The novel appearances of laparoscopic-stapled rectal anastomoses in WSCE can be mistaken for anastomotic leak. To avoid delay in reversal of ileostomy, a flexible sigmoidoscopy can be used to confirm or exclude a leak.
The CEO is confirmed as the primary site of MRI changes in tennis elbow. Oedema was commonly found in asymptomatic elbows, necessitating the presence of thickening or tears in the CEO tendon to objectively diagnose tennis elbow on MRI.
Key content
This review debates the merits of who should perform the ultrasound examinations in gynaecology. In favour of clinicians (gynaecologists):
Gynaecologists, with a captive population, have a vested interest in learning ultrasound examination of the pelvis.
Basic ultrasound has been embedded in the core RCOG curriculum and the new RCOG training module in gynaecology has been launched.
With the ideals of ‘point‐of‐care’ investigation and ‘one stop’ assessment, future service delivery in gynaecological ultrasound could rely largely on gynaecologists.
In favour of radiology staff (radiologists and sonographers):
Gynaecological ultrasound is more than an adjunct to bimanual examination.
There is a concern that relocation of ultrasound into gynaecology clinics and wards may lead to the loss of the systematic approach seen in radiology departments, which covers patient safety, maintenance of equipment, reporting and archiving.
If radiologists are disenfranchised then the risk is loss of specialist radiology support when a vaginal scan does not give all the answers.
Learning objectives
To be aware of training programmes in gynaecological ultrasound.
To be familiar with appropriate methods of record keeping in ultrasound examination.
To understand quality assurance in delivery of an ultrasound service.
To understand the complementary nature of both a vaginal and a transabdominal pelvic ultrasound scan.
Ethical issues
Operators in gynaecological ultrasound should be appropriately trained, adequately resourced and should work within their level of competence.
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