Shoulder impingement syndrome: sonographic evaluation

Article Abstract:

Shoulder impingement syndrome is characterized by soft tissues in the shoulder being squeezed by bone structures when the arm is elevated. This leads to swelling, hemorrhage, and fluid collection and chronic pain. It is thought that the disease begins in people who have anatomic abnormalities that gradually worsen by calcification and deterioration in the shoulder area. A number of imaging techniques are used to examine and diagnose the problem. This study looked at the use of sonography, an imaging technique that uses ultrasound waves, in evaluating shoulder impingement syndrome. Sonography, radiography (X-ray), and arthrography were performed on the shoulders of 381 patients. Surgical data were also available for 102 patients. The sonography was performed with the patients' arms elevated. Abnormal bursal system sonographic results were found in 68 of the patients, with rotator cuff tears confirmed by arthrography in 30 of these patients. Of the 102 patients who underwent surgery, sonographic results indicating fluid collection in the bursal system were found in 37 patients, of which 30 cases were confirmed by surgery. In 21 of the 37 positive sonographic patients, no rotator cuff tear was found at surgery, indicating the disease was at an early stage. Sonographic assessment of the syndrome when compared with surgical results had a sensitivity of 81 and 71 percent, specificity of 95 and 96 percent, and accuracy of 90 and 91 percent for stages I-III and early stages of impingement, respectively. These results indicate that sonography can help diagnose shoulder impingement syndrome in its early stages and thus help effect early treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Joint diseases, Shoulder joint, Bursae of shoulder, Arthrography

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Sonographic evaluation of the placenta: importance of pathologic correlation

Article Abstract:

The placenta is essential to fetal growth and development. When growth of the fetus is retarded, it may be a consequence of placental insufficiency, a problem with the placenta that limits its ability to nourish the fetus. This problem is not well characterized, however, and some believe a small placenta is a result, rather than a cause, of fetal retardation. Ultrasound (US), an imaging technique using high-frequency sound, has been increasingly used to examine the fetus and the placenta. The placenta can now be examined in detail by US. A problem arises in that many abnormalities of the placenta detected by US have been attributed to clinical problems without pathological confirmation. Some of these abnormalities have turned out to be aberrations of US techniques; for example, an ultrasound finding that was originally designated cystic degeneration of the placenta turned out to be an artifact of sonography resulting from transducer selection. Macroscopic (visible) lesions are known to occur in the placenta. They have been characterized by pathologic examinations. A report in the July 1990 issue of Radiology compares pathologically known lesions of the placenta and US images of them. A major result was that US was able to image septal cysts, but not infarcts (areas of dead tissue), underscoring the need to correlate findings of US imaging with pathologic examination before attaching clinical significance to imaging findings. (Consumer Summary produced by Reliance Medical Information, Inc.)

Fetus, Placenta, Pregnancy, Complications of, Pregnancy complications, Placental diseases, Placenta diseases, editorial, Prenatal ultrasonography, Ultrasonics in obstetrics

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Cirrhosis: diagnosis with sonographic study of the liver surface

Article Abstract:

The use of ultrasound (US) in diagnosis of cirrhosis of the liver has improved recently because technological advances have contributed to better imaging of the liver. In order to make the best use of US capabilities, researchers employed sensitive high-frequency small-part probes which allowed them to differentiate healthy from diseased livers in cases where symptoms of cirrhosis were not yet present. Irregularity of the liver surface is known to be a sign of cirrhotic disease, but these surface irregularities are hard to view. The new equipment and techniques employed have improved the diagnosis of abnormalities on the surface of the liver associated with cirrhosis, making US a reliable method for diagnosis of cirrhosis in patients with chronic liver disease.

Liver, Liver cirrhosis, Diagnosis, Ultrasonic, Diagnostic ultrasonography

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