The swollen leg: ultrasonographic demonstration of non-thrombotic causes.

Grey-scale ultrasound is a useful investigation in selected patients with a painful swollen leg. It is of particular value in cases in which there is a clinical suspicion of deep vein thrombosis (DVT) but other features, such as an atypical history or equivocal radiology, suggest alternative pathology. Five such cases are presented in which ultrasound showed transonic lesions. The cause of the swelling of the leg was thus shown to be "cystic' in nature and therefore not due to DVT. This enabled inappropriate and potentially harmful therapy to be avoided and the correct therapy, such as surgical drainage, to be undertaken.

Sonographic demonstration of intrauterine contraceptive devices.

Ultrasonic examination of the uterus is the investigation of choice in the initial localization of an IUCD within the uterine cavity. The use of compound B scanning in conjunction with A scans has been completely reliable to date. Radiography should be reserved for those patients in whom an expected device is not shown within the uterine cavity, and for those in whom the determination of the type of device is important and the scan is equivocal.

The ultrasound diagnosis of hydatidiform mole.

Experience with ultrasound compound 'B' scanning in 18 cases of hydatidiform mole is presented. The scan appearances are analysed with respect to the presence or absence of transonic areas, and to the uniformity of echogenicity elsewhere in the uterus. The differential diagnosis is discussed. The commonest appearance seen in a hydatidiform mole is the combination of multiple small transonic areas with uneven echogenicity in the remainder of the uterine cavity. The condition most likely to cause diagnostic confusion is early normal pregnancy with a bulky decidua, but incomplete abortion and uterine fibroid may also be confused with hydatidiform mole.

The use of combined ultrasonic and isotope scanning in the diagnosis of amoebic liver disease.

The use of combined isotope and ultrasonic scanning in the diagnosis of amoebic liver abscess is described, together with details of three cases of this condition seen in the Bristol area in a period of two years. The addition of ultrasonic scanning greatly increases the accuracy of diagnosis by demonstrating a fluid-filled, space-occupying lesion and should ideally be employed whenever liver abscess is suspected.