Cross-sectional imaging modalities like MRI and CT provide images of the chest which are easily understood by clinicians. However, these modalities may not always be available and are expensive. Lung ultrasonography (US) has therefore become an important tool in the hands of clinicians as an extension of the clinical exam, which has been underutilized by the radiologists. Reinforcement of the ALARA principle along with the dictum of “Image gently” have resulted in increased use of modalities which do not require radiation. Hence, ultrasound, which was earlier being used mainly to confirm the presence of pleural effusion as well as evaluate it and differentiate solid from cystic masses, is now being used to evaluate the lung as well. This review highlights the utility of ultrasound of the paediatric chest. It also describes the normal and abnormal appearances of the paediatric lung on ultrasound as well as the advantages and limitations of this modality.
Rotator cuff tendinopathies are a prevalent cause of reduced activity or disability in the general population. Patients may present with decreased shoulder function such as painful shoulder movements, a painful arc, weakness, discomfort, and stiffness. On clinical evaluation, weak external rotators, a weak supraspinatus, and signs of impingement may be found. 1 Sonoelastography (SE) by measuring stiffness helps to assess the biomechanical and structural properties of tissues. 2 Ultrasound (USG) is an easily accessible imaging tool that relies on alteration of echogenicity for diagnosis of tendinopathy. However, the abnormal tendon may have similar echogenicity to that of the surrounding healthy tissues, making diagnosis difficult in tendinopathy. MRI takes into account change in signal pattern while CT looks at changes in attenuation. These modalities lack the capability of showing very early changes in tendinopathy, which involve alteration of stiffness of the tendon. In the present study, however, we could not come across a case where SE was abnormal and MRI was normal in a symptomatic patient. We undertook this study in order to further understand the utility of SE in the detection of supraspinatus tendinopathies and comparing SE findings with that of MRI. MeThoDs anD MaTerials Subjects Ours was a prospective cross-sectional study, performed over a period of 15 months on 25 consecutive patients (Table 1) (7 females, 18 males; mean age 41.7 years; age range 25-75 years) who had history of mild to moderate discomfort during activity with no significant motion limitation and tenderness over the area of the greater tuberosity, suggested rotator cuff tendinopathy. In all patients, blunt trauma/ open wounds, full thickness supraspinatus tendon (SST) tear, or a previous surgery, and other general contraindications for MRI were excluded. An informed written consent from the patient was taken. The patients were first evaluated with real-time SE followed by MRI. The Ethical Committee and Review Board of our Institution (Department of Radio-diagnosis, Bharati Hospital and Research Centre, Pune, India) approved the study.
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