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Welcome to the August issue of Ultrasound. However, before I describe its contents, I would like to remind readers of the special issue that is planned for early 2017 on Safe Practice in Ultrasound. The call for papers for this special issue is available on the journal website (http://ult.sagepub.com), on the BMUS website (http://www.bmus.org) and the BMUS Ultrapost site (http://www.bmusultrapost.com). So there is no excuse for not seeing it! I would also like to remind you that the deadline for submissions is 15 September.
In this issue, we begin with two original research articles on musculo-skeletal applications of ultrasound. Horton et al. report on a reliability assessment of a novel tool for scoring tendon and sheath disease, which could be used in diagnosis and follow-up. The tool is novel in that it makes separate assessments of the tendon and sheath by measuring thickening of each and scoring levels of pathology from greyscale and power Doppler appearances. Reliability was good for thickness measurements and colour Doppler assessments but poor for grey scale assessments. O’Riordan et al. report on a reliability study of measurements of the longus colli. Altered function and weakness in these muscles have been implicated in chronic neck pain, but their deep location in the neck makes assessment difficult. Inter-rater reliability in ultrasound cross sectional area measurements was moderate due to the difficulty in identifying the borders of the muscle, while intra-rater reliability was excellent.
Twinkle artefact is a colour Doppler artefact that commonly appears behind strongly reflecting interfaces such as calcified lesions. Clarke et al. describe a retrospective study of ultrasound reports on superficial masses, which appears to show a strong correlation between the presence of this artefact and a pathological diagnosis of epidermoid cyst. The retrospective nature of the study is a limiting factor but the findings suggest that further prospective studies would be worthwhile. Continuing the theme of artefacts, Oates and Taylor describe an exercise to communicate to patients why their obstetric ultrasound scan may not produce adequate images. Poor visualisation is commonly caused by beam distortion in overlying fatty tissues, particularly by non-uniform fatty tissue. The authors designed a poster to explain these effects to patients and assessed its impact via a questionnaire. The poster is available on the journal website for Ultrasound readers to download.
Ultrasound assessment is commonly used in the evaluation of symptomatic puerperal women. However, it seems that the ultrasound appearances of the uterine cavity and its contents post-partum are quite variable and the presence of intrauterine echogenic material is quite common. Üçyiğit and Johns review the evidence relating ultrasound appearances to puerperal pathology. Accurate assessment and characterisation of such ultrasound findings are required to avoid diagnostic confusion and avoid inappropriate surgical intervention. We conclude this issue with two obstetric case reports. Dennison reports on a case of closed gastroschisis leading to vanishing midgut. The condition is rare but has poor prognosis and a high mortality rate. The author suggests that if gastroschisis is seen to be reducing and disappearing antenatally, parents should be prepared for a poor outcome. Asymptomatic congenital adenomatoid malformation (CCAM) is a rare multicystic mass arising in the lung parenchyma during the first trimester of fetal life. From experience of a case that was followed up for four years, Adin proposes ultrasound as a screening tool in follow-up, avoiding the radiation exposure from CT scanning.