Ultrasound of Musculoskeletal Hematomas: Relationship of Sonographic Appearance to Age and Ease of Aspiration
Edward S. Yoon, Bin Lin, Theodore T. Miller
Abstract
OBJECTIVE: The purpose of this study was to evaluate the safety and efficacy of ultrasound-guided aspiration of musculoskeletal hematomas, evaluate the associations between the sonographic appearance of hematomas and their age with ease of aspiration, and determine if there is an optimal time frame for aspiration. MATERIALS AND METHODS: A retrospective search of our radiology database was conducted using the keywords "hematoma" and "aspiration" for procedures performed from January 1, 2008, through September 28, 2017, by three fellowship-trained musculoskeletal radiologists. Associations between the ease of aspiration and echotexture of the hematoma and between the ease of aspiration and age of the hematoma were assessed with a marginal ordinal logistic regression model to account for patient-level clusters. Pairwise comparisons of the ease of aspiration between the different echotextures were adjusted for multiple comparisons with the Tukey-Kramer method. This same method was also used to calculate the odds ratio (OR) for the age of the hematoma and ease of aspiration and decompression. Clinical follow-up was assessed for infection and symptomatic relief. RESULTS: value of 0.547, which shows that there is no correlation between the age of the hematoma and ease of aspiration. CONCLUSION: Ultrasound-guided aspiration of hematomas is a safe and effective procedure. The sonographic appearance of a hematoma is unrelated to its age. Although a hematoma with a hypoechoic appearance is easier to aspirate than hematomas with other echotextures, the appearance and age of a hematoma should not dissuade one from trying to aspirate it.