AimTo determine whether early clinical, laboratory and musculoskeletal ultrasound (MSUS) characteristics can be used as early detectors of juvenile idiopathic arthritis.Patients and methodsForty (40) patients with juvenile idiopathic arthritis (JIA) diagnosed according to the ILAR criteria [1] and 20 healthy control children. All patients were subjected to the following assessment at base line and at follow up after 6 months: Clinical evaluation, MSUS examination and laboratory evaluation.ResultsOf the 40 patients, 6 patients (15%) had systemic onset subtype, 8 (20%) oligoarticular extended, 9 (22.5%) oligoarticular persistent, 5 (12.5%) polyarticular rheumatoid factor (RF) +ve, 6 (15%) polyarticular RF −ve, 5 (12.5%) enthesitis related subtype and only one patient (2.5%) had psoriatic JIA. MSUS detected more synovitis than clinical examination (subclinical synovitis) both at base line and at follow up. MSUS is highly sensitive for early detection of joint involvement in JIA when compared to physical examination. Significant decrease in the mean cartilage thickness of the patients measured at follow up as compared to measures at base line.ConclusionMSUS is highly sensitive for early detection of joint involvement in JIA when compared to physical examination
Objective: The aim of this study was to assess the predictive value of endometrial thickness, morphology and vasculature using two-dimensional (2D) Doppler ultrasound on the IVF/ICSI cycle outcome. Subjects and methods: Endometrial thickness, morphology and subendometrial blood flow were assessed using transvaginal ultrasound on the day of hCG in 100 patients undergoing IVF/ICSI treatment in the period between June 2013 and January 2015. Statistical analysis was done. Results: There was no difference in the demographic features or details of ovarian stimulation between pregnant and non-pregnant women. Overall, 40 patients conceived; 23 (57.5%) of them had blood flow in zone III and 15 (37.5%) in zone II. All patients achieved pregnancy had endometrial thickness >8 mm. Using the ROC curve, the cutoff endometrial thickness for non-achieving pregnancy was 7 mm with a sensitivity and specificity of 100%. There was no significant difference in Doppler indices between pregnant and non-pregnant women. Conclusion: When the endometrial thickness is <8 mm, and if there are non-triple endometrial line and non-favorable blood flow zone on day of hCG in IVF/ICSI cycles, pregnancy is unlikely and embryo transfer should be canceled with freezing of all embryos for future transfer to increase the success rate.
Objective: To evaluate the role of color Doppler sonography in comparison with CXR and CT imaging in diagnosis of pneumonia in adults. Patients and methods: Thirty-one patients with clinical suspicion of pneumonia were assessed by chest radiography, CT and sonography. Quantitative and qualitative sonographic examination of lesions was performed using color Doppler imaging. The correlation between color Doppler and CT findings was determined. Results: Lung ultrasound showed high sensitivity (100%), specificity (93.8%) and diagnostic accuracy 96.8% in diagnosis of pneumonia. It detected air bronchogram in all cases, simple effusion in 18 cases and effusion with internal echoes in 8 cases. It was almost agreement with CT findings (K = 0.93). The sensitivity of chest X-ray was low (60%). It was moderate agreement with CT findings (K = 0.608). A significant changes were seen in flow pattern in comparison with severity of necrosis by CT (P value = 0.038). Majority of our cases reflected pulmonary arterial flow pattern that was found in 21 cases. Conclusion: Lung ultrasound with color Doppler imaging is highly accurate and valid alternatively in diagnosis of pneumonia. By qualitative and quantitative impedance measurement, pulmonary and bronchial arteries can be differentiated. The flow pattern of pulmonary arteries was an indicative of good outcome.
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