Australasian Journal of Ultrasound in Medicine最新文献

{"title":"Role of contrast-enhanced ultrasound for differentiation of benign vs. malignant portal vein thrombosis in hepatocellular carcinoma – A systematic review a meta-analysis","authors":"Suprabhat Giri,&nbsp;Arun Vaidya,&nbsp;Dhiraj Agrawal,&nbsp;Jijo Varghese,&nbsp;Ranjan Kumar Patel,&nbsp;Taraprasad Tripathy,&nbsp;Ankita Singh,&nbsp;Swati Das","doi":"10.1002/ajum.12375","DOIUrl":"10.1002/ajum.12375","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction/Purpose</h3>\u0000 \u0000 <p>Patients with cirrhosis and hepatocellular carcinoma (HCC) can develop both benign and malignant portal vein thrombosis (PVT). Characterising the nature of PVT is important for planning an optimal therapeutic strategy. In the absence of typical findings or contraindications to computed tomography (CT) or magnetic resonance imaging (MRI), contrast-enhanced ultrasound (CEUS) could help in this differentiation. The present meta-analysis aimed to evaluate the performance of CEUS for characterising PVT in patients with HCC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Electronic databases of PubMed, Embase and Scopus were searched from inception to 31 December 2022 for studies analysing the role of CEUS in the differentiation of benign and malignant PVT in HCC. Using the bivariate random effect model, pooled sensitivity and specificity were calculated, and the summary receiver operating characteristic (sROC) curve was plotted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 12 studies with data from 712 patients were included in the meta-analysis. The pooled sensitivity and specificity of CEUS for the diagnosis of tumour in vein were 97.0% (95% CI: 93.0–98.7) and 96.8% (95% CI: 92.1–98.7), respectively, without significant heterogeneity. A sROC curve was plotted, and the area under the receiver operating characteristic was 0.99 (95% CI: 0.98–1.00). Despite the presence of publication bias, sensitivity analysis did not show any change in sensitivity and specificity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Our meta-analysis summarises the accuracy data from 12 studies, including &gt;700 subjects. Contrast-enhanced ultrasound had excellent diagnostic accuracy with pooled sensitivity and specificity of 97.5% (95% CI: 93.5–99.1) and 98.2% (95% CI: 91.5–99.6), respectively, without any significant heterogeneity. Additionally, the pooled positive LR, negative LR and DOR were 54.6 (95% CI: 11.1–25.6), 0.02 (0.01–0.07) and 2186.8 (318.3–15022.2), respectively. A positive result increases the pretest probability of malignant PVT from 50% to 98%, whereas a negative result decreases it from 50% to 2%. Most of the studies included in our meta-analysis used identical techniques and 6–12-month follow-up scans to check for thrombus progression or regression. Our analysis showed no significant heterogeneity in the studies, and area under receiver operating characteristic curve (AUROC) with 95% CI was 1.00 (95% CI: 0.99–1.00). This critical meta-analysis thus propels CEUS to the forefront for differentiating benign from tumoural PVT and suggests routinely using CEUS in patients present","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"27 1","pages":"56-64"},"PeriodicalIF":0.0,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138585122","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":"Complete hydatidiform mole with concurrent fetus: Two cases of live, term birth coupled with spontaneous resolution of molar tissue","authors":"Emily M. Warton,&nbsp;Jan E. Dickinson,&nbsp;Scott W. White,&nbsp;Yee Leung,&nbsp;Bligh Berry","doi":"10.1002/ajum.12366","DOIUrl":"10.1002/ajum.12366","url":null,"abstract":"<p>Pregnancies with a complete hydatidiform mole and co-existing fetus (CMCF) are rare, but increasingly common due to the rising prevalence of assisted reproductive technology. They are frequently associated with adverse obstetric outcomes, providing women with the challenge of pregnancy termination or continuing the pregnancy at the risk of maternal-fetal morbidity and fetal mortality.</p><p>This report demonstrates two cases of CMCF pregnancy with excellent maternal-fetal outcomes, including spontaneous resolution of the molar tissue antenatally. It is helpful in counselling women who are diagnosed with this rare and frequently morbid condition in considering how to proceed with their pregnancy.</p>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"27 1","pages":"65-70"},"PeriodicalIF":0.0,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138586055","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":"Clinical audit of ultrasonography for detecting sialoliths in the submandibular gland in paediatric patients: A comparison to computed tomography and magnetic resonance imaging","authors":"Takahiro Hosokawa,&nbsp;Yutaka Tanami,&nbsp;Yumiko Sato,&nbsp;Nodoka Adachi,&nbsp;Hiroshi Asanuma,&nbsp;Eiji Oguma","doi":"10.1002/ajum.12370","DOIUrl":"10.1002/ajum.12370","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To compare the performance of ultrasonography with magnetic resonance imaging (MRI) and computed tomography (CT) for detecting submandibular sialoliths.