (PEA) cardiac arrest. Secondary aims focus on the quality of ultrasound image acquisition, interpretation and retention of learned knowledge.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145828744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact Evaluation After Implementing a Co-Designed Point-Of-Care Ultrasound Program at a Veterans Affairs Emergency Department","authors":"Rebecca G. Theophanous,&nbsp;Catherine A. Staton,&nbsp;Anna Tupetz,&nbsp;Luna Ragsdale,&nbsp;Erica Peethumnongsin,&nbsp;Alexander Gordee,&nbsp;Maragatha Kuchibhatla,&nbsp;Stephanie A. Eucker","doi":"10.1002/ajum.70024","DOIUrl":"10.1002/ajum.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction/Purpose</h3>\u0000 \u0000 <p>Point-of-care ultrasound (POCUS) is an important diagnostic bedside tool, yet a gap remains between Emergency Department (ED) POCUS programme implementation and achieving sustained POCUS use and retention. We performed an impact evaluation of a co-designed POCUS programme implementation intervention and assessed programme acceptability, effectiveness and feasibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Our mixed-methods cohort study implemented a co-designed, multifaceted intervention using the consolidated framework for implementation research at a single Veterans Affairs ED (November 2021–October 2022) to enhance POCUS usability and sustainability, including provider education, image review and archival. Primary ED providers (20/25) participated in hands-on POCUS training sessions between February and May 2022. We assessed POCUS program acceptability, appropriateness, and feasibility via provider pre/post-course surveys, interviews, and health record data using a validated tool (AIM-IAM-FIM; assessing ED POCUS, radiology ultrasound orders, and ED metrics).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ED POCUS significantly increased (from 72 to 267 scans, <i>p</i> &lt; 0.001) 6 months post-intervention, with no significant change in radiology ultrasounds ordered (from 355 to 361, <i>p</i> = 0.417) or ED length-of-stay (from 6.7 to 7.5 h, <i>p</i> = 0.0849). Cardiac, deep vein thrombosis (DVT), soft tissue, musculoskeletal, and biliary ED POCUS were most common; and radiology studies were DVT, biliary and scrotal ultrasound. The pre/post-intervention surveys showed provider comfort with performing and teaching diagnostic and procedural POCUS changed minimally. All respondents approved of POCUS use and education (acceptability), endorsed clinical tool applicability (appropriateness) and stated the course/training was doable (feasibility).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion/Conclusions</h3>\u0000 \u0000 <p>POCUS use increased post-program implementation. Future studies should evaluate program sustainability, incorporate methods to reduce radiology ultrasound and improve patient-centered outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"28 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ipsilateral Phrenic Nerve Paresis Associated With Ultrasound-Guided Supraclavicular Block: A Prospective Cohort Study","authors":"Henry Tsao,&nbsp;Christopher Tang,&nbsp;Adam Cureton,&nbsp;Laura Maskell,&nbsp;Mark Trembath,&nbsp;Philip Jones,&nbsp;Peter J. Snelling","doi":"10.1002/ajum.70030","DOIUrl":"https://doi.org/10.1002/ajum.70030","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Ultrasound-guided supraclavicular block (UGSCB) can provide upper limb regional anaesthesia and is an emerging technique in the emergency department (ED). A potential adverse event is phrenic nerve block causing hemi-diaphragmatic paresis, but its incidence in ED remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This nested prospective cohort study evaluated adult patients (≥ 18 years) without lung disease who underwent UGSCB for closed reduction of distal radius fractures. UGSCB was performed on the injured side using a two-injection method with 20 mL of 0.75% ropivacaine. The primary outcome was ipsilateral diaphragmatic excursion assessed using bedside ultrasound dynamic imaging before and 30 min post-UGSCB during three respiratory manoeuvres: tidal volume breathing (TV), deep inspiration (DI) and sniff inspiration (SI). Diaphragmatic paralysis was defined as ≥ 75% reduction in diaphragmatic excursion, averaged across the three manoeuvres. Secondary outcomes included vital signs including respiratory rate, oxygen saturations, blood pressure and heart rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixteen participants were evaluated. UGSCB was associated with reduced ipsilateral diaphragmatic excursion for TV (mean difference [MD] 1.21 cm, 95% confidence interval [95% CI] 0.69–1.75), DI (MD 3.37, 95% CI 2.15 to 4.59) and SI manoeuvres (MD 1.95, 95% CI 1.23 to 2.68). Diaphragmatic paralysis was observed in 10 participants (62.5%). No significant changes in vital signs were observed following UGSCB.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ED physician-performed UGSCB using a two-injection technique was commonly associated with hemi-diaphragmatic paresis, likely due to concomitant phrenic nerve block. However, this was not associated with respiratory or haemodynamic compromise in adult patients without lung disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"28 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145469498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-Guided Arthrocentesis in the Emergency Department: A Scoping Review (2013–2023)","authors":"Avijit Barai,&nbsp;Sujatha Kamalaksha,&nbsp;Amy Hogben,&nbsp;Thedchanamoorthy Prashanth,&nbsp;Susie Moreton","doi":"10.1002/ajum.70028","DOIUrl":"https://doi.org/10.1002/ajum.70028","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The objective of this scoping review is to map and describe the current scope of research on ultrasound-guided arthrocentesis (UGA) in the emergency department (ED), assess methodological quality, summarise procedural techniques and identify evidence gaps.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Joint aspiration or arthrocentesis procedures are commonly performed in the ED to diagnose and manage painful joints with effusions. The integration of ultrasound technology into arthrocentesis has improved patient care and reduced complications.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Inclusion Criteria&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This scoping review examined all articles in the English language published in the ED settings between January 2013 and December 2023. We included human studies in peer-reviewed journals.