Journal of Medical Ultrasound最新文献

{"title":"A Single Needle Tip Position Approach 'The Middle Trunk' Block-for Supraclavicular Block: An Anatomic Cadaveric Study.","authors":"Sandeep Diwan, S Shivaprakash, Rasika Timane, Pallavi Pai, Anju Gupta","doi":"10.4103/jmu.jmu_1_24","DOIUrl":"10.4103/jmu.jmu_1_24","url":null,"abstract":"<p><strong>Background: </strong>Using conventional anatomical landmark or nerve stimulator guidance, injection of local anesthetic following paresthesia of the middle two fingers resulted in >97% block efficacy. \"Corner pocket\" and \"intracluster\" injections during ultrasound-guided supraclavicular brachial plexus have been suggested for better dermatomal coverage but have limitations. We hypothesized that a single injection of dye at the level of the middle trunk (MT) would result in diffusion in the superior and inferior trunks.</p><p><strong>Methods: </strong>After ethics approval, ultrasound-guided injections were performed with a needle tip positioned within fatty connective tissue at the level of the MT bilaterally in 6 soft-embalmed cadavers. We injected 3.5, 7.5, and 15 ml diluted methylene blue dye in 2 cadavers each. Bilateral neck dissections were performed in the posterior triangle of the neck 30 min after injection in all cadavers to visualize the dye spread.</p><p><strong>Results: </strong>Injection of the lower volume of dye (3.5 ml) spared the superior trunk, suprascapular and phrenic nerve (except 1 specimen), while an injection of the higher volume of dye (15 ml) consistently stained all trunks after a single injection at MT level. Similarly, the suprascapular and phrenic nerves were congruously stained with 15 ml injections, while with 7.5 ml 50% times, the PN was soaked. Dye dispersion in cadaveric brachial plexuses was deep with 15 ml and mild-to-moderate stain pattern with others.</p><p><strong>Conclusion: </strong>We postulate that the use of a single injection MT block technique with an injectate volume of 7.5 ml or more can be an effective technique for a supraclavicular brachial plexus block. However, the findings of this cadaveric study need substantiation from clinical studies.</p>","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"33 2","pages":"125-131"},"PeriodicalIF":0.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12161693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303232","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":"Comparison of Lung Ultrasound Findings in Patients with Pulmonary Tuberculosis and Lobar Pneumonia: A Case-control Study.","authors":"Uma Devaraj, Chitra Veluthat, Kavitha Venkatnarayan, Uma Maheswari Krishnaswamy, Priya Ramachandran","doi":"10.4103/jmu.jmu_52_24","DOIUrl":"10.4103/jmu.jmu_52_24","url":null,"abstract":"<p><strong>Background: </strong>The utility of lung ultrasound (LUS) in diagnosing respiratory disorders is being studied only in recent times. We aimed to describe the ultrasound (USG) features of pulmonary tuberculosis (TB) and compare them with those of lobar pneumonia. In addition, the LUS findings of both diseases were corroborated with chest X-ray findings.</p><p><strong>Methods: </strong>The study subjects consisted of adult subjects recently diagnosed with pulmonary TB and those diagnosed with lobar pneumonia. Both subsets of patients underwent LUS evaluation.</p><p><strong>Results: </strong>Ninety-six subjects with 64 microbiologically confirmed TB and 32 lobar pneumonia patients were included. The study subjects' mean age was 46.78 ± 15.75 years and the majority were males (<i>n</i> = 62; 64.6%). LUS showed focal interstitial pattern, cavity, and irregular pleura in TB patients which were significantly different (<i>P</i> ≤ 0.001) from the findings of air bronchogram and/or shred sign seen in patients with lobar pneumonia. The overall sensitivity of LUS compared to X-ray, to identify abnormalities in TB and lobar pneumonia patients, was 88.6%. The LUS and CXR findings were concordant in 93.75% of TB patients and 90.6%) of lobar pneumonia patients. Additional USG abnormalities other than that seen on CXR were demonstrated in 13 (20.3%) TB patients.</p><p><strong>Conclusion: </strong>LUS is a valuable tool to detect TB and lobar pneumonia and can discriminate between the two conditions. LUS performance was on par with CXR in the detection of abnormalities. The lack of radiation exposure and portability of LUS makes it an attractive tool for bedside use as well as in field conditions where radiography may not be readily available.</p>","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"33 3","pages":"216-221"},"PeriodicalIF":0.