ABSTRACT Purpose Noninflammatory thickening of the subsynovial connective tissue (SSCT) is commonly observed early in carpal tunnel syndrome (CTS). However, previous research on which subject characteristics influence SSCT thickness remains limited. This study aimed to investigate the effect of disease status and severity on SSCT thickness in subjects with and without CTS while considering subject characteristics. Methods A total of 170 wrists from 91 subjects were assessed for the absence/presence of CTS, determined through clinical symptoms and electrodiagnostic testing. Participants completed the Katz hand diagram, Boston Carpal Tunnel Questionnaire (BCTQ), Disability of Arm, Shoulder and Hand (DASH), and Visual Analog Scale (VAS). SSCT thickness and median nerve cross‐sectional area (CSA) were measured via ultrasound. Results Linear mixed‐effects models indicated significant associations between SSCT thickness and CTS presence, as indicated by both clinical symptoms and electrodiagnostic testing ( β = 0.127, p = 0.0007), and the Katz hand diagram ( p = 0.002). Moreover, SSCT thickness was associated with CTS severity, as evidenced by VAS ( β = 0.001; p = 0.001), BCTQ (symptom severity score: β = 0.038, p = 0.005; Functional Status Scale: β = 0.039, p = 0.02), DASH ( β = 0.003, p = 0.002), and CSA ( β = 0.011; p = 0.0001). Conclusion The SSCT thickness was larger in wrists with CTS and increased with increasing CTS severity. Consequently, SSCT thickness emerges as a potential biomarker for both the presence and severity of CTS, offering valuable insights for clinical assessment and management. Trial Registration ClinicalTrials.gov identifier: NCT04491058

ABSTRACT Background Trainees of ultrasound‐guided regional anesthesia (UGRA) should begin with phantoms before use on patients. The phantoms currently available have substantial drawbacks. Our aim was to develop a low‐cost homemade UGRA phantom without perishable parts, which shows sonoanatomical details and hydrodissection when injecting fluid—the “Pink Phantom.” Methods A homemade polymer mass was optimized for ultrasound compatibility, along with target structures such as fascia, nerves, and vessels, mimicking the human groin region. The Pink Phantom's value for UGRA training was assessed in two steps. First, nine experts compared it to a commercial and a biological phantom using a 21‐item VAS questionnaire. Second, 35 UGRA trainees evaluated it after first use with an 8‐item VAS questionnaire. Results Preparation took 1 h per phantom at a cost of approximately 13 $US. The experts' median overall VAS rating of the Pink Phantom (7.8) was slightly higher than their rating of the biological phantom (6.7) and much higher than their rating of the commercial phantom (3.3). UGRA trainees also gave the Pink Phantom a high median overall rating (8.4). Conclusions The Pink Phantom replicates the human groin region with fascia, vessels, and a nerve, offering realistic hydrodissection combined with high durability.

ABSTRACT Objectives To compare four ultrasound models: O‐RADS US, IOTA Simple Rules (SR), Subjective Assessment (SA), and the Sequential SR–Subjective Assessment strategy (SR–SA) for classifying adnexal masses and to assess whether additional discrimination is possible within intermediate‐risk O‐RADS 3 lesions in a middle‐resource setting. Methods Prospective cohort of 122 women. Two IOTA‐certified radiologists performed ultrasound with on‐scan consensus. Each lesion received all four classifications. The reference standard was histopathology or stability at 12‐month imaging follow‐up. Diagnostic metrics were calculated; false negatives were reviewed; O‐RADS 3 and 4–5 subgroups were analyzed; and decision‐tree models were explored. Results Among 121 adnexal/ovarian masses, 40 were malignant (33.1%). With O‐RADS US (≥ 4 positive), sensitivity and negative predictive value (NPV) were highest (97.5%, 98.0%) with specificity 59.3%. SR sensitivity/specificity were 85.0%/82.7%. SA and SR–SA achieved higher specificities (87.7%, 91.4%) with intermediate sensitivities (85.0%, 82.5%). AUCs were 0.784 (O‐RADS US), 0.840 (SR), 0.853 (SA), and 0.859 (SR–SA). SR–SA and SA exceeded O‐RADS US (ΔAUC 0.086, p = 0.027; ΔAUC 0.080, p = 0.034). False negatives occurred in one O‐RADS US case, six SR cases, seven SR–SA cases, and six SA cases. Among O‐RADS 3 lesions ( n = 17), 1 (5.9%) was malignant; decision‐tree analyses found no additional splits. Conclusions O‐RADS US maximized sensitivity and NPV but had lower specificity. SA and SR–SA improved specificity and discrimination but require experienced operators. Model selection should reflect resource constraints: O‐RADS US for safety‐first triage; SA or SR–SA where expertise is available; and targeted MRI when feasible.

