Dr Arun Gupta Director imaging

Dr Rakhee gupta Dr Vinayak Mittal Dr Ritesh MahajanDr Gaurav SharmaDr Sonal Joshi

ADVANCED USG

LOUNGE

ULTRASOUND IMAGE GALLARY

ARTICULAR SYNOVIAL CHONDROMATOSIS EXTRA / JUXTRA ARTICULAR SYNOVIAL

CHONDROMATOSIS INFANTILE HYPERTROPHIC PYLROIC STENOSIS . TRANSIENT ENTEROENTERIC INTUSSESEPTION. RETROCEACAL APPENDIX WITH APPENDICOLITHS DUCT ECTSIA ( BREAST) 3D FETAL FACE IMAGE GALLERY PELVIC VARICOSITIES 3D ANGIOGRAM FETAL ANOMALY

1. Clenched hands2. Dysplastic hip joint3. Club feet 4. Fetal Anasarca 5. Hypoplastic lungs

SYNOVIAL CHONDROMATSOSIS

Synovial chondromatosis (SC), first described by Reichel1 in 1900 is a rare benign disorder char acterized by chondroid metaplasia with multi nodular proliferation of the synovial lining of a diarthrodial joint, bursa, or tendon sheath. Large joints are more com monly affected, the knee most often followed by the hip joint.

ARTICULAR SYNOVIAL CHONDROMATSOSIS .

Multiple loose bodies are appreciated in the joint space of the Rt shoulder . Innemurable and near symmetrical in shape loose bodies are seen in the joint space

Loose bodies In Rt shoulder Joint space

EXTRA / JUXTA ARTICULAR SYNOVIAL CHONDROMATOSIS .

• Appreciated as multiple calcific crescents in the popliteal cyst .

• Usually the calcific foci are multiple and similar in shape .

Crescent shaped calcific foci are appreciated in the popliteal cyst . The cyst per se extends caudally into the Intermuscular myofascial planes .

TRANSIENT ENTEROENTERIC INTUSSUSCEPTION.

Transient (non-obstructing) intussusception without a lead point is known to occur in both adults and children and occurs more frequently than was previously reported.Transient intussusception of the small bowel is most frequently detected incidentally and is presumed to be innocuous.Intussusception without a lead point is known to appear as a non-obstructing segment, usually smaller in diameter and shorter than an intussusception with a lead point.

TRANSIENT ENTEROENTERIC INTUSSESEPTION VIDEO

Click on the image for video

LOOP WITH IN THE LOOP ON AXIAL IMAGE

RETROCEACAL APPENDIX WITH APPENDICOLITHS .

Appendicitis is one of the most common diseases that require urgent surgical intervention. Due to its position, the inflamed appendix can cause many complications in abdominal cavity. Most of these complications are based on the anatomical position of the appendix. According to world literature over 65% of the anatomical positions of appendix is retrocaecal position, followed paracaecal and then the other positions of the appendix in different percentages.

TWO APPENDICOLITHS ARE APPRECIATED IN THE MID THIRD OF THE APPENDIX .

Even deep pressure in the right lower quadrant may fail to elicit tenderness the reason being that the caecum, distended with gas, prevents the pressure exerted by the palpating hand from reaching the inflamed appendix, so it has been called as ' Silent appendicitis'

HYPERTROPHIED PYLORIC STENOSIS

ELONGATED PYLORIC CANAL THICKENED HYPOECHOIC WALL MUSCLES NO PERISTALSIS THROUGH PYLORIC CANAL DOUGHNUT SIGN APPRECIATEDAppreciate the doughnut medial to GB and anterior to Rt kidney Echogenic mucosa with streak of fluid in the mucosal folds are appreciated as hypoechoic strings

MAMMARY DUCT ECTASIA

Ultrasound can be of help In patents with • High risk nipple discharge • Low risk nipple discharge

NICHE INDICATION FOR THIS ULTRASOUND WAS NIPPLE DISCHARGE RT BREAST

DILATED DUCT IN HORIZONTAL ORIENTATION IS APPREICATED IN RT BREAST WITH MID LEVEL ECHOES IN THE CORE ALONG THE DISTAL / RT LATERAL PART OF THE DILATED DUCT . ( CYTOLOGY NEGATIVE FOR MALIGNANT CELLS )

FETAL ANOMALY SERIES

• FETAL ANOMALY SERIES Clenched hands Club feet .Anasarca Dysplatic hip Lung hypoplasia

• PROMINENT NUCHAL FOLD • PERSISTANT CLENCHED

HANDS

ANGULATED ARTICULATIONOF THE PROXIMAL FEMORA IN LEFT HIP REGION. THIS OBSERVATION IS PERSISTENT IN INTERVAL IMAGING ALSO .ASSOCIATED CLUB FOOT APPRECIATED

FETAL ANASARCA CLUB FOOT BILATERAL APPRECIATED ECHOGENIC BOWEL APPRECIATED.INWARD ANGULATION OF THE RIBS APPRECIATED ( LOSS OF VOULME WITH FETAL LUNGS HAVING ATTENUATION OF HYPERECHOIC ECHOPATTERN AS EXPECTED FOR GESTATION

FETAL FACE PROFILES BABY BITING THE FOREARMBABY FROWNING BABY WITH THUMB IN MOUTH

BABY BITTING THE FOREARM

FROWNING BABY

PELVIC VARICOSITIES

LEFT PARAMETRIALPROMINENT VENOUS CHANNELS1. PATIENT WITH PAIN 2. IN LEFT PELVIC

REGION3. VALSALVAE DONE

GREY SCALE COLOR DOPPLER POWER DOPPLER

3D ANGIOGRAM

REFERENCE

DIAGNOSTICULTRASOUNDFOURTH EDITIONCarol M. Rumack, MD, FACRJ. William Charboneau, MD, FACRDeborah Levine, MD, FACR

Ultrasound of CongenitalFetal AnomaliesDifferential Diagnosis and Prognostic IndicatorsDario Paladini MDHead, Fetal Cardiology UnitDepartment of Obstetrics and GynecologyUniversity Federico II of NaplesNaplesItalyPaolo Volpe MDHead, Fetal Medicine UnitDepartment of Obstetrics and GynecologyHospital Di VenereBari