KEYWORDSSonography; Knee; Overload syndromes.Abstract Overload syndromes are caused by repetitive microtrauma, and the knee joint is most frequently affected in adolescents. The reason for this is that the knee joint is engaged in almost all sports activities. Pathologies related to the anterior aspect of the knee are: femoropatellar pain, jumper's knee syndromes, OsgoodeSchlatter disease, Sinding-Larsene Johansson syndrome and patellar stress fractures; to the medial aspect: semimembranous tendon enthesopathy and pes anserinus bursitis; to the lateral aspect: iliotibial band syndrome (runner's knee), popliteus and femoral biceps tendon enthesopathy; to the posterior aspect: fabella syndrome and medial gastrocnemius muscle tendon enthesopathy. Sonography plays a central role in the diagnosis and can also evaluate the evolution of diseases. This method is well accepted by the patients and by their parents, it does not involve exposure to X-rays and it is inexpensive. US imaging should, therefore, be considered a first-line imaging diagnostic technique in functional overuse syndromes of the knee.Sommario Le sindromi da sovraccarico riconoscono come causa principale i microtraumi ripetitivi e il ginocchio è l'articolazione interessata più frequentemente negli adolescenti. La ragione è legata al fatto che il ginocchio è particolarmente sollecitato in tutte le attività fisiche, sia della vita quotidiana sia nelle attività agonistiche. Possono essere interessate varie strutture con conseguenti e diverse patologie, in particolare nel comparto anteriore si realizzano lesioni dell'articolazione femoro-rotulea, del tendine rotuleo (jumper's knee), le sindromi di Osgood-Schlatter e di Sinding-Larsen-Johansson, fratture da stress della rotula; nel comparto mediale la sindrome della plica sinoviale, tendinopatie del tendine del semimembranoso, borsiti della borsa della zampa d'oca; nel comparto laterale la sindrome da frizione della bendelletta ileo-tibiale (runner's knee), tendinopatie del tendine popliteo e del bicipite; nel comparto posteriore patologie legate alla fabella e al tendine del gemello mediale. L'ecografia è in grado porre diagnosi e di valutare il decorso della malattia nella grande maggioranza di queste lesioni, è ben accetta ai pazienti e ai genitori per l'assenza di controindicazioni e di radiazioni ionizzanti, ha costi contenuti ed è pertanto l'esame di scelta nelle sindromi da sovraccarico del ginocchio nell'adolescente. Richiede esperienza e l'integrazione di radiologia tradizionale, TC e RM in alcuni casi quali l'inquadramento delle malformazioni e il disallineamento degli arti inferiori. ª
Breast biopsy consists in the collection of cells or tissue fragments from a breast lesion and their analysis by a pathologist. There are several types of breast biopsy defined on the basis of the type of needle used: fine-needle aspiration and biopsy performed with a spring-based needle. This article focuses on fine-needle aspiration performed under sonographic guidance.It is used mainly to assess cysts that appear to contain vegetations or blood or that are associated with symptoms; lesions and solid nodules that are not unequivocally benign; and axillary lymph nodes that appear suspicious on physical examination and/or sonography.In addition to distinguishing between benign and malignant lesions, ultrasound guided fine-needle aspiration also plays an important role in tumor grading and in immunocytochemical identifying specific tumor markers. This article describes the technique used and the possible causes of false negative and false positive findings. Despite its limitations, fine-needle aspiration has become a fundamental tool for the identification and preoperative management of malignant breast lesions.
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