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The prevalence of psoriatic arthritis among patients with psoriasis has a marked variability with ethnic and geographic variations. Inflammatory changes associated with psoriatic arthritis include bone erosion, tenosynovitis, and synovial hypertrophy, but enthesitis is considered the hallmark. Both X-ray and magnetic resonance imaging (MRI) are usefull in the diagnosis of psoriatic arthritis, but ultrasonography is the best imaging modality to assess entheses. Ultrasound findings of enthesitis include a loss of the regular fibrillar architecture, hypoechoic thickening, hypervascularization of tendons, ligaments, and joint capsules at their bony attachment, bony changes (including irregularities and erosions). Ultrasound has also proved the ability to detect inflammatory subclinical findings and to be useful in the follow-up of therapies.

Lateral Ankle sprain is a common sports-related trauma with the mechanism of injury ranging from inversion to plantar flexion. These injuries commonly affect the ligaments but can also affect the associated soft tissue structures like the eversion muscles and tendons. Prompt and accurate diagnosis of such injuries is warranted so as to ensure early return to play and prevent long-term complications. Lateral ankle sprain injuries in sports may not always be associated with ligament injuries. We report a never before reported case of lateral ankle sprain injury in a soccer player with the unusual finding of isolated partial tear of Extensor digitorum longus muscle and its fascia leading to myo-fascial herniation. The lateral ankle ligaments were intact. The diagnosis was clinched on a high-frequency ultrasound scan supported by dynamic maneuvers which in fact proved to be superior to MRI as the latter failed to demonstrate the myo-fascial herniation in our case. We therefore propose that real-time ultrasound scanning with dynamic maneuvers should be the first line of investigation to assess sports injuries in anatomically complex joints like the ankle.

Iliotibial band syndrome or friction syndrome is an overuse disorder of the lateral knee. It is commonly reported in athletes, such as runners and cyclists, and refers to pain related to physical activity. The diagnosis is based on clinical history and physical assessment. Imaging, including ultrasound, is mainly performed in recurrent or refractory cases. The purpose of this paper is to review the etiology, diagnosis, and therapy of iliotibial band syndrome with a focus on ultrasound imaging and ultrasound-guided treatment. Ultrasound findings include soft-tissue edematous swelling or discrete fluid collection, suggestive of bursitis, between the iliotibial band and the lateral femoral epicondyle. The thickening of the iliotibial band has been inconsistently reported. Treatment varies according to the disease phase and, in the acute phase, consists of rest, physical therapy, and anti-inflammatory medications. Ultrasound-guided local steroid injections are effective in relieving symptoms.

The anterior abdominal wall, which is composed of three layers (skin and adipose tissues; the myofascial layer; and the deep layer, consisting of the transversalis fascia, preperitoneal fat, and the parietal peritoneum), has many functions: containment, support and protection for the intraperitoneal contents, and involvement in movement and breathing. While hernias are often encountered and well reviewed in the literature, the other abdominal wall pathologies are less commonly described. In this pictorial review, we briefly discuss the normal anatomy of the anterior abdominal wall, describe the normal ultrasonographic anatomy, and present a wide range of pathologic abnormalities beyond hernias. Sonography emerges as the diagnostic imaging of first choice for assessing abdominal wall disorders, thus representing a valuable tool for ensuring appropriate management and limiting functional impairment.

Background Several disorders may result in forefoot pain. An uncommon cause of forefoot pain is subcutaneous plantar veins thrombosis (SCPVT) involving veins superficial to the plantar fascia. Purpose To describe the ultrasound (US) appearance of SCPVT, which has been described only once in the radiological literature. Material and Methods We performed a retrospective search of our PACS system from 2016 to 2020 to collect all cases of US-diagnosed SCPVT. We collected data on seven patients. Two radiologists analyzed the US images retrieved. All US examinations were performed with a multifrequency linear probe (frequencies in the range of 5–17 MHz). Results A localized plantar nodule was palpable in 86% of patients. The subcutaneous thrombosed vein appeared in all patients as a round or ovoid nodule located in the subcutaneous tissues that corresponded in four patients (4/5, 80%) to the painful palpable nodule. The size was in the range of 4–7 mm (mean = 5.4 mm). The thrombosed vein presented a connection with adjacent patent veins, appeared enlarged, and almost filled with hypo-isoechoic material, and in two patients (2/7, 29%), a thin peripheral fluid component surrounding the thrombus was detectable. Continuous scanning demonstrated slow blood movements inside the peripheral component due to blood circulation. Failure to compress the lumen of the thrombosed vein during the real-time US was evident in all patients. Conclusion SCPVT is a rare or underreported condition. Sonologists must know the US appearance of SCPVT to exclude other conditions and avoid unnecessary invasive studies.

