An accurate evaluation of thyroid volume, in patients of all ages, is important for the correct diagnosis of a goiter and for sonographic monitoring of thyroid diseases. It is especially important in pediatrics because the linear measurements of a developing thyroid gland do not correlate well with age, sex, or body composition variables. Diverse methods are used to estimate thyroid size and volume. Sonographic volumetry and visual inspection and palpation are used to evaluate the thyroid. Although thyroid size can be easily assessed on physical examination, due to the superficial location of the gland, palpation has low sensitivity and specificity for the management and diagnosis of thyroid disorders. Therefore, thyroid volume measured sonographically is more accurate than thyroid size assessed with a physical examination. Imprecise calculation of thyroid size and volume may lead to false-positive or false-negative diagnoses of thyromegaly, which may result in unnecessary or delayed care.

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While originally described in the 18th century, the incidental detection of renal artery aneurysms (RAAs) has increased significantly with the advent and increased usage of modern cross-sectional imaging. Although the incidence remains low, RAAs are clinically important, especially if measuring greater than 2 cm in diameter. Therefore, ultrasonographers and radiologists alike should be aware of its features on multiple imaging modalities as well as imaging pitfalls. Renal duplex sonography is widely used for the evaluation of renal arteries stenosis, fibromuscular dysplasia, renal veins patency, and for the status of renal transplants. RAA is another, albeit rare, indication for renal arteries duplex examination. Furthermore, RAAs may be an incidental finding on abdominal or renal ultrasound. Therefore, familiarity with the sonographic presentation of a RAA is important. Diagnosing RAAs with duplex ultrasound may become exceptionally difficult when the aneurysm has peripheral calcification, even more so when the aneurysm is situated by the renal hilum. Those calcified arterial walls may produce strong acoustic shadowing, mimicking a renal calculus.

Patients are frequently referred for pelvic sonograms to evaluate for adnexal masses. Determining the etiology of the adnexal mass can be challenging, but is necessary to establish a follow-up strategy and correct diagnosis. It is particularly important in those cases when adnexal lesions appear to be complex and the ovaries are not visualized sonographically. Perineural cysts were found incidentally by Tarlov in 1938 during autopsy. This report documents a lesion now bearing his name, Tarlov cysts (TCs). They are defined as cerebrospinal fluid-filled saccular lesions located in the extradural space of the sacral spinal canal and are formed within the nerve root sheath at the dorsal root ganglion. The perineurium and neural tissue make up the cysts' walls. Usually asymptomatic, a TC is mostly found on magnetic resonance imaging (MRI) of the lumbar spine and sacrum. Occasionally, a TC mimics an adnexal cyst.

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Peripheral arterial disease (PAD) commonly results from progressive narrowing of arteries in the extremities because of atherosclerosis. More than 8 million people in the United States have PAD. The majority of individuals with PAD are seniors with one or more cardiovascular disease risk factors. Because patients with PAD may be asymptomatic, the true incidence of PAD may be underreported. Accurate and timely diagnosis of PAD is very important for optimal treatment.

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