Pub Date : 2023-10-16DOI: 10.1177/87564793231201584
{"title":"SDMS CME Credit – Detecting Hemopneumothorax With Lung Sonography: A Case Report","authors":"","doi":"10.1177/87564793231201584","DOIUrl":"https://doi.org/10.1177/87564793231201584","url":null,"abstract":"","PeriodicalId":45758,"journal":{"name":"JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136113516","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}
Pub Date : 2023-10-16DOI: 10.1177/87564793231201585
{"title":"SDMS CME Credit – Comparing Ultrasonography With Plain Radiography in the Diagnosis of Long Bone Fractures","authors":"","doi":"10.1177/87564793231201585","DOIUrl":"https://doi.org/10.1177/87564793231201585","url":null,"abstract":"","PeriodicalId":45758,"journal":{"name":"JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136113687","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}
Pub Date : 2023-10-14DOI: 10.1177/87564793231200173
Joy D. Guthrie, Serena M. Bierig
Objective: Laboratory accreditation has been shown to impact variability and completeness. However, little data exist demonstrating the impact of personnel credentialing on completeness and efficiency. Therefore, the aim of this study was to evaluate exam completeness and efficiency among staff with an advanced cardiac sonographer (ACS) credential, Registered Diagnostic Cardiac Sonographer or Registered Cardiac Sonographer and noncredentialed staff. Materials and Methods: Retrospective review of adult and pediatric echocardiograms at eight facilities in three states. Exam completeness was compared with Intersocietal Accreditation Commission (IAC) standards and completeness by pathology was compared with the American Society of Echocardiography (ASE) standards. Results: This study was based on the review of 1147 patient cases. Of the cases reviewed, 60.3% were performed by credentialed (non-ACS) sonographers, 28.3% were completed by credentialed ACS, and 11.3% by noncredentialed staff. The credentialed staff completed exams ≤ 12 hours. The exams were reviewed for compliance with IAC standards and completed by ACS staff: 80.0% in aortic stenosis and 55.6% in non-ACS staff. Those patient cases for mitral regurgitation (14/19) were 73.7% IAC compliant, cases completed by credentialed non-ACS (20/56) were 35.7% compliant, and those completed by noncredentialed sonographers (2/11) only 18.2% were compliant. Cases specific to patent ductus arteriosus were 92.1% compliant with IAC standards that were completed by ACS compared with 77.9% completed by non-ACS staff. Cases of pulmonary hypertension were also evaluated for IAC compliance and 61.8% met the standard with ASE versus 41.7% completed by non-ACS. Conclusion: Examinations performed by ACS are more often complete in important pathology. Examination efficiency is highest among credentialed sonographers.
{"title":"Impact of Advanced Cardiac Sonographers on Exam Completeness in the Echocardiography Laboratory","authors":"Joy D. Guthrie, Serena M. Bierig","doi":"10.1177/87564793231200173","DOIUrl":"https://doi.org/10.1177/87564793231200173","url":null,"abstract":"Objective: Laboratory accreditation has been shown to impact variability and completeness. However, little data exist demonstrating the impact of personnel credentialing on completeness and efficiency. Therefore, the aim of this study was to evaluate exam completeness and efficiency among staff with an advanced cardiac sonographer (ACS) credential, Registered Diagnostic Cardiac Sonographer or Registered Cardiac Sonographer and noncredentialed staff. Materials and Methods: Retrospective review of adult and pediatric echocardiograms at eight facilities in three states. Exam completeness was compared with Intersocietal Accreditation Commission (IAC) standards and completeness by pathology was compared with the American Society of Echocardiography (ASE) standards. Results: This study was based on the review of 1147 patient cases. Of the cases reviewed, 60.3% were performed by credentialed (non-ACS) sonographers, 28.3% were completed by credentialed ACS, and 11.3% by noncredentialed staff. The credentialed staff completed exams ≤ 12 hours. The exams were reviewed for compliance with IAC standards and completed by ACS staff: 80.0% in aortic stenosis and 55.6% in non-ACS staff. Those patient cases for mitral regurgitation (14/19) were 73.7% IAC compliant, cases completed by credentialed non-ACS (20/56) were 35.7% compliant, and those completed by noncredentialed sonographers (2/11) only 18.2% were compliant. Cases specific to patent ductus arteriosus were 92.1% compliant with IAC standards that were completed by ACS compared with 77.9% completed by non-ACS staff. Cases of pulmonary hypertension were also evaluated for IAC compliance and 61.8% met the standard with ASE versus 41.7% completed by non-ACS. Conclusion: Examinations performed by ACS are more often complete in important pathology. Examination efficiency is highest among credentialed sonographers.","PeriodicalId":45758,"journal":{"name":"JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135803349","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}