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187213","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":"Epididymo-orchitis with Epididymal Abscess in a Patient with Disseminated Tuberculosis: A Case Report.","authors":"Vishal Kumar, Basanta Manjari Swain, Sangram Panda, Sudhanshu Sekhar Mohanty","doi":"10.4103/jmu.jmu_28_24","DOIUrl":"10.4103/jmu.jmu_28_24","url":null,"abstract":"<p><p>Tuberculosis (TB) remains a global health concern, and while primarily affecting the lungs, extrapulmonary manifestations such as genitourinary tubercular epididymitis are rare and diagnostically challenging. Accurate differentiation is crucial for appropriate treatment. This case study presents a 34-year-old man with left scrotal swelling, backache, and fever, highlighting the importance of considering TB in genitourinary conditions. High-resolution sonography revealed an edematous left testis with increased vascularity and hypoechoic nodules. Further imaging, including high-resolution computed tomography thorax and CEMRI dorso-lumbar spine, confirmed disseminated TB. Despite negative urine culture, aspiration cytology from the epididymal collection indicated tubercular etiology. Urogenital TB, especially isolated epididymal involvement without renal effects, presents diagnostic challenges, often occurring in immunocompromised patients. The case underscores the role of clinical, biochemical, and radiological evidence in establishing a correct diagnosis. High-resolution ultrasonography plays a crucial role in diagnosing scrotal pathologies, and when accompanied by an epididymal collection, further diagnostic steps involving biochemical parameters and aspiration followed by cytoanalysis and culture are essential. The diagnosis of TB epididymitis can be confirmed through acid-fast bacilli (AFB) identification, positive AFB culture, or granulomas seen in a biopsy specimen in the right clinical context. Radiological imaging aids in detecting local and disseminated disease forms, including complications such as hydrocele, testicular calcifications, scrotal abscesses, sinus tracks, and fistulous communications.</p>","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"33 3","pages":"282-284"},"PeriodicalIF":0.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187254","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":"A 28-year-old Male with Complaints of Redness in Right Eye with Proptosis.","authors":"Bhumireddy Vijaya Madhuri, Akash Rauniyar, Bineeta Parihar, Sonal Saran","doi":"10.4103/jmu.jmu_50_24","DOIUrl":"https://doi.org/10.4103/jmu.jmu_50_24","url":null,"abstract":"","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"33 1","pages":"92"},"PeriodicalIF":0.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11978262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033945","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":"Enhanced Diagnosis of Severe Community-acquired Pneumonia by Lung Ultrasound.","authors":"Diana Adrião, Catarina Antunes Salvado, Catarina Pacheco, Érico Costa","doi":"10.4103/jmu.jmu_104_24","DOIUrl":"https://doi.org/10.4103/jmu.jmu_104_24","url":null,"abstract":"<p><p>Lung ultrasound (LUS) has emerged as a crucial tool in the diagnosis and monitoring of acute respiratory failure, particularly in critically ill patients. In this case, a man in his late 50s presented to the emergency department with respiratory distress and rapidly deteriorated, requiring invasive ventilation and intensive care unit admission for septic shock and multiorgan dysfunction. LUS revealed extensive consolidation with linear-arborescent dynamic air bronchogram, specific for community-acquired and ventilator-associated pneumonia, with a global LUS score of 22, indicating significant severity. LUS demonstrated greater sensitivity and specificity compared to chest radiography, allowing for a more reliable and timely diagnosis. The use of LUS was especially valuable given the patient's hemodynamic instability, which made computed tomography unfeasible. As a portable, radiation-free imaging modality, LUS offers significant advantages over traditional methods, particularly in emergency and critical care settings, where rapid bedside assessments are essential for guiding treatment and ensuring continuous patient monitoring.</p>","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"33 1","pages":"61-63"},"PeriodicalIF":0.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11978255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986959","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":"Monogenic Syndromes: The Need for Clinical Vigilance in Fetuses with Pierre Robin Sequence in the Era of Noninvasive Prenatal Screening.","authors":"Yong-Shan Chen, Dong-Zhi Li","doi":"10.4103/jmu.jmu_20_24","DOIUrl":"https://doi.org/10.4103/jmu.jmu_20_24","url":null,"abstract":"","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"33 1","pages":"82-83"},"PeriodicalIF":0.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11978257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991039","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":"CME Test.","authors":"","doi":"10.4103/jmu.jmu_1_25","DOIUrl":"https://doi.org/10.4103/jmu.jmu_1_25","url":null,"abstract":"","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"33 1","pages":"94"},"PeriodicalIF":0.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11978266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003944","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":"A 28-year-old Male with Complaints of Redness in the Right Eye with Proptosis: Direct Carotid-cavernous Fistula.","authors":"Bhumireddy Vijaya Madhuri, Akash Rauniyar, Bineeta Parihar, Sonal Saran","doi":"10.4103/jmu.jmu_51_24","DOIUrl":"10.4103/jmu.jmu_51_24","url":null,"abstract":"","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"33 2","pages":"181-182"},"PeriodicalIF":0.