Journal of Diagnostic Medical Sonography

The MAGEC (Magnetic Expansion Control) rods were introduced to a medical institution in 2015. The rod expansion procedures were initially evaluated with radiographs. The staff undertook a quality initiative to reduce radiation exposure by utilizing sonography.

The radiation dose for a typical visit was measured by examining DICOM imaging data, stored in PACS. Imaging visit time was determined from the difference between times of first radiograph/sonogram before distraction to last radiograph/sonogram after distraction.

The 21 patients (8 male, 13 female) were an average age of 11.4 ± 2.82 years (age at implant = 7.5 ± 1.94) when evaluated. The average length of time for a radiographic visit was 40.7 ± 20.7 minutes, whereas a sonography visit was 10.7 ± 3.7 minutes. Radiation dose per study visit prior to the introduction of the MAGEC clinic was 0.42 ± 0.39 mSv. Given an ideal patient schedule, the MAGEC clinic could reduce radiation dose by 1.3 to 2.5 mSv annually, with 95% confidence.

This quality improvement study demonstrated a reduction in radiation exposure and imaging time. The added benefits were providing a successful multidisciplinary imaging clinic and creation of a new exam that aligned with the “ultrasound first” initiative.

Sonographic evaluation for acute appendicitis in children often involves an exhaustive protocol, for which the therapeutic yield has not been formally evaluated. The purpose of the study was to pilot a retrospective chart review of children receiving an abdominopelvic sonogram upon presenting with suspected acute appendicitis.

An annual retrospective chart review was designed to review abdominopelvic sonograms to rule out appendicitis and specifically performed at a Canadian children’s teaching hospital. Studies were excluded if the requisition stated multiple clinical concerns or if the patient was >18 years at the time of the sonogram.

Based on 230 patient cases reviewed, alternative diagnostic sonographic findings were found in 141 (61%) charts. Only 18 patient cases (8%) demonstrated both alternative sonographic findings as well as a change in management by the emergency room physician.

Alternative diagnostic findings, based on a complete abdominopelvic sonogram, were common (61%) in this chart review but rarely changed patient management.

The purpose of this mixed-methods study was to gather benchmark data on curricular content related to imaging of transgender patients. In addition, the intent was to explore program directors’ opinions on the need to include this content in the curriculum.

An online survey was emailed to all directors (n = 982) of accredited imaging programs in the United States.

In total, 331 (34%) program directors participated in the survey. Fifty-six percent currently do not include this content in their curriculum and 67% reported no discussion of adding the material. There was a modest and significant positive correlation between the program directors’ perceived level of knowledge, regarding imaging transgender patients, and their perceived importance of including this material in the curriculum (r = 0.370; P < .001). Positive (55%), negative (7%), and neutral themes (38%) emerged from the qualitative data analysis.

These findings were consistent with literature regarding a lack of curriculum specific to transgender patients. Program directors recognized the need to include this content, although barriers exist related to readiness to implement, limited faculty knowledge with the material, and lack of educational resources. Program directors are seeking strategies and resources to guide the integration of this material into the curriculum.

A review of the anatomy of the synovial recesses of the knee is important to better understand the different effusion presentations, update the diagnosis criteria of knee effusion based on the measured synovial recesses and discuss the differentiation of some effused recesses from other lesions around the knee.

This review focuses on the anatomy of the synovial recesses of the knee and classifies them into three groups (anterior, parameniscal, and posterior recesses), as well as provides an overview on the etiology of knee effusion, its sonographic detection, and diagnosis criteria.

Knee effusion is a very common pathological finding in sonography of the knee. The unique joint structure of the knee provides the possibility to host complex synovial recesses. Fluid in some of the synovial recesses is valuable for the diagnosis of knee effusion, while in certain situations, some recesses may impose diagnostic uncertainty. Knowledge of these synovial recesses is essential to avoid diagnostic pitfalls.

This review provides an important discussion of the differentiation of some recesses effusions from other lesions around the knee.

Children with critical congenital heart disease (CHD) often present in remote areas with life-threatening illness. Although performing complete pediatric echocardiograms requires significant training, remote locations necessitate sonographers with limited pediatric experience screen for CHD. The Sonographer University (SU) was designed to improve comfort in adult sonographers scanning children and recognizing CHD.

The SU consisted of lectures, multimedia case studies, roundtable discussions, pathology stations, and hands-on scanning of 20 volunteer pediatric patients with either normal or diseased hearts. Topics included an overview of critical congenital heart lesions, crucial views for each defect, and pitfalls in imaging children.

Forty-four participants completed the SU seminar. In pretest assessment, approximately two-thirds said they were currently required to scan children. Participants’ comfort level sonographically scanning children and recognizing CHD improved substantially. A posttest showed that the course improved participants’ skill, knowledge, and confidence with pediatric studies.

The SU seminar helped sonographers from remote areas to develop improved recognition of CHD, confidence in pediatric scanning, and methods for obtaining assistance with imaging a critically ill child.