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirteen patients with suspected submandibular sialoliths who underwent ultrasonography and CT or MRI were included. Sialoliths were diagnosed using CT (11 cases) or MRI (two cases). The submandibular duct was classified into distal and proximal ducts based on the point around the mylohyoid muscle. Sialoliths located in the proximal duct were difficult to differentiate from those located within the submandibular gland (SMG). Therefore, the location of the sialoliths was classified as follows: within the SMG/proximal duct and within the distal duct. The ultrasound results were compared with CT/MRI results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 13 patients included, two had sialoliths in both the SMG/proximal duct and the distal duct, three had sialoliths in the SMG/proximal duct, and five had sialoliths in the distal duct on CT or MRI. In this small cohort, all five sialoliths in the SMG/proximal duct were detected by ultrasoonography; however, of the seven cases with sialoliths located in the distal duct, only three could be detected by ultrasonography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The incidence of sialoliths in the distal duct was higher than that in the SMG/proximal duct. Ultrasonography showed a good performance compared with CT/MRI in the SMG/proximal duct but not in the distal duct.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"27 1","pages":"19-25"},"PeriodicalIF":0.0,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138585685","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":"Artificial intelligence as a teaching tool for gynaecological ultrasound: A systematic search and scoping review","authors":"Alison Deslandes,&nbsp;Jodie Avery,&nbsp;Hsiang-Ting Chen,&nbsp;Mathew Leonardi,&nbsp;George Condous,&nbsp;M. Louise Hull","doi":"10.1002/ajum.12368","DOIUrl":"10.1002/ajum.12368","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The aim of this study was to investigate the current application of artificial intelligence (AI) tools in the teaching of ultrasound skills as they pertain to gynaecological ultrasound.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A scoping review was performed. Eight databases (MEDLINE, EMBASE, EMCARE, CINAHL, Scopus, Web of Science, IEEE Xplore and ACM digital library) were searched in December 2022 using predefined keywords. All types of publications were eligible for inclusion so long as they reported the use of an AI tool, included reference to or discussion of teaching or the improvement of ultrasound skills and pertained to gynaecological ultrasound. Conference abstracts and non-English language papers which could not be adequately translated into English were excluded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The initial database search returned 481 articles. After screening against our inclusion and exclusion criteria, two were deemed to meet the inclusion criteria. Neither of the articles included reported original research (one systematic review and one review article). Neither of the included articles explicitly provided details of specific tools developed for the teaching of ultrasound skills for gynaecological imaging but highlighted similar applications within the field of obstetrics which could potentially be expanded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Artificial intelligence can potentially assist in the training of sonographers and other ultrasound operators, including in the field of gynaecological ultrasound. This scoping review revealed however that to date, no original research has been published reporting the use or development of such a tool specifically for gynaecological ultrasound.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"27 1","pages":"5-11"},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.12368","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139258816","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":"Novel technique for ultrasound-guided needle tracking: An inexpensive reusable phantom model utilising a closed electrical circuit","authors":"Hillary J. McKinley,&nbsp;Isaak Jones,&nbsp;Madeline LaRochelle,&nbsp;Erik Christensen,&nbsp;Weeden Bauman,&nbsp;Peter Croft","doi":"10.1002/ajum.12367","DOIUrl":"10.1002/ajum.12367","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Purpose:There are a variety of commercially made ultrasound training phantoms available for educational purposes. A new concept in phantoms is presented that utilises a low-cost method to create a reusable phantom.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A closed electric circuit was combined with insulating material to create a novel phantom that can be used to practise needle tracking under ultrasound guidance on repeated occasions. A tricolour light-emitting diode (LED) illuminates when the needle (under ultrasound gudiance) contacts one of three metal objects embedded in the phatom material.