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Don’t be subtle: Use POCUS for hard to see fractures

August 24, 2014 0 Comments
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 […]

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POCUS and recurrent abdominal pain in the elderly

August 20, 2014 0 Comments
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 […]

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Pilonidal Abscess: Hair today, gone tomorrow

August 16, 2014 1 Comment
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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Glass FB in Palm

August 12, 2014 0 Comments
Glass FB in Palm

This guy got a glass FB in his hand a couple of weeks earlier. You could sort of imagine a little bump and a little mark. POCUS clearly showed it ~ 1 mm deep. I made an X and (luckily) fished it out. I took a lousy picture with my obsolete Palm Treo showing the […]

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Purulent tenosynovitis on POCUS

August 8, 2014 0 Comments
Purulent tenosynovitis on POCUS

This is from a fellow with the classic high pressure air/water injected in his hand a few days earlier. You can see the pus next to the tendon.

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Viral Parotitis

August 3, 2014 0 Comments
Viral Parotitis

A 9 month old child presented to the ED. URTI symptoms, fever and swelling below the left ear. The child looked well with a fullness near the left angle of the jaw. POCUS revealed a swollen parotid with a Swiss-cheese like appearance. I checked the other side for a control but it looked the same. […]

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Lots of Gallbladder views for the album

July 28, 2014 0 Comments
Lots of Gallbladder views for the album

One of my colleagues found a nice gallbladder. I took some pictures of it after my shift was over-clearly I’m getting a bit obsessed here. It illustrates a number of findings suggestive of cholecystitis.   There are a number of views here. Some from under the right ribs anteriorly, some from through the chest wall […]

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Colles and POCUS

July 24, 2014 2 Comments
Colles and POCUS

I like to use POCUS for hematoma blocks and Colles fractures. Here’s one. I first mark the most obvious area of the radial fracture. Then I aim from slightly cephalad at a 45 degree angle to inject the fracture. By the way, I’ve never actually seen the hematoma in the “hematoma” block. I then follow […]

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Staghorn Calculus

July 20, 2014 0 Comments
Staghorn Calculus

This fellow had a chronic history of renal stones (also a stent). The POCUS showed his collecting system filled with calculus. The entire calyceal system and pelvis was packed with stones.

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Take the appendix challenge

July 17, 2014 0 Comments
Take the appendix challenge

Do you want to improve your imaging skills safely?  Then take challenges like this case from Dr. Gordon.  When you have someone waiting to get a CT for appendicitis, look for the appendix yourself with POCUS.  If you see it and still can’t convince your surgeon to go to the OR, then getting an elective […]

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