Pub Date : 2023-09-25DOI: 10.1177/87564793231200192
Jose Luis Bastida, Maria S. Horenstein
This case study describes a 13-year-old male who presented with ventricular fibrillation and pulseless ventricular tachycardia (VT) that occurred during football practice. An echocardiogram showed severely diminished biventricular function with an ejection fraction (EF) of 23% and an anomalous left main coronary artery from the right sinus with an apical echogenic mass of 1.2 cm × 1.2 cm, believed to be a thrombus. The patient underwent unroofing of the left main coronary artery. He was discharged on lisinopril, aspirin, and metoprolol, and a follow-up echocardiogram 79 days after discharge showed improved EF of 51% and resolution of the apical thrombus. It is crucial to remember that postsurgical approaches may still present challenges even after the initial repair or intervention. It is important to remain vigilant and aware of any potential issues that may arise as they can have significant impact on the overall success of the procedure.
这个案例研究描述了一个13岁的男性谁提出心室颤动和无脉性室性心动过速(VT)，发生在足球练习。超声心动图显示双心室功能严重下降，射血分数(EF)为23%，左冠状动脉主动脉与右窦异常，顶端回声肿块大小为1.2 cm × 1.2 cm，认为是血栓。病人接受了左冠状动脉主干去顶术。出院后给予赖诺普利、阿司匹林和美托洛尔治疗，出院后79天随访超声心动图显示EF改善51%，根尖血栓消退。重要的是要记住，即使在最初的修复或干预后，术后入路仍然可能存在挑战。重要的是要保持警惕，意识到可能出现的任何潜在问题，因为它们会对手术的整体成功产生重大影响。
{"title":"The Importance of Cardiac Prescreening: A Case Report of Cardiac Arrest in a Teen Athlete","authors":"Jose Luis Bastida, Maria S. Horenstein","doi":"10.1177/87564793231200192","DOIUrl":"https://doi.org/10.1177/87564793231200192","url":null,"abstract":"This case study describes a 13-year-old male who presented with ventricular fibrillation and pulseless ventricular tachycardia (VT) that occurred during football practice. An echocardiogram showed severely diminished biventricular function with an ejection fraction (EF) of 23% and an anomalous left main coronary artery from the right sinus with an apical echogenic mass of 1.2 cm × 1.2 cm, believed to be a thrombus. The patient underwent unroofing of the left main coronary artery. He was discharged on lisinopril, aspirin, and metoprolol, and a follow-up echocardiogram 79 days after discharge showed improved EF of 51% and resolution of the apical thrombus. It is crucial to remember that postsurgical approaches may still present challenges even after the initial repair or intervention. It is important to remain vigilant and aware of any potential issues that may arise as they can have significant impact on the overall success of the procedure.","PeriodicalId":45758,"journal":{"name":"JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135815714","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}
Pub Date : 2023-09-22DOI: 10.1177/87564793231198521
Casey Farrell, Kay Cooper, Simon Hayward, Craig Walker
Objective: Lung ultrasonography (LUS) is a safe, quick, and portable diagnostic tool, which can accurately detect postoperative pulmonary complications, postsurgically, without ionizing radiation. The aim of this scoping review was to map the evidence base regarding the use of LUS to assess cardiac surgery patients. Materials and Methods: The JBI methodology was used to conduct this particular scoping review. Results: In total, 90 publications were identified and of those, 73 were research studies, six were narrative reviews, and 11 were narrative, opinion, and text articles. The studies that were included were predominantly observational cohorts and aimed to determine or compare LUS diagnostic ability, prognostic ability, or both. The LUS methods used with patients were heterogeneous and variably reported. Conclusion: Despite an increasing number of studies since 2014, standardized protocols for the use of LUS are yet to be widely adopted and remain an important area for further work. Future research should consider exploring perceptions and experiences of LUS, the use of LUS in treatment outcome measurement, and use by nonphysician health care professionals.
