Ruptured Achilles Tendon
Imaging the Achilles tendon is technically easy and a nice way to rapidly confirm your diagnosis of tear. Always compare to the unaffected side. Beware anisotropy which can make sections of any tendonous structure look black and torn. If the ultrasound beam is interrogating a section of tendon away from 90 degrees it can look […]
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 […]
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 […]
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.
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. […]
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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