ABSTRACT Peripheral intravenous catheter (PIVC) insertion is a common clinical procedure, but it can be challenging, especially in patients with difficult intravenous access (DIVA). Ultrasound‐guided PIVC (USGPIVC) insertion is recognised as best practice in these cases, improving first attempt success rates, reducing complications, and enhancing patient comfort. Sonographers, with their advanced imaging and dexterity in anatomical assessment, are well positioned to contribute to vascular access services through USGPIVC. This educational article, informed by the 2025 ASA guideline, outlines scope of practice considerations, training and competency requirements, procedural techniques and infection control standards. Practical guidance is offered on vein selection, insertion approaches, artefact mitigation, and post‐procedural care. By adopting USGPIVC, sonographers can enhance patient outcomes, reduce procedural delays, and contribute meaningfully to multidisciplinary care teams. This resource supports professional development and encourages institutions to recognise sonographers' potential in delivering high‐quality vascular access services. With appropriate credentialing and ongoing education, USGPIVC represents a significant opportunity to enhance sonographic practice and meet evolving healthcare needs.

ABSTRACT Chronic venous disease (CVD) is a prevalent vascular disease. Duplex ultrasound (US) is considered the first‐choice imaging modality for evaluating venous anatomy and hemodynamics in patients with CVD. In Australia and New Zealand, chronic venous insufficiency (CVI), often referred to as venous insufficiency (VI) scans, is primarily performed by medical sonographers. Currently, inconsistency in the performance and reporting of CVI ultrasound presents a challenge, and a practical solution to this dilemma is a clinical guideline to assist sonographers in making appropriate, consistent, and evidence‐based decisions throughout the scanning and reporting process. The aim of this article is to introduce a new guideline for sonographers on how to perform duplex US assessment for CVD, to provide a brief overview of its development and the methodology used, to explain its contents, and outline how it can be effectively used clinically to promote standardized practices and maintain the integrity of duplex US examinations. This guideline fills a critical gap by offering clear, evidence‐informed recommendations and general guidance on scanning techniques, interpretation, and reporting of sonographic findings.

ABSTRACT Introduction Cranial ultrasound (cUS) screening is routinely performed in preterm neonates. This study compared cranial ultrasound abnormalities (CUA) detected at 6 weeks postnatal age (PNA) and term equivalent age (TEA) with early neurodevelopment outcomes at 3–4 months corrected age. Methods Pre‐planned substudy of a prospective single‐centre cohort included high‐risk infants born before 32 weeks of gestation who underwent cUS at 6 weeks PNA and TEA. Severe CUAs, defined as significant intraventricular haemorrhage, white matter injury or ventricular enlargement were compared with outcomes at 3–4 months corrected age, including Hammersmith Infant Neurological Examination (HINE), General Movement Assessment (GMA), and early cerebral palsy (CP) diagnosis. Results Fifty‐four infants were included (median gestation 26.8 weeks, birthweight 782 g). Abnormal HINE scores (< 57) were found in 18 (33%), absent fidgety GMAs in 5 (9%), and early CP in 2 (4%). Severe CUAs were not significantly associated with abnormal HINE at 6 weeks PNA ( p = 0.77) or TEA ( p = 0.77), absent fidgety GMAs at 6 weeks PNA ( p = 0.39) or TEA ( p = 0.14) or early CP at 6 weeks PNA ( p = 0.16) or TEA ( p = 0.52). Conclusion In this exploratory study, severe CUAs on cUS were not associated with early neurodevelopmental outcomes. Larger studies are needed to determine whether meaningful associations exist.

