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Objective: The aim of the present study was to illustrate the (potential) diagnostic role of high resolution US images in assessing the elementary lesions of dactylitis., Methods: Using high-frequency US machines/probes, we matched the micro-anatomical cadaveric architecture of the digit with multiple sonographic findings of dactylitis. High-sensitive color/power Doppler assessments have also been performed to evaluate the digital microvasculature., Discussion: Modern US equipment/features guarantee prompt and in-depth B-mode and color/power Doppler imaging of tiny anatomical structures of the digit which are usually not properly visible with standard US machines. More specifically, hypervascularization of the digital subcutaneous tissue, fibrous pulleys of flexor tendons, dorsal synovial pads as well as pathological changes of the distal entheseal anchorage network can be accurately detected., Conclusion: In clinical practice, high-end US equipment can be used to accurately assess the digits in patients with dactylitis. This way, simple and convenient sonographic diagnosis of different elementary lesions can be timely established., (© 2023. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)

Padel is a racket sport, combining high-frequency and low-intensity athletic gestures, that has been gaining growing scientific interest in recent years. Musculoskeletal injuries are very common among padel players with an incidence rate of 3 per 1000 h of training and 8 per 1000 matches. To the best of our knowledge, a comprehensive collection describing the most common sonographic findings in padel players with musculoskeletal injuries is lacking in the pertinent literature. In this sense, starting from the biomechanical features of padel-specific gestures we have reported the ultrasonographic patterns of most frequent injuries involving the upper limb, the trunk, and the lower limb. Indeed, comprehensive knowledge of the biomechanical and clinical features of musculoskeletal injuries in padel is paramount to accurately perform a detailed ultrasound examination of the affected anatomical site. So, the present investigation aims to provide a practical guide, simple and ready-to-use in daily practice, to optimize the sonographic assessment of padel players by combining it with the clinical findings and the biomechanical features of athletic gestures., (© 2024. The Author(s).)

In daily practice, medical history and physical examination are commonly coupled with anthropometric measurements for the diagnosis and management of patients with lymphatic diseases. Herein, considering the current progress of ultrasound imaging in accurately assessing the superficial soft tissues of the human body; it is noteworthy that ultrasound examination has the potential to augment the diagnostic process. In this sense/report, briefly revisiting the most common clinical maneuvers described in the pertinent literature, the authors try to match them with possible (static and dynamic) sonographic assessment techniques to exemplify/propose an 'ultrasound-guided' physical examination for different tissues in the evaluation of lymphedema., (© 2021. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)

Foot pain is common in daily clinical practice but thrombosis of the foot veins is rarely considered as a differential diagnosis. Several cases of plantar veins thrombosis are reported in literature but a detailed description of ultrasonographic findings in case of thrombosis of the dorsal venous arch of the foot is lacking. We report a case of ours with a thrombosis of the medial marginal vein and dorsal venous arch of the foot, showing its close anatomical relation with the extensor hallucis longus tendon., (© 2020. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)

Vascular anomalies are classified as vascular tumors (VT) and vascular malformations (VM). VTs are divided according to their clinical behavior, while VMs are classified according to their flow characteristics, histopathologic features, and associations with other anomalies. Sonography emerges as the diagnostic imaging method of first choice for assessing abdominal wall disorders and masses, thus representing a valuable tool for the diagnosis and follow-up of abdominal wall VMs. In this review, we report a case of abdominal wall arteriovenous malformation (AVM) in a 17-year old and briefly discuss the cases of abdominal wall VMs.

Syndesmotic injuries, also referred as high ankle sprains, may cause significant ankle instability and chronic pain. Ultrasound (US) is a well-proven imaging modality to evaluate the ligaments of the ankle, due to its high spatial resolution and the possibility to perform dynamic examinations. However, considering the syndesmosis complex, the sonographic appearance of the posterior inferior tibiofibular ligament (PITFL) is not well described in the pertinent literature and, to the best of our knowledge, we found no report of PITFL avulsion demonstrated at US, as in the case presented.

