MSK & Breast

When do we perform infant hip evaluations?

4 - 6 weeks of age

What is hip dysplasia?

Inability of hip socket to properly support femoral head

What are the symptoms of hip dysplasia?

1. Hip click on physical exam

2. Limited abduction

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1. Gluteal muscles

2. Labrum

3. Acetabulum

4. Ilium

5. Triradiate cartilage

6. Ischium

7. Femoral head

Which angle is used to evaluate hip dysplasia?

Alpha

What are the classifications for hip dysplasia?

• Type I or normal: Alpha angle > 60

• Type II or normal from newborn to three months: Alpha angle 44 - 60

• Type III or dislocation: Alpha angle < 43

• Type IV or gross dislocation: Alpha angle not measurable

What is transient arthritis?

Inflammation of hip joint associated with recent respiratory infections

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Normal pediatric hip

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Transient arthritis seen as effusion in joint

What is septic arthritis?

Inflammation of hip joint due to bacterial infection that is considered a MEDICAL EMERGENCY

What is the most common tendon to rupture?

Achilles tendon

What is the sonographic appearance of a tear in tendon?

1. Focal thinning

2. Discontinuity of internal fibers

3. Hematoma

4. Effusion

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Achilles tendon tear

What is tendinosis?

Degenerative changes in tendon with no signs or symptoms of damage

What is tendinitis?

Acute inflammation of tendon with symptoms

What is bursitis?

Inflammation and fluid accumulation of a joint bursa

What is a Baker’s cyst?

Cystic structure located in medial popliteal fossa

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Baker’s cyst

What is the most common hand tumor?

Ganglion cyst

What is a ganglion cyst?

Cystic formation adjacent to joint

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Layers of skin

• Epidermis

• Dermis

• Hypodermis or subcutaneous adipose tissue

• Fascia

• Muscle

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Layers of skin

• Epidermis

• Dermis

• Hypodermis or subcutaneous adipose tissue

• Fascia

• Muscle

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Foreign body located in muscle

What is reactive hyperemia?

Hypervascularity around foreign body with inflammation

What is a sebaceous cyst?

Epidermal inclusion cyst located in inframammary fold, axillary area, and near areola

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Sebaceous cyst

What is acute mastitis?

Inflammation of breast that most commonly occurs during lactation (puerperal mastitis)

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Acute mastitis

What is a breast abscess?

Complex cystic structure that causes fever and swelling

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Breast abscess

What is the most common benign breast mass?

Fibroadenoma

What is the most common malignant breast mass?

Invasive ductal carcinoma

What sonographic characteristics increase suspicion of malignancy in a breast mass?

1. Irregular margins and indistinct borders

2. Hypoechoic

3. Heterogenous

4. Posterior shadowing

5. Spiculations

6. Fine, linear branching calcifications

7. Vertical orientation

8. Fixed position

What is a galactocele?

Localized accumulation of milk caused by obstruction of lactiferous ducts

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Galactocele