{"title":"Exploring the Use of Lung Ultrasonography to Assess Cardiac Surgery Patients: A Scoping Review","authors":"Casey Farrell, Kay Cooper, Simon Hayward, Craig Walker","doi":"10.1177/87564793231198521","DOIUrl":"https://doi.org/10.1177/87564793231198521","url":null,"abstract":"Objective: Lung ultrasonography (LUS) is a safe, quick, and portable diagnostic tool, which can accurately detect postoperative pulmonary complications, postsurgically, without ionizing radiation. The aim of this scoping review was to map the evidence base regarding the use of LUS to assess cardiac surgery patients. Materials and Methods: The JBI methodology was used to conduct this particular scoping review. Results: In total, 90 publications were identified and of those, 73 were research studies, six were narrative reviews, and 11 were narrative, opinion, and text articles. The studies that were included were predominantly observational cohorts and aimed to determine or compare LUS diagnostic ability, prognostic ability, or both. The LUS methods used with patients were heterogeneous and variably reported. Conclusion: Despite an increasing number of studies since 2014, standardized protocols for the use of LUS are yet to be widely adopted and remain an important area for further work. Future research should consider exploring perceptions and experiences of LUS, the use of LUS in treatment outcome measurement, and use by nonphysician health care professionals.","PeriodicalId":45758,"journal":{"name":"JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136059998","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}
Pub Date : 2023-09-20DOI: 10.1177/87564793231198485
Monique Riemann, Lydia Dana
A 16-year-old female initially presented to urgent care, with a 2-day history of nausea, vomiting, headache, and abdominal pain. After falling and having a tonic/clonic seizure at urgent care, the patient was transferred to an emergency room and subsequently admitted to the pediatric intensive care unit within the hospital for monitoring. Due to persistent tachycardia and hypertension, a renal Doppler examination was performed to evaluate for possible renal artery stenosis. Instead, a 4.0-cm right adrenal mass was discovered, prompting catecholamines and metanephrines testing, and subsequent endocrinology assessment. The diagnosis of pheochromocytoma was made, and a full diagnostic evaluation was completed to exclude extra-adrenal tumor growth and genetic association. Surgical resection of the tumor was successfully accomplished, and the patient was scheduled for annual metanephrine monitoring. This case highlights the significance of a thorough evaluation of the adrenal glands in pediatric patients presenting with atypical hypertension, where renal artery stenosis is suspected.
