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Ultrasonographic Findings of the Peroneal Tendons and Associated Pathology
S50
Ultrasound in Medicine and Biology
11 - Ultrasound in Musculoskeletal PA.11.004 Ultrasound Evaluation Protocol and Systematization for Investigating Hip Development Dysplasia - the Hospital Israelita Albert Einstein Hospital Experience M. R. C. Silva, C. A. P. Braga, L. R. A. Camara, M. A. N. Germano, R. M. Tanaka, M. J. Francisco Neto, M. B. G. Funari Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil Brief Description of the Purpose of the Review of Literature: Sonography constitutes currently the main diagnostic modality for the evaluation of developmental dysplasia of the hip. This method gives information about the morphology of the acetabulum, the anatomical relationship between femoral head and acetabulum and dynamic aspects related to stability of this joint. Description (s) Condition (s), Method (s) Or Technique (s): Ultrasound evaluation using broadband linear transducers with a frequency of 5-12 MHz. We developed a protocol for examination and photographic documentation pattern based on the methodology described by Graf and Harcke. We developed also a standard report with all information necessary to the orthopedist assistant interpretation, as the inclusion of a table with data from previous studies. Conclusion: Adopting a systematic protocol for the implementation of this method is important in its uniformity and consequent reduction of interpersonal variability within the group of radiologists. It is also a facilitator for the understanding of the data by the orthopedist assistant. Brief Discussion of the Case: Null. PD.11.001 Ultrasonographic Findings of Morel-Lavallee Lesions I. Yang, A. Y. Jung, H. S. Hong, J. Y. Woo, S. K. Jeh, J. Y. Hwang, Y. N. Kim, H. M. Kim, Y. Lee Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea Brief Description of the Purpose of the Study: The purpose of this study was to review the sonographic features of Morel-Lavallee lesions by correlating US image findings with a lesion’s age. Methods: We obtained the sonography reports 20 Morel-Lavallee lesions of the hip and extremities in 18 patients with a history of trauma. US images were reviewed to characterize the echogenicity, shape, homogeneity, margins, and location of the lesions. The results were correlated with the age of the lesion and clinical histories. Main Results: All Morel-Lavallee lesions were hypoechoic or anechoic fluid collections, and located between the subcutaneous fat and underlying fascia. Regarding shape of the fluid collections, the lobular shaped lesions were all less than 14 days of lesion’s age, and the flat fluid collecionts were all greater than 1 month of age. Regarding homogeneity, the heterogeneous fluid collections were all less than 25 days of age, and the homogeneous fluid collections were all greater than 1 month of age. Importance of the Conclusions: Acute Morel-Lavallee lesions tended to be heterogenous, lobular, and became more homogeneous and flat in shape as the lesions evolved. So, ultrasound was useful for characterizing Morel-Lavallee lesions with their chronological changes. PD.11.002 Up to How Small of a Glomus Tumor of the Finger Can the High Resolutional Ultrasonography Demonstrate! I. Yang, A. Y. Jung, H. S. Hong, J. Y. Woo, S. K. Jeh, J. Y. Hwang, Y. N. Kim, H. M. Kim, Y. Lee Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea Brief Description of the Purpose of the Study: The purpose of this retrospective study is to define how small can be the size of tumor
Volume 39, Number 5S, 2013 that high resolutional ultrasound examination can demonstrate the glomus tumors of the fingers. Methods: Twenty one cases of glomus tumors of the finger were included in this retrospective study. Preoperative ultrasonography was done using a 10-12 MHz linear transducer (IU22, Philips Medical System, Bothell,WA) & a 6-15 MHz linear transducer (LOGIQ E9, GE Healthcare, Milwaukee,WI) to evaluate the location, size and vascularity of the tumor. All Ultrasound Doppler studies were performed by the same radiologist. These results were compared with operative findings. Main Results: Simple radiography showed normal in 11 cases (52%), seven cases(33%) revealed mild erosive change, and three cases (15%) demonstrated osteolytic bone destruction. Twenty cases (95%) located at subungal area, and one case (5%) showed at volar side of the finger. The mean size of the tumor was 4.5mm (from 2mm to 8mm). In all twenty one patients, ultrasound study was able to confirm the diagnosis. All tumors presented a Doppler hypersignal, and compatible with the diagnosis of