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Data Sources&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;PubMed, Ovid MEDLINE, Embase, Cochrane CENTRAL, ClinicalTrials.gov and OpenGreyEU, searched 1 January 2013 to 31 December 2023 (last run: 18 April 2024). Reference lists hand-searched.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We applied PRISMA ScR guidelines and Joanna Briggs Institute (JBI) guidelines for this scoping review. A medical librarian constructed a robust and replicable search strategy for contemporary literature in key clinical databases. We registered the protocol in the Open Science Framework (OSF). In addition, we performed a screening of titles, abstracts and full texts through www.rayyan.ai in collaboration with the reviewers. Two reviewers performed screening and data charting independently, with any discordance reviewed by a third investigator.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;During the initial screening, we found 255 articles. After removal of duplicates, we found 182 abstracts for further screening. We identified 30 articles following the abstract screening. We performed a rigorous screening of these 30 full-text articles and included 11 articles for the final review. We found the majority of these articles were case reports (&lt;i&gt;n&lt;/i&gt; = 5, 45%) and case series (&lt;i&gt;n&lt;/i&gt; = 3, 27%). There was only one randomised controlled trial. Most of the research (&lt;i&gt;n&lt;/i&gt; = 8, 73%) was conducted in the USA, which limits the generalisability of the research findings. A significant research gap has been identified, which opens the avenues for future research in this field.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 ","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"28 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carotid Web Case Report: A Carotid Bifurcation Disorder Causing Stroke Without Localised Significant Stenosis","authors":"Samantha Hill,&nbsp;Lucy Guazzo,&nbsp;Teal Derboghossian","doi":"10.1002/ajum.70027","DOIUrl":"https://doi.org/10.1002/ajum.70027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A 33-year-old gentleman presented to the Emergency Department with headaches and vertigo following neck manipulation with a chiropractor and was discharged following an unremarkable CT. Three weeks after the initial presentation, the patient re-presented within 24 h of a secondary neck manipulation, experiencing dysphasia and dysarthria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key Findings</h3>\u0000 \u0000 <p>An MRI demonstrated an embolic infarct, and further investigations were requested. Multiple modalities excluded dissection; however, an intraluminal filling defect supported thrombus in the right proximal internal carotid artery (ICA). Subsequent ultrasound imaging demonstrated a mobile thrombus at the origin of the ICA arising from the posterior wall. Intraoperative notes suggested the presence of a carotid web associated with thrombus formation, and subsequent histopathology confirmed this finding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Carotid webs represent focal septum-like luminal protrusions, usually at the level of the ICA ostium. Strokes associated with carotid webs are considered rare, with an incidence of 0.7%–2.5%. However, the stroke re-occurrence rate in this population is 44% on best medical therapy. This case demonstrates the potential difficulty of discerning a web in the presence of thrombus on CTA, MRI and ultrasound. Furthermore, it highlights the high-risk properties of carotid webs for thrombus formation and as a potential cause of stroke. Carotid webs should be excluded as a potential cause of stroke, particularly in young and African populations where the incidence of carotid webs is suspected to be higher. Sonographer education specific to carotid webs is needed for accurate and timely detection of this rare disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"28 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145317435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Complex Disease on the Accuracy of Transvaginal Ultrasound Diagnosis of Uterosacral Ligament Endometriosis","authors":"Shay M. Freger,&nbsp;Ido Mick,&nbsp;Saar Aharoni,&nbsp;Mathew Leonardi","doi":"10.1002/ajum.70021","DOIUrl":"10.1002/ajum.70021","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the impact of complex disease states, including pouch of Douglas (POD) obliteration and deep endometriosis (DE) of the bowel, on the diagnostic accuracy of transvaginal ultrasound (TVUS) for detecting endometriosis of the uterosacral ligaments (USLs) and torus uterinus (TU).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This diagnostic accuracy study evaluated the performance of TVUS in diagnosing DE of the USLs and TU, using laparoscopic visualisation with histological confirmation as the reference standard among two previously reported prospectively collected cohorts. Complex disease states were defined as complete POD obliteration and/or DE of the bowel. Diagnostic accuracy metrics, including sensitivity, specificity, positive and negative predictive values (PPV) and likelihood ratios (LR), were calculated before and after the exclusion of complex disease cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 177 participants, 18.6% (33/177) had POD obliteration, 18.6% (33/177) had DE of the bowel and 16.4% (29/177) had both. Accuracy ranged from 93.1% to 94.7% for USLs and 97.2%–98.5% for TU, with minimal change after exclusion (≤ 1.5%). Sensitivity declined following exclusion, by −6.4% (left USL), −3.5% (right USL) and −2.7% (TU) after POD obliteration exclusion and further decreases of −1.8%, −3.4% and −4.4%, respectively, after bowel DE exclusion. Specificity remained ≥ 97.8% across all sites and reached 100% at the USLs after POD obliteration exclusion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Contrary to the assumption that complex disease states hinder TVUS accuracy, their presence may enhance lesion recognition, likely due to increased sonographic attentiveness when severe disease is suspected. While TVUS remains highly specific, its sensitivity decreases in the absence of complex disease, emphasising the need for meticulous and systematic imaging approaches.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"28 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}