{"title":"Sonographic Findings of Pheochromocytoma in an Adolescent Female During an Evaluation for Possible Renal Artery Stenosis","authors":"Monique Riemann, Lydia Dana","doi":"10.1177/87564793231198485","DOIUrl":"https://doi.org/10.1177/87564793231198485","url":null,"abstract":"A 16-year-old female initially presented to urgent care, with a 2-day history of nausea, vomiting, headache, and abdominal pain. After falling and having a tonic/clonic seizure at urgent care, the patient was transferred to an emergency room and subsequently admitted to the pediatric intensive care unit within the hospital for monitoring. Due to persistent tachycardia and hypertension, a renal Doppler examination was performed to evaluate for possible renal artery stenosis. Instead, a 4.0-cm right adrenal mass was discovered, prompting catecholamines and metanephrines testing, and subsequent endocrinology assessment. The diagnosis of pheochromocytoma was made, and a full diagnostic evaluation was completed to exclude extra-adrenal tumor growth and genetic association. Surgical resection of the tumor was successfully accomplished, and the patient was scheduled for annual metanephrine monitoring. This case highlights the significance of a thorough evaluation of the adrenal glands in pediatric patients presenting with atypical hypertension, where renal artery stenosis is suspected.","PeriodicalId":45758,"journal":{"name":"JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136308001","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}
High-resolution sonography is a valuable imaging technique to evaluate scrotal trauma. Scrotal injuries can be caused by both blunt and penetrating forces, causing harm to the testicles and other scrotal contents. This case study follows the diagnosis of a gunshot victim’s testicular injury and how the use of sonography plays a major role in both the diagnosis and surveillance of testicular rupture. The initial sonogram identified mild enlargement and an irregularity of the right testicle. Hemorrhage surrounding the right testicle, soft tissue emphysema, scrotal wall edema, and some echogenic debris and/or a foreign body in the scrotum were also identified. Testicular rupture is a rare but serious injury and prompt medical attention is necessary in such cases to reduce long-term complications, including, but not limited to, infection, disability, and loss of the testicle.
{"title":"Sonographic Assessment of a Ruptured Testicle From a Gunshot Wound: A Case Study","authors":"Shannon Anderson, Amy Bro, Malinda Harris, Kimberly Bensyl","doi":"10.1177/87564793231200189","DOIUrl":"https://doi.org/10.1177/87564793231200189","url":null,"abstract":"High-resolution sonography is a valuable imaging technique to evaluate scrotal trauma. Scrotal injuries can be caused by both blunt and penetrating forces, causing harm to the testicles and other scrotal contents. This case study follows the diagnosis of a gunshot victim’s testicular injury and how the use of sonography plays a major role in both the diagnosis and surveillance of testicular rupture. The initial sonogram identified mild enlargement and an irregularity of the right testicle. Hemorrhage surrounding the right testicle, soft tissue emphysema, scrotal wall edema, and some echogenic debris and/or a foreign body in the scrotum were also identified. Testicular rupture is a rare but serious injury and prompt medical attention is necessary in such cases to reduce long-term complications, including, but not limited to, infection, disability, and loss of the testicle.","PeriodicalId":45758,"journal":{"name":"JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136308005","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}
Pub Date : 2023-09-08DOI: 10.1177/87564793231194612
Sumayya Ateeq, S. M. Y. Farooq, Hamnah Fatima, Mehreen Fatima, Maya Chaudhary, Muqadas Sabir, Shaherbano Shafique, Abdul Basit, Sadia Mushtaq, Muhammad Liaqat
The intima-media thickness (IMT) of the common carotid artery (CCA) can indicate cardiovascular and cerebrovascular disease risk, which could aid in early disease identification and prevention. This study was designed to correlate carotid artery IMT with age, obesity, diabetes, and hypertension using sonography. This cross-sectional cohort study included 300 individuals of all ages selected through convenient sampling at a university clinic in Lahore from November 2022 to February 2023. An Xario XG ultrasound equipment system (Toshiba, Tokyo, Japan) and a 7.5- to 10-MHz linear transducer was used to examine the patients. The CCA-IMT was evaluated in 300 individuals (mean age 36.83 years). Significant statistical differences were observed between hypertensive/non-hypertensive and diabetic/non-diabetic individuals ( P < .05). CCA-IMT was positively correlated with age and higher in obese/overweight individuals. This large cohort study found a significant difference in CCA-IMT between hypertensive/diabetic and normal individuals. CCA-IMT was positively correlated with age and body mass index.
