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Ultrasound evaluation of tibial periosteal ganglion withintraosseous componentChoi YS, Choi KH, Kim B-S, Kim DH, Chun TJ, Yang S-O, EuljiHospital, Eulji University School of Medicine, Korea

Periosteal ganglion cyst occurring within or beneath the periosteum isa rare condition and has not well recognized. It can easily be misdi-agnosed as other surface bony lesions due to suspicious periostealreaction on plain radiograph. We experienced a periosteal ganglion inthe tibia, which had cortical defect accompanied by intraosseous com-ponent in the metaphysis of distal tibia. We will demonstrate ultrasoundfindings of the periosteal ganglion with MR imaging findings, andreview the literature. Ultrasound can be used to characterize the loca-tion and cystic nature of the mass in evaluating the periosteal ganglion.

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Sonography of the knee after traumaRamova ELP, Poposka A, Military Hospital, Macedonia; Orthopedicclinic-Medical faculty-Skopje, Macedonia

Objectives: The knee sonography is significant method for periartic-ular structures and their changes, however, it is not significant forinternal exploration of knee structures. The aim of our study was toshow sonography like a diagnostic method in determination of patho-logical changes before following conservative treatment of soft tossestissue trauma.Methods: Thirty-six patients, male, over age 37.2 years, were withtrauma of knee and surgically treated with immobilization and drugs.They were sent for rehabilitation to our department. The sonographywas made before and after treatment, in standard way.Results: The patients after first sonography were divided in two groupsfor rehabilitation, A: physical procedures and B: physical proceduresand gymnastic. The patients after treatment and second sonographywere divided in tree groups, A: no changes, no clinical changes (45%),B: no changes, functional knee instability (33%), C: changes andclinical indication of MRI (22%).Conclusions: The knee sonography is with limitation in internalchanges of it. MRI is not indication for diagnosis, immediately aftertrauma. We can use knee sonography before and after treatment todetermine the therapy and condition.

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Sonographic evaluation of anterior and posterior cruciateligament rupture signs in acutely injured knees: Comparisonwith arthroscopic findingsKim DH, Kim YS, Oh HW, Koh KH, Chosun University Hospital,Korea

Objectives: To determine the accuracy of sonography and to promotethe method as an inexpensive screening method in the diagnosis ofacute rupture of the ACL/PCL in the setting of a knee trauma.Methods: Seventy-two consecutive patients (20 to 25 y) with a kneetrauma were included this study. The equipment used was a MedisonSA-9900 (Medison Co., ROK) with a 5.0–12.0 MHz linear transducer.The standard planes for assessing the ACL/PCL were transverse scanof the popliteal fossa with prone position and with relaxed knee andoblique sagittal scan of the knee parallel to ACL/PCL with supineposition. The sonographic criteria for diagnosing ACL/PCL rupturewere directly visualized rupture and indirect signs: echo-poor space atthe femoral insertion of the ACL, S-shaped course and thickening ofACL/PCL and protrusion of the posterior fibrous capsule. The con-tralateral knee was examined for comparison in all cases.

Results: Indirect sonographic criteria describe a better sensitivity (0.9)and specificity (0.8) than the direct criteria (0.7/0.6) in diagnosing acuterupture of ACL/PCL. Echo-poor space at the femoral insertion, hema-toma shows the best sonographic criterion.Conclusions: Sonography has a well documented and reasonably highsensitivity and a very high specificity for diagnosing acute lesions ofACL/PCL.

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Sural nerve imaging with high-resolution ultrasonographyIto T, Kijima M, Sakuta M, Nishiyama K, Department of Neurology,Kyorin University School of Medicine, Japan; Department ofNeurology, National Hospital Organization Chiba Medical Center,Japan

Objectives: To establish reference values for the sural nerve size, weanalyzed the normal sural nerve characteristics on high-resolutionultrasonography (US).Methods: Forty-four sural nerves in 22 healthy subjects were prospec-tively evaluated using high-resolution US. The transverse and antero-posterior diameters, and cross-sectional area of the nerves were used asUS parameters; and the age, height, weight and body mass index of thepatients, as body parameters. Correlation between US and body param-eters was evaluated.Results: The sural nerve appeared as an ovoid hyperechoic honeycombstructure transversely, while it appeared as a hyperechoic tubular struc-ture with parallel linear internal echoes longitudinally. The measure-ments with mean � standard deviation for transverse diameter, antero-posterior diameter and cross-sectional area were 2.4 � 0.3 mm, 1.6 �0.2 mm, and 3.0 � 0.5 mm2, respectively. There were no significantdifferences of US parameters between gender and between left andright sides (p � 0.05). Correlation between the cross-sectional area andheight was significant (r � 0.32, p � 0.03), and the cross-sectional areawas represented by the equation: cross-sectional area (mm2) � 0.19 �1.77 � height (m).Conclusions: High-resolution US is an useful imaging method forevaluating the sural nerve. The obtained reference values for the suralnerve size should be helpful in the diagnosis of the sural nerve abnor-malities.

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A new method for ultrasound evaluation of the iliopsoas tendoninsertionBird SJ, Benson Radiology, Australia

Sonographic evaluation of the iliopsoas insertion is difficult using thetraditional sagittal approach from the anterior aspect of the hip. Thedifficulties arise due to the depth of the tendon and the steep course tothe lesser trochanter resulting in anisotropy. Refraction artifact from theoverlying sartorius, rectus femoris and vastus medialis muscle edges,combined with the femoral neurovascular bundle further degrade theimage. I describe a new sonographic technique that overcomes thesedifficulties and produces images of excellent definition. Abduction andexternal rotation of the hip, combined with an approach angled steeplythrough the pectineus, adductor brevis and adductor longus musclebellies provides an excellent acoustic window and imaging perpendic-ular to the tendon insertion free of anisotropy.

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High resolution ultrasonography of carpal tunnel syndrome: Adynamic evaluationLan HH-C, Wang P-Y, Keng C-Y, Su Y-G, Lee T, Lee S-K, TaichungVeterans General Hospital, Taiwan; Yuanshan and Suao VeteransHospital, Taiwan

P252 Ultrasound in Medicine and Biology Volume 32, Number 5S, 2006