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This prototype model provides a simple solution for trianing ultrasound needle guidance is particularly geared towards programmes with a high volume of users. This protoype provides a starting point for a new concept in educational phantom trainers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"27 2","pages":"120-123"},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139259577","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":"Prevalence of anomalies on the routine mid-trimester ultrasound: 3172 consecutive cases by a single maternal–fetal medicine specialist","authors":"Colin A. Walsh,&nbsp;Nicole Lees","doi":"10.1002/ajum.12369","DOIUrl":"10.1002/ajum.12369","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction/Purpose</h3>\u0000 \u0000 <p>The routine mid-trimester fetal anatomy ultrasound (FAS) is offered to every pregnant woman and remains critical in the detection of structural fetal anomalies. Our study aimed to determine the prevalence of abnormalities on routine FAS performed by a single operator, who is an experienced sub-specialist in maternal–fetal medicine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis of all routine FAS performed a tertiary private obstetric ultrasound practice in metropolitan Sydney over a 7-year period, August 2015–July 2022. An advanced ultrasound protocol including detailed cardiac views was used in every case. Second opinion scans for suspected abnormalities were excluded. Fetal anomalies were classified into major and minor, based on the likely need for neonatal intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 14,908 obstetric ultrasound examinations, routine FAS were performed on 3172 fetuses by a single operator. More than 99% of women had screened low-risk for fetal aneuploidy. Structural anomalies were identified in 5% (157/3172) of fetuses; the prevalence of major anomalies was 1% (30/3172). Almost 60% of total anomalies were either cardiac or renal. No differences were identified in anomaly rates for singletons compared with twins (5.0% vs. 4.2%; P = 0.75). The prevalence of placenta previa and vasa previa was 10% and 0.1%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The prevalence of fetal anomalies on routine FAS by a single operator using a standardised protocol was higher in our practice (5%) than in previously published studies. Although most anomalies were minor, the rate of major abnormality was 1%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The routine mid-trimester FAS remains an integral component of prenatal ultrasound screening.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"27 1","pages":"12-18"},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139258417","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":"Comparison of lung ultrasound scoring systems for the prognosis of COVID-19 in the emergency department: An international prospective cohort study","authors":"Peter J Snelling,&nbsp;Philip Jones,&nbsp;Rory Connolly,&nbsp;Tomislav Jelic,&nbsp;Dan Mirsch,&nbsp;Frank Myslik,&nbsp;Luke Phillips,&nbsp;Gabriel Blecher,&nbsp;the COVID LUS Study Group","doi":"10.1002/ajum.12364","DOIUrl":"10.1002/ajum.12364","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of this study was to evaluate whether the lung ultrasound (LUS) scores applied to an international cohort of patients presenting to the emergency department (ED) with suspected COVID-19, and subsequently admitted with proven disease, could prognosticate clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was an international, multicentre, prospective, observational cohort study of patients who received LUS and were followed for the composite primary outcome of intubation, intensive care unit (ICU) admission or death. LUS scores were later applied including two 12-zone protocols (‘de Alencar score’ and ‘CLUE score’), a 12-zone protocol with lung and pleural findings (‘Ji score’) and an 11-zone protocol (‘Tung-Chen score’). The primary analysis comprised logistic regression modelling of the composite primary outcome, with the LUS scores analysed individually as predictor variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between April 2020 to April 2022, 129 patients with COVID-19 had LUS performed according to the protocol and 24 (18.6%) met the composite primary endpoint. No association was seen between the LUS score and the composite primary end point for the de Alencar score [odds ratio (OR) = 1.04; 95% confidence interval (CI): 0.97–1.11; P = 0.29], the CLUE score (OR = 1.03; 95% CI: 0.96–1.10; P = 0.40), the Ji score (OR = 1.02; 95% CI: 0.97–1.07; P = 0.40) or the Tung-Chen score (OR = 1.02; 95% CI: 0.97–1.08).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Compared to these earlier studies performed at the start of the pandemic, the negative outcome of our study could reflect the changing scenario of the COVID-19 pandemic, including patient, disease, and system factors. The analysis suggests that the study may have been underpowered to detect a weaker association between a LUS score and the primary outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In an international cohort of adult patients presenting to the ED with suspected COVID-19 disease who had LUS performed and were subsequently admitted to hospital, LUS severity scores did not prognosticate the need for invasive ventilation, ICU admission or death.