Different ultrasound approaches have been proposed to evaluate the distal biceps brachii tendon, such as lateral, posterior, medial, and anterior, all allowing good visualization of the distal biceps tendon and its pathologic appearances. Here we describe a new method of ultrasound evaluation of the distal biceps tendon insertion with the patient in the so-called crab position. The crab position is used to evaluate the posterior compartment of the elbow but also the lateral and medial compartments. This position allows for coverage of 75% the elbow in a single position, with less discomfort for the patient and a fair amount of saved time. In this position, after the evaluation of the common extensor tendon in the long axis, turning the transducer 90° and moving it distally allows for optimal visualization of the distal biceps brachii tendon in the axial plane. It is a simple, quick approach that allows for excellent visualization of the insertion of the distal biceps brachii tendon while avoiding an anisotropic effect.

The medial gastrocnemius is the most commonly injured muscle in the calf, and while traumatic lesions of the medial gastrocnemius are frequently described in the medical literature and clinical and sonographic diagnoses are easy, those of the soleus are less easily recognisable clinically or by sonography. We present a case of traumatic lesions of the medial gastrocnemius, diagnosed clinically and with ultrasound, while MRI also detected two lesions of the soleus. The case presented and the review of the literature highlight how clinical and ultrasound examinations can lead to misunderstandings about traumatic injury to the soleus.

Background The capacitive micromachined ultrasound transducer (CMUT) is a new ultrasound (US) probe manufactured by state-of-the-art cutting-edge semi-conductor micromachined electro-mechanical systems (MEMS) technology. Purpose To demonstrate the peculiar characteristics of each probe and the limitations that should be improved. Material and Methods This study was performed from March to April 2018. The only inclusion criterion was the presence of disease, so all patients with musculoskeletal, skin, and subcutaneous pathology were included. A total of 66 patients entered this study. The exams of each patient, with both probes, were evaluated retrospectively and independently by three radiologists. Panoramicity of the images, the definition of superficial structures (2 cm), and Doppler signal were assessed. A 5-point scale was used for each parameter. Results A total of 89 pathologies were detected. The mean of score for 4G-CMUT was higher than L64 for the panoramicity of the images and the definition of the deep structures. Instead, the mean score for L64 was higher than for 4G-CMUT in the evaluation of superficial structures and Doppler signal. A statistically significant difference was found ( P Conclusion CMUT is a breakthrough in US technology. It allows the use of a single probe for different US examinations. The musculoskeletal, skin, and subcutaneous US can be evaluated with a piezoelectric linear transducer or CMUT. In the present study, the overall diagnostic performance was similar. Improvements in CMUT will provide even more dynamic and flexible imaging capabilities by a transducer, with a wider bandwidth.

In recent years, women and girls are increasing their sport participation, and female sports are becoming more challenging. While more women and girls are participating in sports, there is still a lack of information about gender-specific lesions. We will therefore evaluate gender differences in sports injuries, analyzing the five sports and sporting activities that are most widespread in the western world: running, soccer, basketball, water sports, and winter sports. The ability to make correct ultrasonographic diagnoses in sports injuries is improving as the technology is advancing. Ultrasonography demonstrates tissue structure with two-dimensional grayscale images, while blood flow can be visualized with color and power Doppler. Furthermore, ultrasonography is the preferred imaging modality for studying soft-tissue lesions dynamically. High-quality diagnostic ultrasound cannot be performed without the knowledge of the underlying clinical background, and an understanding of gender-specific injuries and mechanisms of injuries is therefore important for assessing proper diagnostic and treatment guidelines tailored to phenotypic differences in professional and amateur athletes between male and female.