{"title":"Sonographic Association of Common Carotid Artery Intima-Media Thickness With Age, Obesity, and Hypertension","authors":"Sumayya Ateeq, S. M. Y. Farooq, Hamnah Fatima, Mehreen Fatima, Maya Chaudhary, Muqadas Sabir, Shaherbano Shafique, Abdul Basit, Sadia Mushtaq, Muhammad Liaqat","doi":"10.1177/87564793231194612","DOIUrl":"https://doi.org/10.1177/87564793231194612","url":null,"abstract":"The intima-media thickness (IMT) of the common carotid artery (CCA) can indicate cardiovascular and cerebrovascular disease risk, which could aid in early disease identification and prevention. This study was designed to correlate carotid artery IMT with age, obesity, diabetes, and hypertension using sonography. This cross-sectional cohort study included 300 individuals of all ages selected through convenient sampling at a university clinic in Lahore from November 2022 to February 2023. An Xario XG ultrasound equipment system (Toshiba, Tokyo, Japan) and a 7.5- to 10-MHz linear transducer was used to examine the patients. The CCA-IMT was evaluated in 300 individuals (mean age 36.83 years). Significant statistical differences were observed between hypertensive/non-hypertensive and diabetic/non-diabetic individuals ( P < .05). CCA-IMT was positively correlated with age and higher in obese/overweight individuals. This large cohort study found a significant difference in CCA-IMT between hypertensive/diabetic and normal individuals. CCA-IMT was positively correlated with age and body mass index.","PeriodicalId":45758,"journal":{"name":"JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78930596","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}
Pub Date : 2023-09-01Epub Date: 2023-06-06DOI: 10.1177/87564793231176009
Shawn C Roll, Sandy C Takata, Buwen Yao, Lynn Kysh, Wendy J Mack
Objective: Establish median nerve CSA reference values and identify patient-level factors impacting diagnostic thresholds.
Methods: Studies were identified through a robust search of multiple databases, and quality assessment was conducted using a modified version of the National Institute of Health Study Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. A meta-analysis was performed to identify normative values stratified by anatomic location. A meta-regression was conducted to examine heterogeneity effects of age, sex, and laterality.
Results: The meta-analysis included 73 studies; 41 (56.2%) were high quality. The median nerve CSA [95% CI] was 6.46mm2 [6.09-6.84], 8.68mm2 [8.22-9.13], and 8.60mm2 [8.23-8.97] at the proximal forearm, the carpal tunnel inlet, and the proximal carpal tunnel, respectively. Age was positively associated with CSA at the level of proximal carpal tunnel (β=0.03mm2, p=0.047). Men (9.42mm2, [8.06-10.78]) had statistically larger proximal tunnel CSA (p = 0.03) as compared to women (7.71mm2, [7.01-8.42]). No difference was noted in laterality.
Conclusion: A reference value for median nerve CSA in the carpal tunnel is 8.60mm2. Adjustments may be required in pediatrics or older adults. The diagnostic threshold of 10.0mm2 for male patients should be cautiously applied as the upper limit of normative averages surpasses this threshold.
