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• Case of the Week - Case # 94

  18-year-old G1P0 female presents with spotting and cramping. Her vitals are stable and she is afebrile. Your resident states he sees an IUP and notices the flicker of the cardiac activity. You perform a focused ultrasound and note the following...... Posted Sep 22 2008, 11:42 PM by Rob with | with no comments Filed under: Intermediate, Advanced, Pregnancy, Pelvic US

• Case of the Week - Case # 93

  25-year-old male presents with recurring right hand swelling three weeks after punching a glass window. You perform a focused ultrasound and note the following...... Posted Sep 15 2008, 11:02 PM by Rob with | with no comments Filed under: Intermediate, Advanced, Musculoskeletal, Hand, trauma, Foreign body

• Case of the Week - Case # 92

  34-year-old female with left lower abdominal pain and spotting. She has a quant of 786. Her vitals are stable and she is afebrile. You perform a focused ultrasound and note the following...... Posted Sep 08 2008, 05:14 PM by Rob with | with 2 comment(s) Filed under: Pelvic, Beginner, Intermediate, Advanced, OB, Pregnancy, Pelvic US

• Case of the Week - Case # 91

  48-year-old male presents with severe upper abdominal pain that was sudden in onset. The patient has no PMH although he relates a history of heavy ETOH abuse. His vitals reveal a stable BP but the patient's heart rate is in the 130's. His abdominal exam reveals exquisite tenderness with guarding in the midepigastric and RUQ regions…... Posted Sep 02 2008, 12:01 AM by Rob with | with no comments Filed under: FAST, RUQ, Intermediate, Advanced, Pelvicerforated viscus

• Case of the Week - Case # 90

  A 54-year-old male presents with a significant UGI bleed. He seeks his care at an outside hospital and you have no records for him at your hospital. Due to his GI bleeding, you want to fluid resuscitate the patient but are concerned due to his CHF history. You perform a focused echo to assess for global LV function and note the following…... Posted Aug 25 2008, 09:25 AM by Rob with | with no comments Filed under: Beginner, Intermediate, Advanced, Cardiac, CVP

• Case of the Week - Case # 73

  74-year-old white female presents with dyspnea for two days. On examination, you notice that her heart sounds are muffled and you performed a focused ultrasound to assess for pericardial effusion...... Posted Apr 30 2008, 02:09 AM by Rob with | with no comments Filed under: Intermediate, Advanced, Cardiac

• Case of the Week - Case # 66

  An 87-year-old female nursing home resident presents to the ED hypotensive after a fall. The patient has a history of organic brain syndrome, a fib on coumadin, hypertension, coronary artery disease, hypothyroidism and gout. The patient is nonverbal. Her vitals signs are as follows: BP 62/40, HR 108, RR 26 and PO of 95%. Her physical examination reveals multiple abrasions and a large ecchymotic region in the left flank and left lateral thorax. You perform a FAST exam to evaluate her for the hypotension. Her pericardial window reveals no evidence of pericardal effusion or tamponade. Her perihepatic and pelvic windows were negative. You note the following on her perisplenic window...... Posted Mar 04 2008, 04:57 PM by Rob with | with no comments Filed under: FAST, Advanced, trauma

• Case of the Week - Case # 61

  A 23-year-old female presents with vaginal bleeding and lower abdominal pain. She is approximately 6 weeks pregnant by date and has a positive bedside UCG. Her vitals are as follows: BP 88/46, HR 122, RR 24 and T 37.1C. Her physical exam reveals moderate lower abdominal tenderness with guarding. She has mild, nonclotted blood in the vaginal vault but bimanual examination is limited due to pain. You are concerned about an ectopic pregnancy and perform a bedside ultrasound...... Posted Jan 30 2008, 09:36 PM by Rob with | with no comments Filed under: FAST, Pelvic, Intermediate, Advanced, Pregnancy

