A method of classification for hematomas of the rectus abdominis sheath (RSH) is proposed based on findings observed in CT in the 13 cases of RSH in the present study. Type I hematomas (five cases) are slight and do not require hospitalization. Type II (three cases) and type III (five cases) are moderate and severe hematomas, respectively, and do require hospitalization. The patients with type III hematomas were all undergoing anticoagulant therapy and presented with a picture of acute abdomen, and in all five cases blood transfusion was carried out. Ultrasonography and, in particular, CT permitted a correct diagnosis of RSH. RSH should be considered (anticoagulant therapy induced) in females with sudden abdominal pain to avoid unnecessary surgical intervention.

RSH must be suspected in women of advanced age undergoing treatment with anticoagulants who present the clinical triad of acute abdominal pain, infraumbilical mass, and anemic syndrome. CT is the examination of choice for the diagnosis of RSH. Early diagnosis of RSH permits conservative management, even in the case of large hematomas with hemodynamic repercussions and avoids unnecessary surgical intervention.

Objective. The purpose of this study was to evaluate the reproducibility of median nerve cross-sectional area (CSA) measurements using the indirect method (ellipsoid formula) and the direct or tracing method. Methods. The median nerve CSA was measured in 22 wrists of patients with carpal tunnel syndrome by means of high-frequency sonography. Measurements were made at the level of the pisiform bone by a standardized sonographic examination protocol. Two observers with different levels of experience performed the measurements, independently and blinded. An analysis of reliability was carried out, and the concordance between the methods was determined with parametric statistical tests. Results. The results point to good reproducibility of the median nerve CSA measurements obtained by both methods, whether performed by an experienced observer or by an inexperienced observer after a short learning period. Conclusions. The results suggest sonography for median nerve CSA measurements is reproducible by either the direct or indirect method when a standardized sonographic examination protocol is used.

The piriformis syndrome is an uncommon cause of sciatica, buttock or thigh pain. Because of the deep location of the muscle and sciatic nerve, infiltration has traditionally been guided by electromyography, fluoroscopy, computed tomography or magnetic resonance imaging. The aim of the present study is to describe a simple technique for ultrasound (US)-guided perisciatic infiltration of corticosteroids and anaesthetic using the inferior gluteal artery as a landmark. This technique was used satisfactorily in ten patients. Although the series in the study is limited, the procedure for US-guided infiltration of the perisciatic nerve is a quick, simple, economical and effective technique and can be considered an alternative in the percutaneous treatment of the piriformis syndrome.

The results of this study show that carotid IMT measurement using THI sonography and a standardized protocol is accurate and reproducible.