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Related Concept Videos

Cardiovascular System Abnormal Findings I: Inspection and Palpation01:29

Cardiovascular System Abnormal Findings I: Inspection and Palpation

In a cardiovascular examination, inspection and palpation are crucial for identifying abnormalities.
Abnormal findings observed during an inspection
Cardiovascular System Abnormal Findings II: Auscultation01:25

Cardiovascular System Abnormal Findings II: Auscultation

Auscultation, an essential part of a heart examination, is done using a stethoscope. It provides crucial information about heart function and possible heart problems. Due to heart problems, abnormal sounds can be heard during systole or diastole. These sounds include S3 and S4 gallops, opening snaps, systolic clicks, and murmurs.
Abnormal Heart Sounds
Gallops:
Imaging Studies for Cardiovascular System I:Echocardiography01:17

Imaging Studies for Cardiovascular System I:Echocardiography

Cardiac imaging studies encompass a wide range of noninvasive and minimally invasive techniques designed to visualize the heart's structure and function in detail. One such technique is echocardiography, which uses high-frequency ultrasound waves to produce detailed images of the heart, known as echocardiograms.
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion, evaluates...
Imaging Studies for Cardiovascular System II:Types of Echocardiography01:20

Imaging Studies for Cardiovascular System II:Types of Echocardiography

Echocardiography plays a role in assessing cardiac health and detecting heart conditions, with various types providing critical insights for diagnosis and treatment.
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for diagnosing...
Imaging Studies for Cardiovascular System III: X-Ray01:20

Imaging Studies for Cardiovascular System III: X-Ray

The most common cardiovascular diagnostic test is an X-ray. It produces images of the heart, blood vessels, and adjacent structures.
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...

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Related Experiment Video

Updated: Jul 18, 2026

Intraoperative Ultrasound in Spinal Surgery
05:53

Intraoperative Ultrasound in Spinal Surgery

Published on: August 17, 2022

"Inappropriate" spinal ultrasounds for suspected occult spinal dysraphism.

Nicholas Sader1, Brij S Karmur2, Michael B Keough3

  • 11Department of Neurosurgery, Oklahoma University College of Medicine, Oklahoma City, Oklahoma.

Journal of Neurosurgery. Pediatrics
|February 13, 2026
PubMed
Summary

Many spinal ultrasounds for neonates are inappropriately ordered, missing surgical needs. Following guidelines could save millions and improve care for occult spinal dysraphism.

Keywords:
congenitaloccult spina bifidasimple dimplespinal MRIspinal dysraphismspinal ultrasound

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Area of Science:

  • Medical Imaging
  • Pediatric Radiology
  • Neurosurgery

Background:

  • Spinal ultrasound is a key tool for diagnosing occult spinal dysraphism in neonates with sacrococcygeal dimples.
  • Adherence to Choosing Wisely Canada guidelines for imaging is crucial but often not followed.
  • Inappropriate imaging may lead to unnecessary costs and delayed diagnosis.

Purpose of the Study:

  • To evaluate the appropriateness of spinal ultrasounds in neonates across two Canadian provinces.
  • To compare the diagnostic accuracy of spinal ultrasound and MRI in identifying the need for neurosurgical intervention.
  • To assess the potential impact of adhering to Choosing Wisely guidelines on healthcare costs and patient outcomes.

Main Methods:

  • A multicenter retrospective cohort study of neonates under six months old from January 2017 to December 2018 in Alberta and British Columbia.
  • Data collected included demographics, reasons for imaging, ultrasound findings, and surgical outcomes.
  • Appropriateness was determined by adherence to Choosing Wisely guidelines; diagnostic accuracy was assessed using sensitivity, specificity, PPV, and NPV.

Main Results:

  • Out of 1043 ultrasounds, 37% were inappropriately ordered.
  • Spinal ultrasound showed 36% sensitivity and 98% specificity for predicting surgery.
  • Spinal MRI demonstrated 73% sensitivity and 76% specificity for predicting surgery.

Conclusions:

  • Spinal ultrasound has high specificity but low sensitivity (36%) for predicting surgical intervention.
  • Approximately 37% of spinal ultrasounds were inappropriately ordered, suggesting significant room for guideline adherence.
  • Following Choosing Wisely guidelines could lead to substantial cost savings (estimated CAD$1.86 million over a decade) with minimal risk of missing surgically relevant spinal dysraphism.