Peroneal intrasheath instability is a painful snapping condition of the lateral ankle. It consists of a transient retromalleolar subluxation of the peroneal tendons without disruption of the superior peroneal retinaculum or evidence of a previous definite trauma. In type A intrasheath instability, the peroneus longus and brevis tendons are intact, and there is an intertendinous intrasheath switch. In type B intrasheath instability, the peroneus brevis tendon has a longitudinal split tear through which the peroneus longus subluxates. Both types can be missed on a physical examination because there is no displacement of the peroneal tendons over the lateral malleolus. Dynamic ultrasound is the imaging modality of choice for evaluating retromalleolar subluxation of the peroneal tendons. This review article aims to provide an overview of the anatomic basis for peroneal intrasheath instability and provide physicians with guidelines for its ultrasound assessment.

Injuries to the collateral ligaments of the metacarpophalangeal (MCP) and interphalangeal (IP) joints are commonly encountered in both athletes and nonathletes. They require prompt evaluation to ensure proper management and prevent loss of joint motion and permanent disability. Imaging is often required to confirm the diagnosis and assess injury severity. This review article aims to provide physicians with guidelines for sonographic assessment of the collateral ligaments of the MCP and IP and related injuries. Sonographic features of ligament injuries ranging from sprains and partial-thickness tears to full-thickness tears are described. Specific lesions of the ulnar collateral ligament of the thumb MCP joint, such as gamekeeper's thumb, skier's thumb, and Stener lesions, are also included. In conclusion, sonography is effective in evaluating the collateral ligaments of the MCP and IP joints and related injuries and represents a valuable tool for diagnosis.

This document is the updated 2019 revision of the EFSUMB Clinically Safety Statement. A Safety Statement has been published by EFSUMB annually since 1994 by the Safety Committee (ECMUS) of the federation. The text is deliberately brief and gives a concise overview of safety in the use of diagnostic ultrasound.Dieses Dokument ist die 2019 aktualisierte Revision des EFSUMB-Clinically-Safety-Statements. Diese Stellungnahme zur Sicherheit wird von der EFSUMB seit 1994 jährlich durch das Sicherheitskomitee (ECMUS) der EFSUMB veröffentlicht. Der Text ist bewusst kurz gehalten und gibt einen prägnanten Überblick über die Sicherheit bei Anwendung des diagnostischen Ultraschalls.

Tendon disorders commonly cause hand and wrist disability and curtail the performance of work-related duties or routine tasks. Imaging is often needed for diagnosis, but it requires knowledge of the complex anatomic structures of the tendons of the hand and wrist as well as familiarity with related disorders. This review article aims to provide medical professionals with guidelines for the sonographic assessment of the tendons of hand and wrist and related disorders. Sonographic features of tendon disorders affecting the hand and wrist are described here, specifically: infectious tenosynovitis; tendon rupture or tearing; stenosing forms of tenosynovitis such as De Quervain disease and trigger finger; intersection syndrome; insertional tendinopathy; several forms of tendinous instability such as extensor carpi ulnaris instability, climber finger, and boxer knuckle; and tendinopathy in inflammatory rheumatic diseases. Postsurgical evaluation of the hand and wrist tendons is also discussed, including the healthy and pathologic appearances of operated tendons as well as impingement from orthopedic hardware. In conclusion, sonography is effective in assessing the tendons of the hand and wrist and related disorders and represents a valuable tool for diagnosis.

The os peroneum (OP) is a small sesamoid bone located inside the peroneus longus tendon (PLT), close to the cuboid. The OP can be the cause of pain and can be associated with lesions of the PLT. OP involvement in PLT disorders is frequently misdiagnosed by radiologists. Painful os peroneum syndrome (POPS) refers to a variety of conditions presenting with pain localized on the lateral aspect of the cuboid area. The syndrome can be observed as a consequence of local acute trauma such as ankle sprains or chronic overuse. Because of its intra-tendinous location, in tears of the peroneus longus tendon, the OP can show changes in its morphology or position, depending on the location of the tendon’s tear. Based on the level of the PLT tears, we propose a classification in three subtypes: tears localized proximal to the os peroneum (type I), at its level (type II) or distal to it (type III). These tears present with different changes on OP morphology or location. The aim of this article is to review the normal anatomy, imaging appearance and differential diagnosis of disorders of the OP as well as post-treatment imaging. Teaching points • PLT tears can be classified in three subtypes according to OP location. • POPS is characterized by pain on the lateral aspect of the cuboid. • OP involvement in PLT disorders is frequently misdiagnosed by radiologists.