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"27 2","pages":"75-88"},"PeriodicalIF":0.0,"publicationDate":"2023-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.12364","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136157235","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":"Hand and finger, ultrasound-guided, percutaneous core needle biopsies: A safe procedure with high diagnostic accuracy","authors":"Stephanie Magoon,&nbsp;Vanessa Peters,&nbsp;Felipe Ferreira de Souza,&nbsp;David Chen,&nbsp;Patrick Owens,&nbsp;Juan Pretell-Mazzini,&nbsp;Natalia Fullerton,&nbsp;Jean Jose,&nbsp;Andrew Rosenberg,&nbsp;Ty K. Subhawong","doi":"10.1002/ajum.12365","DOIUrl":"10.1002/ajum.12365","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction/Purpose</h3>\u0000 \u0000 <p>To determine the diagnostic accuracy and complication rates of ultrasound-guided, percutaneous core needle biopsies of soft tissue masses in the hand and fingers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Reports from all ultrasound-guided procedures between 21 May 2014 and 17 March 2022 were queried for keywords including “hand”, OR “finger”, AND “biopsy”. Patient demographics, lesion size and location, biopsy needle gauge and the number of cores obtained were recorded. The final pathology of the mass excision was then compared with the core needle biopsy (CNB) for each patient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-six records were reviewed, and 37 patients met inclusion criteria. Maximum lesion diameter averaged 1.45 cm with a range between 0.4 and 4.3 cm. The frequency of needle gauges used was 14G (14%), 16G (24%), 18G (38%), 20G (11%) and ‘not reported’ (14%). The mean number of tissue cores obtained was 2.9 (SD 1.2; range 1 to 6), excluding nine cases that reported ‘multiple’. The frequency of CNB diagnoses included tenosynovial giant cell tumour (TGCT) at 30%, ganglion cyst at 11% and epidermal inclusion cyst at 5%. CNB was 100% sensitive in detecting the three (8%) malignancies. Of the 37 tumours biopsied, 16 were surgically excised. One angiomyoma was originally diagnosed as a haemangioma on CNB, but all other histologic results were concordant for a diagnostic accuracy of 97%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Small soft tissue masses in the hands and fingers, even those less than 1 cm, are often amenable to ultrasound-guided CNB. Performance under image guidance facilitates retrieval of core specimens adquate for histologic diagnosis with relatively few passes using higher gauge needles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Overall, ultrasound-guided CNB of the hand and fingers is safe and highly accurate in diagnosing soft tissue tumours. The accuracy is unrelated to the needle's gauge, the number of passes and the size of the lesions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"26 4","pages":"243-248"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.12365","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135265698","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":"Boxer's knuckle: Sonographic anatomy and assessment of sagittal band tears of the dorsal hood","authors":"Michelle Fenech","doi":"10.1002/ajum.12363","DOIUrl":"10.1002/ajum.12363","url":null,"abstract":"<p>Hand injuries are common in amateur and professional boxers and result in time lost from training and competition.<span>^1-3</span> Injuries to the dorsal hood account for 16% of all hand and wrist injuries in boxers.<span>^{1, 3}</span> ‘Boxer's knuckle’ describes a closed injury to the metacarpophalangeal joint (MCPJ) of the hand and is used synonymously to describe tears of the sagittal bands of the dorsal hood and associated extensor tendon instability.<span>^{4, 5}</span> It can result from a direct blow to the flexed MCPJ, commonly from boxing or punching, or from relatively low-energy repetitive injuries.<span>⁵</span> Patients typically present with a painful and swollen dorsal MCPJ, and the space between knuckles, with pain associated with forming a closed fist, loss of full extension and snapping of extensor tendons with MCPJ flexion.<span>^{6, 7}</span> Boxer's knuckle soft tissue injuries are less appreciated than boxer's fracture that typically involves a fracture of the fifth or fourth metacarpal neck with volar angulation and can occur from a similar mechanism of injury.<span>⁸</span></p><p>Tears of the sagittal bands of the dorsal hood can be clinically overlooked or underappreciated, as the symptoms can often be non-specific, and the associated tendon subluxation or dislocation may not always be observed.<span>^{9, 10}</span> If not diagnosed and treated adequately and in a timely manner, sagittal band tears can result in long-term persistent pain at the MCPJ and hand function impairment.