FINAL

What are the symptoms of thyroiditis?

1. Swelling

2. Tenderness

3. Diffusely enlarged

4. Palpable

5. Pain

How does thyroiditis appear on an US?

1. Diffusely enlarged gland

2. Slightly irregular echo pattern

3. Hypoechoic compared to adjacent muscles

4. Calcifications may occur after inflammation

What is the most common thyroid abnormality?

Nodular Thyroid Disease

What machine adjustments should be made for scanning the thyroid isthmus?

1. Decrease depth

2. Move focus to just below isthmus

What transducer is used for thyroid isthmus?

1. 12-18 MHz

2. Linear

Which salivary gland most commonly has sialolithiasis?

Submandibular

Salivary Gland Image

1. A = Parotid

2. B = Submandibular

3. C = Sublingual

What is the most common autoimmune disease of the salivary glands?

Sjogren’s

What is the palpable midline neck mass seen in children?

Thyroglossal Duct Cyst

Who does Hashimoto’s affect the most?

Young or middle-aged females

What muscle is anterolateral to the thyroid?

Sternocleidomastoid

What muscle is posterolateral to the thyroid?

Longus Coli Muscle

Transverse thyroid image

1. A = Right lobe

2. B = Isthmus

3. C = Left Lobe

4. D = Esophagus

5. E = Trachea

6. F = Thyroid

7. G = Carotid Artery

Muscles on US

1. A = Strap Muscles

2. B = Sternocleidomastoid

What is the strong deep penile fascia that is superficial to the tunica albuginea?

Buck’s fascia

What is Mondor’s Disease?

1. Cord or string-like blood clot in superficial dorsal vein of penis

2. Beaded appearance

What is a palpated, well-demarcated, midline dorsum in the penis?

Peyronie’s Disease

What is the most common cause of erectile dysfunction?

Vasculogenic Impotence

What is Peyronie’s Disease?

Fibrosis of fibrous sheaths covering corpora cavernosa

Which way does the penis bend in someone with Peyronie’s Disease?

Bends TOWARDS diseased area

What are the symptoms of epididymitis?

1. Hypervascular testes

2. Slight fever

3. Heaviness

4. Tenderness

Which side of the body are varicoceles most common?

Left side

What does a tunica albuginea cyst look like?

1. Well circumscribed

2. Anechoic

3. 2-5 mm

What is the tunica albuginea?

Dense, fibrous capsule covering testis

What do microcalcifications in a testicle mean?

Microlithiasis

Image of testicle

1. A = Epi Head

2. B = Testes

3. C = Epi Tail

What does epi look like compared to testes on ultrasound?

1. Head = slightly more echogenic than testis

2. Body = slightly less echogenic than testes

3. Tail = thicker than epi head

What is the most common location for prostate carcinoma?

Peripheral zone of prostate

What is the normal range for PSA levels?

0.0-4.0 ng/ml

What is the cephalic portion of the prostate?

Base

Benign prostatic hyperplasia (BPH) originates in which area?

Transition Zone

Which mammography view shows if a lesion is in the superior or inferior aspect of the breast?

Medial-Lateral Oblique View

Which mammography view shows if a lesion is in the medial or lateral aspect of the breast?

Cranio-Caudad View

ABC and 123 method on breast

1. 123 = inner, middle, outer

2. ABC = skin layer or depth

A mass is documented on breast ultrasound as being located at 6 o’clock 2A. What does 2A indicate?

Mid distance from nipple, close to skin

Under what conditions is increased transducer pressure not particularly helpful?

Performing Doppler

What correctly identifies the expected sonographic changes in breast tissue with age?

1. Amount of fatty tissue increases

2. Amount of fibroglandular tissue decreases

Fat within the premammary and retromammary regions will not increase in…

Women on hormone replacement therapy (HRT)

Which carcinoma is ultrasound often more affective at demonstrating than mammography?

