Miscellaneous Flashcards
What is the most reliable finding in patients with abscesses?
Presence of fever
Increased WBC count
How does an abscess appear on ultrasound?
Complex mass
Debris, septations and gas can be seen within
In the absence of gas within a collection, how is an abscess differentiated from a hematoma?
Percutaneous aspiration
What is a biloma?
Extrahepatic collections of extravasated bile
How do bilomas appear on ultrasound?
Cystic masses located in the RUQ
What surgeries result in the complication of a lymphocele?
Renal transplantation
Gynecological surgery
Vascular surgery
Urological surgery
What is a lymphocele?
Leakage of lymph from a renal allograft, or by a surgical disruption of the lymphatic channels
What is a urinoma?
Collection of urine which is located outside of the kidney or bladder
What are urinomas most commonly associated with?
Renal transplantation
Posterior urethral valve obstruction
How does a urinoma appear on ultrasound?
Loculated fluid collection
What is developmental dysplasia of the hip?
Spectrum of disorders affecting the proximal femur and acetabulum that leads to hip subluxation and dislocation
What are risk factors for hip dysplasia?
Female Firstborn Frank breech presentation Family history Oligohydramnios
Which hip is DDH three times more common?
Left hip
What are the two stress maneuvers of the hip?
Barlow – dislocation of the hip by adducting and pushing the legs posteriorly
Ortolani – relocation of the dislocated hip by abducting the leg
What are the two groups of neoplasms in lymphoma?
Non-Hodgkin’s lymphoma
Hodgkin’s disease
How do lymph nodes appear sonographically?
Anechoic/hypoechoic mass containing a central echogenic foci
What is the “sandwich” or “mantle” sign?
Presence of perivessel lymphoma
Where do lymphomatous nodules typically cluster?
Anterior and posterior to linear structures such as the aorta, IVC and SMA
What are associated findings with non-Hodgkin lymphoma?
Nodal masses Fever Night sweats Weight loss Splenomegaly Hepatomegaly Cytopenia Abdominal mass causing bowel obstruction Hydronephrosis due to retroperitoneal nodes
What are two mechanisms that produce ascites?
Low serum osmotic pressure – protein loss
High portal venous pressure
What are causes of ascites?
Cirrhosis
Renal failure
Congestive heart failure
Cancer
What is pseudomyxoma peritonei?
Malignancy characterized by the progressive accumulation of mucus secreting tumor cells within the peritoneum
How does pseudomyxoma peritonei appear on ultrasound?
Bowel loops are seen matted to the posterior abdominal wall
What is most commonly associated with cancer of the appendix?
Pseudomyxoma peritonei
How is an adominal paracentesis performed with ultrasound?
Area of abdominal fluid (midline or lateral) is localized avoiding the epigastric vessels bilateral on the mammary line
What is a pleural effusion?
Accumulation of fluid within the plural space
What causes transudative effusions?
Increased hydrostatic pressure and decreased plasma oncotic pressure
Heart failure – Most common cause
Liver failure – Cirrhosis
Renal failure – Nephrotic syndrome
What causes exudative effusions?
Increased capillary permeability
Pneumonia
Cancer
PE
What is the laboratory analysis of pleural effusions?
Total protein LDH Cell count and differential Gram stain Aerobic and anaerobic bacterial cultures Cytology
How is pneumothorax identified on ultrasound?
Absence of gliding of the parietal and visceral pleura and presence of a comet tail artifact
How is thoracentesis performed with ultrasound?
Dorsal intercostal space is selected superior to the visualized diaphragm
Needle insertion is on the superior aspect of the rib
Pleural fluid is aspirated slowly as not to exceed 1.5 L per day
What is a Baker’s cyst?
Collection of synovial fluid in the popliteal fossa
What are causes of a Baker’s cyst?
Rheumatoid arthritis
Osteoarthritis
Overuse of the knees
What is a giant cell tumor of the tendon sheath?
Second most common tumor of the hand and wrist
How does a giant cell tumor appear on ultrasound?
Solid masses that may have varying appearances
Beware of cystic appearing masses that do not have sound enhancement
What forms the linea alba?
The rectus sheath encasing the rectus abdominis muscles
Where is the arcuate line?
Midway between the umbilicus and the symphysis pubis where the posterior wall of the sheath ends
What causes a rectal sheath hematoma?
Bleeding from the superior or inferior epigastric vessels or from a tear of the rectus muscle
What determines the location of a rectal sheath hematoma?
The linea alba and the arcuate line
What space will a rectus muscle hematoma extend into if it is inferior to the arcuate line?
Space of Retzius
Causes external compression and irritation of the urinary bladder
What causes rectal sheath hematomas?
External trauma Trauma from surgery Vigorous muscle contraction Valsalva with severe coughing/vomiting Pregnancy Anticoagulation therapy
