Palpation ligaments

This lesion can occur when the erect penis is forcibly displaced towards the feet (Pryor and Hill 1979). Diagnosis of rupture of the suspensory ligament is made by history and by palpation of a gap between the base of the shaft of the penis and the symphysis pubis. An abnormal angle is noted during erection. Ultrasonography is able to document the gap between the pubis and the penile shaft and associated hematomas of the soft tissues (Fig. 12.5), but usually does not provide additional useful information (Bertolotto and Pozzi Mucelli 2004). 

Ligaments are tough fibrous bands that connect bone to bone. Because they lie very deep, they are difficult to palpate. Some are not accessible to palpation. 

The carpal tunnel is almost invariably injected blindly after palpation of the flexor carpi radialis tendon, which is a good landmark to assess the position of the median nerve. Transverse and longitudinal planes may be helpful to confirm the adequate location of the needle tip relative to the flexor tendon. Because the median nerve is usually displaced from its location after release of the transverse carpal ligament, local injections to treat postsurgical recurrences are difficult without imaging guidance. In these cases, US may help to determine the position of the nerve and to mark the skin in order to ensure a safe local injection. 

Interpretation of lOUS includes the sonographic information combined with intraoperative inspection and palpation. Surgical mohilisation of the liver with dissection of the falciform ligament is of great help, as it provides easy access to all parts of the organ. Complete visualisation of the liver including its posterior aspect requires insonation from the anterior, lateral and posterior approach. The examination usually takes 10-15 min. 

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