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12161699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303230","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":"Ultrasound Diagnosis of Rotator Cuff Tears: The Necessity for Technical and Qualification Upgrades.","authors":"Yaqun Tang, Junguo Zhang, Weiwen Chen, Wenhong Yi, Jingjiao Xu, Hongmei Liu","doi":"10.4103/jmu.jmu_68_24","DOIUrl":"10.4103/jmu.jmu_68_24","url":null,"abstract":"<p><strong>Background: </strong>The dependence of each subtype of rotator cuff tears (RCTs) on ultrasound (US) experience and technique is unknown. The aims of this study were to investigate the necessity of physician qualification and US technical upgrades - possible further diagnostic triage strategies when certain sites of involvement are not clear, by analyzing the degree of dependence of symptomatic rotator cuff on qualifications and techniques.</p><p><strong>Methods: </strong>Two-dimensional US and contrast-enhanced US (CEUS) images of 84 patients who had undergone arthroscopy from 2014 to 2022 were retrospectively analyzed by two senior and two junior radiologists, using a randomized blinded method. A multivariable logistic model was established with the probability of correct diagnosis to investigate the extent to which qualifications, techniques, and subtypes affect the accurate diagnosis of RCTs.</p><p><strong>Results: </strong>Qualification, mode, and subtype were statistically different (<i>P</i> < 0.05), where CEUS was 10.48 times more likely to be diagnosed correctly than US and 2.43 times by senior than by junior physicians overall (<i>P</i> < 0.05). CEUS was 19.89, 5.15, and 10.48 times more likely than US to be diagnosed correctly when the subtypes were bursal-side partial-thickness tear (<i>P</i> < 0.05), articular-side partial-thickness tear, and small full-thickness tear, respectively (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>In clinical practice, when bursal-side tendon involvement is suspected on US, it is more practical to recommend CEUS than to improve seniority, whereas for articular-side tendon involvement, qualification upgrade is recommended first.</p>","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"33 3","pages":"228-235"},"PeriodicalIF":0.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186994","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":"Ultrasonographic Evaluation of the Distal Medial Hamstring Tendons and their Association with Posteromedial Knee Pain.","authors":"Hatem Saadeldin Mohammed, Yasser A Elmotaleb Gazar, Saad Ghanem, Doaa Waseem Nada, Ahmed Maaty, Adel Ibrahim Azzam","doi":"10.4103/jmu.jmu_56_24","DOIUrl":"10.4103/jmu.jmu_56_24","url":null,"abstract":"<p><strong>Background: </strong>Periarticular abnormalities are common ultrasonographic (U/S) findings in individuals with knee pain. Incidental U/S observations, including thickening of the distal hamstring tendons, require explanations for their clinical importance. In addition, it is unclear whether or not these tendon modifications are related to knee pain. The objective is to determine U/S findings of distal medial hamstring tendons in patients with posteromedial (PM) knee pain and assess the diagnostic significance of tendon thickness in predicting tendinopathy in those patients.</p><p><strong>Methods: </strong>We studied the distal medial hamstring tendons (semimembranosus [SM] and semitendinosus [ST]) of 104 patients (104 knees) with nontraumatic unilateral PM knee pain and 118 healthy controls (236 knees). U/S evaluations included tendon thickness, echogenicity, the presence of intrasubstance tears, calcifications, and vascularity.</p><p><strong>Results: </strong>The mean age of patients and controls was 51.7 ± 10.4 years and 49.8 ± 9.9 years, respectively. The mean Visual Analog Scale (VAS) for pain among patients was 5.1, with 58.6% of them reporting pain at the medial joint line. The study patients had significantly higher mean SM and ST tendon thicknesses than the controls (7.17 mm vs. 5.46 mm and 3.93 mm vs. 3.45 mm, respectively). U/S abnormalities among patients were hypoechogenicity (62.5%), intrasubstance tears (31.7%), loss of fibrillar pattern (23.1%), baker cyst (20.2%), calcification (18.3%), anserine bursitis (11.5%), and neovascularization (6.7%). We found significant correlations between tendon thickness and VAS (<i>r</i> = 0.752, <i>P</i> = 0.004) as well as pain location (<i>r</i> = 0.680, <i>P</i> = 0.008). SM tendon thickness measured by U/S was more accurate in predicting tendinopathy than ST (80.6% vs. 68.9%).</p><p><strong>Conclusion: </strong>U/S changes tend to occur frequently in individuals experiencing PM knee pain. Among the various abnormalities detectable by U/S, an increase in tendon thickness serves as a reliable indicator of tendinopathy and correlates strongly with the location and severity of knee pain. When dealing with PM knee pain, a comprehensive evaluation of the distal medial hamstring tendons through U/S examination can be instrumental in achieving a timely and accurate diagnosis as well as an effective treatment plan.</p>","PeriodicalId":45466,"journal":{"name":"Journal of Medical Ultrasound","volume":"33 3","pages":"241-247"},"PeriodicalIF":0.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186927","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}