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Atherosclerosis is a chronic inflammatory disease that can be undetected in middle-aged patients. Abdominal aortic calcifications (AACs) are one form of cardiovascular disease (CVD), and these can go undetected during a routine physician visit. Sonography has the potential to assess CVD progression, quantify plaque in the aorta, and help to quantify risk in asymptomatic patients.
This pilot study modified a current AAC grading system to create a scoring method for sonographic images among a small cohort of asymptomatic participants. A traditional portable ultrasound unit was used to image participants, and a subset underwent the same imaging with a handheld transducer and tablet.
In this cohort, six males and five females, it was possible to adequately visualize and assess plaque, utilizing both types of ultrasound equipment. The abdominal aorta was divided into segments on the sonogram for quality of grading. Ten participants were categorized with a grade II and one participant was given a grade IIIA.
Replication of this modified grading system is needed to better understand the clinical utilization of sonography as a risk assessment tool. The risk assessment scoring was not dependent on the type of device used.

To determine the accuracy of supine and prone approaches to sonographically measured kidney dimensions.
The kidney dimensions of 109 participants were sonographically determined in supine and prone patient positions. The two measurements were compared with each other using the intra-class correlation, coefficient of variation for duplicate measurements and Bland-Altman plot. The two sets of measurements were each compared with measurements from computed tomography.
There was a very strong agreement between kidney dimensions in supine and prone positions. There was also an agreement between kidney dimensions in supine and prone positions and computed tomography measurements.
The kidney dimensions obtained using patient-in-supine position and patient-in-prone position approaches may be equivalent and the two approaches may be used interchangeably.

The objective of this study was to determine the elasticity of sternocleidomastoid muscle (SCM) in patients with congenital muscular torticollis (CMT).
In all, 41 patients and 22 controls were included in the study, and the elasticity of the patients’ SCM was measured. Echogenicity, thickness, and strain values of the SCM were also obtained.
The thickness and strain values of the SCM were higher in the patient group than in the control group (
The strain elastography technique can be used in the diagnosis of CMT.

The study aimed to determine the accuracy of sonography in diagnosing pyomyositis.
A retrospective review of pyomyositis cases in a government hospital between January 1, 2016 and June 30, 2019 was done. All cases underwent a sonogram for the indication of pyomyositis. Positive purulence for surgical cases and improved laboratory parameters for conservative cases were confirmatory for pyomyositis. Comparison with sonographic results using a 2 × 2 contingency table was done to determine sensitivity and specificity.
A total of 122 cases were included. The sonographic results corresponded with 95% of surgical cases and 89% of conservative cases. A lack of false and true negatives for surgical cases resulted in a sensitivity of 100% (95% confidence interval [CI] = 93%–100%) and a specificity of 0% (95% CI = 0%–71%). In conservative cases, sonography had a sensitivity of 92% (95% CI = 82%–97%) and a specificity of 0% (95% CI = 0%–84%) due to a lack of true negatives.
Sonography is not limited to primarily as a screening tool but a capable diagnostic imaging choice for pyomyositis, particularly in low-resource settings. The results show the strength of sonography, particularly in the suppurative stage of pyomyositis.
Localized inflammation, leukocytosis, increased erythrocyte sedimentation rate and c-reactive protein should warrant a consideration of pyomyositis.
Clinical and laboratory findings are complementary to imaging when considering pyomyositis.
Sonography is not limited to as primarily a screening tool.
Sonography appears to have more utility in the suppurative stage of pyomyositis.

There has always been some issues in the accurate diagnosis of pneumonia, a common cause of emergency department (ED) visits and revisits, which is typically made based on the patient’s clinical syndrome. This is made more difficult due to the traditional chest radiography having limited accuracy. This prospective multicenter study was conducted to determine the diagnostic accuracy of a point-of-care lung sonography performed by emergency physicians for the diagnosis of pneumonia in an acute care setting. This was compared with chest computed tomography (CT), the diagnostic gold standard.
ED patients who presented with signs and symptoms of pneumonia were eligible to enroll in the study. After enrollment, point-of-care lung sonography was performed on patients by emergency physicians who had passed a focused teaching course on lung sonographic findings of pneumonia. All enrolled patients were followed up. Patients who underwent a chest CT during their hospital admission course were finally included and analyzed.
Emergency physicians who performed a point-of-care lung sonography had a sensitivity of 100%, specificity of 75%, positive predictive value of 88.88%, negative predictive value of 100%, and an overall accuracy of 90% in the diagnosis of pneumonia.
These emergency physicians could accurately diagnose pneumonia, with a point-of-care lung sonography, after completing a focused sonography course.

