• Workstation: Hand surgery: San Rafael Hospital. HSJD. Madrid. Hand and upper limb surgery: Nuestra Señora del Rosario Hospital. Madrid.
• Anamnesis and physical examination: 37-year-old woman who, while kitesurfing (overexertion) about 1.5 years ago, hurt her wrists. She reports the appearance of “tumours” on the back of her wrists that have gradually disappeared, although the pain has persisted. The examination reveals a doubtful Watson test and a “provocation test”Dorsal Wrist Yo“mpigment” + (Image 1).
• Ultrasound: In the short axis, we can see several cystic images of heterogeneous content with hypoechoic predominance immediately dorsal to the dorsal scapholunate ligament on the right wrist, with a slight “bulging” of the same being observed. In the long axis, a septate cystic image with hypoechoic content is again seen on the dorsum of the scapholunate ligament that expands distally towards the midcarpal joint. These same findings can be seen on the right wrist (video).

Hidden Ganglion Eco Course Hand and Wrist from Spanish Society of Ultrasound on Vimeo.

La entrada Ganglión oculto radiocarpiano bilateral se publicó primero en SEECO.

La entrada Síndrome de Mirizzi se publicó primero en SEECO.

• Case name: SPLENOMEGALY and INFARCTS.
• Author's name: Dr. Bruno Sagástegui Aguilar.
• Author's job position: Work center: SONOSCAN Ultrasound Center (Private) and TOMONORTE Diagnostic Imaging Center (Private) Trujillo – PERU.
• Clinical and examination: A 35-year-old female patient presents pain in the left flank, feeling a "bulge" below the costal margin when taking a deep breath. The patient has been diagnosed with infectious mononucleosis. The attending physician requests a hepatobiliary ultrasound. She denies other symptoms. She has no history of surgery or trauma.
• Ultrasound findings: An enlarged spleen is seen with the presence of 2 avascular hypoechoic lesions with slightly irregular edges and a fine echogenic halo within which fine hyperechoic lines (reflective-specular) perpendicular to the ultrasound beam are identified (bright band sign). Both are wedge-shaped in the sagittal section and oval-shaped in the axial section, located in the middle third. (Images 1 and 2 – Videos 1 to 3)
• Diagnosis: The findings are compatible with an enlarged spleen with the presence of infarcts.

La entrada Esplenomegalia e Infartos se publicó primero en SEECO.

• Case name: DIASTASIS OF THE RECTUS ABDOMINALI.
• Author's name: Dr. Bruno Sagástegui Aguilar.
• Author's job position: Work center: SONOSCAN Ultrasound Center (Private) and TOMONORTE Diagnostic Imaging Center (Private) Trujillo – PERU.
• Clinical and examination: A 52-year-old male patient presents with a bulge in the supraumbilical region of the midline, which is more noticeable when the patient flexes or performs Valsalva on the abdomen. (Image 1). Denies pain or other symptoms. No contributing history.
• Ultrasound findings: At the supraumbilical level, in the epigastric area, a slight separation of the rectus abdominis muscles is observed. As the transducer moves distally, this separation increases until reaching a maximum value of 3.62 cm. (Normal separation not greater than 2 cm). No hernial defects are observed. Muscle planes with preserved fibrillar pattern. (Image 1 and Video 1)
• Diagnosis: The findings are compatible with diastasis of the rectus abdominis muscles at the supraumbilical level.

La entrada Diastasis de los rectos abdominales se publicó primero en SEECO.

• Case name: FOCAL NODULAR HYPERPLASIA – FNH.
• Author's name: Dr. Bruno Sagástegui Aguilar.
• Author's job position: Work center: SONOSCAN Ultrasound Center (Private) and TOMONORTE Diagnostic Imaging Center (Private) Trujillo – PERU.
• Clinical and examination: A 35-year-old female patient comes for a check-up and to rule out fatty liver. Asymptomatic. No contributing history.
• Ultrasound findings: Solid, slightly heterogeneous, predominantly echogenic nodular lesion with partially defined irregular edges that, on power Doppler, shows increased vascularization and measures 36.2 x 30 x 34.9 mm. It is located in the right lobe. (Image 1 and Video 1)
• Diagnosis: The findings are compatible with focal nodular hyperplasia in the liver.

La entrada Hiperplasia nodular focal – HNF se publicó primero en SEECO.

• Case name: Iliotbial band syndrome
• Author's name: Dr. Americo Enrique Villalobos Pacheco
• Author's job position: Work center: Ultrasonido Polígono (Private) / High Specialty Unit of the Mexican Social Security Institute, Mérida, Yucatán, Mexico.
• Clinical and examination: A 30-year-old male patient presents pain on the lateral side of the right knee when flexing and extending. History: he did crossfit for 3 months. In the last week, the pain on the lateral side of the right knee worsened, so he went to his sports doctor who was referred to a radiologist.
• Ultrasound findings: The iliac band is thickened, has a heterogeneous appearance, and is hypoechoic with an extension of 20 mm proximal to the insertion into the Gerdy tubercle. Doppler shows increased vascularity. The cortex of the tubercle is irregular.
• Diagnosis: Iliotibial Band Syndrome.

