Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
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Langerhans cell histiocytosis is a rare disease characterized by clonal proliferation of Langerhans-type cells, causing local or systemic effects. One of the most affected sites in children is the skull. We describe 2 cases of children presenting to the pediatric emergency department with symptoms isolated to the scalp and the point-of-care focused skull ultrasound findings, which assisted in the diagnosis of Langerhans cell histiocytosis in both cases.
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Observational Study
Changes in Sonographically Measured Inferior Vena Caval Diameter in Response to Fluid Loading in Term Pregnancy.
The purpose of this study was to determine whether the inferior vena caval (IVC) diameter is influenced by intravascular volume changes in pregnancy. ⋯ Measurable variations in the IVC diameter occur in response to volume changes in normal term pregnancy and postpartum.
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Randomized Controlled Trial Comparative Study
Comparison of Outside Versus Inside Brachial Plexus Sheath Injection for Ultrasound-Guided Interscalene Nerve Blocks.
Ultrasound-guided interscalene brachial plexus blocks are commonly used to provide anesthesia for the shoulder and proximal upper extremity. Some reviews identify a sheath that envelops the brachial plexus as a potential tissue plane target, and current editorials in the literature highlight the need to establish precise and reproducible injection targets under ultrasound guidance. We hypothesize that an injection of a local anesthetic inside the brachial plexus sheath during ultrasound-guided interscalene nerve blocks will result in enhanced procedure success and provide a consistent tissue plane target for this approach with a reproducible and characteristic local anesthetic spread pattern. ⋯ Except for faster onset, this prospective randomized trial did not find any advantages to performing an interscalene block inside the brachial plexus sheath. There was a higher incidence of transient paresthesia when injections were performed inside compared to outside the sheath.
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We aimed to estimate the spread of injections for ultrasound-guided cervical nerve root blocks and to determine the optimal injectate volume required in this procedure. ⋯ Ultrasound-guided cervical nerve root blocks show potential utility for targeting an anesthetic into the cervical root area. This study may be helpful for deciding the most appropriate volume for the procedure.