<span>^11-13</span> Diagnostic imaging, including sonography, can play an important role in directly imaging the soft tissue structures surrounding the MCPJ and diagnosing sagittal bands tears and tendon instability; however, an appreciation of the mechanism of injury, sonographic anatomy, sonographic technique, and normal and abnormal sonographic appearances is required.</p><p>The anatomy of the extensor (dorsal) mechanism of digits 2–5 of the hand is complex and often overwhelming. It combines an array of dorsal soft tissue structures including extensor tendons, the dorsal plate and the dorsal hood (extensor expansion).<span>¹⁴</span> The dorsal hood is interrelated with intermetacarpal and palmar hand structures which aid in producing finger movement and MCPJ stability.<span>¹⁵</span> The intermetacarpal structures include collateral ligaments, lumbrical and interosseous muscles and their associated tendons. Palmar structures of the hand around the MCPJ include the palmar plate, A1 pulley, flexor tendons, the deep transverse metacarpal ligament (DTMCL) and the associated neurovascular structures.<span>¹⁵</span> The dorsal, intermetacarpal and palmar structures surrounding the MCPJ all need to be sonographically assessed in cases of suspected sagittal band tears.</p><p>Extension of the proximal interphalangeal joint (PIPJ) and distal in","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"26 4","pages":"216-229"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.12363","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136014304","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":"Evidence-based innovation in ultrasound practice","authors":"Gillian Whalley","doi":"10.1002/ajum.12362","DOIUrl":"10.1002/ajum.12362","url":null,"abstract":"<p>I have recently returned from ASUM's annual New Zealand conference and am surprised by two things – how diverse ultrasound practice is and how much I enjoyed listening to presentations outside my speciality area. This is because some of the challenges we face in terms of developing an evidence base for our practice of, and justification for, our scanning approaches are similar. Many of us are facing the pressure of ‘getting through lists’: some are advocating for reducing scanning protocols or performing targeted examinations; others are advocating for extending scopes of practice outside traditional boundaries; whilst some are even advocating for skipping ultrasound and moving straight to other imaging modalities.</p><p>Whatever your innovative idea is, it should be evidence-based and proven to alleviate the problem at hand; whether it be workforce shortages, time poverty or a long waitlist. In this issue of AJUM, we focus on the areas of innovation and research that could enhance practice if adopted widely. And as you read these articles, I challenge you to think about whether similar issues exist in your speciality areas. Are there innovations that could be introduced? Or are there teaching tips that could enhance everyone's practice? Is there a way to streamline our practice and training? One of the key strategic goals of ASUM is <i>to deliver evidence-based standards and research</i>, and this issue of our society's journal should tick a continuing education box for many of you. I'm hopeful it will also stimulate you to undertake your own research in your area or practice.</p><p>Rocha <i>et al</i>.<span>¹</span> present an analysis of a large cohort of women investigated for endometriosis in which they evaluated the anatomical distribution of endometriosis with ultrasound and tested a recommended prediction model that used a patient-administered questionnaire from the World Endometriosis Research Foundation. They found the performance of the questionnaire added little clinical value and suggested further refinement of the questionnaire may be needed.</p><p>Samet <i>et al</i>.<span>²</span> present a small study where they investigated the difference between supine and prone patient positioning for identifying the popliteal fossa sciatic nerve and found supine positioning allowed for quicker identification with the potential to improve ultrasound-guided nerve block. Often, patient positioning is seen as a sonographer or patient preference, but quantifying one position's impact and potential benefit over another is useful and can inform future practice.</p><p>Another variation in practice is the choice of transducer. Lung ultrasound can be performed with either a curvilinear or phased array transducer, and preference may simply come down to which one is available at the time of the scan. There are reasons why operators may prefer one over the other, such as rib spaces or frequency, but many regard them as interchangeab","PeriodicalId":36517,"journal":{"name":"Australasian Journal of Ultrasound in Medicine","volume":"26 3","pages":"129-130"},"PeriodicalIF":0.0,"publicationDate":"2023-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajum.12362","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10223326","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}