glomus tumor. Importance of the Conclusions: These studies are useful for the smaller size of the mass up to 4.5mm. PD.11.003 Ultrasonographic Findings of the Peroneal Tendons and Associated Pathology Sun Joo Lee, Hye Jung Choo, Ji Sung Park, Yeong-Mi Park Inje University Busan Paik Hospital, Busan, Korea Introduction: Disorders of the peroneal tendons are common in patients with lateral ankle discomfort and knowledge of anatomy, normal variations, and pathology is essential. Methods Involved: A 10-year retrospective search of our department’s radiology archive was completed to identify pathology and variations of the peroneal tendons. Discussion: Pathologic conditions of the peroneal tendons that were identified included tendinosis, tenosynovitis, tear, dislocation, as well as injury of the superior peroneal retinaculum, intrasheath subluxation, ganglion cyst, and os peroneum fracture. A number of anatomic variants were also identified, which included hypertrophy of the peroneal tubercle, an accessory peroneus quartus muscle, and a low-lying peroneus brevis muscle. Conclusion of the Presentation: Ultrasound (US) is useful diagnostic tool prior to surgical treatment. This essay reviews the ultrasound features of peroneal tendon pathology and variations. In particular, ultrasound is emphasized for the dynamic evaluation of peroneal tendon subluxation and dislocation. The recognition of the ultrasound features of the anatomic variants and common pathology of the peroneal tendons is important to formulate a comprehensive differential diagnosis and guide treatment strategy. PD.11.004 Ultrasonographic Finding of Pilar Sheath Acanthoma in the Lower Extremity Sun Joo Lee, Hye Jung Choo, Ji Sung Park, Yeong-Mi Park Inje University Busan Paik Hospital, Busan, Korea Brief Description of the Purpose of the Report: Pilar sheath acanthoma is a rare, benign follicular hamartoma, with a level of differentiation between trichofolliculoma and dilated pore of Winer, which is a patulous follicle containing hair. It almost occurs in the face, especially upper lip and forehead. To the best of our knowledge, US finding have not been documented. We report the US finding of a case of pilar sheath acanthoma in the lower extremity. Medical History: A patient, male, 56-years old, was hospitalized to treat subcutaneous nodule with a central pore-like opening on the medial aspect of the right lower leg.
Ultrasound in Medicine and Biology
11 - Ultrasound in Musculoskeletal PA.11.004 Ultrasound Evaluation Protocol and Systematization for Investigating Hip Development Dysplasia - the Hospital Israelita Albert Einstein Hospital Experience M. R. C. Silva, C. A. P. Braga, L. R. A. Camara, M. A. N. Germano, R. M. Tanaka, M. J. Francisco Neto, M. B. G. Funari Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil Brief Description of the Purpose of the Review of Literature: Sonography constitutes currently the main diagnostic modality for the evaluation of developmental dysplasia of the hip. This method gives information about the morphology of the acetabulum, the anatomical relationship between femoral head and acetabulum and dynamic aspects related to stability of this joint. Description (s) Condition (s), Method (s) Or Technique (s): Ultrasound evaluation using broadband linear transducers with a frequency of 5-12 MHz. We developed a protocol for examination and photographic documentation pattern based on the methodology described by Graf and Harcke. We developed also a standard report with all information necessary to the orthopedist assistant interpretation, as the inclusion of a table with data from previous studies. Conclusion: Adopting a systematic protocol for the implementation of this method is important in its uniformity and consequent reduction of interpersonal variability within the group of radiologists. It is also a facilitator for the understanding of the data by the orthopedist assistant. Brief Discussion of the Case: Null. PD.11.001 Ultrasonographic Findings of Morel-Lavallee Lesions I. Yang, A. Y. Jung, H. S. Hong, J. Y. Woo, S. K. Jeh, J. Y. Hwang, Y. N. Kim, H. M. Kim, Y. Lee Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea Brief Description of the Purpose of the Study: The purpose of this study was to review the sonographic features of Morel-Lavallee lesions by correlating US image findings with a lesion’s age. Methods: We obtained the sonography reports 20 Morel-Lavallee lesions of the hip and extremities in 18 patients with a history of trauma. US images were reviewed to characterize the echogenicity, shape, homogeneity, margins, and location of the lesions. The results were correlated with the age of the lesion and