ULTRASOUND IMAGING IN BENIGN TESTICULAR CYSTS

https://youtu.be/jamnyu3pN4I

" Cervix sign" in congenital hypertrophic pyloric stenosis

Fig 1- Transverse epigastric high-resolution US scan of a neonate showing classical " Cervix sign " due to hypoechoic mural thickening of gastric pyloric canal , s/o Congenital hypertrophic pyloric stenosis.

SMA stenosis at origin on color & spectral Doppler

 Fig 1- Midline Sagittal color Doppler image upper abdomen showing narrowing  of SMA at origin with aliasing on color.

 Fig 2- Same color Doppler scan upper abdomen showing hypoechoic plaque at SMA origin with luminal narrowing & color aliasing.

Fig 3- Spectral waveform at stenosis showing high velocities

APPENDICITIS WITH PERFORATION AT TIP

ULTRASOUND EVALUATION OF APPENDICITIS WITH PERFORATION AT TIP

Clinicals- F/70y with pain RIF

Fig1- High resolution ultrasound scan of RIF shows thick walled tubulo target like gut Lesion consistent with inflamed appendix . A small breach is seen in mural continuity at tip with perifocal small amount of fluid and inflamed fat ( arrows) - s/o perforation.

Fig 2- HRSG scan of RIF shows inflamed appendix in longitudinal plane with small amount of fluid & fat reaction at tip ( indicative of perforation)

MOREL LAVALLEE LESION ON ULTRASOUND

" MOREL LAVALLEE LESION"

Clinicals - H/O trauma 

- Painful swelling anterior aspect of knee 

 Fig 1- Sagittal Extended field of view image anterior aspect of knee joint showing well defined area of  fluid collection in subcutaneous  fat plane with few thin septas & fat lobules . The lesion is extending above and below knee joint .

Fig 2- High resolution US scan anterior aspect knee joint showing fluid , thin floating septas & echogenic fat lobules with in superficial fascia & subcutaneous plane . The findings are consistent with "Morel Lavallee Lesion "

MOREL LAVALLEE LESION -  It is due to  closed degloving soft tissue injury associated with trauma . In this lesion skin & subcutaneous fat abruptly separate from underlying deep fascia forming a hemolymphatic mass . Thigh at greater trochanteric area is the most common site .

ULTRASOUND CHEST- Empyema thoracis & Enlarged Thymus

ENCYSTED /LOCULATED INFECTED PLEURAL EFFUSION [ EMPYEMA THORACIS]

Fig 1- Utrasound image of left side chest showing  thick walled loculated pleural effusion with internal echos and septas  - indicative of empyema .

Fig 2- CXR PA of the same case showing homogeneous opacity left mid and lower zone with smooth upper margin  . The opacity is obscuring cardiac and dome outline .

D/D - 1) Consolidation - point against - absent air bronchograms

2)- Pleural effusion  - point against - no mass effect - this can be explained as it is loculated empyema 

USG OF ENLARGED THYMUS 

CXR: Shows upper mediastinal widening

USG scan(chest, left parmedian TS view) of the same pediatric case: Shows enlarged thymus as well defined soft tissue mass in the region of superior mediastinum retrosternal space. 

USG scan(chest, left parmedian LS view) of the same pediatric case: Shows enlarged thymus as well defined soft tissue mass in the region of superior mediastinum retrosternal space, antero-superior to heart and great vessels. 

TRANSPERINEAL US SCAN DEPICTING ANAL FISTULA WITH PERIANAL ABSCESS

CASE  1- 

CLINICAL PROFILE  - A young female c/o pain during defecation  & some pus discharge per rectum 

EXAMINATION - High resolution transperineal USG  

Fig -1 , High resolution trans perineal US scan  showing  anal canal [ AC] in transverse plane with  hypoechoic fistula track at about 11 o' clock position  continuous with irregular right lateral perianal abscess .


                                                                    CASE 2

Fig 2 - High resolution trans perineal US scan  of another case showing  anal canal [ AC] in transverse plane with  hypoechoic fistula track at about 1 o' clock position  continuous with irregular left  lateral perianal abscess .