A PROSPECTIVE STUDY COMPARING ULTRASONOGRAPHIC FINDINGS AND INFLAMMATORY MARKERS AS A PREDICTOR OF JOINT EROSIONS IN RHEUMATOID ARTHRITIS.

Rheumatoid arthritis is chronic infiammatory disease that affects the joints. This results in painful joints, swelling and stiffness in the joints. The present prospective comparative study aimed to compare the USG Doppler findings with the infiammatory marker levels in being a better predictor of joint erosions in rheumatoid arthritis. Total 50 patients coming rheumatology and medicine OPD were studied for infiammatory markers and ultrasonography findings. Radiological investigations such as High resolution USG power Doppler (4-12 MHz) and x-ray of the affected joints were carried out. Majority of participants (60%) belonged to 31-50 years of age group and female gender (86%). The change in infiammatory markers were found to be poorly correlated to joint erosions, while that of USG erosions was found to be strongly positively correlated with the same. Multivariate regression analysis showed that in presence all others also only delta USG erosion significantly impacts delta VDH, or the gold standard(X Ray) for evaluation joint erosion This strongly proves that USG erosion is a better predictor of joint erosions than the other independent variables(infiammatory markers)

Ultrasonographic Findings in Eyes with Retinopathy of Prematurity in Malaysia

RetCam is an excellent screening tool for the detection of retinopathy of prematurity (ROP). However, affordability is a barrier when adopting the use of RetCam in developing countries. We aimed to describe different stages of ROP using ultrasonographic B-scan and to evaluate the association between funduscopic examinations and ultrasonographic B-scan findings in premature neonates with ROP in Malaysia. A descriptive cross sectional study was conducted in 90 eyes of 47 premature neonates with different stages of ROP in three tertiary hospitals in Malaysia. Experienced ophthalmologists performed detailed funduscopic examinations using binocular indirect ophthalmoscopy (BIO). A masked examiner performed a 10 MHz ultrasonographic B-scan evaluation with 12 meridian position images within 48 hours of clinical diagnosis. Data from the clinical examination and ultrasonographic findings were collected and analysed. We recruited 37 eyes (41.1%) with stage 1 ROP, 29 eyes (32.3%) with stage 2, 18 eyes (20.0%) with stage 3, and 3 eyes (3.3%) with stages 4 and 5 based on the clinical assessment. Ultrasonography correctly identified 3 (8.1%) stage 1 eyes, 17 (58.6%) stage 2 eyes, 13 (72.2%) stage 3 eyes, and 3 each (100%) of the stage 4 and 5 eyes. There was a significant association between the funduscopic signs and the ultrasound findings for stage 2 ROP and above (Fisher’s exact test, p <0.001). In conclusion, all stages of ROP were detected and described with a 10 MHz ultrasonic B-scan system. A significant association was observed between funduscopic signs and ultrasonographic findings in premature Malaysian neonates with stage 2 ROP and above.

The predictive value of abnormal ultrasonographic finding for fetal trisomy in the second trimester / 대한산부인과학회지

OBJECTIVE: The purpose of this study is to evaluate obstetrical characteristics related to fetal trisomies and to survey the predictive value of abnormal second trimester ultrasonographic findings for fetal trisomies. METHODS: We reviewed the medical records of 3,023 patients who had fetal karyotyping performed between May 1989 and May 2005, and then retrospectively examined 71 cases of trisomies diagnosed prenatally. All patients were classified into three groups according to indications of fetal karyotyping such as positive triple test result, maternal age older than 35 at delivery, and abnormal ultrasonographic findings and we compared the obstetrical features and positive predictive value of each indication. RESULTS: Thirty two cases (39%) of total trisomies had abnormal ultrasonographic findings. Abnormal ultrasonographic findings were significantly more common (16 cases, 76%, P=0.001) in fetuses with trisomy 18 compared to the other trisomies. Structural anomalies in fetuses with trisomy were usually detected in late second trimester. The positive predictive value of abnormal ultrasonographic findings was 3.0% (elderly woman; 1.4%, positive triple test; 1.7%) in trisomy 21 and 6.3% (elderly woman; 1.6%, positive triple test; 1.8%) in both trisomy 21 and 18. CONCLUSION: The positive predictive value of abnormal ultrasonographic findings for diagnosis of fetal trisomy is higher than the other indications for fetal karyotyping. In addition, screening of trisomy 18 with an ultrasonography may be still more important because the majority of fetuses with trisomy 18 show various congenital anomalies.

