Static ultrasound was used to examine the cross-sectional anatomy of the fingers principally to determine the feasibility of demonstrating the normal anatomy of the flexor tendons and also to investigate the possibility of showing pathological anatomy. The study showed that normal and pathologic anatomy of the flexor tendons could be easily demonstrated using the available ultrasound equipment. The exact clinical usefulness and the role of this new procedure awaits further clinical studies with surgical and pathological correlation.

SUMMARY Abdominal wall endometriosis (AWE) often occurs in the surgical scar of a previous Caesarean section. In females with unexplained lower abdominal and pelvic pain who have had a C‐section, the abdominal wall should be carefully examined to rule out AWE.

In 1977, Bree' reported the sonographic identification of fetal vernix in the amniotic fluid. Using static B scanning, he presented two cases of floating echogenic objects within the amniotic fluid during the late third trimester. With the use of modern real-time equipment it is common to find large amounts of floating echogenic flakes within the amniotic fluid at, or beyond term. In these cases each fetal movement produces a snow storm appearance by stirring the floating vernix. To my knowledge, there has been no previous report of a similar finding during the second trimester. The present article discusses the possible causes of second trimester echogenic amniotic fluid and reports on a case which demonstrated the snow storm appearance. CASE REPORTA 24-year-old para 2 gravida 3 woman presented with minimal vaginal bleeding and 13.5 weeks of amenorrhea. Her two previous pregnancies were complicated by IUGR. The first pregnancy ended at 37 weeks with the birth of a 2.4-kg live baby. The second pregnancy resulted in a 2.15-kg live birth at 39 weeks. Except for a past history of bronchial asthma, there was no other significant medical or surgical history. Her asthma remained inactive during her pregnancies. Initial physical examination confirmed the presence of a pregnancy of about 13-14 weeks but demonstrated no abnormality. Specifically, there was no evidence of hypertension, tachycardia, or fever. Laboratory studies showed no anemia, proteinuria, or any other abnormality. 498positive. She was managed by bedrest and her bleeding stopped.A dynamic image ultrasound examination at 15 weeks of gestation confirmed the presence of a live single intrauterine pregnancy with a gestational age consistent with dates. A small extramembranous hematoma was seen along the posterior wall of the lower segment of the uterus (Fig. 1). No retroplacental hematoma was noted and the amniotic fluid appeared clear. She was discharged but continued to have intermittent spotting and bleeding and was seen again on follow-up examination at 17 weeks of gestation. Real-time ultrasound study at this time showed normal growth of the fetus since the last examination. The extramembranous hematoma persisted. A new finding at this time was the appearance of a cloud of echogenic floating flakes within the amniotic fluid. These were stirred by fetal movement and then sedimented rapidly. This was interpreted as representing either blood or meconium within the amniotic fluid. At 20 weeks she was admitted with abdominal pain and vaginal bleeding with passage of large clots. Dynamic and static studies showed continued growth of the fetus. A small retro-placental lucency had developed on the right side since the previous examination. This was thought to represent a small abruption. The intra-amniotic echogenic material persisted, producing a snow storm appearance with each fetal movement or external compression (Fig. 21. Two days after the last ultrasound examination she delivered a dead fetus. Amniotic fluid was observed at that time to be dirty green. T...

Female genital tuberculosis is an uncommon condition. We have recently performed an ultrasound examination on an unexpected case and we present the sonographic findings. CASE REPORTA 59-year-old female was admitted to the hospital because of congestive heart failure. She also had diabetes mellitus and rheumatoid arthritis. After her heart failure and diabetes were controlled, urinary analysis revealed microscopic hematuria. An intravenous urogram was performed and demonstrated a large indentation on the right side of the dome of the bladder. She was referred for pelvic sonography .The sonogram demonstrated a well-defined mass indenting the urinary bladder. There was considerable sound transmission but no posterior enhancement. This mass extended from the midline to the right side. The vagina could be identified, but the junction with the mass was obscured by refractive shadowing from the top of the bladder. The uterus and the ovaries could not be identified with certainty (Figs. 1-3). As these organs might be atrophic and difficult to be imaged, a definite distinction between a uterine or ovarian mass could not be made confidently.The patient gave no history of vaginal discharge nor postmenopausal bleeding. The clinical impression was that this was more likely to be an ovarian mass. Laparoscopy was not contemplated because of previous operations. At laparotomy, extensive dense adhesion was encountered making it difficult to ascertain the origin of the mass. FIGURE 1. Longitudinal scan midline: B = urinary bladder; U = uterus = mass; and X = cervix.

The entity of caecal faecoliths is not well known to most radiologists. It presents as a hard tender palpable mass in the right iliac fossa. It usually occurs in older women with chronic constipation. On ultrasound it appears as an intracaecal, highly echogenic, shadowing mass. Plain radiographs may show lamellated calcifications. Barium enema shows a well defined intracaecal mass. Using a combination of ultrasound and plain films or barium enema, a preoperative diagnosis should be possible.