The article is a review of the literature on the importance of echocardiography in the detection and evaluation of the mitral annular disjunction, a specific anatomical anomaly characterized by a distinct separation between the mitral annulus and the wall of the left atrium on the one hand and the basal part of the posterolateral segment of the left ventricular myocardium on the other. Mitral annular disjunction is a common component of arrhythmic mitral valve prolapse with left ventricular fibrosis. Data are presented on the relationship between mitral annular disjunction and ventricular arrhythmias in patients without mitral valve prolapse. Along with echocardiography, the importance of other non-invasive imaging methods in the diagnosis of mitral annular disjunction is given.

The brief pictorial review presents the ultrasound features of left ventricle and mitral valve rare congenital abnormalities. The ultrasound findings in such abnormalities as double-chambered left ventricle, bifid cardiac apex, diverticulum of the left ventricle, and double-orifice mitral valve are described. Knowledge of the anatomical and ultrasound features provides the accurate differential diagnosis of presented abnormalities.

Loeffler’s endocarditis is a rare disease characterized by a progressive course, poor prognosis, and high mortality. Early non-invasive diagnosis of this disease is difficult due to the lack of a specific clinic and pathognomonic signs according to instrumental examinations. The article presents the clinical case of 52-year-old patient with an atypical (neurological) onset of the disease. Echocardiography revealed thrombosis of the left ventricle with a normal ejection fraction without signs of global and segmental dysfunction (4 months after neurological manifestations), which are signs of the second stage of Loeffler’s endocarditis. Despite the fact that there was no eosinophilia upon admission to the hospital, a careful study of the outpatient chart revealed a repeated increase in eosinophils (27, 77, and 64% in three studies with a two-month interval) 9 months before the onset of clinical manifestations. Despite therapy, the disease progresses with the formation of the left ventricle restrictive diastolic dysfunction (the third stage of Loeffler’s endocarditis), the signs of which were revealed 7 months after the onset of clinical manifestations.

Objective: to assess the correlations between pain severity and changes in intra-articular structures according to ultrasound and x-ray examination of the knee in patients with rheumatoid arthritis and osteoarthritis.
Material and methods: a total of 60 patients with rheumatoid arthritis and osteoarthritis (15 males and 45 females aged 22–80 years) underwent standard clinical and laboratory evaluation, ultrasound and x-ray examination of both knees (n = 120) within a week after including to the study. Patients were divided into two groups according the diagnosis: the first group – patients with rheumatoid arthritis (n = 27) and the second group – patients with osteoarthritis (n = 33). Pain severity assessed by the visual analogue scale. Synovial vascularity was assessed by using of color Doppler imaging according to the 4-grade scale.
Results: there were no significant differences between the groups of patients in terms of disease duration and pain severity, including in functional tests. A strong correlation was found between the pain severity and degree of synovial vascularity (r = 0.805, P < 0.001) and a weak correlation between the pain severity and synovial hypertrophy (r = 0.473, P < 0.001) during ultrasound examination. A moderate correlation was found between the pain severity and size of marginal osteophytes (r = 0.673, P < 0.001) and a very weak correlation between the pain severity and joint space width (r = 0.395, P < 0.001) during x-ray examination. The synovial hypervascularity in color Doppler imaging (grade 2 and 3) associated with pain severity is more typical for rheumatoid arthritis than for osteoarthritis (P = 0.001).
Conclusion: the most significant correlations between the severity of the pain syndrome, on the one hand, and ultrasound and x-ray signs, on the other hand, were determined for the synovial vascularity degree during ultrasound examination and the size of the marginal osteophytes during x-ray examination.

Extranodal diffuse large B-cell lymphoma characterized by any organ primary lesion, except for lymph nodes. The article presents a rare case of this disease with primary site in the sciatic nerve. Neurolymphomatosis is a process peripheral nerves, roots, and cranial nerves infiltration by the lymphoma cells. Ultrasound examination of the left sciatic nerve was performed in 67-years-old female patient with the use of Affinity 70 (Philips, Netherlands) with 4–18 MHz linear probe. A local intraneural fusiform, markedly hypoechoic lesion (9.5 × 2.3 × 3.5 cm), covering the entire cross-sectional area of the nerve was found at the level of the middle third of the thigh. The loss of a typical nerve ultrasound pattern, heterogeneity of the structure with linear anechoic (liquid) layers, and single signals in color Doppler imaging were revealed. Focal hyperechogenicity of tissue, corresponding to a desmoplastic reaction was found on the periphery of the lesion. Magnetic resonance imaging confirmed the presence of the intraneural mass. An open nerve biopsy showed the presence of diffuse large B-cell lymphoma. Six cycles of R-CHOP chemotherapy were performed with dynamic ultrasound assessment of the size and structure of the lesion in the intervals between them. Thus, ultrasound provides early diagnosis of focal lesion of peripheral nerves and suggests its nature at the initial stage of the diagnostic pathway.