Abstract
This study from Germany of over 2000 patients shows that while most small (≤4 cm) renal cell carcinomas are slow growing and carry a good prognosis, a significant minority are not. Some small ones metastasise, and the researchers believe that identification of molecular biomarkers related to prognosis is likely to hold the key to future management.
These researchers state that antenatal diagnosis of a nuchal cord should not be a concern to obstetricians since management of labour and delivery does not change. Thankfully, they do not recommend routine ultrasound for detection of nuchal cord. My understanding is that nuchal cords are often transient anyway and that ultrasound is unreliable with many false positives, so why cause anxious mothers-to-be even more anxiety?
Second trimester foetuses with a thicker than normal nuchal translucency (NT) should be referred for a detailed cardiac assessment. Although an increased NT is an indicator for heart abnormalities, it is not useful for predicting the severity of the abnormality.
This study from New York highlights the limitations of focused vascular sonography. A two-point compression technique for identifying lower limb proximal DVT failed to identify on six occasions isolated thrombus in the femoral vein.
Still on the subject of DVT, which is a hot topic currently, this study involving nearly 700 patients found that appropriately trained nurses performed very well against expert ultrasound physicians when diagnosing proximal DVT in the lower limb.
It seems patients with transplanted kidneys may be at a greater risk of complications from stones for two reasons: underlying metabolic disorders such as hyperparathyroidism, and obstruction caused by a stone at the ureterovesical anastomosis.
No, not really. This Australian team found that ultrasound has a relatively small role to play in cases of acute scrotal pain. It may be useful only where there is a low clinical suspicion of torsion. The message here is that ultrasound examination should not delay prompt surgical exploration.
This investigation uses microbubble contrast to compare vascular patterns in dogs’ testes. The team looked at normal testicular vasculature and compared it with the vascular appearance of benign and malignant testicular lesions. Hyperenhancement is associated with malignancy.
MSK ultrasound is not used commonly by paediatric rheumatologists although there is growing interest. The researchers suggest that the next step is to standardise joint assessment in healthy children so that synovitic joints can be differentiated from normal joints. They recognise the importance of focused training for this user group.
This review reveals that paediatric emergency medicine physicians are identifying sonographically not just common bowel complications in children such as appendicitis, intussusception and pyloric stenosis but also bone fractures and cardiac conditions. With the right training there is no stopping them.
With a sample size of 943 sets of twins, this study shows that, contrary to popular belief, ultrasonic estimated fetal weight in twin pregnancies is just as accurate in overweight mothers as in those who are underweight or of a normal BMI. Perhaps it is a case of practise makes perfect.
This group challenges the 2003 ‘Rotterdam consensus’ criteria set for diagnosing polycystic ovaries using ultrasound. Instead of using the current threshold of more than 12 follicles of 2–9 mm per ovary, they recommend the threshold be raised to more than 25 follicles. They also suggest that the presence of multiple small follicles in the absence of clinical or biochemical markers in ovulatory women may be of no consequence.