La entrada Síndrome de la Banda iliotibial se publicó primero en SEECO.

• Case name: Cholangiocarcinoma-Klatskin tumor.
• Author's name: Dr. Bruno Sagástegui Aguilar.
• Author's job position: Work center: SONOSCAN Ultrasound Center (Private) and TOMONORTE Diagnostic Imaging Center (Private) Trujillo – PERU.
• Clinical and examination: A 54-year-old female patient has had intermittent "dull" pain in the right upper quadrant for 2 years. Mild jaundice and choluria appeared 1 month ago. She does not report any other symptoms. History: DM-2 for 8 years. Laparoscopic cholecystectomy 5 years ago. The treating physician requested a hepatobiliary ultrasound.
• Ultrasound findings: At the level of the hepatic hilum, a solid isoechoic nodular lesion is seen, slightly hypoechoic with irregular, partially defined edges that exert a mass effect on the adjacent vascular structures and intrahepatic bile ducts, dilating them. (Image 1 and Videos 1 and 2).
• Diagnosis: The findings are compatible with Hilar Cholangiocarcinoma – Klatskin Tumor.

La entrada Colangiocarcinoma -Tumor de Klatskin se publicó primero en SEECO.

• Case name: COMPLETE TEAR OF THE DISTAL MYOTENDINOUS JUNCTION OR POSTERIOR FASCIA OF THE RIGHT RECTUS FEMORALIS.
• Author's name: Dr. Bruno Sagástegui Aguilar.
• Author's job position: Work center: SONOSCAN Ultrasound Center (Private) and TOMONORTE Diagnostic Imaging Center (Private) Trujillo – PERU.
• Clinical and examination: A 35-year-old male patient presents a bulge in the proximal third and a depression in the distal third of the anterior compartment of the right thigh, soft, non-painful, without inflammatory changes. (Image 1). Background: 3 weeks ago, while playing soccer, he felt a pull when kicking the ball, fell to the ground unable to stand up, and then extensive bruising appeared.
• Ultrasound findings: Retraction of the rectus femoris muscle towards the proximal (bell clapper) is observed due to rupture of the distal myotendinous junction. (Image 1 and 2), Anechogenic collection is associated in the lateral and lower portion (hematoma) that separates it from the deep fascia. (Videos 1 and 2)
• Diagnosis: The findings are compatible with a complete tear of the distal myotendinous junction or posterior fascia of the right rectus femoris.

La entrada Desgarro completo de la unión miotendinosa distal o fascia posterior del recto femoral se publicó primero en SEECO.

• Case name: LIVER HEMANGIOMA.
• Author's name: Dr. Bruno Sagástegui Aguilar.
• Author's job position: Work center: SONOSCAN Ultrasound Center (Private) and TOMONORTE Diagnostic Imaging Center (Private) Trujillo – PERU.
• Clinical and examination: A 36-year-old female patient, asymptomatic, comes for a check-up. She denies any contributory history. She requests a hepatobiliary ultrasound to rule out fatty liver.
• Ultrasound findings: In the hepatic segment VIII, a solid, slightly heterogeneous, predominantly hyperechoic nodular lesion with somewhat irregular edges measuring 38.7 x 32.1 x 38.5 mm was observed, which exerted a mass effect on the adjacent vascular structures. The color and power Doppler studies did not show intranodular signal uptake. (Image 1 and Videos 1 to 3).
• Diagnosis: The findings are compatible with hepatic hemangioma.

La entrada Hemangioma Hepático se publicó primero en SEECO.

• Case name: De Quervain's tenosynovitis associated with heterotopic calcifications and synovial hypertrophy of the APL
• Author Name: Dr. Sosa, Gustavo Luis
• Author's job position: Institut Universitari Quirón Dexeus – ICATME, Sports Medicine Associate.
• Clinical and Examination: History of left radius diaphyseal fracture 14 years ago, complicated by pseudoarthrosis, which was re-operated on and consolidated. 4 years ago, extensor tenosynovitis and the first extensor groove treated with corticosteroids on several occasions, operated on with tenosynovectomy and tenolysis. Consultation for severe pain and Finkelstein +
• Radiography : Anteroposterior and Lateral presence of osteosynthesis material
• Ultrasound: Hypoechoic thickening of the first groove at the expense of the ECRB can be observed, with a single septum. Multiple hyperechoic images in the 1st extensor groove already distal to it, which do not leave a posterior acoustic shadow and a lump/synovial hypertrophy of the APL in the distal third of the forearm. Dopler (-).

La entrada Tenosinovitis De Quervain se publicó primero en SEECO.