Water-bath method for sonographic evaluation of superficial structures of the extremities in children

High-resolution sonography using a stand-off pad or a gel mound is a standard technique for the evaluation of soft-tissue structures of the hands and feet in children. However, the complex curved surfaces of the hands and feet often yield suboptimal contact between the transducer and the skin. Additionally, the small field of view, relative compressibility of the soft-tissue structures by the transducer, patient motion and discomfort from contact of the transducer with the pathology often limit conventional US evaluation. A water-bath technique overcomes these limitations. We present our experience of water-bath technique of superficial sonography in 23 children. Water-bath technique was performed with good patient cooperation and was superior to the standard technique for depiction of shallow skin ulcers, subcutaneous masses, vascular malformations, osteomyelitis and foreign bodies.