Stress Fractures of the Calcaneus Diagnosed by Sonography: Report of 8 Cases

We present a retrospective review of 8 patients (6 women and 2 men, with an age range of 46–80 years; mean age, 60.2 years) in whom sonography was used to diagnose a calcaneal stress fracture. Sonography was performed because of a clinical suspicion of soft tissue injuries. Two patients were first assessed by standard radiography; for the remaining patients, sonography was the first imaging technique used. Patients were subsequently examined by magnetic resonance imaging, except for 1 patient in whom the diagnosis was made only on a clinical‐sonographic correlation. On sonography, there was thickening of the periosteum and subcutaneous edema in all patients; a calcified bone callus was evident in none of the 8 patients. Cortical irregularities were found in 6 of 8 patients. Color Doppler imaging showed local hypervascular changes of the periosteum in all patients. Sonography, together with clinical findings, can be used to diagnose a calcaneal stress fracture. We suggest that sonologists should include a calcaneal stress fracture in their differential diagnosis in cases of mechanical hind foot pain. They must also include, as a part of every sonographic examination of the ankle, an examination of the calcaneus and be aware of the sonographic appearance of stress fractures. If the diagnosis is still uncertain after the sonographic examination, magnetic resonance imaging should be prescribed.     

Ultrasound Imaging for Traumatic Brain Injury

Traumatic brain injury (TBI) is challenging to assess even with recent advancements in computed tomography and magnetic resonance imaging. Ultrasound (US) imaging has previously been less utilized in TBI compared to conventional imaging because of limited resolution in the intracranial space. However, there have been substantial improvements in contrast‐enhanced US and development of novel techniques such as intravascular US. Also, continued research provides further insight into cerebrovascular parameters from transcranial Doppler imaging. These advancements in US imaging provides the community of TBI imaging researchers and clinicians new opportunities in clinically monitoring and understanding the pathologic mechanisms of TBI.