Imaging Study: USG Cases

Showing posts with label USG Cases. Show all posts

February 29, 2024
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Case 123: Penile Fracture || Ultrasound

Clinical Features:

A 31-year-old male patient came with penile trauma.

Ultrasound Features:

- Irregular mixed echogenic area is noted in the right corpora cavernosum near the root with adjacent tunica albuginea disruption & perialbugineal extension.

- Color Doppler shows no vascularity within this mixed echogenic area.

- Cavernosal artery appears intact.

- Overlying skin appears thickened, and edematous with fat-plane irregularity with increased skin vascularity indicating inflammatory changes.

Remember:

Penile Fracture Grading:

Grade 0: Intact tunica albuginea. Hematoma superficial or deep to Buck's fascia

Grade I: Defect in the tunica albuginea and/or corpora cavernosa

Grade II: Defect in the tunica albuginea and/or corpora cavernosum. Associated peri-albugineal and/or cavernosal hematoma

Grade III: Defect in the tunica albuginea, Buck fascia (with hematoma) and the corpus spongiosum

Grade IV: Involvement of corpus spongiosum with urethra and/or vascular injury, with any vascular malformation

Ultrasound Diagnosis:

Grade II penile fracture

Ultrasound Images:

Irregular mixed echogenic area is noted in right corpora cavernosum near the root with adjacent tunica albuginea disruption & perialbugineal extension.

YouTube Link:

For further demonstration, don't forget to check our video:

Case 122: Adenomyomatosis of Gallbladder || Ultrasound

USG Cases, USG Gall Bladder

Clinical Features:

A 70-year-old male patient came with right upper abdominal pain.

Ultrasound Features:

Generalized gallbladder wall thickening with multiple areas showing intramural hyperechoic foci and comet tail artifacts.

Remember:

- The high frequency ultrasound may help better visualization of comet tail artifacts & wall thickening.

- Search for mass lesion & calculus.

Ultrasound Diagnosis:

Chronic cholecystitis with adenomyomatosis of gallbladder.

Ultrasound Images:

Generalized gallbladder wall thickening with multiple areas showing intramural hyperechoic foci and comet tail artifacts.

YouTube Link:

For further demonstration, don't forget to check our video:

Case 121: Appendicular Abscess || Ultrasound

USG Cases, USG Intestine

Clinical Features:

11-year-old female patient came with severe right lower abdominal pain.

Ultrasound Features:

- Right iliac fossa shows an irregular thick-walled complex collection with internal low-level echoes.

- Vermiform appendix is not separately visualized.

- Surrounding thickened fat layer is seen.

- Adjacent bowel loops show sluggish movements.

- Color Doppler shows prominent perilesional vascularity.

- The lesion compresses adjacent psoas muscle with no intrapsoas abnormality at present.

- Adjacent multiple prominent lymph nodes are seen.

Remember:

Peritoneal collection adjacent to a gangrenous appendix or abscess may suggest perforation.

Ultrasound Diagnosis:

Appendicular Abscess

Ultrasound Images:

Appendicular abscess

YouTube Link:

For further demonstration, don't forget to check our video:

Case 120: Missed Abortion || 9-10 Weeks || Ultrasound

USG Cases, USG Obstetrics, USG Uterus

Clinical Features:

A young married female patient came with

- Amenorrhoea for 2 months.

- Pervaginal small bleeding.

- Lower abdominal pain.

Ultrasound Features:

- About 9-10 weeks of single intrauterine dead embryo.

- No cardiac activity, even on Doppler.

Remember:

Ultrasound Diagnosis:

Missed abortion of about 9-10 weeks size.

Ultrasound Images:

9-10 weeks of single intrauterine dead embryo with no cardiac activity, even on Doppler.

YouTube Link:

For further demonstration, don't forget to check our video:

Case 119: Adenomyosis | Uterus || Ultrasound

USG Cases, USG Uterus

Clinical Features:

A 35-year-old female patient came with

- Dysmenorrhoea

- Menorrhagia

Ultrasound Features:

- Uterus is enlarged & globular with asymmetric myometrial thickening.

- Myometrium is inhomogeneous with irregular junctional zone, subendometrial tiny cystic spaces along with echogenic lines & islands & fan-shaped shadowing without any translesional abnormal vascularity.

Remember:

Check two journals for studying adenomyosis:

1.Van den Bosch, T., Dueholm, M., Leone, F.P.G., Valentin, L., Rasmussen, C.K., Votino, A., Van Schoubroeck, D., Landolfo, C., Installé, A.J.F., Guerriero, S. and Exacoustos, C., 2015. Terms, definitions and measurements to describe sonographic features of myometrium and uterine masses: a consensus opinion from the Morphological Uterus Sonographic Assessment (MUSA) group. Ultrasound in Obstetrics & Gynecology, 46(3), pp.284-298.

2. Van den Bosch, T., De Bruijn, A.M., De Leeuw, R.A., Dueholm, M., Exacoustos, C., Valentin, L., Bourne, T., Timmerman, D. and Huirne, J.A.F., 2019. Sonographic classification and reporting system for diagnosing adenomyosis. Ultrasound in obstetrics & gynecology: the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 53(5), pp.576-582.

Ultrasound Diagnosis:

Uterine Adenomyosis

Ultrasound Images:

Enlarged & globular uterus with inhomogeneous asymmetric myometrium showing irregular junctional zone, subendometrial tiny cystic spaces along with echogenic lines & islands & fan-shaped shadowing without any translesional abnormal vascularity.

A small nabothian cyst is also seen.