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This is the second part of a two-part article in which we focus on the ultrasound (US) appearance of the pathological ulnar nerve (UN) and its main branches. Findings in a wide range of our pathological cases are presented with high-resolution US images obtained with the latest-generation US machines and transducers., (© 2024 American Institute of Ultrasound in Medicine.)

We report a case of intermittent dislocation of the flexor hallucis longus at its passage in the retro-malleolar area, related to a post-traumatic detachment of the retrotalar pulley from the medial tubercle of the talus. High-resolution ultrasound depicted the anterior dislocation of the tendon during dynamic stress, by asking the patient to flex his hallux against the examiner resistance, with the ankle in slight dorsiflexion. The tendon normally relocated after the dynamic maneuver. Tendon dislocation was associated with a painful snap., (© 2024. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)

We review the ultrasound (US) findings in patients who present with meralgia paresthetica (MP). The anatomy of the lateral femoral cutaneous nerve at the level where the nerve exits the pelvis and potential entrapment sites that can lead to MP are discussed. A wide range of pathological cases are presented to help in recognizing the US patterns of MP. Finally, our experience with US-guided treatment is discussed., (© 2021 American Institute of Ultrasound in Medicine.)

Foot pain is common in daily clinical practice but thrombosis of the foot veins is rarely considered as a differential diagnosis. Several cases of plantar veins thrombosis are reported in literature but a detailed description of ultrasonographic findings in case of thrombosis of the dorsal venous arch of the foot is lacking. We report a case of ours with a thrombosis of the medial marginal vein and dorsal venous arch of the foot, showing its close anatomical relation with the extensor hallucis longus tendon., (© 2020. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)

This pictorial review focuses on the ultrasound (US) appearance of the normal and pathological radial nerve (RN) and its branches and provides tips with which to locate them and avoid misinterpretation of normal findings. A wide range of our pathological cases are reviewed and presented to help in familiarizing the reader with common and uncommon clinical scenarios that affect the RN and its main branches., (© 2021 American Institute of Ultrasound in Medicine.)

Ultrasound is considered an excellent imaging modality to evaluate the nerves of the limbs. The deep peroneal nerve (DPN) is one of the terminal branches of the common peroneal nerve. The DPN may be affected by various disorders, which may be clinically challenging to show. This Pictorial Essay reviews the normal ultrasound anatomy of the DPN and presents disorders that may involve the nerve and its main branches along its course, from proximal to distal., (© 2020 American Institute of Ultrasound in Medicine.)

Syndesmotic injuries, also referred as high ankle sprains, may cause significant ankle instability and chronic pain. Ultrasound (US) is a well-proven imaging modality to evaluate the ligaments of the ankle, due to its high spatial resolution and the possibility to perform dynamic examinations. However, considering the syndesmosis complex, the sonographic appearance of the posterior inferior tibiofibular ligament (PITFL) is not well described in the pertinent literature and, to the best of our knowledge, we found no report of PITFL avulsion demonstrated at US, as in the case presented.

Disorders of retinacula are frequent in acute and repetitive microtrauma of the ankle. Ultrasound (US), thanks to its spatial resolution and dynamic capabilities, is routinely used in the evaluation of the posttraumatic ankle for accurate delineation of ligaments and tendons. In addition, US can provide a depiction of normal retinacula and a detailed assessment of their pathologic changes. An accurate US assessment of ankle retinacula is helpful in choosing the proper treatment. In this pictorial essay, we briefly review the normal anatomy of ankle retinacula, describe their normal US appearance, and present a wide range of US pathologic abnormalities., (© 2019 by the American Institute of Ultrasound in Medicine.)

Ultrasound is a well-proven imaging modality for showing peripheral nerve disorders and guiding perineural injections. The aim of this review is to focus on small peripheral nerve abnormalities, which are usually not recognized by sonologists. In fact, most of these small nerves have a tiny diameter (<2 mm), and their anatomy is less familiar. We describe the most common causes of small peripheral nerve disorders, providing an accurate description of their anatomic locations and relationships with adjacent structures; we also focus on technical hints that may help in their evaluation., (© 2019 by the American Institute of Ultrasound in Medicine.)

Calcific tendinopathy (CTe) is a frequent disorder related to the deposition of calcium hydroxyapatite crystals within tendons. Ultrasound has been shown to be an excellent imaging modality for the evaluation of CTe. During the resorptive phase of CTe, calcium deposits may migrate inside the tendons or in neighboring tissues and lead to local inflammation and severe pain. In this pictorial essay, we describe the ultrasound appearance of a spectrum of CTe migrations. Knowledge of the different migration patterns can help sonologists in their detection and in establishing the correct diagnosis., (© 2019 by the American Institute of Ultrasound in Medicine.)

