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Cases

Scrotal ultrasound: it’s what’s inside that matters

March 31, 2014 0 Comments
Scrotal ultrasound: it’s what’s inside that matters

Editor’s note: Testicular torsion is a scary condition that we can’t afford to miss.  It cannot be diagnosed on history and physical alone in almost 50% of cases so ultrasound is crucial to decision-making.  POCUS can be extremely helpful in detecting the torted testis but it is important to understand that a partially torted, or […]

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What’s that red thing doing in an abscess??

March 24, 2014 0 Comments
What’s that red thing doing in an abscess??

At the course and in the book, we suggest that physicians should be wary of important neighboring structures. Even with EDE/POCUS guidance for abscesses, this is still a pitfall. I recently saw a young male who is an IV drug abuser. Yes, we do have those in Sudbury! He had injected himself and developed an […]

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Dr. Gordon doesn’t like failed I&Ds

March 16, 2014 0 Comments
Dr. Gordon doesn’t like failed I&Ds

I really don’t like doing an I&D and then finding nothing or no pus anyway. I find it helpful to know just where the pus is, where it goes, if there’s something else besides pus, or if it needs serious surgical intervention. Once I looked at neck swelling that didn’t look too horrible but the […]

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How do you like your liver?

March 4, 2014 0 Comments
How do you like your liver?

With POCUS we teach beginners to focus on the most basic knobology, physics, and imaging of the area that will answer their simple clinical question.  When mastering the FAST scan it’s all about focussing on the free fluid, don’t get distracted by anything else going on. With more experience however, we all start to appreciate […]

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POCUS for Aortic Dissection – A Case

February 27, 2014 3 Comments
POCUS for Aortic Dissection – A Case

It was 10pm on a busy shift in the emergency department. A 69 year-old man presented with sudden onset retrosternal chest pain radiating to his back. The pain lasted an hour and then resolved spontaneously. He drove himself to the ED for assessment. His initial ECG at triage was normal. While in the ED, he […]

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Dr. Gordon: Examples of Hydronephrosis

February 21, 2014 0 Comments
Dr. Gordon: Examples of Hydronephrosis

Hydronephrosis is a nice thing to see. Generally speaking you know the diagnosis when you see it. When it’s severe it’s pretty obvious. One of the pictures here is from a patient with a blocked nephrostomy tube. The pelvis is basically blown up like a balloon in the center of the kidney. Not too hard […]

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Another reason to use POCUS for Central Lines

February 11, 2014 0 Comments
Another reason to use POCUS for Central Lines

It’s easy to forget that POCUS not only increases our success and reduces our complication rates for inserting central lines, it also helps us avoid putting lines where they don’t belong! While most clots will be visible a significant number can only be appreciated by the lack of compressibility of the vein.  Below is another […]

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More bowel POCUS: A case of diverticulitis

February 4, 2014 0 Comments
More bowel POCUS: A case of diverticulitis

This patient had LLQ pain. POCUS with the linear transducer and virtual concave on showed a tender area over the colon here and a small area of free fluid with the small bowel peristalsing around in the fluid. From this I made the diagnosis of diverticulitis. The CT confirmed this: a small area of oedematous sigmoid […]

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Dr. Gordon brings up a case of gastro

January 29, 2014 0 Comments
Dr. Gordon brings up a case of gastro

This child was ~ 5 years old. Previously well. One day history of lots of vomiting and diarrhea. Looked pretty wiped out. Nothing specific to find on exam. POCUS revealed the maximum IVC diameter to be much less than the aortic diameter. According to some paediatric studies in normal patients the two diameters should be […]

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When superficial thrombophlebitis isn’t benign

January 22, 2014 0 Comments
When superficial thrombophlebitis isn’t benign

A 57 year old woman presented to the ED with left leg pain and swelling for a week. She had no past medical history, and no risk factors for DVT. On examination there was a palpable superficial cord running along the medial leg from the knee to the groin. This cord was erythematous, warm and […]

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