Dolor pélvico en niñas y adolescentes: hallazgos ultrasonográficos / Pelvic pain in children and adolescents girls: ultrasonographic findings

Describir los hallazgos ultrasonográficos en niñas y adolescentes que consultaron por dolor pélvico entre marzo y octubre de 2008. Estudio descriptivo. Muestra: 190 niñas y adolescentes que cumplieron con los criterios de inclusión. Servicio de Ginecología Infanto Juvenil del Hospital de Niños "Dr. José Manuel de los Ríos". En total se estudiaron 11 niñas, 76 adolescentes tempranas, 75 en adolescencia media y 21 en adolescencia tardía. Los grupos fueron homogéneos para las medidas uterinas y ováricas. 57 pacientes consultaron por dolor pélvico, 9 por dismenorrea y 3 por hallazgo ultrasonográfico de tumor parauterino. En el grupo de edad que más hallazgos se encontraron fue en la adolescencia temprana (34 pacientes). En el 67,9 por ciento no se encontró ningún hallazgo y el 32,1 por ciento se encontraron hallazgos ultrasonográficos. El 16 por ciento consultó por dolor pélvico agudo y el 84 por ciento por dolor pélvico crónico. El 77,4 por ciento consultó por dolor pélvico de tipo punzante y el 22,6 por ciento por dolor pélvico tipo cólico. El folículo dominante fue el hallazgo ultrasonográfico encontrado en el mayor porcentaje de las pacientes (10,5 por ciento). El mayor porcentaje de las pacientes incluidas en este estudio tenía ultrasonido pélvico normal. El ultrasonido es el método aceptado como la primera modalidad diagnóstica por imágenes en pacientes con dolor pélvico

To describe the ultrasonographic findings in children and adolescent girls that consulted for pelvic pain between March and October 2008. Descriptive study. Sample: 190 children and adolescent girls that met the inclusion criteria. Servicio de Ginecologia Infanto Juvenil del Hospital de Niños "Dr. Jose Manuel de los Rios". A total of 11 children, 76 early, 75 medium and 21 late adolescent girls were studied. The groups were homogeneous for the uterine and ovarian measurements. 57 patients consulted for pelvic pain, 9 for dysmenorrhea and 3 for ultrasonographic findings of para uterine tumors. The age group with more findings was the early adolescence (34 patients). In 67.9 percent there were no findings and in 32.1 percent ultrasonographic changes were found. The 16 percent consulted for acute pelvic pain and 84 percent for chronic pelvic pain. The 77.4 percent consulted for sharp pelvic pain and 22,6 percent for colic pelvic pain. The dominant follicle was the ultrasonographic finding in the higher percentage of patients (10,5 percent). The higher percentage of patients included in this study had a normal pelvic ultrasound. The ultrasound is the accepted method for diagnostic of images in patients with pelvic pain

Cornual pregnancy diagnosed at 9 weeks of atypical ultrasonographic findings / 대한산부인과학회지

A cornual pregnancy occurs when the conceptus implants at the cornus of the uterus which is the junction between the fallopian tube and uterine cavity. Cornual pregnancy is a rare form of ectopic pregnancy and its diagnosis is difficult. It accounts for 2 to 4% of tubal pregnancy and rupture usually occurs between 8 weeks and 16 weeks of gestation. The rich vascularity in this location makes the rupture particularly dangerous, resulting in higher maternal mortality. We have experienced a case of unruptured cornual pregnancy at 9 weeks of atypical ultrasonographic findings, which was hourglass appearance. We present this case with a brief review of the literature.

