Introduction: Thoracic Outlet Syndrome (TOS) describes compression of neurovascular structures in the thoracic outlet. Dynamic ultrasound is valuable in evaluating vascular TOS using positional arm manoeuvres. In this presentation we outline key techniques, measurements, and important pitfalls outlined in the literature.
Methods: Ultrasound assessment typically uses colour and spectral Doppler to examine baseline flow and vessel calibre in rest position, then with arm abduction and provocative positions (military brace position) to reproduce symptoms that patients experience. The dynamic assessment allows for clinicians to observe changes in vessel diameter, flow pattern, narrowing of the venous and arterial vessels.
Results: These findings can suggest a diagnosis of vascular TOS when correlated with symptoms and arm manipulation. Dynamic imaging also helps to identify specific compression sites such as the costoclavicular space). Contrastingly, there are pitfalls to accurately diagnosing TOS. Provocative manipulation to arm can trigger findings of TOS in asymptomatic individuals, with studies showing significant arterial waveform changes in a substantial proportion of healthy subjects during provocative tests. Ultrasound is also operator dependent, which can contribute to false positives or false negatives. Finally, there are lack of universally standardised imaging protocols further complicates diagnosis.
Conclusion: Dynamic ultrasound remains a valuable diagnostic assessment to assess TOS when performed with technique and protocol outlined in the literature.

Introduction: Carotid intima-media thickness (IMT) is a well-established noninvasive surrogate marker of atherosclerosis. Risk factors like diabetes mellitus, hypertension, hyperlipidemia, smoking, and lifestyles accelerates vascular thickening, but comparative data on manual versus automatic IMT measurement methods across imaging planes remain limited.
Methods: The IMT was assessed by manual measurements and with the newly developed B-mode ultrasound IMT measurement software. Approximately 30 young healthy male volunteers from Health Sciences students were included in the study. The manual measurements of the CCA-IMT were performed using the automated range calibrated trackball on the scanner approximately at 10 mm proximal to the carotid bulb. The average of three measurements was taken in consideration. The Manual IMT measurement was taken by one operator and the automated IMT measurement was taken by another operator who was blinded to other operator. The intra- and interobserver reliability of the automatic detection and manual measurements were analyzed.
Expected Results: - We expect that IMT measurements will be the same. Automatic measurements will strongly correlate with manual readings, with narrow limits of agreement, and reduced observer variability. - Longitudinal and transverse views will yield similarly reliable IMT values, though plane-dependent variance may emerge.
Expected Conclusions: Automatic measurement systems can reliably assist manual methods, enhancing repeatability and reducing operator dependence.
Take home message: These findings support expanded use of manual or automated IMT assessment in clinical vascular screening.

Introduction: Fibromuscular dysplasia is a clinically significant, non-atherosclerotic arterial disease that has been reported in most arterial beds commonly assessed with Duplex ultrasound. Despite this, the condition remains poorly understood by some sonographers and referrers, which can lead to misdiagnosis or inappropriate management.
Methods: This presentation will review the ultrasound features of fibromuscular dysplasia, including characteristic velocity changes, flow disturbance, vessel tortuosity, and arterial beading, along with key probe selection and patient positioning considerations. Current literature recommendations for disease description and reporting will also be discussed.
Results and Conclusion: The understanding of fibromuscular dysplasia continues to evolve, adopting a contemporary approach to identification, description, and reporting is important to support accurate diagnosis and optimal patient management.