Cases
Incidental findings on Renal POCUS
One of the exaggerated fears that was voiced by imaging specialists when POCUS/EDE was first developing was that a whole host of abnormalities would be found on bedside ultrasound that would lead to lots of unnecessary confirmatory tests. The reality is that this fear has not been borne out. Incidental findings on POCUS are few […]
Hypothermic Heart on POCUS
This never-ending winter reminded me of hypothermia case that I saw a number of years ago. It was an elderly female in her mid-70s with an unclear history. She was found on the ground at the entrance to her home by family one morning in the middle of winter. EMS was activated. She was found […]
Exploring airway pathology with POCUS
One of my colleagues suspected a subtle presentation of airway problems. A CXR was ordered which suggested something pushing the trachea over to the right. A previous CXR was similar but not as pronounced. A CT showed a mass, looking like a Thyroid Colloid Cyst. As predicted, it was pushing on the trachea. I […]
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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
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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