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Downloaded from http://journals.lww.com/ultrasound-quarterly by BhDMf5ePHKbH4TTImqenVA5KvPVPZ0P5BEgU+IUTEfzO/GUWifn2IfwcEVVH9SSn on 06/10/2020 LITERATURE REVIEWS Yoshimi Endo, MD, Section Editor The objective of this retrospective ob- first trimester. Although previous studies Occult Fractures of the servational study was to evaluate the using 2-dimensional ultrasound have Scaphoid: The Role of diagnostic and therapeutic effect of ul- shown relatively poor reliability, 3D ul- trasound (US)Yguided corticosteroid and trasound may be more accurate, as it Ultrasonography in the local anesthetic injections. According to allows manipulation of an acquired vol- Emergency Department the authors, although US-guided injec- ume of images in multiple planes. tion is widely used for the treatment of Eighty-five fetuses with gesta- Platon A, et al. Skeletal Radiol. degenerative joint disease of the midfoot, tional age ranging from 79 to 95 days 2011;40:869Y875. there are limited published data regard- were included in the study. The genital The purpose of this study was to assess ing its efficacy. angle, the angle between the genital tu- the accuracy of wrist ultrasound (US) Fifty-nine patients who underwent bercle and the long axis of the fetal body, performed by an emergency radiologist US-guided injection and whose post- was measured on the midsagittal plane in diagnosing scaphoid fractures, using procedure course was available were in- after manipulation of the acquired 3D computed tomography scan as a criterion cluded in the study. At day 1, 66.7% of volume. There was a statistically signif- standard. the patients reported a positive response, icant difference in the genital angle be- Sixty-two consecutive patients clini- whereas 78.4% reported a positive ther- tween the 2 genders, and using genital cally suspected of having a scaphoid frac- apeutic response at 2 weeks after injec- angle of 27 to 29 degrees as the cutoff ture but having normal radiographs were tion. Some patients who did not have a yielded a sensitivity of 100% and speci- enrolled in the study. Ultrasound was con- therapeutic response on day 1 still re- ficity of 98.0% for fetal gender. Assess- sidered positive if there was cortical dis- ported a positive response after 2 weeks, ment of reproducibility using a second continuity along the scaphoid, or if there whereas some who did report a positive observer yielded a high degree of corre- was hemarthrosis in either the radio- response on day 1 no longer felt a posi- lation (r = 0.998). scaphoid or scaphotrapezium trapezoid tive response by 2 weeks. Response on The authors conclude that 3D joint spaces. the first day was not a statistically sig- ultrasound is reliable in predicting fetal Thirteen (21%) of 62 patients were nificant predictor of therapeutic effect at gender as early as 11 to 13 weeks of found to have a scaphoid fracture on 2 weeks. gestation, although they state that at computed tomography, and US correctly Although less data were available 11 weeks, the accuracy may be lower. identified 12 (92%) of the 13. When the beyond 2 weeks, positive response was fractures were divided into 2 groups ac- still seen in 67.5% of patients at 2 to cording to likelihood of complication Contrast Enhanced 4 weeks, in 57.5% of patients at 1 to 3 based on fracture location, US correctly Ultrasound in the Detection months, in 15% at 3 to 6 months, and in identified all 8 of the fractures with 10% of patients at 6 to 12 months. of Liver Metastases: A higher potential for complications. The authors conclude that, although The authors state that relative easy Prospective Multi-Centre there was variation in the degree and access of the waist of the scaphoid by the length of therapeutic responses, corticos- Dose Testing Study Using US probe may explain the higher sensi- teroid injection appears to be effective for tivity of US for scaphoid waist fractures a Perfluorobutane managing pain related to degenerative compared with fractures of the distal pole. joint disease of the midfoot for up to 3 Microbubble Contrast The study demonstrated a high months. The retrospective design of the false-positive rate, which was partly rela- Agent (NC100100) study and absence of a control group are ted to the presence of occult fractures limitations cited by the authors. Correas JM, et al. Eur Radiol. other than that of the scaphoid. 2011;21:1739Y1746. The authors conclude that wrist US may be useful in triaging patients The purpose of this study was to iden- Accuracy of Fetal Gender suspected of having scaphoid fractures. tify the optimal concentration of a per- Determination in the fluorobutane microbubble contrast agent (NC100100) for detecting hepatic me- Efficacy of Ultrasound-Guided First Trimester Using tastases on contrast-enhanced ultrasound Steroid Injections for Pain Three-Dimensional (CEUS). NC100100 acts as a late hepa- tospecific phase contrast agent via up- Management of Midfoot Ultrasound take by Kupffer cells, and its use has Joint Degenerative Disease Youssef A, et al. Ultrasound Obstet been shown to increase sensitivity for Gynecol. 2011;37:557Y561. hepatic metastases compared with con- Drakonaki EE, et al. Skeletal Radiol. The purpose of this study was to assess ventional ultrasound. 2011;40:1001Y1006. the accuracy of 3-dimensional (3D) ul- One-hundred fifty-seven patients The author declares no conflict of interest. trasound in predicting fetal gender in the with hepatic metastases confirmed on Ultrasound Quarterly & Volume 27, Number 4, December 2011 www.ultrasound-quarterly.com 269 Copyright © 2011 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. Downloaded from http://journals.lww.com/ultrasound-quarterly by BhDMf5ePHKbH4TTImqenVA5KvPVPZ0P5BEgU+IUTEfzO/GUWifn2IfwcEVVH9SSn on 06/10/2020
Ultrasound quarterly – Wolters Kluwer Health
Published: Dec 1, 2011
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