Journal of Medical Ultrasound最新文献

Lung ultrasound (LUS) has emerged as a crucial tool in the diagnosis and monitoring of acute respiratory failure, particularly in critically ill patients. In this case, a man in his late 50s presented to the emergency department with respiratory distress and rapidly deteriorated, requiring invasive ventilation and intensive care unit admission for septic shock and multiorgan dysfunction. LUS revealed extensive consolidation with linear-arborescent dynamic air bronchogram, specific for community-acquired and ventilator-associated pneumonia, with a global LUS score of 22, indicating significant severity. LUS demonstrated greater sensitivity and specificity compared to chest radiography, allowing for a more reliable and timely diagnosis. The use of LUS was especially valuable given the patient's hemodynamic instability, which made computed tomography unfeasible. As a portable, radiation-free imaging modality, LUS offers significant advantages over traditional methods, particularly in emergency and critical care settings, where rapid bedside assessments are essential for guiding treatment and ensuring continuous patient monitoring.

Background: The dependence of each subtype of rotator cuff tears (RCTs) on ultrasound (US) experience and technique is unknown. The aims of this study were to investigate the necessity of physician qualification and US technical upgrades - possible further diagnostic triage strategies when certain sites of involvement are not clear, by analyzing the degree of dependence of symptomatic rotator cuff on qualifications and techniques.

Methods: Two-dimensional US and contrast-enhanced US (CEUS) images of 84 patients who had undergone arthroscopy from 2014 to 2022 were retrospectively analyzed by two senior and two junior radiologists, using a randomized blinded method. A multivariable logistic model was established with the probability of correct diagnosis to investigate the extent to which qualifications, techniques, and subtypes affect the accurate diagnosis of RCTs.

Results: Qualification, mode, and subtype were statistically different (P < 0.05), where CEUS was 10.48 times more likely to be diagnosed correctly than US and 2.43 times by senior than by junior physicians overall (P < 0.05). CEUS was 19.89, 5.15, and 10.48 times more likely than US to be diagnosed correctly when the subtypes were bursal-side partial-thickness tear (P < 0.05), articular-side partial-thickness tear, and small full-thickness tear, respectively (P < 0.05).

Conclusion: In clinical practice, when bursal-side tendon involvement is suspected on US, it is more practical to recommend CEUS than to improve seniority, whereas for articular-side tendon involvement, qualification upgrade is recommended first.

Background: Periarticular abnormalities are common ultrasonographic (U/S) findings in individuals with knee pain. Incidental U/S observations, including thickening of the distal hamstring tendons, require explanations for their clinical importance. In addition, it is unclear whether or not these tendon modifications are related to knee pain. The objective is to determine U/S findings of distal medial hamstring tendons in patients with posteromedial (PM) knee pain and assess the diagnostic significance of tendon thickness in predicting tendinopathy in those patients.

Methods: We studied the distal medial hamstring tendons (semimembranosus [SM] and semitendinosus [ST]) of 104 patients (104 knees) with nontraumatic unilateral PM knee pain and 118 healthy controls (236 knees). U/S evaluations included tendon thickness, echogenicity, the presence of intrasubstance tears, calcifications, and vascularity.

Results: The mean age of patients and controls was 51.7 ± 10.4 years and 49.8 ± 9.9 years, respectively. The mean Visual Analog Scale (VAS) for pain among patients was 5.1, with 58.6% of them reporting pain at the medial joint line. The study patients had significantly higher mean SM and ST tendon thicknesses than the controls (7.17 mm vs. 5.46 mm and 3.93 mm vs. 3.45 mm, respectively). U/S abnormalities among patients were hypoechogenicity (62.5%), intrasubstance tears (31.7%), loss of fibrillar pattern (23.1%), baker cyst (20.2%), calcification (18.3%), anserine bursitis (11.5%), and neovascularization (6.7%). We found significant correlations between tendon thickness and VAS (r = 0.752, P = 0.004) as well as pain location (r = 0.680, P = 0.008). SM tendon thickness measured by U/S was more accurate in predicting tendinopathy than ST (80.6% vs. 68.9%).

Conclusion: U/S changes tend to occur frequently in individuals experiencing PM knee pain. Among the various abnormalities detectable by U/S, an increase in tendon thickness serves as a reliable indicator of tendinopathy and correlates strongly with the location and severity of knee pain. When dealing with PM knee pain, a comprehensive evaluation of the distal medial hamstring tendons through U/S examination can be instrumental in achieving a timely and accurate diagnosis as well as an effective treatment plan.