Saving Brainspace with POCUS
February 8th, 2018
Here is a cool case that Lloyd Gordon recently sent us...
"A 60 year-old woman had a fever of 39.[...]
Cases
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 […]
Shoulder pain from eating hamburgers?! Find the Dx with POCUS
While eating a hamburger, an 85 year-old obese woman felt a sudden and sharp pain in her right shoulder. Although she has a past history of rhematoid arthritis, she had no prior shoulder pain. She was also taking coumadin for atrial fibrillation. On arrival, she was unable to move her arm. Several diagnoses come to […]
Don’t let bilious patients get you down
This patient complained of a really vague lateral LUQ discomfort, possibly post prandial (I got that history after I saw the GB on POCUS). She looked fine and the physical exam was unhelpful. I really didn’t know what was going on (doesn’t sound very inspiring) so I just looked around with the probe. Pleura/Lung/CVS/LKKS/IVC/Aorta all […]
POCUS = Better ED throughput
The E-FAST exam is often discussed in the lit for the evaluation of major trauma cases. But I must use it at least as often in minor trauma. I recently saw a 44 y.o. male who had fallen off a ladder and landed on his right side on hard ground. The fall occurred on the […]
Arm DVT
Dr. Lloyd Gordon has a case of proximal arm DVT to share. Like doing a scan for proximal leg DVT, looking for lack of vein compressibility is key but in the majority of cases if you look carefully you will see some clot in the lumen with varying amounts of echogenicity. So while most of […]
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