Sonography is widely known as an accurate imaging tool for assessment of the rotator cuff of the shoulder, the long head of the biceps tendon, and joint disorders, but it is rarely performed to evaluate the coracoid process and the adjacent soft tissues. Nevertheless, sonography can show anatomic details of this region and be used to assess several pathologic conditions. The aims of this pictorial essay are to briefly review the anatomy of the coracoid process region, describe examination technique and normal sonographic appearances, and present the sonographic findings of the main disorders affecting this region.

Trigger finger is a common pathologic condition of the digital pulleys and flexor tendons in the hand. The key clinical finding is a transient blockage of the digit when it is flexed with subsequent painful snapping when it is extended. Imaging is a helpful guide for establishing the severity of the disease, identifying the underlying cause, and deciding the appropriate management. This narrative review aims to recall the anatomic and pathologic bases and describe the ultrasound features of trigger finger, also including common ultrasound findings and complications after therapy. Ultrasound enables an accurate static and dynamic evaluation of trigger finger as well as a comparison with the adjacent normal digits and thus should be considered the radiologic modality of first choice for its diagnosis.

Medial head of the gastrocnemius tear described as “tennis leg” is the third most commonly strained muscle in elite athletes, after the biceps femoris and rectus femoris. Although especially frequent among tennis athletes, this injury also occurs in other sports such as skiing, running, and jumping. The diagnosis is made clinically, but imaging, particularly sonography, is useful in confirming the diagnosis and in excluding other causes of calf pain.

The fabella syndrome and the Iliotibial band friction syndrome are the most frequent friction syndromes of the knee. The syndrome related to the fabella is relatively rare and more frequent in young athletes, such as high-performance runners. Fabella syndrome has been linked to the increase in tensile forces of the lateral part of the knee, although it is not clear because only some people develop the syndrome. The excessive increase in internal rotation of the knee in competition sports leads to torsional strain on the iliotibial band, with compression of the highly innervated adipose tissue between the iliotibial band and femoral condyle, so Iliotibial band syndrome is a frequent injury among competitive cyclists and long-distance runners. Ultrasonography is a very useful tool in the diagnosis and during the follow-up of the friction syndromes of the knee.

The tendons of the ankle may be divided into four compartments: anterior, medial, posterior, and lateral. The anterior compartment includes the tibialis anterior, extensor hallucis longus, and extensor digitorum longus tendons; an accessory peroneus tertius tendon may also be present. The medial compartment includes the tibialis posterior, flexor digitorum longus and flexor hallucis longus tendons; the posterior compartment, the Achilles and plantaris tendons; and the lateral compartment, the peroneus longus and the peroneus brevis tendons; a peroneus quartus tendon may also be present. Tendinopathy is easily diagnosed with ultrasound, and ultrasonographic-guided therapeutic procedures seem to be the most effective therapy in the same tendinopathy. Dynamic ultrasound is then the modality of choice for evaluation of tendon instability.

Hip pain may originate from various structures, but gluteus medius and gluteus minimus tendons, iliotibial band and gluteus maximus, pubic symphysis, and rectus abdominis-adductor aponeuroses pathologies are the primary causes. Static ultrasound may show many anomalies, but dynamic ultrasound, which allows real-time assessment of the relative movements of the structures, is the modality of choice for evaluation snapping hip syndrome.

The tendons and the muscles about the pelvis, on the basis of their anatomic location, can be divided into four groups: anterior, medial, lateral, and posterior, on the basis of their function in hip flexors, adductors, abductors, medial rotators, extensor, and external rotators.