ABSTRACT Postoperative neuromas are uncommon benign nerve lesions that may develop after surgical procedures. While neuromas are frequently reported in the lower limbs and craniofacial regions, involvement of the radial nerve, particularly its deep terminal branches, is rare. This case study documents a rare postoperative neuroma of the terminal branch of the posterior interosseous nerve (PIN) following dorsal wrist ganglion excision. Ultrasound played a pivotal role in diagnosis and image‐guided management, emphasizing its importance in peripheral nerve evaluation. The patient was treated with ultrasound‐guided steroid injection and physiotherapy, showing partial pain relief at three‐month follow‐up.

ABSTRACT Introduction Accurate and timely diagnosis of peripheral arterial disease (PAD) is essential to prevent progression and guide effective treatment. This study aims to compare the diagnostic accuracy and limitations of Doppler ultrasonography (DUS) and digital subtraction angiography (DSA) in evaluating the severity and anatomical distribution of PAD, particularly in infra‐popliteal arteries, to improve diagnostic decision‐making in vascular care. Methods This cross‐sectional study involved 40 PAD patients scheduled for lower limb revascularization. All participants underwent both DUS and DSA. DUS was performed by experienced sonographers using a standardized protocol to assess both supra‐ and infra‐popliteal arteries, while DSA was conducted during the procedure with contrast‐enhanced x‐ray imaging. Diagnostic performance and concordance between DUS and DSA were analyzed using chi‐square tests, Kappa coefficient, and correlation (Pearson and Spearman). Results A total of 504 arterial sections were analyzed. The concordance between DUS and DSA was 63.5% for supra‐popliteal arteries and 34.9% for infra‐popliteal arteries. DUS demonstrated higher diagnostic accuracy in the supra‐popliteal regions, with a positive predictive value (PPV) of 83.2% and a negative predictive value (NPV) of 85.4%. However, in infra‐popliteal arteries, the PPV and NPV were lower (68.5% and 72.3%, respectively), indicating reduced reliability in detecting distal arterial lesions. Conclusion DUS is a valuable non‐invasive tool for assessing PAD in supra‐popliteal arteries but has limited accuracy in infra‐popliteal evaluations. Supplementary imaging modalities such as DSA remain essential for precise diagnosis and treatment planning in distal arterial disease.

ABSTRACT Hydrocele of the canal of Nuck is a rare condition in female patients. It is caused by a failure of complete obliteration of the canal of Nuck, which develops into a protruding part of the parietal peritoneum into the female inguinal canal. This condition can cause inguinal swelling, mostly resulting in pain in the groin region. Ultrasound serves as an accurate and efficient diagnostic imaging tool to differentiate hydrocele of the canal of Nuck from other pathologies, thereby aiding in appropriate patient management and treatment. This article discusses the related anatomy, the different types of hydrocele of the canal of Nuck, the ultrasound diagnosis criteria, and the treatment options for hydrocele of the canal of Nuck. A knowledge of the hydrocele of the canal of Nuck can help sonographers to make the correct diagnosis in the clinical settings.

ABSTRACT Introduction Artificial intelligence ( AI ) has advanced image interpretation capabilities, and AI has gained increasing prominence in medical imaging. Point‐of‐care ultrasound ( POCUS ) is a key imaging tool where AI can be applied. A bibliometric study on AI in POCUS has not yet been published in the literature. Therefore, using bibliometric and statistical methods, we aimed to analyze publications on AI in POCUS . Methods This research is a bibliographic and descriptive analytical study. The Web of Science database was utilized to identify existing publications and conduct the analyses. A non‐linear regression analysis (using an exponential model) was employed to predict the number of publications over the following years. Additionally, the study employed bibliometric network visualization, world map visualization, and publication relationship visualization. Results Examining the distribution of publications related to AI in POCUS , 77.2% (207) are articles, 17.5% (47) are review articles, and the remaining are other types of publications. The strong relationship between lung ultrasound and AI reflects the impact of the COVID ‐19 pandemic on research. However, the high frequency of terms related to multiple systems, including pulmonary, cardiovascular, trauma‐related, and neurologic conditions, suggests wide‐ranging clinical applicability. These findings may help guide the planning and prioritization of future AI ‐based research in POCUS . Conclusion This bibliometric study on artificial intelligence in POCUS examined 268 publications. The analyses in this study can be a valuable resource for researchers working on AI in POCUS or who will work on AI in POCUS in the future.