Invasive Lobular Carcinoma

When establishing correct gray scale and gain settings for sonographic breast imaging, all structures should be compared to the mid-level echogenicity of which structure?

Fat

The Rotter's nodes are part of what lymph node chain?

Axillary lymph node chain

What is the fremitus maneuver?

When Color Doppler is used to distinguish borders of a mass

The fremitus maneuver can be used to…

Better distinguish borders of a breast lesion

When a breast has metastatic tumors, are they more likely to be single or multiple?

Multiple

If the TCGs are decreased in the near-field of the image, what changes are seen?

Superficial tissues become darker

What is the step ladder sign?

1. Demonstrates INTRACAPSULAR silicone rupture

2. Multiple parallel linear and curvilinear echogenic lines within implant

What is the normal sonographic appearance of the periosteum?

Thin, echogenic line that runs parallel to the cortex of bone

What is compartment syndrome?

Compression of blood vessels and nerves causing cessation of blood flow to that compartment

What are the scan planes for MSK?

1. SAX

2. LAX

What is not associated with rotator cuff anatomy and therefore not evaluated in a shoulder ultrasound examination of the rotator cuff?

Triceps tendon

What is the appearance of a Baker’s cyst?

Cyst on back of knee

When performing a sonogram, what is the most commonly seen pathology of the knee?

Baker's cyst

What is the sonographic appearance of a normal bursa?

Small hypoechoic flat sac containing a small amount of normal fluid with a hyperechoic wall and peribursal fat

What is defined as a closed connective and synovial sac that normally contains a small amount of fluid and facilitates the gliding of one MSK structure on another?

Bursa

Be sure to use light transducer pressure when scanning through the… to avoid causing…

1. Anterior Fontanelle

2. Bradycardia

What scanning technique uses an abundance of gel to avoid using pressure?

Floating Technique

The anterior fontanelle becomes progressively smaller and closes completely at how many months of age?

15 months

Spinal sonography is useful in the normal infant until approximately how many months of age?

3 to 6 months

On a sonogram of a patient with a tethered cord, the conus medullaris will terminate at or below the level of which vertebral body?

L3

What is the best transducer routinely used to evaluate the neonatal spine?

Linear

In which of the following maneuvers does the examiner attempt to push the femoral head out of the socket when performing a neonatal hip sonogram?

Barlow’s maneuver

Which scanning plane allows for assessment of the femoral head coverage with respect to how well it is contained in the acetabulum?

Coronal Neutral

A 2-year-old patient presents with a low-grade fever and has recently had an upper respiratory infection. She has started refusing to bear weight on her right hip. What is the MOST likely diagnosis?

Transient Synovitis

What is the normal value of the alpha angle when assessing the neonatal hip for DDH?

> 60 degrees

What is the impression of the hip if the alpha angle measures 40 degrees?

Type III hip, dislocated

What is a terminal myelocystocele?

1. CSD abnormality

2. Large, fluid-filled mass in lumbar region

3. Central canal widens and directly communicates with fluid-filled sac

What is an abnormal dilation of the terminal
ventricle which communicates with the central spinal cord canal?

Terminal myelocystocele

What is the most common cause of acute scrotal pain?

Epididymitis

Microlithiasis is associated with an…

Increased risk of malignancy

List three (3) sonographic features consistent with acute epididymitis.

1. Enlarged epididymis 

2. Hypoechoic epididymis 

3. Hypervascularity

List three (3) possible causes for an increased PSA.

1. BPH 

2. Carcinoma 

3. Increasing age 

Which of the following is the MOST sensitive indicator of the presence of prostate cancer?

Increased prostate-specific antigen (PSA)

A 35-year-old postpartum women presents for a breast ultrasound reporting having breast tenderness and breast edema. The sonographer notices that the skin of the affected breast appears red and thickened. Sonography reveals a superficial tubular structure with a beaded appearance.

1. What is the most likely diagnosis?

2. This pathology is most commonly associated with what specific structure?

1. Mondor's Disease 

2. Lateral thoracic vein