Issac Cheong, Lucila Avanzato, Raúl Alejandro Gómez, Federico Matías Álvarez Vilariño, María Virginia Mazzola, Gastón Adrián Baiona, M. S. Santagiuliana, M. Furche, F. Tamagnone, P. M. Merlo
Fat embolism (FES) is a condition that can lead to severe organ effects and death in patients with long bone fractures. Diagnosis is challenging due to multiple criteria. This case report presents the use of point‐of‐care ultrasound (POCUS) in diagnosing right ventricular dysfunction associated with fat embolism syndrome. A 36‐year‐old patient with a history of obesity presented with multiple fractures and respiratory failure after a road accident. Bedside echocardiography showed evidence of dilated right chambers, right ventricular outflow tract shortened acceleration time, and mild tricuspid insufficiency. Venous ultrasonography showed microembolic signals (MES) interpreted as fat embolism. The patient was treated with fracture reduction and osteosynthesis, which showed improvement in right ventricular dysfunction and the disappearance of MES. FES is a clinical syndrome that occurs after an identifiable bone injury. This case highlights the utility of POCUS in the diagnosis of FES.
{"title":"Diagnosis of fat embolism syndrome using point‐of‐care ultrasound","authors":"Issac Cheong, Lucila Avanzato, Raúl Alejandro Gómez, Federico Matías Álvarez Vilariño, María Virginia Mazzola, Gastón Adrián Baiona, M. S. Santagiuliana, M. Furche, F. Tamagnone, P. M. Merlo","doi":"10.1002/sono.12397","DOIUrl":"https://doi.org/10.1002/sono.12397","url":null,"abstract":"Fat embolism (FES) is a condition that can lead to severe organ effects and death in patients with long bone fractures. Diagnosis is challenging due to multiple criteria. This case report presents the use of point‐of‐care ultrasound (POCUS) in diagnosing right ventricular dysfunction associated with fat embolism syndrome. A 36‐year‐old patient with a history of obesity presented with multiple fractures and respiratory failure after a road accident. Bedside echocardiography showed evidence of dilated right chambers, right ventricular outflow tract shortened acceleration time, and mild tricuspid insufficiency. Venous ultrasonography showed microembolic signals (MES) interpreted as fat embolism. The patient was treated with fracture reduction and osteosynthesis, which showed improvement in right ventricular dysfunction and the disappearance of MES. FES is a clinical syndrome that occurs after an identifiable bone injury. This case highlights the utility of POCUS in the diagnosis of FES.","PeriodicalId":29898,"journal":{"name":"Sonography","volume":" 11","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139143595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Disappeared left atrial “myxoma”: Left atrial thrombus was misdiagnosed as myxoma","authors":"Meng Dai, Jiaying Chen, Xuejie Li","doi":"10.1002/sono.12396","DOIUrl":"https://doi.org/10.1002/sono.12396","url":null,"abstract":"","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"73 s327","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139146585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hypoechoic liver in a fetus with trisomy 21 but without transient abnormal myelopoiesis at birth","authors":"Emma Manunui, M. Necas","doi":"10.1002/sono.12395","DOIUrl":"https://doi.org/10.1002/sono.12395","url":null,"abstract":"","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"8 10","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139158347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Issac Cheong, Lucila Avanzato, Milton Bermeo, Patricio José Duarte, Javier Arrinda, P. M. Merlo
{"title":"Cardiac involvement in a case of severe eosinophilic syndrome characterized by echocardiography","authors":"Issac Cheong, Lucila Avanzato, Milton Bermeo, Patricio José Duarte, Javier Arrinda, P. M. Merlo","doi":"10.1002/sono.12393","DOIUrl":"https://doi.org/10.1002/sono.12393","url":null,"abstract":"","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"33 11","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139161517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Spurway, Georgina Luscombe, Melanie Laird, Conan Chan
This study explores the impact on arteriovenous fistula (AVF) creation and maturation of four methods of heating the scanning environment during ultrasound upper limb mapping, and sonographer perceived useability of the environments.A retrospective audit at Orange and Bathurst hospitals involving patients who underwent ultrasound upper limb mapping (2016–2022). Patients were scanned using warm gel and three additional methods of warming. Two sonographers provided their preference and opinions on each environment. Data on AVF type, brachial artery blood flow (QBRA), AVF maturity status at 3 and 6 months and intervention within this timeframe was retrieved. Data from the three additional heated environments was combined for analysis (heated environments) against the heated gel only environment (gel environment).Eighty‐five patients met selection criteria. There was no significant difference in the proportion of successfully created AVFs between the heated and the gel environments (90% vs. 94%). A greater percentage of AVFs mapped in the heated environments reached maturity without intervention compared to the gel environment (70% vs. 48%, respectively). There was a statistically significant higher QBRA in the AVFs mapped in the heated environments (1.25 L/min) that reached maturity by 3 months without intervention compared to the gel environment (0.95 L/m; p = .008). Sonographers found a warm blanket/electric throw the easiest methods of heating the scanning environment.Using an electric throw and/or a warm blanket during ultrasound upper limb mapping is practical and optimises the scan environment, which provides surgeons with quality information that ultimately improves AVF creation outcomes.
