Limited scleroderma: sonographic pattern in the stage of erythema/edema

Objective. To describe the sonopattern of limited scleroderma (LS) in the early stages after the onset of erythema.Materials and methods. The work describes a clinical case of limited plaque scleroderma. The sonographic examination was carried out on an ultrasound scanner using a transducer with operating frequencies of 10–16–18 MHz. Material sampling for the histologic examination of the skin was performed from the area with the most pronounced inflammatory changes under sonographic control.Results. It has been found that increased echogenicity of the dermis, “blurring” of the dermis/hypodermis boundary, increased echogenicity and the “stalactite-like” pattern of subcutaneous fat occur in the frst week of the disease; normalization or a signifcant improvement of the sonopattern is noted by the end of the second week or by the beginning of the third week after the onset of erythema.Conclusion. There is a certain parallelism between the histologic and sonographic patterns, which makes it possible to adequately assess both the activity and the stage of the LS process.

Pathologic continuum in lumbosacral ligamentosis: comparison of sonographic and histologic data

Objective: to establish sonographic criteria allowing determining the stage of the pathologic continuum in lumbosacral ligamentosis.Material and methods. The sonographic data were compared with the results of the morphological studies of the samples of the iliolumbar ligaments, long dorsal sacroiliac ligaments, and sacrotuberous ligaments in 100 corpses. The age range of the studied subjects was 25–90 years. Among them, there were 64 men (average age 62.4 ± 11.8 years) and 36 women (average age 58.8 ± 15.1 years). Sonography of the ligament samples was performed in Bmode and using Multi-Slice View technology (Voluson 730 Expert and Toshiba Aplio XG ultrasound scanner, scanning frequency — 16–18 MHz).Results. A sonographic pattern inherent in the stage of adaptive changes, the stage of potentially reversible changes, and the stage of irreversible changes has been determined.Conclusion. Sonography can be used for a sufficiently accurate assessment of the stage of the pathologic continuum in lumbosacral ligamentosis.

“Black Ink” Sonographic Pattern as a Predictor for Invasive Papillary Thyroid Micro Carcinoma: A Case Report

Background: This study investigated the utility of the Sonographic pattern "Black Ink" with BRAF mutation testing of thyroid fine-needle aspiration cytology specimens for the risk papillary thyroid microcarcinoma (PTMC). Case Presentation: We describe a case of a 41-year-old Caucasian woman affected by a ultrasonography “Black Ink” papillary thyroid microcarcinoma (PTMC) of the left lobe of the thyroid gland with very tiny size (Ø 0.4 cm). The characteristics, with the Diagnostic Imaging using Ultrasonography (US), Superb Micro-Vascular Imaging (SMI), fine-needle-aspiration cytology (FNAC) and mutation analysis are here discussed. There are more rare subtypes of thyroid cancer as papillary microcarcinoma "Black Ink" that even if small, are invasive and there is why the need to early diagnosis to avoid their aggressive behavior is needed. Nowadays, focusing on the size, the cut-off for non-occult tiny tumors has dropped to 0.3 cm. This value is of great relevance. Conclusion: Ultrasonography, FNAC and BRAF molecular study have proven to be the most sensitive diagnostic combination for the early detection of thyroid cancer. Despite the size of this micro-lesion, the Black Ink ultrasonographic pattern associated with malignant cytology at FNAC represents an important biological risk factor and could still be a predictor of the PTMC and risk for neck lymph node metastases.

Does a relationship exist between the number of training or competition hours and the presence of sonographic alterations in the shoulder of CrossFit athletes?

Introduction CrossFit is a sport that is on the rise and has a known injury rate thanks to studies that have affirmed that the shoulder is the area that suffers the most damage. To date, no objective tool has been used to evaluate this. The aim of the present study was to determine the frequency of structural sonographic alterations in CrossFit athletes and its relationship with accumulated hours of practice and/or competition in the sport and shoulder pain. Material and Methods A cross-sectional descriptive study was conducted with sonographic assessments performed on 208 shoulders of 104 participants at official CrossFit gyms in Barcelona, between April and May 2017. The participants were requested to complete a specific questionnaire on CrossFit sports practice that included demographic data, the existence of pain, data on training routines, and clinical history. Ultrasound (US) examinations were made on the supraspinatus tendons (SST), on the long head of the biceps (LHB), and on the acromioclavicular (AC) joint. Results The presence of focal hypoechoic areas (FHAs) in the LHB (48.1%) and in the SST (60.6%) were the most common alterations in this sample, whereas, at the level of the AC joint, the most common disorder was the presence of cortical defects (30.3%). Shoulder pain was present in 37.5% of the participants. The probability of experiencing pain increased when the athletes accumulated > 1,000 hours of training (odds ratio [OR] = 2.0). In these athletes, the probability of presenting a focal hypoechoic area (FHA) decreased in the LHB (OR = 0.3), and the width of the SST increased a mean of 0.5 mm (p < 0.01). In athletes who participated in competitions, the sonographic pattern also presented an increased width of the SST and LHB tendons; however, this was not related with an increased probability of experiencing pain. Conclusions The sonographic pattern of the shoulder of CrossFit athletes presented structural changes in the SST and LHB tendons when subjects accumulated > 1,000 hours of training or when they participated in competitions. It is essential to relate the sonographic findings with the clinical findings of a patient to define whether these findings are, indeed, pathological. The probability of experiencing pain in the shoulder doubles when > 1,000 hours of CrossFit training are accumulated. This finding bears no relation with competing.