Plantar fascia disorders are common in the adult population, cause pain and disability, and may curtail the performance of athletic activities. Plantar fasciitis is the most common injury of the plantar fascia and, despite its name, has a degenerative rather than inflammatory nature and is related to overuse—trauma (prolonged walking, running, or standing) leading to microtears. Partial or complete tears of the plantar fascia are uncommon. Imaging, particularly sonography, is of great help for achieving correct diagnosis, prompting appropriate treatment, and aiding in the determination of prognosis.

Morel-Lavallee lesion is a post-traumatic, soft tissue degloving injury, involving separation of subcutaneous tissue from the underlying fascia; accumulation of blood, lymph, and other breakdown products; disruption of perforating blood vessels; and the creation of potential spaces.

Post-traumatic muscle injury is one of the most common sports-related injuries. These injuries may be classified according to their pathogenetic mechanism in extrinsic injuries, such as contusion or penetrating wound and intrinsic injuries, caused by contraction and contemporary elongation of the muscles, that lead to muscle fiber destruction at the myotendinous junction. Ultrasound is performed to define the location and extent of the lesion and to assess possible compression of the surrounding structures.

Occult fractures as well as stress fractures are common sports injuries. Occult fractures are fractures not revealed on radiographs. Stress fractures can be divided in fatigue and insufficiency fractures, depending on their pathogenesis. Fatigue fractures result from repeated abnormal stresses on a normal bone. Insufficiency fractures result from a normal stresses applied to bones weakened. Various authors have reported ultrasound as having a high sensitivity for the investigation of fractures, but CT and MRI are the examination of choice to evaluate occult and stress fractures.

Jumper’s knee, Osgood-Schlatter disease, and Sinding-Larsen-Johansson syndrome are the most frequent overuse syndromes of the knee. The diseases depend mainly on training frequency and level of performance, but many factors, both intrinsic and extrinsic, contribute to the pathogenesis: weight, body mass index, waist-to-hip ratio, arch height of the foot, quadriceps flexibility and strength, hamstring flexibility, and vertical jump performance, as well as different intrinsic factors (ligamentous laxity, Q-angle, patella height, tenderness, pattern of force development) and the hardness of the ground underneath. The diagnostic criteria include local pain, swelling, and tenderness upon clinical examination. Ultrasonography is a very useful tool in the diagnosis and in the follow-up.

The synovial space of the knee consists of several interconnected structures, and a variety of bursae may be encountered around the knee. Joint and bursae effusion is the first manifestation of synovial disease and may be the result of trauma, overuse, systemic disease, etc. In athletes, overuse syndromes and ligamentous, osseous, and meniscal injuries are the most common causes of effusion and may be well evaluated with sonography.

This review aims to provide the radiologist with simple and systematic guidelines for evaluation of the Achilles tendon after complete rupture repair. Currently, there is a plethora of nonsurgical and surgical treatments, but sonographic examination has shown no significant differences between them. A systematic analysis of several parameters (morphologic characteristics, structure, color Doppler vascularization, and mobility) should be undertaken. Morphologically, the repaired tendon is larger, wider, or both. The loss of the fibrillary structure, inhomogeneity, and the surgical material in the context of the tendon are "normal" aspects after a repaired rupture. The presence of fluid collections when affecting greater than 50% of the surface of the tendon and extensive calcifications should be considered pathologic aspects. In the immediate postoperative period, there is the absence of vascularization detectable by color Doppler imaging. During the first 3 months, there is an increase in intratendinous vascularization with hypervascularization. From 3 to 6 months, stabilization and regression of the vascularization occur. Beyond the first 6 months, the hypervascularization is pathologic. The pattern of motion is, generally, reduced considerably more often in surgically treated tendons than in non-surgically treated ones. Elastography generally shows a hard appearance, with only a relatively heterogeneous pattern. In conclusion, a treated tendon will never regain a normal sonographic appearance, and the operator must distinguish between normal posttreatment changes and real pathologic characteristics.

Sonography allows for rapid, cost-effective, noninvasive, and dynamic evaluation of soft tissue structures, thus representing a valuable tool for ruling out musculoskeletal disorders of the wrist. Because of the complexity of the wrist joint, sonographic training and familiarity with normal and variant anatomy are needed to avoid misdiagnosis and improper treatment. The aim of this article is to enlighten readers about the structures representing normal findings or common variants during sonographic evaluations of the wrist. The main text reviews the pertinent gross anatomy and procedures that are recommended to assess the soft tissue structures of the wrist, with particular emphasis given to tendons, nerves, and ligaments. Detailed explanations of the scanning techniques and sonographic appearance of the wrist structures are provided in the figure legends.

