Invited Review: Managing uncommon and unexpected findings during neuromuscular ultrasound-Article

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Neuromuscular ultrasound is a valuable tool in diagnosing and managing various conditions related to the nerves and muscles. However, clinicians often encounter unexpected or uncommon findings during ultrasound exams, which can pose challenges in terms of identification and management. This review aims to address these concerns by describing the sonographic appearance of commonly observed pathologies and anatomic variants in different tissues, such as skin, subcutaneous, bony, glandular, lymphatic, and vascular tissues. The review also outlines techniques to ensure proper clinical and ultrasound evaluation of unexpected findings and highlights strategies for managing such findings. Effective communication of findings to patients and referring clinicians is emphasized to avoid unnecessary testing and ensure appropriate follow-up. The review further discusses the principles and techniques of neuromuscular ultrasound assessment, including the importance of open-ended and closed-ended evaluation and the use of B-mode imaging and Doppler blood flow evaluation. The role of ultrasound in identifying and managing uncommon findings in different tissues is discussed, such as lipomas, lymph nodes, edema, cellulitis, abscesses, foreign bodies, ectopic calcification, gouty tophi, and eosinophilic fasciitis in the skin and subcutaneous tissues. Anatomic variants in nerves, bones, and salivary and thyroid glands are also described. The review concludes by emphasizing the importance of proper reporting and communication of incidental findings to patients and referring clinicians.

Keywords

neuromuscular ultrasound

diagnosing and managing conditions

unexpected findings

sonographic appearance

pathologies

anatomic variants

tissues

clinical and ultrasound evaluation

managing findings

communication of findings