Some structural abnormalities have been reported on sonography of pancreas in patients with beta-thalassemia which can indicate that the patient is developing diabetes. In this study, the aim was to investigate the findings of pancreatic sonography in patients, with beta-thalassemia major.
This cross-sectional study included information extracted from the medical record and entered into an information form. A cohort of 190 people were split into case and control groups, retrospectively. The required data were extracted from patient’s documents. Data were analyzed with SPSS software, version 22; with the chi-square statistical tests. A
This study consisted of 33 males and 61 females in the case group and 32 males and 64 females in the control group. The most common echogenicity observed during pancreatic sonography, in the control group, was an isoechoic feature (72.3%), followed by hyper and hypoechogenicity (18.1% and 9.6%, respectively). The prevalence of an isoechoic texture in the patient case group was 58.3%, while hyper and hypoechogenicity were seen in 26% and 2.1%, respectively (
This study demonstrates, in this patient group, that there was a poor relationship between pancreatic head size with serum ferritin levels and pancreatic echogenicity with diabetes. These results may suggest using sonography to diagnose early stages of diabetes in patients with thalassemia.

Traumatic peripheral nerve injury is not a common finding in the general population but is increasingly being recognized and diagnosed in trauma and emergency medicine settings. Peripheral nerve injury can cause temporary or long-term motor and sensory loss, as well as intense pain and disability, if left untreated. The cause of peripheral nerve injury is diverse and often involves soft tissue damage, fractures, and hemorrhage in cases of traumatic injury. Peripheral nerve injury does not always heal spontaneously and, depending on severity, may warrant surgical intervention and repair. Although electrodiagnosic testing and surgical exploration are considered gold standards for peripheral nerve injury, high-resolution sonographic examination supplemented by clinical findings may be of value. The use of sonography demonstrated utility in determining a strategic management timeline and the efficacy of a surgical intervention.

Serous cystadenofibromas are benign surface epithelial stromal tumors of the ovary. Many of the sonographic features of serous cystadenofibromas mimic what are traditionally considered possible characteristics of malignancy. Depending on the size of the ovarian neoplasm, there can be increased risk for ovarian torsion. Meticulous sonographic evaluation and appropriate optimization are critical for establishing the risk for malignancy and likelihood of torsion. This case describes how sonography was used to help identify a serous cystadenofibroma in a postmenopausal woman.

Malignant melanoma is a cellular cancer that produces pigmentation of the skin. The tendency toward melanoma may be inherited, and risk factors are increased with overexposure to the sun and ultraviolet radiation. Melanomas commonly present as a dark, asymmetrical, mole-like spot that spreads, with an irregular border. It is uncommon to find a melanoma in the auricular regions and even rarer for it to be a primary malignancy of the auricles. Utilizing sonography to evaluate melanoma lesions could serve as a prognostic indicator, regarding Breslow’s depth, an aide in staging, as well as surgical planning. However, utilizing multiple diagnostic imaging modalities is essential in the proper evaluation and staging of a melanoma. Currently there are revolutionary, effective systemic therapies available for patients with a metastatic melanoma. Current therapies are focused on immunotherapy and checkpoint inhibitors. These treatment options provide an opportunity for selected metastatic melanoma patients to achieve healthy long-term success.

Horseshoe kidney in the presence of autosomal dominant polycystic kidney disease is a rare occurrence of two relatively common and unrelated renal findings. Visualization of multiple, bilateral cysts along with fusion of the kidneys by a midline isthmus can usually isolate these diagnoses. Accurate sonographic evaluation is essential in determining the degree of disease progression and possible complications associated with these diseases. Sonography is also useful in identifying extrarenal involvement and eliminating differential diagnoses.

Penile fracture is a rare urological emergency requiring prompt diagnosis and management. The role of high-resolution ultrasonography is established in detecting a tear, in the tunica albuginea. The late complications of penile fracture are distressing and may manifest as asymmetrical and insufficient penile tumescence, penile ischemia, and sometimes urethral stenosis. The current case series demonstrates the combined role of post-papaverine penile Doppler duplex ultrasonography and sonourethrography techniques in assessing the late presenting cases of penile fractures. The combination of these two techniques was found to be a useful comprehensive imaging tool. This combination can be employed in clinical practice to define the extent of trauma and penile insufficiency, in an efficient manner.

Ultrasound imaging architecture, the underlying engineering design and structure that enables an imaging platform to perform its wide and varied array of clinical applications, has evolved significantly over the past two decades. By integrating technological advances and innovative design elements into contemporary premium-level imaging systems, many of the constraints associated with conventional imaging architecture have been mitigated. This progress has opened the door to the introduction of novel diagnostic capabilities into the sonographic armamentarium. Of necessity, then, is the need for a concomitant evolution of educational endeavors; didactic and clinical approaches that will ensure that sonography practitioners remain competent as the future of our profession and scopes of practice unfold. This paper, and the associated supplemental white paper, offers a synopsis of advanced ultrasound imaging architecture that, hopefully, can serve as a springboard for development of similarly evolved educational endeavors.