{"title":"Heating the scanning environment during ultrasound upper limb mapping: Impact on arteriovenous fistula creation outcomes and sonographer's perceptions of heating method useability","authors":"J. Spurway, Georgina Luscombe, Melanie Laird, Conan Chan","doi":"10.1002/sono.12385","DOIUrl":"https://doi.org/10.1002/sono.12385","url":null,"abstract":"This study explores the impact on arteriovenous fistula (AVF) creation and maturation of four methods of heating the scanning environment during ultrasound upper limb mapping, and sonographer perceived useability of the environments.A retrospective audit at Orange and Bathurst hospitals involving patients who underwent ultrasound upper limb mapping (2016–2022). Patients were scanned using warm gel and three additional methods of warming. Two sonographers provided their preference and opinions on each environment. Data on AVF type, brachial artery blood flow (QBRA), AVF maturity status at 3 and 6 months and intervention within this timeframe was retrieved. Data from the three additional heated environments was combined for analysis (heated environments) against the heated gel only environment (gel environment).Eighty‐five patients met selection criteria. There was no significant difference in the proportion of successfully created AVFs between the heated and the gel environments (90% vs. 94%). A greater percentage of AVFs mapped in the heated environments reached maturity without intervention compared to the gel environment (70% vs. 48%, respectively). There was a statistically significant higher QBRA in the AVFs mapped in the heated environments (1.25 L/min) that reached maturity by 3 months without intervention compared to the gel environment (0.95 L/m; p = .008). Sonographers found a warm blanket/electric throw the easiest methods of heating the scanning environment.Using an electric throw and/or a warm blanket during ultrasound upper limb mapping is practical and optimises the scan environment, which provides surgeons with quality information that ultimately improves AVF creation outcomes.","PeriodicalId":29898,"journal":{"name":"Sonography","volume":" 4","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138962979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tracy Truong, N. Kennedy, Vasundhara Kaushik, Jennifer Alphonse, A. Quinton
When scanning for deep endometriosis a 20 mL syringe is used to insert gel into the vagina for a gel sonovaginography (SVG) examination. This is invasive and can cause discomfort. The aim of this study is to compare participant experience with the self‐administration of 20 mL of gel total using a 10 mL syringe versus 20 mL syringe for participants undergoing a gel SVG ultrasound to assess for any participant discomfort.This study was a quantitative pilot study with 31 participants. Consenting participants were instructed to insert a total of 20 mL of gel divided equally into one 20 mL and one 10 mL syringe, into their own vagina prior to SVG. After the SVG, a questionnaire was provided to determine the level of discomfort experienced.Overall participants found the instructions clear and the insertion of either syringe tolerable. The results demonstrated that 22/31 (71%) of participants had no discomfort inserting the 10 mL syringe. In comparison, 17/31 (55%) reported slight or mild discomfort inserting the 20 mL syringe. The majority of participants preferred inserting one 20 mL syringe rather than two 10 mL syringes.Participants found the gel insertion using either syringe tolerable with most participants finding the 10 mL syringe more comfortable but would overall prefer inserting one 20 mL syringe instead of two 10 mL syringes. Future studies on larger numbers of multicultural participants using variable syringe sizes with varying amounts of gel should be considered.