The hamstring muscle complex is made by a group of posterior biarticular thigh muscles, originating at the ischial tuberosity, which extend the hip and flex the knee joint. Proximal hamstring injuries are frequent among athletes, commonly involving their long myotendinous junction during an eccentric contraction. In this pictorial essay, we describe the ultrasound technique to visualize the normal anatomy of the proximal hamstring muscle-tendon-bone complex and present ultrasound findings in patients with traumatic injuries and tendinopathies., (© 2018 by the American Institute of Ultrasound in Medicine.)

Background: Production and consumption of fresh mushrooms reached high levels in recent years but only a few data regarding microbiological quality of these products are available, although their potential microbial load is expected to be high. EU and Italian legislation have not set a limit on microbial counts in these products and label information is often unclear. This study investigates the microbial quality of samples of fresh cultivated mushrooms sold in Tuscany so that both food business operators and legislators can obtain data about potential microbial risk for consumers and debate about the opportunity of realizing an update on fresh mushrooms labels that should include information to protect consumers' health., Study Design: This study reports the microbial load in samples of cultivated and commercialized Agaricus bisporus. Samples were obtained from different shops in Florence, chosen among those products whose labels did not indicate how the product should be consumed., Methods: From March through May 2014, 20 couples of samples of A. bisporus were acquired in Florence. Microbiological analysis included the quantification of the microbial counts for mesophilic aerobic microorganisms and Enterobacteriaceae, as indicators of hygienic practices during cultivation and manufacturing. The analyses were carried out at two subsequent stages: one immediately (T0) and one at the end of the shelf life (T1), i.e. close to the expiry date stated on the label., Results: The high microbial load observed exceeds the reference values set as acceptable for raw foods in Tuscany and is worse than the ones reported in other studies on this subject. The results are particularly alarming in light of the fact that A. bisporus is usually consumed raw and there is no mandatory specification on the label that informs consumers that the product must be cooked before being consumed., Conclusion: This research highlights the importance of adequate and complete information on fresh mushrooms labels, that should include information about the need for sanitization before the consumption, the appropriate storage temperature, and the maximum duration of shelf life. Data obtained could also be useful for food business operators to gather information about the microbial quality of fresh cultivated commercialized mushrooms in order to implement quality controls of the production process and storage conditions.

Killian-Jamieson diverticulum (KJD) is a pharyngoesophageal diverticulum that can be observed during a neck ultrasound examination. Because of its position, it is frequently misinterpreted as a thyroid nodule. We present a case of an incidental finding of KJD, where changes in shape during dynamic scanning led to the correct diagnosis, preventing from invasive procedures such as fine needle aspiration., Competing Interests: The authors have no conflict of interest. Informed consent All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. All patients provided written informed consent for enrolment in the study and for the inclusion in this article of information that could potentially lead to their identification. Human and animal studies The study was conducted in accordance with all institutional and national guidelines for the care and use of laboratory animals.

Calcific tendinopathy of the shoulder is a common condition caused by calcium hydroxyapatite crystals, affecting the tendons of the rotator cuff. Among uncommon complication, one is the migration of the calcium in the subacromion-subdeltoid bursa. More rare is the intraosseous migration. We present four cases of an even more rare condition, not well described in literature yet, the intramuscular migration of calcium., Competing Interests: The authors have no conflict of interest. Informed consent All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. All patients provided written informed consent for enrolment in the study and for the inclusion in this article of information that could potentially lead to their identification. Human and animal studies The study was conducted in accordance with all institutional and national guidelines for the care and use of laboratory animals.

The fractures of sesamoid bones of the hand are rare, sometimes the diagnosis is missed. We report a case of fracture of both the ulnar and radial sesamoids of the metacarpophalangeal (MCP) joint of the thumb. The trauma (hyperextension of the thumb during a soccer match) also caused a lesion of the volar plate. The diagnosis was made by ultrasound (US) and confirmed by CT scan.

Clinical experience with permanent epicardial pacing during a five year-period in our centre is presented. The report is based on 37 epicardial and 656 transvenous pacemaker implantations. Intraoperative and early postoperative mortality were absent in the epicardial pacing group. Late hospital mortality, morbidity and electro-mechanical complications were less than with transvenous pacing. Among the complications peculiar to the epicardial pacing technique, we observed 3 cases of breakage of a lead, at the level of its epicardial connection. We conclude that the use of epicardial leads represents a safe and effective technique of cardiac pacing.