123sonography

Summer is peak sports season, and this comes with certain injuries! Check out this case of a 32-year-old male who injured his wrist a month ago during an outdoor sport ⚽️ 🥴

Despite initial X-rays showing no fractures, he continues to experience pain in the hypothenar region.
What do you see in the images of the proximal and distal carpal tunnel?

A) Scaphoid fracture
B) Hook of the hamate fracture
C) Focal nerve enlargement

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How to assess the collapsibility index of the inferior vena cava? Dr. Yogen Singh is demonstrating how this is done 🐙

What does the collapsibility index actually measure?

A) The percentage decrease in the IVC diameter during inspiration compared with its maximum diameter during expiration.
B) The average diameter of the IVC used to estimate central venous pressure.
C) The velocity of blood flow through the IVC used to assess venous return to the heart.

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Vascular Inferno 🪼🔥

Look at the following ultrasound loops: What US features do you recognize?

A) Slightly atrophic thyroid gland tissue.
B) Hypovascularization.
C) Increased intrathyroidal blood flow on color Doppler.

Which pathology would you suspect? 🐙 What lab tests would be needed for diagnosis?

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🪼 Case: 14 yo boy admitted with palpitations. The ECG is clearly abnormal, showing left axis deviation, LV hypertrophy, and repolarization changes. An echo is needed to define the cause. Watch this series of loops from this patient's echo exam and answer the following question:

Which heart defect best explains the echo findings? 🫀🔍

A. Ebstein anomaly with severe tricuspid regurgitation
B. Tricuspid atresia with ASD and VSD
C. Severe pulmonary stenosis with right ventricular hypertrophy

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Let's take a deep dive 🤿

Look at the following echo loops and answer the following quiz question! (Additional clues are provided via labels)

What is the most likely diagnosis? 🐙🔍

A) Severe valvular aortic stenosis
B) HOCM with SAM causing dynamic LVOT obstruction
C) LVH due to subaortic membrane with LVOT obstruction

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This summer, we are not leaving any clinical treasures at the bottom of the sea! 🪼🪸🐙

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A throwback to Sarajevo, where Prof. Thomas Binder hosted a Masterclass with the topic of applying guidelines to daily practice! 🫀

Here are some impressions, a huge thank you to everyone involved, we enjoyed the time we had in Bosnia!

The Ultimate ECHO GAME at CardioAlex 🫀

Even if you couldn't participate in this quiz on site, here is your chance to test your knowledge. What do you think the correct answer is?

Where are myxomas most commonly located? 🧐

A) In the left atrium
B) In the right atrium
C) Equally across all inner cardiac structures

And can myxomas be located on the valves? We asked our SonoAssistant and it provides the following examples ...

Our database also highlights the exceptions! Our SonoAssistant shows cases we have reported of atypical valvular myxomas. Get our SonoAssistant now, together with our Echo Pass, for only 23€ /month 👉 https://zurl.co/avWyp

In carotid ultrasound, you might come across flow reversal (retrograde flow) in the carotid artery as detected via Doppler measurements 🔍

In this case, the images show diastolic flow reversal due to severe aortic regurgitation, in which blood is “pulled back” toward the left ventricle during diastole.

While Aortic Regurgitation (AR) is the classic textbook case where this can occur, there are a few pathophysiological mechanisms that can present with this pattern.

🧐 Quiz: Which of the following conditions can also cause retrograde flow reversal?

A) A severe, near-total narrowing (stenosis) further up the internal carotid artery, causing a high-resistance “to-and-fro” or staccato waveform proximally.
B) Subclavian steal syndrome, typically causing retrograde flow in the common carotid artery.
C) Aortic stenosis, producing a restricted forward flow which can ultimately lead to reverse flow.

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