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Bronchopulmonary Sequestration

Introduction Bronchopulmonary sequestration (BPS) is a solid lung lesion of nonfunctioning pulmonary tissue, a supernumerary lobe of the lung, which lacks connection to the tracheobronchial tree and receives its blood supply from an aberrant systemic feeding artery, originating commonly from the descending aorta. Two forms are recognized: intralobar sequestration (ILS), which is incorporated into normal lung tissue, and extralobar sequestration (ELS), which has its own pleural…

Congenital Cystic Adenomatoid Malformation of the Lung

Introduction Congenital cystic adenomatous malformations (CCAMs) of the lung represent the most common lung defect diagnosed prenatally. CCAMs are intrapulmonary lesions with a typical hyperechoic appearance on ultrasound (US), with or without cystic components. Both sides of the lung, both sexes, and all races are equally affected. Most fetuses with CCAM are detected prenatally and have a good outcome, but appropriate identification and ongoing surveillance are…

Mortons neuroma

Cause, clinical and ultrasound findings Fibrous tissue around the interdigital nerve may result from friction from wearing high heels, abnormal loading, etc. The patient has stabbing or aching pain and a tender area at the interdigital space on pressure (Tinel test). Ultrasound findings are a hypoechoic lesion (neuroma) at the intermetatarsal space, with or without associated bursitis. On pressure, the bursitis is shifted away and the…

Plantar fasciitis

Cause, clinical and ultrasound findings Plantar fasciitis is characterized by inflammation and microtearing of the calcaneal insertion of the plantar fascia; the condition is related to arthritis, weight bearing for long periods, improper shoes and excessive physical activity. Presentation includes burning, stabbing or aching pain and a tender area at the medial side of heel. Ultrasound findings are hypoechoic thickening of the calcaneal origin of the…

Talonavicular joint

Cause, clinical and ultrasound findings Reasons for the injection include inflammatory arthritis and osteoarthritis. The patient has functionally limiting midfoot/forefoot pain. Ultrasound findings are hypoechoic fluid and/or synovial proliferation with or without neovascularity bulging out of the joint. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Metatarsophalangeal joint

Cause, clinical and ultrasound findings Reasons for the injection include inflammatory arthritis and osteoarthritis. The patient has functionally limiting forefoot pain. Ultrasound findings are hypoechoic fluid and/or synovial proliferation with or without neovascularity bulging out of the joint. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Sinus tarsi

Cause, clinical and ultrasound findings The causes of sinus tarsi syndrome are not well defined. The condition is associated with oedema and swelling in the space between the calcaneus and talus. Some consider the cause to be cruciate and interosseous ligament injury, while others believe it to result from arthropathy in the adjacent subtalar joints; some regard sinus tarsi syndrome to be a biomechanical problem. Ultrasound…

Tibialis posterior tendon sheath

Cause, clinical and ultrasound findings Inflammatory arthritis, athletic activity or injury may cause tendinopathy or tenosynovitis of the ankle tendons. The patient suffers pain and swelling on the medial aspect of the foot. Ultrasound shows tendon sheath distension with fluid or synovial tissue (tenosynovitis). A hypoechoic appearance of the tendon and neovascularity in and around the tendon. You’re Reading a Preview Become a Clinical Tree membership…

Peroneal tendon sheath

Cause, clinical and ultrasound findings Inflammatory arthritis, athletic activity or injury may cause tendinopathy or tenosynovitis of the ankle tendons. The patient suffers pain and swelling on the lateral aspect of the foot. Ultrasound shows tendon sheath distension with fluid or synovial tissue (tenosynovitis). A hypoechoic appearance of the tendon and neovascularity in and around the tendon. You’re Reading a Preview Become a Clinical Tree membership…

High-volume injection for achilles tendinopathy (saline stripping)

Cause, clinical and ultrasound findings Chronic Achilles tendinopathy may be associated with overuse injury, athletic activity, inflammatory arthritis or obesity. Presentation may include pain and swelling at the heel and impaired performance. Ultrasound findings may include fusiform thickening and intratendinous hypoechoic areas with varying degrees of neovascularity. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If…

Anterolateral gutter

Cause, clinical and ultrasound findings Reasons for the injection include inflammatory arthritis, osteoarthritis and posterolateral ligament injury. The joint may present with functionally limiting anterolateral pain. Ultrasound findings may include hypoechoic fluid and/or synovial proliferation with or without neovascularity bulging out of the joint. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a…

Subtalar joint

Cause, clinical and ultrasound findings Reasons for the injection include inflammatory arthritis, osteoarthritis, osteochondral injury, tarsal coalition and loose bodies. The joint may present with functionally limiting hind foot pain. Ultrasound findings may include hypoechoic fluid and/or synovial proliferation with or without neovascularity bulging out of the joint. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership…

Ankle joint

Cause, clinical and ultrasound findings Reasons for the injection include synovitis/effusion in the anterior ankle joint due to arthritis or prior trauma. The joint may present with swelling, pain and/or stiffness or painful or limited movement. Ultrasound findings may include hypoechoic fluid and/or synovial proliferation with or without neovascularity bulging out of the tibiotalar joint. To discriminate hypoechoic synovial tissue from fluid collection, use Doppler (to…

Popliteal cyst (baker’s cyst)

Cause, clinical and ultrasound findings A Baker’s cyst is a defect in the posterior wall of the knee joint capsule, usually with underlying osteoarthritis. The cyst’s onset can be either spontaneous or gradual. It presents with a visible ‘fullness or bulge’ on the posterior aspect of the knee; pain may be present on knee flexion. Ultrasound findings are that of a comic magazine “speech bubble” shaped…

Distal iliotibial tract

Cause, clinical and ultrasound findings Pain in the iliotibial tract typically results from overuse by runners or from poor lower limb biomechanics as the iliotibial tract flicks over the lateral femoral condyle. On examination, the patient’s pain can be elicited on palpation over the distal portion of the iliotibial tract and over the lateral femoral condyle; pain can also be experienced on both passive leg adduction…

Pes anserine complex (bursitis)

Cause, clinical and ultrasound findings Reasons for the injection include overuse and diseases such as rheumatoid arthritis and diabetes. Pain is experienced mainly over the medial aspect of the tibia, distal to the joint line of the knee. Ganglion cysts also can arise in this region, but they are often painless, thickened and hard due to their viscoid nature. Pain may be elicited with resisted knee…

Proximal tibiofibular joint

Cause, clinical and ultrasound findings Reasons for the injection include rheumatoid arthritis, osteoarthritis and trauma. A painful tibiofibular joint may present with effusion and/or a ganglion. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Patella tendon

Cause, clinical and ultrasound findings Pain in the patella tendon typically results from overuse by athletes who run, dance or perform jumps. Pain may be elicited on resisted leg extension and palpation of the inferior pole of the patella. Ultrasound findings may include a disorganized hypoechoic (sometimes anechoic patches) region of the proximal part of the patella tendon with neovascualrization. You’re Reading a Preview Become a…

Knee joint

Cause, clinical and ultrasound findings Reasons for the injection include rheumatoid arthritis, osteoarthritis, gout, calcium pyrophosphate deposition and trauma. A painful knee joint may present with capsular-pattern (Cyriax) limited flexion with a hard end feel. The knee will have a varying degree of effusion. Fluid is present in the suprapatellar pouch and in the medial and lateral recesses, which on ultrasound appear anechoic. You’re Reading a…