” … A group of noted obstetricians and gynecologists maintain that ultrasound is more cost-effective and safer than other imaging modalities for imaging the female pelvis and should be the first imaging modality used for patients with pelvic symptoms…”
Using ultrasound technology to visualize the tongue’s shape and movement can help children with difficulty pronouncing “r” sounds, according to a small study. The ultrasound intervention was effective when individuals were allowed to make different shapes with their tongue in order to produce the “r” sound, rather than being instructed to make a specific shape….
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Named after the British surgeon James Rutherford Morison, Morison’s pouch is also known as the hepatorenal recess or the subhepatic recess (the space that separates the liver from the right kidney). This recess is free of fluid under normal circumstances, but can fill with fluid under certain conditions such as hemoperitoneum or ascites. This space can best be visualized via ultrasound. According to the Textbook of Pediatric Emergency Medicine, “The amount of intraperitoneal fluid needed for detection by ultrasound has been reported to be as little as 100 mL and will depend on the source of the bleeding and patient positioning.” In adults, any low frequency probe is adequate to visualize the space. However, in pediatric trauma patients who have small intercostals spaces a microconvex probe should be used to avoid rib shadowing. Morison’s Pouch is one of the 4 views of the FAST exam.
References: Textbook of Pediatric Emergency Medicine 6th Edition pages 1732-1733. Edited by Gary Robert Fleisher and Steven Ludwig
Sudha A. Anupindi, Mark Halverson, Asef Khwaja, Mihajlo Jeckovic, Xing Wang and Richard D. Bellah
The purpose of this article is to describe the indications and techniques for bowel ultrasound for inflammatory bowel disease and other common and uncommon entities and describe and illustrate their imaging appearances, including endoscopic or surgical correlation.
Ultrasound is a useful tool for the evaluation of inflammatory bowel disease and many other bowel diseases. Radiologists must become familiar with the full potential of ultrasound in the evaluation of the bowel in children because the need for alternative radiation-free imaging techniques continues to grow.
Targeted ultrasound has been well established for the evaluation of bowel pathology in children for intussusceptions, appendicitis, and hypertrophic pyloric stenosis for more than a decade. In many places, ultrasound is the first line of imaging over CT and radiography for these diagnoses. Ultrasound of the bowel is a routine part of the evaluation of both adults and children with inflammatory bowel disease (IBD) in Europe but is only recently emerging as a potential technique in the evaluation of patients in North America. With attention on radiation safety and awareness by health care staff, patients, parents, and media, now is an opportune time to shift the focus of IBD imaging from radiation-dependent modalities, such as fluoroscopy and CT, to radiation-free modalities, such as ultrasound. Ultrasound is easy to perform, accessible, and inexpensive. It can be performed with little preparation and without sedation, making it more appealing in the pediatric population. However, there are limitations in performing bowel ultrasound, including: children with large body habitus, excessive bowel gas, and postoperative patients in whom the anatomy may be distorted. Other challenges of bowel ultrasound include the need for specialized training and experience to perform and interpret these examinations. Publications in the last few years have shown that ultrasound can depict both the intramural and extramural pathology of IBD, particularly Crohn disease. Because of increasing concern for radiation exposure, pediatric imagers have been optimizing and expanding the role of ultrasound in the assessment of bowel pathology.
We introduced dedicated nonemergent bowel ultrasound in our department for IBD more than 3 years ago, and we have expanded the indications for using bowel ultrasound and tailored the ultrasound technique for different clinical scenarios. Because of the limited role of ultrasound in the workup of bowel neoplasms, infections, and celiac disease, we have chosen not to focus our discussion on these topics. At our institution, targeted bowel ultrasound is used not only in the evaluation of children with IBD but also for detection and diagnosis of other disease processes, such as necrotizing enterocolitis (NEC), Henoch-Schönlein purpura (HSP), foreign bodies, and polyps. Our aim is to enhance the clinicians’ and radiologists’ knowledge of these useful, perhaps uncommon, applications. The purpose of this article is to describe the indications and current techniques for bowel ultrasound and illustrate exemplary cases with correlation with endoscopy or surgery and provide practical key teaching points to optimize imaging and recognize hallmarks of each disease.
See full Article at:
American Journal of Roentgenology: Vol. 202, No. 5, Published by ARRS; http://www.ajronline.org/doi/full/10.2214/AJR.13.11661