Hoffa's (infrapatellar) fat pad (HFP) is one of the knee fat pads interposed between the joint capsule and the synovium. Located posterior to patellar tendon and anterior to the capsule, the HFP is richly innervated and, therefore, one of the sources of anterior knee pain. Repetitive local microtraumas, impingement, and surgery causing local bleeding and inflammation are the most frequent causes of HFP pain and can lead to a variety of arthrofibrotic lesions. In addition, the HFP may be secondarily involved to menisci and ligaments disorders, injuries of the patellar tendon and synovial disorders. Patients with oedema or abnormalities of the HFP on magnetic resonance imaging (MRI) are often symptomatic; however, these changes can also be seen in asymptomatic patients. Radiologists should be cautious in emphasising abnormalities of HFP since they do not always cause pain and/or difficulty in walking and, therefore, do not require therapy. Teaching Points • Hoffa's fat pad (HFP) is richly innervated and, therefore, a source of anterior knee pain. • HFP disorders are related to traumas, involvement from adjacent disorders and masses. • Patients with abnormalities of the HFP on MRI are often but not always symptomatic. • Radiologists should be cautious in emphasising abnormalities of HFP.

We report the case of a 22-year-old athlete who sustained a blunt thoracic trauma to the right chest causing a costal cartilage fracture. Plain radiographs revealed no abnormalities while sonographic (US) examination performed a week later because of persistent pain led to the diagnosis of a displaced fracture of the right tenth costal cartilage. A follow-up US examination confirmed the healing of the fracture and allowed the patient to return to competitive sport activity. We recommend the use of US in patients with persisting pain after thoracic trauma with negative plain radiographs of the ribs to rule out radiographically occult costal cartilage fractures. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound, 2017

Ultrasound examination of the elbow may be performed with the patient seated and the elbow placed on the examination table/bed. The medial aspect of the elbow is generally examined with the elbow in extension or in the so-called crab position, the posterior aspect in the crab position, the lateral aspect with the elbow in flexion or in the crab position, the anterior aspect with the upper limb in an extended and supinated position. In the anterior aspect the key structures to be evaluated are: the distal biceps muscle and tendon, the distal brachialis muscle and tendon, the anterior joint recess with the anterior fat pad, the median nerve, the radial nerve, the brachial artery and the articular cartilage, in the lateral aspect: the common extensor tendon, the lateral collateral ligament, the radial nerve and part of the radiocapitellar joint, in the posterior aspect: the triceps, the anconeus muscles, the olecranon bursa, the olecranon fossa with the posterior recess and the ulnar nerve, in the medial aspect: the common flexor tendon, the medial collateral ligament and the pronator teres.

This study aimed at comparing the diagnostic accuracy of ultrasonography (US) and magnetic resonance imaging (MRI) for the detection of joint effusion of the knee.For this retrospective study, approbation by the institutional review board was not required, and written informed consent from the patients was waived. One hundred and fifty-eight patients (83 men and 75 women; median age 41.2 years; age range 13-81 years) who underwent US and MRI of the knee were included in the study. The sensitivity and specificity of US with respect to MRI in the evaluation of the effusion of the knee and in each recess were compared.In evaluating joint effusion of the knee, compared with MRI, US correctly identified 78 of 96 patients with joint effusion, showing a sensitivity of 81.3 % and a specificity of 100 %, with a positive predictive value (PPV) of 100 % and a negative predictive value (NPV) of 77.5 % (p value = 0.001). Various results were obtained comparing ultrasound with MRI, regarding the various recesses.US showed high specificity and sensitivity in diagnosing knee joint effusion and could be used in patients who cannot undergo MRI.Confrontare l’accuratezza diagnostica dell’ecografia (US) e la risonanza magnetica (MRI) per il rilevamento di versamento articolare del ginocchio.Per questo studio retrospettivo, non e’ stata necessaria formale approvazione da parte del Comitato Etico, ed e’ stato derogato il consenso informato scritto. Centocinquanta pazienti (83 uomini e 75 donne; età media: 41,2 anni; range di età: 13–81 anni) sottoposti a US e MRI del ginocchio sono stati inclusi nello studio. E’ stata valutata la sensibilità e la specificità dell’ US rispetto allan MRI nella valutazione del versamento del ginocchio e in ciascun recesso.Nella valutazione versamento articolare del ginocchio, rispetto alla MRI, l’ US ha identificato correttamente 78 su 96 pazienti con versamento articolare, mostrando una sensibilità del 81,3 % e una specificità del 100 %, con un valore predittivo positivo (PPV) del 100 % e un valore predittivo negativo (VPN) del 77,5 % (l’US ha mostrato elevata specificità e sensibilità nella diagnosi del ginocchio versamento articolare e potrebbe essere utilizzato in pazienti che non possono essere sottoposti a MRI.