{"title":"Patient experience when self‐introducing gel into the vagina for assessment of deep endometriosis: A pilot study","authors":"Tracy Truong, N. Kennedy, Vasundhara Kaushik, Jennifer Alphonse, A. Quinton","doi":"10.1002/sono.12391","DOIUrl":"https://doi.org/10.1002/sono.12391","url":null,"abstract":"When scanning for deep endometriosis a 20 mL syringe is used to insert gel into the vagina for a gel sonovaginography (SVG) examination. This is invasive and can cause discomfort. The aim of this study is to compare participant experience with the self‐administration of 20 mL of gel total using a 10 mL syringe versus 20 mL syringe for participants undergoing a gel SVG ultrasound to assess for any participant discomfort.This study was a quantitative pilot study with 31 participants. Consenting participants were instructed to insert a total of 20 mL of gel divided equally into one 20 mL and one 10 mL syringe, into their own vagina prior to SVG. After the SVG, a questionnaire was provided to determine the level of discomfort experienced.Overall participants found the instructions clear and the insertion of either syringe tolerable. The results demonstrated that 22/31 (71%) of participants had no discomfort inserting the 10 mL syringe. In comparison, 17/31 (55%) reported slight or mild discomfort inserting the 20 mL syringe. The majority of participants preferred inserting one 20 mL syringe rather than two 10 mL syringes.Participants found the gel insertion using either syringe tolerable with most participants finding the 10 mL syringe more comfortable but would overall prefer inserting one 20 mL syringe instead of two 10 mL syringes. Future studies on larger numbers of multicultural participants using variable syringe sizes with varying amounts of gel should be considered.","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"32 3","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138605552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Editorial: A new phase for Sonography: Online only publication","authors":"Kerry Thoirs","doi":"10.1002/sono.12390","DOIUrl":"https://doi.org/10.1002/sono.12390","url":null,"abstract":"","PeriodicalId":29898,"journal":{"name":"Sonography","volume":" 6","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138617339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 23‐year‐old man with a history of a testicular germ cell tumor (GCT) that was incompletely treated, is presented with dyspnea. Significant bilateral pulmonary masses were seen on computed tomography (CT). A large, hypermobile mass in the left atrium (LA) as well as mitral valve dysfunction and moderate pulmonary hypertension was detected by transthoracic echocardiography (TTE). Urgent cardiac surgery was performed to prevent the tumor embolism in addition to restore mitral valve function and reduce pulmonary hypertension. Pathologic reports confirmed testicular GCT. GCT metastasis to the heart and lungs is an incredibly rare phenomenon. To our knowledge, this is the first case of simultaneous GCT metastasis to both lungs and LA. This article highlights the importance of cardiac examinations and imaging in germ cell tumor patients. If there is a functional complication for vital organs such as the heart or lungs, surgical interventions are given priority before starting chemotherapy.
一名 23 岁的男子曾患睾丸生殖细胞瘤 (GCT)，治疗不彻底，现出现呼吸困难。计算机断层扫描（CT）发现双侧肺部有明显肿块。经胸超声心动图（TTE）检查发现，左心房（LA）有一个巨大、活动度大的肿块，同时还发现二尖瓣功能障碍和中度肺动脉高压。为了防止肿瘤栓塞，同时恢复二尖瓣功能和减轻肺动脉高压，患者接受了紧急心脏手术。病理报告证实为睾丸 GCT。GCT转移到心脏和肺部是一种非常罕见的现象。据我们所知，这是第一例同时转移到肺和 LA 的 GCT。本文强调了生殖细胞瘤患者心脏检查和成像的重要性。如果心脏或肺部等重要器官出现功能性并发症，在开始化疗前应优先考虑手术治疗。
{"title":"Simultaneous bilateral pulmonary and cardiac invasion of metastatic testicular germ cell tumor: A rare case report","authors":"Taghi Riahi, Mahboubeh Pazoki, Sam Zeraatian Nejad Davani, Reza Jahangiri, Nastaran Khodakarim, Alireza Jafarzadeh, Soroush Mostafavi","doi":"10.1002/sono.12387","DOIUrl":"https://doi.org/10.1002/sono.12387","url":null,"abstract":"A 23‐year‐old man with a history of a testicular germ cell tumor (GCT) that was incompletely treated, is presented with dyspnea. Significant bilateral pulmonary masses were seen on computed tomography (CT). A large, hypermobile mass in the left atrium (LA) as well as mitral valve dysfunction and moderate pulmonary hypertension was detected by transthoracic echocardiography (TTE). Urgent cardiac surgery was performed to prevent the tumor embolism in addition to restore mitral valve function and reduce pulmonary hypertension. Pathologic reports confirmed testicular GCT. GCT metastasis to the heart and lungs is an incredibly rare phenomenon. To our knowledge, this is the first case of simultaneous GCT metastasis to both lungs and LA. This article highlights the importance of cardiac examinations and imaging in germ cell tumor patients. If there is a functional complication for vital organs such as the heart or lungs, surgical interventions are given priority before starting chemotherapy.","PeriodicalId":29898,"journal":{"name":"Sonography","volume":"26 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139220130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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