Four sonographic diagnostic criteria for appendicitis, (1) any visualization, (2) appendiceal diameter greater than 6.0 mm, (3) muscular wall thickness greater than or equal to 3.0 mm, and (4) presence of a complex mass, were compared in a series of 200 patients clinically suspected of having appendicitis. The diagnosis of appendicitis was confirmed histopathologically and included all forms of appendicitis with mucosal invasion by inflammatory cells. The sensitivities of all the criteria were low (11% to 75%) and the usefulness of this test as a screening procedure is questioned. The combined criteria of an appendix with a muscular wall thickness (MWT) greater than or equal to 3.0 mm and visualization of a complex mass (CM) separate from the adnexa in females proved most useful as a diagnostic test (sensitivity, 68%; specificity, 98%). We conclude that the diagnosis of appendicitis is still difficult, despite the addition of graded compression ultrasound as a diagnostic test. We do not recommend its use as the only screening test, but do recommend it, rather, in a diagnostic role after the initial clinical screening.

COVID-19 has not spared a single system in the human body. Although acute respiratory failure culminating sometimes in death remains the most common manifestation of severe infection, hypercoagulability leading to deep vein thrombosis (DVT), pulmonary embolism (PE), and stroke have also been identified widely.Here, we describe a young patient with a COVID-19 infection who developed right basilic vein thrombosis. This case demonstrates how thrombosis can occur in uncommon sites and how clinicians should be vigilant for thrombotic complications in both the inpatient and outpatient settings.

The soleal sling may be a site of tibial nerve entrapment. Objective diagnosis of this syndrome is difficult with current nerve conduction study techniques, magnetic resonance imaging, and neurosensory testing. Diagnostic ultrasound is ideally suited to visualize the tibial nerve statically and dynamically as it enters the soleal sling, thus making an objective diagnosis of soleal sling impingement much easier.