We report a case of a patient with cubital tunnel syndrome caused by presence of a non-thrombotic vein in the cubital tunnel. Cubital tunnel syndrome is a symptom complex caused by the compression of the ulnar nerve at the elbow. It is the second most common peripheral compression neuropathy. Ulnar compression at the elbow can be clinically diagnosed; however, an electroneurographic examination is necessary to confirm the diagnosis. Sonography and MRI may be required to locate nerve lesions, but primarily to evaluate the causes of compression. We decided to report this case because it shows the importance of the ultrasound in the diagnosis of the cause of compressions, including those rare and unexpected.

The presence of the subacromial-subdeltoid (SASD) bursa inflammation has recently been proposed as a primary radiologic factor predicting persistent limitation and pain in operated patients. The aim of the study was to verify the hypothesis that pain, or increased shoulder pain, could be associated with SASD bursitis not only in operated patients but also in general population.A consecutive series of 1940 shoulder ultrasound examinations were performed by our Department over a 5-year period using linear multi-frequency probes. All reports of examination executed for shoulder pain were reviewed. The video clips were independently reviewed by two radiologists: effusion in the SASD bursa and the presence of other pathological conditions were evaluated and confirmed.A total of 1147 shoulder video clips were re-evaluated, and 1587 pathologies were detected; 65.5 % of patients had only one pathology, 30.4 % had two and 4.1 % presented three pathologies. The difference between the group with and without effusion is statistically significant for acromioclavicular joint arthritis, supraspinatus tendon calcific tendinopathy, full-thickness and superficial tear of the supraspinatus, traumas and rheumatoid arthritis with a p value0.01.Our study shows that the effusion in the SASD bursa is frequently associated with shoulder pain often independently from the underlying pathology; further studies are needed to confirm the statistical significance of this relationship by clarifying possible confounding factors.La presenza di alterazioni flogistiche a livello della borsa subacromiondeltoidea (BSAD) è stata recentemente proposta come fattore principale per predire la comparsa di dolore e limitazione funzionale nei Pazienti operati a livello della spalla. Lo scopo del nostro studio è di verificare l’ipotesi che il dolore, o l’incremento dello stesso, sia associato con la flogosi della BSAD non solo nei Pazienti operati ma anche nella popolazione generale.In 5 anni nel nostro dipartimento sono state eseguite, utilizzando esclusivamente sonde lineari multifrequenza, 1940 ecografie della spalla. Tutti gli esami aventi come indicazione il dolore sono stati selezionati. I videoclip degli esami selezionati sono stati rivalutati da due radiologi indipendentemente: è stata in tal modo confermata la presenza di versamento nella BSAD e di altri reperti patologici.Sono stati rivalutati i videoclip di 1147 ecografie di spalla. Sono state individuate 1587 alterazioni patologiche; il 65.5 % dei Pazienti presentava unicamente un riscontro patologico, il 30.4 % ne presentava due e il 4.1 % ne presentava 3. La differenza tra gruppo con e senza versamento è statisticamente significativa (Il nostro studio mostra come il versamento nella BSAD sia frequentemente associato con il dolore di spalla spesso indipendentemente dalla patologia sottostante; ulteriori studi sono necessari per confermare tale relazione e chiarire l’influenza di possibili fattori confondenti.