Journal of Diagnostic Medical Sonography

This random, retrospective cross-sectional study was performed to determine the frequency of uterine malformation in restricted gene pool communities. During 2003—2006, 800 women from the community of LaCrete in northern Alberta, Canada (known restricted gene pool for over 500 years), participated. Of the participants, 156 (19.5% of the study population) showed some form of structural uterine malformation. This is 5.5 times higher than what is reported in the general population. All 156 subjects were further investigated with magnetic resonance imaging, 3D sonography, hysterosalpingiography, hysteroscopy, and laparoscopy. These tests revealed that 30 of these women had no previous pregnancies or live births, 40 had one or more previous pregnancies and live births and more than two miscarriages, and 55 had recurrent miscarriages. This study has provided new insights into the increasing number of uterine malformations in the LaCrete population. The significantly higher prevalence of uterine malformations in a restricted gene pool community compared to the reported prevalence in the general population might indicate a direct link between a lack of genetic diversity and the development of uterine malformations in women.

A systematic review was performed to identify studies reporting summary data (mean, standard deviation) of sonographic cross-sectional measurements of the ulnar nerve at the elbow. Comparisons of measurements were performed to determine whether statistical differences existed between groups of individuals symptomatic and asymptomatic of ulnar nerve entrapment at the elbow (UNE). Across the four studies meeting the selection criteria of the search, five sample groups were identified and compared: three asymptomatic of UNE and two symptomatic of UNE. There were significant differences between measurements of people with and without UNE (P < .0001—.041). Significant differences also existed between the two symptomatic populations (P < .0001—.0062) and between the three asymptomatic populations (P < .0001—.41). This systematic review demonstrates that significant differences exist between sonographic measurements of ulnar nerve dimension between people with and without UNE, confirming that these measurements are potential discriminators of UNE. The demonstration of significant differences between measurements of ulnar nerve size within sample populations with similar symptomatic status suggests that further studies are required to confirm the effect of ulnar nerve pathologies, measurement protocols, and anthropometric factors.

Sonographic guidelines have been provided for assessing lymph nodes both in the axilla and other areas of the body. The objective of this study was to determine the feasibility of using sonography and Doppler to provide diagnostic nodal information for women 55 years and older. The authors conducted a retrospective longitudinal study of a group of women 55 years and older who provided their prior health histories, mammography, and sonogram results, as well as eventual pathology reports, to help establish the value of Doppler measurements, nodal dimensions, and subjective assessment data collected at the time of the breast sonogram. Each patient consented to allow 15 minutes of scanning of her axilla to evaluate three lymph nodes. Fifty-two women provided data points that were captured and compared to published guidelines, such as longitudinal/diameter (L/D) ratio, resistive index (RI), and Stavros's subjective grading scale. The longitudinal axis compared to the diameter of a node (L/D ratio), shape, and RI was statistically correlated with published guidelines. Sonographic measures and Doppler assessment of axillary lymph nodes are feasible, and continued research could result in a reliable set of parameters that could be used as an economical, noninvasive imaging technique for possible staging of women 55 years and older.

Venous insufficiency (VI) is a pathology that is underappreciated and commonly missed sonographically. When performed correctly, a sonographic evaluation lends information that can provide a minimally invasive treatment option for the patient. The purpose of this case study is to provide an overview of the essential steps in the sonographic evaluation for VI, highlighting components specific to radiofrequency ablation of the great saphenous vein.

Amniotic band syndrome (ABS) may result in fetal anomalies that vary in severity from minor to lethal. Although numerous conditions have been grouped with this diagnosis, a subset of this population will have no other intrauterine abnormalities other than isolated defects of the extremities. ABS may present as constriction rings and congenital amputation affecting the limbs and digits. Routine sonographic evaluation of the fetus in the second trimester can identify the major defects associated with ABS. Detailed evaluation of the fetal extremities, including views of the hands and feet, will increase the detection of minor defects.

Uterus didelphys, also known as a duplicated uterus, is an embryological abnormality resulting from the failure of fusion of the Mullerian ducts, causing full uterine development to erroneously occur bilaterally. The occurrence of uterus didelphys is very low in the general population and often predisposes women to a variety of gynecological difficulties. There appears to be a high association with obstetrical complications, such as spontaneous abortion, preterm labor, cervical incompetence, and malpresentation. Uterus didelphys is also associated with urinary tract abnormalities. Presented is a case of a woman with a didelphys uterus and a twin pregnancy.

Urachal abnormalities are rare, especially in adults, and are usually incidentally detected with sonography or by computed tomography. When discovered, they may help to explain patient symptoms. The author reports an incidental finding of urachal diverticula in an adult male. In addition, this report reviews different types of urachal abnormalities, etiology, associated pathology, and treatment.

Unexpected Doppler findings in the arteries of the lower extremity may be found during a routine noninvasive vascular examination. Low-resistive Doppler arterial waveforms in the external iliac and femoral arteries are abnormal and often indicators of proximal high-grade stenosis. Occasionally, other medical conditions could also cause anomalous low-resistive arterial waveforms in the arteries of lower extremities. Detailed knowledge of vascular anatomy, careful sonographic scanning, and meticulous analysis of Doppler waveforms in all examined vessels are paramount for adequate examination and reporting. Vascular sonographers should consider different clinical scenarios whenever abnormal Doppler waveforms are detected.

Testicular fracture with or without rupture is a rare but serious complication of scrotal trauma. Sonography is well established as the gold standard for testicular injury in an acute setting. The normal testicular parenchymal pattern is homogeneous by gray-scale sonography and free of internal irregularities. The sonographic findings in testicular fracture include a distinct or indistinct fracture line coursing through the testicle. This case study demonstrates an acute testicular fracture with associated hematocele. The fracture line in this examination was seen dissecting the left testicle without scrotal wall rupture and sustained flow to the superior half of the testicle. Prompt evaluation by gray scale and color and spectral Doppler revealed adequate flow to the superior portion of the testicle. Sonography proved helpful in guiding the surgical treatment that resulted in salvage of the upper half of the traumatized testicle instead of the customary orchiectomy (removal of the testicle).