Bilaterality of Papillary Thyroid Carcinoma: Analysis of Clinicopathologic Factors and the Value of Preoperative Ultrasonography / 대한내분비외과학회지

PURPOSE: Papillary thyroid carcinoma (PTC) is the most common endocrine malignancy. The extent of the initial surgical treatment for PTC is still controversial and the bilaterality of PTC is an important factor for determining the extent of surgical resection. The aim of this study was to analyze clinicopathologic factors and the value of preoperative ultrasonography (PU) for bilateral tumor. METHODS: We retrospectively reviewed clinicopathologic factors and PU findings of 91 patients who underwent total thyroidectomy for PTC at the Dongguk University Ilsan Hospital from January 2006 to April 2009. RESULTS: Of the 91 patients, 28 (30.7%) had bilateral PTC in postoperative pathology. Of these 28 patients, only 18 patients (64.3%) were checked for bilateral PTC by PU findings and fine needle aspiration cytology. Sensitivity and specificity for bilaterality of PTC were 64.3% and 85.7%, respectively. The presence of benign nodules or malignant nodules in the same lobe in PU (P=0.008) and post-operative pathology (P=0.014) were statistically correlated with bilaterality. CONCLUSION: For the surgical care of PTC, bilaterality must always be considered, even though the tumor is diagnosed unilateral small PTC. PU in PTC patients has limited diagnostic value for bilateral PTC.

Comparison of the Ultrasonographic Study and the Electrodiagnostic Study on the Ulnar Neuropathy around the Elbow Region

OBJECTIVE: To evaluate the relationship between the electrophysiologic findings and the ultrasonographic findings of the ulnar neuropathy around the elbow. METHOD: We examed 20 elbows with the ulnar neuropathy around the elbow and 22 healthy elbows. We measured the cross-sectional area (CSA) and the diameters of the long, short axis of the ulnar nerve at the swollen portion and the compressed portion by ultrasonography. RESULTS: The CSA, diameters on the longitudinal and transverse view of the swollen portion of the ulnar nerve of the patients group was larger than that of the control group (p0.05). There was significant correlation between the decrement of the nerve conduction velocity across elbow and the increment of the diameter on the swollen portion on the longitudinal and transverse view (r=0.541, 0.466, p<0.05, respectively). CONCLUSION: The difference of diameter between swollen and compressed portion of the ulnar nerve on the ultrasonography was correlated with the conduction velocity decrement on the electrophysiologic study.

The Comparison of Therapeutic Effect of Shoulder Pain with Simple and Mixed Type in Patients with Adhesive Capsulitis

OBJECTIVE: This study was designed to divide the patients with adhesive capsulitis into two groups by ultrasonographic findings, such as simple capsulitis and mixed capsulitis patients and to compare the improvement of range of motion and shoulder pain in one month. METHOD: We examined 50 patients with adhesive capsulitis diagnosed by physical examination. In accordance to ultrasonographic findings, we divided the patients into two groups such as capsulitis and mixed capsulitis in patients with adhesive capsulitis. We treated shoulder pain by intraarticular injection and medication. We examined the range of motion of shoulder and visual analogue scale at each visiting time in a month. RESULTS: The mean age of patients was 55.3 (range: 39~77) years. There were 26 patients with simple capsulitis and 24 patients with mixed capsulitis. The average duration of pain was 16.1+/-23.9 months. There was meaningful difference of shoulder range of motion and visual analogue scale between pretreatment and posttreatment in patients with simple capsulitis and mixed capsulitis. But, there was no meaningful difference of shoulder range of motion and visual analogue scale between two groups. CONCLUSION: No specific difference was noted between the simple and the complex groups of adhesive capsulitis in the effect of treatment.

Ultrasonographic findings in tubal pregnancy.

The ultrasonographic findings in 48 cases of tubal pregnancies were studied in the Perinatology Unit, Department of Obstetrica and Gynaecology, Siriraj Hospital. All patients were scanned with linear array transducer. The ultrasonographic findings demonstrated a slightly enlargement of uterus in 26 cases. No evidence of intrauterine gestation sac was seen in all cases. In 4 cases, pseudosacs were found while the decidual reaction was found, as evidences of a sharp intrauterine echoes in 16 cases. The adnexal complex mass was found in 43 patients of which 6 extrauterine gestational sacs were found. The presence of blood in the cul-de-sac was found in 41 patients.