• Case of the Week - Case # 53

  A 56-year-old male with PMH of chronic alcoholism and Hepatitis C presents to the ED with 2 days of right hand pain. Pt states he is not sure what happened. He remembers being in an altercation and being pushed down several steps. He adds that he is concerned that he was bit because the assailant had bitten him on his back last year during a fight. His vital signs are stable. His plain radiographs are negative for fracture or ROFB. His labs are normal with the exception of an elevated CRP and ESR. On examination, fusiform swelling of the right ring finger is noted with a wound note proximally. He is holding his finger in a preferred flexed position and is unable to completely straighten his finger. You consult the hand service due to your concern of a flexor tenosynovitis. The hand fellow forcibly straightens out the finger and states: "See this is just a simple cellulitis. Admit the patient to medicine." You perform a focused ultrasound and note the following: ... Posted Dec 03 2007, 02:03 PM by Rob with | with no comments Filed under: Advanced, Musculoskeletal, Hand

• Case of the Week - Case # 52

  48-year-old white male presents to ED 5 days after crush injury at work with a heavy wooden box. For the past few days he has been experiencing worsening pain, redness and swelling in this right index finger. His vital signs are stable and he is afebrile. On examination, you notice fusiform swelling of the digit with erythema and an open wound. His is holding his finger in a partially flexed position and states it is too painful to extend the digit. His plain films of the hand are negative for fracture. You perform a focused ultrasound to assess for the presence of an abscess and a flexor tenosynovitis.... Posted Nov 26 2007, 11:52 PM by Rob with | with no comments Filed under: Advanced, Musculoskeletal

• Case of the Week - Case # 29

  A 64-year-old white female with a PMH of metastatic breast CA, hypertension, osteoarthritis and peripheral vascular disease presents to the ED after being noted by family to have mental status changes.... Posted May 30 2007, 11:27 PM by Rob with | with no comments Filed under: Advanced, Cardiac

• Case of the Week - Case # 25

  26-year-old male with severe bullous lung disease presents to the ED with severe right sided pleuritic chest pain. His vitals are stable and he is not hypoxic. His upright CXR reveals the severe bullous disease but no obvious pneumothorax. You perform a thoracic ultrasound and note the following...... Posted May 02 2007, 01:40 AM by Rob with | with no comments Filed under: Beginner, Advanced, lung

• Case of the Week - Case # 19

  84 y.o. BF with history of HTN, CAD, CHF and A fib (on Coumadin) presents with nontraumatic right shoulder pain. Her vitals are stable and her temperature is 38.1 C. On physical examination, you note the obvious swelling of the right shoulder. She has good passive range of motion but it causes moderate pain. Her plain x-rays of the shoulder reveal DJD and “soft tissue swelling” but no acute fracture or dislocation. Her labs include the following: WBC count-12.84, ESR-54, CRP-8.1 and INR-3.7. You perform an ultrasound of her right shoulder...... Posted Mar 14 2007, 12:00 AM by Rob with | with no comments Filed under: Intermediate, Advanced, Musculoskeletal

• Case of the Week - Case # 13

  17 y.o male presents stating “I need an abscess on my foot drained again.” Patient reports that about once a year he needs to get an abscess drained in the same place on his foot. He denies past trauma or known FB. Patient has no other PMH and he is afebrile with stable vital signs. On examination, he has a slightly erythematous raised area on the dorsum of his foot. There is no fluctuance noted.... Posted Jan 24 2007, 12:22 PM by Rob with | with no comments Filed under: Advanced, Musculoskeletal, Procedural ultrasound, Abscess, Foreign body

• Clinical Case # 4

  44-year-old female presents with right flank pain of two-months duration. She was diagnosed with pyelonephritis six weeks earlier and urine culture revealed E. coli. The patient could not afford the antibiotics and therefore has not been treated. She relates having fevers on and off, chills and cloudy urine. Her vitals are stable...... Posted Nov 22 2006, 05:05 PM by Rob with | with no comments Filed under: Renal, Intermediate, Advanced, UTI