Case Series: Superficial Sonography in Urgent Care

Abstract

Sonography is an essential imaging modality, known for its real-time capabilities, relative low cost, and multiple diagnostic applications. Although there are protocols which are well-established for specific examinations, there are not clear guidelines for sonographic examinations of soft tissues. Many sonographers have to establish their own imaging protocols when completing a soft tissue examination. This case series details five soft tissue examinations that represent just a few of the clinical requests generated in an Urgent Care (UC) facility. Since UC usage has increased over the past several years, it appears likely that any sonographer working in such outpatient settings will benefit from as much exposure to soft tissue examinations as possible.

Case Series: Multiple Soft Tissue Lesions Demonstrated by Sonography and MRI Correlation

“…Diagnostic choices to utilize sonography and/or MRI to evaluate soft tissue masses have been well-documented in the literature. [1][2][3][4][5][6][7][8][9] A comparison between sonography, MRI, and CT was conducted by Stojkovic et al and they evaluated 107 patients with cystic echinococcosis. They submitted that sonography was the cornerstone of diagnosis, staging, and follow-up for these cystic structures.…”

“…Several authors have discussed the advantages and disadvantages of utilizing multiple diagnostic imaging techniques to diagnose soft tissue masses. [1][2][3][4][5][6][7][8][9] The American College of Radiology (ACR) has established a guide, known as the Appropriateness Criteria, to provide best practice recommendations for the choice of diagnostic assessments of these masses. It serves as a guide to determining whether, when, and in which order plain radiographs, diagnostic medical sonography, magnetic resonance imaging (MRI), computed tomography (CT), and/or fluorodeoxyglucose-positron emission tomography/CT should be used.…”

“…3 For example, many conditions, including infection, trauma, and cellulitis, can appear as soft tissue masses. 3,5 When soft tissue masses are superficial, they are often recognized quickly, yet deep soft tissue masses are usually not identified until the mass has grown large, which is denoted by >10 cm. 3 Church et al 3 recommend beginning diagnostic imaging with radiographs to determine the presence or lack of bony involvement for diagnosing soft tissue masses.…”

“…1,5 Also, color and pulsed-wave Doppler enable further characterization of the lesion's vascularity or lack of vascularity. 5,7…”

“…3 For example, many conditions, including infection, trauma, and cellulitis, can appear as soft tissue masses. 3,5 When soft tissue masses are superficial, they are often recognized quickly, yet deep soft tissue masses are usually not identified until the mass has grown large, which is denoted by >10 cm. 3…”