Test your knowledge: Coincidental ultrasound findings in the inguinal region
As mentioned in earlier posts ultrasound imaging can be used to evaluate muscles, tendons, ligaments, bursa and sometimes cartilage and nerves for detecting minor or major lesions or abnormalities in the anatomy.
Past week, a patient with prolonged ventral hip pain presented in the clinic. Clinical examination ruled out any problems concerning the hip joint. Using ultrasound a thickened origin of the rectus femoris tendon was detected; it was also painful on palpation and resistance tests. As the problem was identified, other near-by structures (femoral head, acetabulum, adductor tendons) were also examined with ultrasound to rule out additional pathology – this led to a surprising coincidental finding!
What is seen in the ultrasound images below? The other picture provides a hint of what we’re looking for. Do you also know the main risk factors for developing this condition?
The correct answer was: Arterial calcification / Atherosclerosis / Plaque of the femoral artery.
The risk factors for peripheral arterial disease (PAD) are similar to the risk factors for atherosclerosis elsewhere. The three risk factors most strongly associated with PAD are advanced age (older than 60 years), cigarette smoking, and diabetes mellitus (DM). PAD is more frequent in older adults, with a 1.5- to twofold increase in risk for every 10-year increase in age. Smoking or DM increases the risk of PAD independently by approximately threefold. In addition, smoking has a synergistic effect on other risk factors, and the number of pack/years is associated with disease severity. Smokers have at least double the risks of mortality, disease progression, and limb amputation rates compared with nonsmokers. Although diabetics often have extensive involvement, diffuse and advanced PAD appear to be related to the duration of diabetes rather than glycemic control. Other important risk factors include dyslipidemia (elevations of total cholesterol, low-density lipoprotein [LDL], triglyceride [TG], and lipoprotein levels are all independent risk factors for PAD) and hypertension. (Source here)