The vertibrobasilar circulation is very variable with many anatomical variations commonly seen. These extend not just to dominant and non dominant vertebral arteries, but also include a myriad of circle for Willis variations that may impact.
The diameter of the vertebral artery will most certainly be a factor in…[Read more]

If the fluid is beneath the iliotibial band or the G-maximnus muscle it is in the trochanteric bursa.

If fluid is beneath the gluteus medius tendon not is the sub- gluteus medius bursa.

If fluid is beneath the gluteus minimus tendon not is the sub- gluteus minimus bursa.

So as you can imagine the trochanteric bursa is…[Read more]

Just wondering what types of bursitis you would be calling these. I get confused when I start seeing different pockets of fluid. How do you distinguish between subgluteal medius, subgluteal minimis and trochanteric bursa?

Image 1 – I assume at least one of these fluid pockets is troch bursitis..? But what do we call the…[Read more]

Do you happen to have any pictures of actual Gluteofemoral bursitis? 🙂

I would be in favour of calling this vistas laterals origin tendinosis rather than a bursa.

Steve.

Just had a run of patients that had posterolateral hip pain (distal to the trochanter, just at the proximal posterolateral femur). With these patients, they did not seem to have any troch bursitis but at the prox femur, there’s this hypoechoic thickening of the tissue just superficial to the bone…. sometimes bony irregularity seen……[Read more]

But the posterior wall is very weak.

This is a common finding in older males.

If you compare it to the linea alba in the anterior abdominal wall, what you have sent me is like…[Read more]

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Tendinopathy is a word I am not that fond of.

It is an umbrella term that simply means the tendon is diseased.

But it does not say what sort of pathology it is specifically suffering from.

So I like the word tendinopathy on a referral, but not on a report.

If it has tendinosis, this can be divided into the following:

Reactive…[Read more]

That is a very angry looking joint!

I am thinking that you are seeing gout tophus (aggregations of monosodium grate crystals)

The vascularity I think is fairly typical of a gout affected joint.

Steve.

Good question!

Impingement happens under the “Coraco-Acromial Arch” which includes the bony acromion, the CA ligament and the coracoid process.

The most common site for impingement is under the CA ligament just adjacent to its origin from the acromion.

This is why this area becomes key to assessing impingement.

When you scan, check…[Read more]

When assessing for shoulder impingement, what is the reason that the transducer should be positioned to observe movement of the soft tissues under the CA ligament rather than the bony acromion?

Thank you

There are many options for you to consider,

The tricky bit for you is that the recurrent motor branch of the median nerve and also the palmar cutaneous branch (if you are interested in the location of that as well) is that they are about the smallest nerves we can see with ultrasound.
I use a variety of equipment my clinical…[Read more]