Cases
Smith’s Fracture
This patient had a displaced looking wrist. However the POCUS didn’t look particularly displaced at all. I was wondering about the discrepancy but not enough to get the old brain in gear (do U/S waves cause dementia in the operator?). I should have learned from my last POCUS on a Smith’s that they look very […]
Dr. Richard on Armpits, Metal Rods, Pus, and T-shirts
Here’s a neat case from Dr Bernard Richard from Valleyfield in la belle province… A 30 y.o. man fell on a metal rod a week ago. He was seen in the ED and had his 10 cm right axillary wound sutured. I saw him a week later for 4 cm lump that was located 15 […]
Nobody expects the liver abscess
I reviewed the computer charting, elderly lady with one day history of fever, vomiting, diarrhea and confusion. Sounded like a boring old gastro, give her fluids, take cultures and refer. No need to drag the U/S to the room when I’m already behind and pressed for time. Still, spare the probe and spoil the patient. […]
Time is testicle!
Scrotal EDE is one of the topics that Greg presents at EDE 3. While not a life-threatening entity (try telling that to an 18 y.o. male!), it still carries with it significant morbidity. Ultrasound is key to the diagnosis and can help assess the success of attempts at de-torsion. I recently saw an 18 y.o. […]
Weird Symptoms
This patient was in his 70s with the usual litany of diseases and medications. He actually looked quite well. He complained of pain from his R neck to his R flank. The physical exam was not helpful. I had no inkling of what was wrong. I POCUS’ed his carotids/jugulars/CVS/Aorta/Kidneys/liver/spleen/bladder and all looked fine. His GB […]
Don’t become Jaundiced about POCUS
This patient came in with jaundice and the LFTs were elevated. They had had a cholecystectomy in the past. POCUS revealed a large dilated fluid-filled structure in the RUQ. After looking at the kidneys/liver +/- Doppler it became clear it was a very dilated CBD. CT confirmed the biliary dilatation and obstructing mass. [Ed. note: […]
Gas Gangrene
An elderly woman was sent to the ER by her senior’s residence in the middle of the night for bloody stools. The triage nurse found out that there was no blood but there was pus coming from her rectum. There was a very red and swollen area starting from the anus and extending onto her […]
Don’t be subtle: Use POCUS for hard to see fractures
A young man had clinically a distal radius fracture. The X-ray looked negative to myself and the radiologist. But with a little bit of fiddling I found the # on U/S. Before I would have said this was a Salter fracture through the epiphysis. POCUS clearly showed the # proximal to the epiphysis. Another fellow […]
POCUS and recurrent abdominal pain in the elderly
A 82 yr. old patient came in for chronic recurrent epigastric pain. A CT was done on the previous admission which showed pancreatic calcifications, consistent with chronic pancreatitis. On this visit the patient had a similar presentation. She looked well, with a pretty benign abdomen and normal labs. I was pressed for time and didn’t […]
Pilonidal Abscess: Hair today, gone tomorrow
This may seem like overkill; POCUS for an obvious abscess. Still it was interesting to see the ingrown hair inside the abcess. Also the point of maximal induration was not where the actual abcess was, strangely enough. So in the end the POCUS showed not only that the abscess was ready to be drained but where […]
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