Medial knee pain is common in clinical practice and can be caused by various conditions. In rare cases, it can even be by calcific bursitis of the medial collateral ligament (MCL). Treatment of calcific bursitis and/or calcification of the MCL classically includes observation, local injections, shockwave therapy and surgical resection. We report a case of nontraumatic medial knee pain poorly responsive to conservative treatments. Ultrasound (US) imaging revealed a massive lobed hyperechoic formation with partial acoustic shadow in the MCL context compatible with calcific bursitis, and magnetic resonance imaging (MRI) confirmed the presence of the bursa's calcific deposit surrounded by hyperintense signal compatible with pericalcific edema. We performed a double-needle ultrasound-guided percutaneous lavage (UGPL), which is today a fairly common treatment for many musculoskeletal disorders, such as rotator cuff calcific tendinopathy and elbow extensor tendons pathology, but regarding the knee, it is not part of ordinary care. This report shows the clinical and imaging presentation of calcific bursitis of the MCL and describes in detail the technique to perform the UGPL with a system of two needles, two syringes and a double connection to ensure a correct lavage of the calcium deposit without significant intrabursal pressure increase and consequently without pain during the procedure.

We report a case of a 67-year-old woman suffering from intermittent claudication secondary to severe popliteal stenosis due to compression by a popliteal ganglion cyst extending into the adventitia of the popliteal artery. After declining vein bypass grafting, this patient was successfully treated using ultrasound-guided aspiration of the cyst, which restored normal flow to the popliteal artery. Whilst aspiration of Baker's cysts causing claudication has been attempted before, this represents the first reported case of successful recanalization of the popliteal artery by ganglion cyst aspiration and further supports an important possible aetiology and treatment for cystic adventitial disease., (© 2024. Crown.)

Purpose: In correlation with magnetic resonance imaging (MRI), this study attempts to assess the effectiveness of the diagnostic of ultrasonography (US) features and shear wave elastography (SWE) in determining the different causes of heel pain., Materials and Methods: 55 heels with a mean age of 38.33 ± 10.8 were included in the study (10 control cases and 41 cases, 4 of which had bilateral heel pain). There were 23 female cases (56.1%) and 18 male cases (43.95%). Examinations using shear wave elastography (SWE) and ultrasound (US) were done in different positions. MRI and the obtained data were correlated., Results: When used to diagnose different heel pain causes, ultrasound demonstrated great sensitivity and specificity. SWE demonstrated a good correlation with MRI findings and enhanced the ultrasound's diagnostic precision in identifying plantar fasciitis early on (increased accuracy from 88.9 to 93.33% with 100% sensitivity and 83.3% specificity) and Achilles tendinopathy (increased accuracy from 88.9 to 97.8 with 94.7% sensitivity and 100% specificity)., Conclusion: In summary, we concluded that heel pain can be efficiently examined by both ultrasound (US) and shear wave elastography (SWE) with the former being used as the primary effective tool and the latter being done to increase diagnostic accuracy. We also concluded that SWE improved the ultrasound's diagnostic precision in identifying patients with early plantar fasciitis and Achilles tendinopathy and showed a robust relationship with clinical outcomes, enhancing patient evaluation and follow-up., (© 2024. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)

Calcific tendinopathy is characterized by the deposition of calcium, mostly hydroxyapatite crystals, in tendons. Women are more frequently affected than men, with prevalence in the fourth and fifth decades of life. This condition has been reported between 2.5 and 7.5% of healthy shoulders in adults, but other tendons may also be affected. A complication of this condition is the migration of calcium deposits from tendons, usually the supraspinatus, into the subacromial-subdeltoid bursa. We reported a rare complication of calcific tendinopathy, that is, calcium deposits migrated from the long head of the biceps tendon over the proximal tract of the biceps brachii muscle.

We report a case of intermittent dislocation of the flexor hallucis longus at its passage in the retro-malleolar area, related to a post-traumatic detachment of the retrotalar pulley from the medial tubercle of the talus. High-resolution ultrasound depicted the anterior dislocation of the tendon during dynamic stress, by asking the patient to flex his hallux against the examiner resistance, with the ankle in slight dorsiflexion. The tendon normally relocated after the dynamic maneuver. Tendon dislocation was associated with a painful snap., (© 2024. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)

Masses in the parapharyngeal area are rare and often due to infectious phenomena arising from the oral cavity or pharynx which lead to abscess formation. Less frequently, the lesion can be neoplastic. Tumours of the parapharyngeal space are rare, accounting for less than 1% of all head and neck neoplasms. We report the case of a patient who came to our observation for mandibular pain. Multiparametric diagnostic imaging was done thus showing a parapharyngeal mass. An ultrasound guided biopsy was performed by a transcutaneous route with a high median approach at neck level, to characterize the mass in the right tonsillar region. The histological examination reported the final histological diagnosis of sarcomatoid carcinoma., (© 2024. The Author(s).)