clinical histories. Main Results: All Morel-Lavallee lesions were hypoechoic or anechoic fluid collections, and located between the subcutaneous fat and underlying fascia. Regarding shape of the fluid collections, the lobular shaped lesions were all less than 14 days of lesion’s age, and the flat fluid collecionts were all greater than 1 month of age. Regarding homogeneity, the heterogeneous fluid collections were all less than 25 days of age, and the homogeneous fluid collections were all greater than 1 month of age. Importance of the Conclusions: Acute Morel-Lavallee lesions tended to be heterogenous, lobular, and became more homogeneous and flat in shape as the lesions evolved. So, ultrasound was useful for characterizing Morel-Lavallee lesions with their chronological changes. PD.11.002 Up to How Small of a Glomus Tumor of the Finger Can the High Resolutional Ultrasonography Demonstrate! I. Yang, A. Y. Jung, H. S. Hong, J. Y. Woo, S. K. Jeh, J. Y. Hwang, Y. N. Kim, H. M. Kim, Y. Lee Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea Brief Description of the Purpose of the Study: The purpose of this retrospective study is to define how small can be the size of tumor
Volume 39, Number 5S, 2013 that high resolutional ultrasound examination can demonstrate the glomus tumors of the fingers. Methods: Twenty one cases of glomus tumors of the finger were included in this retrospective study. Preoperative ultrasonography was done using a 10-12 MHz linear transducer (IU22, Philips Medical System, Bothell,WA) & a 6-15 MHz linear transducer (LOGIQ E9, GE Healthcare, Milwaukee,WI) to evaluate the location, size and vascularity of the tumor. All Ultrasound Doppler studies were performed by the same radiologist. These results were compared with operative findings. Main Results: Simple radiography showed normal in 11 cases (52%), seven cases(33%) revealed mild erosive change, and three cases (15%) demonstrated osteolytic bone destruction. Twenty cases (95%) located at subungal area, and one case (5%) showed at volar side of the finger. The mean size of the tumor was 4.5mm (from 2mm to 8mm). In all twenty one patients, ultrasound study was able to confirm the diagnosis. All tumors presented a Doppler hypersignal, and compatible with the diagnosis of glomus tumor. Importance of the Conclusions: These studies are useful for the smaller size of the mass up to 4.5mm. PD.11.003 Ultrasonographic Findings of the Peroneal Tendons and Associated Pathology Sun Joo Lee, Hye Jung Choo, Ji Sung Park, Yeong-Mi Park Inje University Busan Paik Hospital, Busan, Korea Introduction: Disorders of the peroneal tendons are common in patients with lateral ankle discomfort and knowledge of anatomy, normal variations, and pathology is essential. Methods Involved: A 10-year retrospective search of our department’s radiology archive was completed to identify pathology and variations of the peroneal tendons. Discussion: Pathologic conditions of the peroneal tendons that were identified included tendinosis, tenosynovitis, tear, dislocation, as well as injury of the superior peroneal retinaculum, intrasheath subluxation, ganglion cyst, and os peroneum fracture. A number of anatomic variants were also identified, which included hypertrophy of the peroneal tubercle, an accessory peroneus quartus muscle, and a low-lying peroneus brevis muscle. Conclusion of the Presentation: Ultrasound (US) is useful diagnostic tool prior to surgical treatment. This essay reviews the ultrasound features of peroneal tendon pathology and variations. In particular, ultrasound is emphasized for the dynamic evaluation of peroneal tendon subluxation and dislocation. The recognition of the ultrasound features of the anatomic variants and common pathology of the peroneal tendons is important to formulate a comprehensive differential diagnosis and guide treatment strategy. PD.11.004 Ultrasonographic Finding of Pilar Sheath Acanthoma in the Lower Extremity Sun Joo Lee, Hye Jung Choo, Ji Sung Park, Yeong-Mi Park Inje University Busan Paik Hospital, Busan, Korea Brief Description of the Purpose of the Report: Pilar sheath acanthoma is a rare, benign follicular hamartoma, with a level of differentiation between trichofolliculoma and dilated pore of Winer, which is a patulous follicle containing hair. It almost occurs in the face, especially upper lip and forehead. To the best of our knowledge, US finding have not been documented. We report the US finding of a case of pilar sheath acanthoma in the lower extremity. Medical History: A patient, male, 56-years old, was hospitalized to treat subcutaneous nodule with a central pore-like opening on the medial aspect of the right lower leg.