{"title":"Sonographic reference values for median nerve cross-sectional area: A meta-analysis of data from healthy individuals.","authors":"Shawn C Roll, Sandy C Takata, Buwen Yao, Lynn Kysh, Wendy J Mack","doi":"10.1177/87564793231176009","DOIUrl":"10.1177/87564793231176009","url":null,"abstract":"<p><strong>Objective: </strong>Establish median nerve CSA reference values and identify patient-level factors impacting diagnostic thresholds.</p><p><strong>Methods: </strong>Studies were identified through a robust search of multiple databases, and quality assessment was conducted using a modified version of the National Institute of Health Study Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. A meta-analysis was performed to identify normative values stratified by anatomic location. A meta-regression was conducted to examine heterogeneity effects of age, sex, and laterality.</p><p><strong>Results: </strong>The meta-analysis included 73 studies; 41 (56.2%) were high quality. The median nerve CSA [95% CI] was 6.46mm<sup>2</sup> [6.09-6.84], 8.68mm<sup>2</sup> [8.22-9.13], and 8.60mm<sup>2</sup> [8.23-8.97] at the proximal forearm, the carpal tunnel inlet, and the proximal carpal tunnel, respectively. Age was positively associated with CSA at the level of proximal carpal tunnel (β=0.03mm<sup>2</sup>, p=0.047). Men (9.42mm<sup>2</sup>, [8.06-10.78]) had statistically larger proximal tunnel CSA (p = 0.03) as compared to women (7.71mm<sup>2</sup>, [7.01-8.42]). No difference was noted in laterality.</p><p><strong>Conclusion: </strong>A reference value for median nerve CSA in the carpal tunnel is 8.60mm<sup>2</sup>. Adjustments may be required in pediatrics or older adults. The diagnostic threshold of 10.0mm<sup>2</sup> for male patients should be cautiously applied as the upper limit of normative averages surpasses this threshold.</p>","PeriodicalId":45758,"journal":{"name":"JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10468154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10152153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-30DOI: 10.1177/87564793231193430
Amjad Khan, Zarin Fatma, R. Bacha, Bakht Rokhan, S. Akhtar, Majid Iqbal, I. Raheem
Objective: This study was designed to compare sonography to skeletal radiography, in the diagnosis of long bone fractures. Materials and Methods: This was a cross-sectional and analytical study including 188 patients of varied ages that had 251 suspected long bone fractures. It was conducted over a 9-month period, in the emergency department of a teaching hospital, within the Swat district of Pakistan. After assessing the clinical symptoms of the fracture by an emergency orthopedic physician, sonography was followed by a radiograph performed for these referred patients. Results: Sonography shows a diagnostic accuracy of 91.23% for detecting long bone fractures, with a sensitivity and specificity of 100% and 76.84%, respectively. The positive predictive value and negative predictive value were 87.64% and 100%, respectively. Sonography was able to detect small fractures (up to 0.23 mm) that are often missed on the patient’s radiograph. Conclusion: Sonography may be useful as an initial screening imaging technique for the diagnosis of long bone fractures. The potential exists to reduce the need for unnecessary skeletal radiographs, which could reduce treatment time, cost, and ionizing radiation hazards.
{"title":"Comparing Ultrasonography With Plain Radiography in the Diagnosis of Long Bone Fractures","authors":"Amjad Khan, Zarin Fatma, R. Bacha, Bakht Rokhan, S. Akhtar, Majid Iqbal, I. Raheem","doi":"10.1177/87564793231193430","DOIUrl":"https://doi.org/10.1177/87564793231193430","url":null,"abstract":"Objective: This study was designed to compare sonography to skeletal radiography, in the diagnosis of long bone fractures. Materials and Methods: This was a cross-sectional and analytical study including 188 patients of varied ages that had 251 suspected long bone fractures. It was conducted over a 9-month period, in the emergency department of a teaching hospital, within the Swat district of Pakistan. After assessing the clinical symptoms of the fracture by an emergency orthopedic physician, sonography was followed by a radiograph performed for these referred patients. Results: Sonography shows a diagnostic accuracy of 91.23% for detecting long bone fractures, with a sensitivity and specificity of 100% and 76.84%, respectively. The positive predictive value and negative predictive value were 87.64% and 100%, respectively. Sonography was able to detect small fractures (up to 0.23 mm) that are often missed on the patient’s radiograph. Conclusion: Sonography may be useful as an initial screening imaging technique for the diagnosis of long bone fractures. The potential exists to reduce the need for unnecessary skeletal radiographs, which could reduce treatment time, cost, and ionizing radiation hazards.","PeriodicalId":45758,"journal":{"name":"JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80621134","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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