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.

Objectives The purposes of this study were to investigate interobserver reproducibility using acoustic radiation force impulse imaging and to develop an acoustic radiation force impulse scoring system. Methods Fifty healthy volunteers with normal liver function test values were selected for the study. Shear wave velocity measurements, expressed in meters per second, were taken in a deep portion of liver segment 6. Two observers with different levels of experience performed the measurements independently and blindly. Results All of the measurements taken by the 2 observers were valid, even in volunteers with a body mass index of greater than 28 kg/m2. The results point to very good interobserver reproducibility of shear wave velocity measurements, with an intraclass coefficient correlation of 0.86 (P < .001). Conclusions The results of this study show that shear wave velocity measurements using the acoustic radiation force impulse technique and a standardized protocol are accurate and reproducible.

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.

• Acoustic radiation force impulse imaging provides ultrasonic shear wave velocity measurements. • SWV measurements were higher in patients with inflammation or fibrosis than NAFLD. • ARFI differentiates NAFLD from NASH in patients with morbid obesity. • Results suggest that ARFI can detect NASH in asymptomatic morbidly obese patients.

In our experience, the use of human thrombin for the treatment of iatrogenic femoral pseudoaneurysms is highly efficient (100%), the administered dose is significantly less than with bovine thrombin, and the risk for allergy is potentially lower. At our hospital, human thrombin has replaced bovine thrombin and is the first line of treatment for an iatrogenic pseudoaneurysm.