Purpose: Muscular atrophy implies structural and functional alterations related to muscular force production and movement. This condition has been reported to be the main reason for generalized muscle weakness; it reflects the severity of the disease and can have a profound impact on short- and long-term clinical outcomes. The purpose of this study was to determine whether muscle atrophy ultrasound parameters early predict muscle weakness, morbidity, or 28-days mortality., Methods: This was a prospective, observational single center cohort study. Ultrasound was used to determine the cross-sectional area and muscle thickness of the rectus femoris on the first and third day of ICU stay. The main outcome was the incidence of significant muscle atrophy (≥ 10%)., Results: Ultrasound measurements were made in 31 patients, 58% (18/31) of which showed significant muscle atrophy. The relative loss of muscle mass per day was 1.78 at 5% per day. The presence of muscle atrophy presents increased risk for limb muscle weakness and handgrip weakness. The 28-days mortality rate was similar in both subgroups., Conclusion: The presence of muscle atrophy presents an increased clinical risk for the development of limb ICUAW and handgrip, although these observations were not statistically significant. The results could be used to plan future studies on this topic., (© 2023. The Author(s).)

A spectrum of pathologies can cause clicking, popping or snapping of the shoulder joint. These can lead to a patient seeking attention in clinical practice due to pain, discomfort and impact on activities of daily living. Traditionally these can originate from pathologies which involve biceps tendon, tears of the rotator cuff or the glenoid labrum, articular cartilage or due to loose bodies and scapulothoracic joint dysfunction [Guillin et al. in Br J Radiol 85:1343-1353, 2012; Vidoni et al. in Indian J Musculoskelet Radiol 4:61-69, 2022]. Subacromial subdeltoid (SASD) bursitis is a well-described entity and one of the commonest causes of shoulder pain. We present SASD bursitis as an unusual cause of clicking/snapping in the shoulder without associated pain in a healthy young male. The clinical presentation, diagnostic strategy with complementary imaging and the role of interventional radiology in its effective management is highlighted to support clinicians faced with a diagnostic dilemma., (© 2022. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)

This pictorial essay clarifies the complex anatomical and ultrasonographic features of the Achilles tendon. Utilizing high-frequency ultrasound probes (12-18 MHz), the study visualizes the tripartite segmentation of the tendon as it relates to anatomical fascicles. Notably, there is variability in the ultrasound visibility of fascicles and this partition influences biomechanical properties and susceptibility to injury. This essay not only enhances the understanding of Achilles tendon anatomy but also underscores the importance of anatomical knowledge for comprehending associated pathologies. The findings suggest potential areas for further research into tendon pathology, facilitating the development of targeted rehabilitation strategies., Competing Interests: Declarations. Conflict of interest: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Ethical approval: Ethical approval is not required for this work. Consent: Not applicable. Registration of research studies: Not applicable., (© 2025. The Author(s).)

Shoulder Injury Related to Vaccine Administration (SIRVA) is a complication caused by improperly administered vaccinations. It triggers an inflammatory cascade that damages shoulder structures, resulting in prolonged shoulder pain and restricted range of motion. Common diagnoses in SIRVA patients include shoulder bursitis (all classified as subacromial bursitis), adhesive capsulitis, and rotator cuff injuries such as tears or tendinopathy. Less frequent diagnoses include biceps tenosynovitis, shoulder synovitis, intramuscular hematoma, and polymyalgia rheumatica or polymyalgia rheumatica-like syndrome. We present a case of SIRVA with prominent subcoracoid bursitis, confirmed via ultrasound. Ultrasound plays a critical role in static and dynamic assessments, providing accurate diagnoses and valuable guidance for identifying associated pathologies and managing SIRVA., Competing Interests: Declarations. Conflict of interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article. Ethical approval: Not applicable. Informed consent: Written and verbal informed consent was obtained from the patient for the publication of this case report. Consent to participate/informed consent: Written and verbal informed consent was obtained from the patient for the publication of this case report. Consent to publish: The authors affirm that the patient provided informed consent for publication of the images in figures., (© 2025. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)

Iliotibial band pathologies can result in lateral knee pain. These are commonly seen in runners and cyclists. Lateral knee pain following knee arthroplasty can be due to distal iliotibial band enthesopathy or impingement by the femoral component. Cementoplasty is a common procedure performed during treatment of osseous lesions. We describe a case of ITB friction syndrome due to small focus of cement following cementoplasty for GCT (giant cell tumour)., (© 2023. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)