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• Case of the Week - Case # 78

  52-year-old laborer presents with swelling to his right middle finger two days after sustaining a puncture wound with a piece of metal. His vitals are stable and he is afebrile. His physical exam is unremarkable with the exception of fusiform swelling and erythema of the digit. There is no evidence of lymphangitis or clinical evidence of an abscess. You perform an ultrasound and note the following...... Posted Jun 03 2008, 02:08 AM by Rob with | with no comments Filed under: Intermediate, Musculoskeletal, Abscess

• Case of the Week - Case # 64

  A 27-year-old male presents to the ED after injuring his right leg. He states that he tripped while running down some stairs and adds he believes he twisted his knee prior to hitting the ground at the base of the stairs. On examination, he has a large knee effusion. His x-rays are negative for fracture per radiology. Orthopedics attempted to aspirate the effusion prior to splinting the leg. You perform an ultrasound prior to performing your attempt and note the following...... Posted Feb 19 2008, 11:03 PM by Rob with | with no comments Filed under: Intermediate, Musculoskeletal, Procedural ultrasound

• 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 # 49

  A 39-year-old male presents to the ED with a swollen left ankle. He states he was bit by his cat two days ago and has noted progressive pain and redness. On examination, the patient is febrile at 38.4 C and his exam reveals extensive erythema over the ankle with several puncture wounds noted medially. You consult the ortho service due to your concern that the patient has more than a simple cellulitis. The ortho resident tells you this is "just a cellulitis" and tells you to admit the patient to medicine. You perform a bedside ultrasound and note the following...... Posted Oct 30 2007, 01:00 AM by Rob with | with no comments Filed under: Intermediate, Musculoskeletal

• 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

• Case of the Week - Case # 10

  A 67-year-old female presents to the ED with posterior knee pain. Your resident has just completed an orthopedics rotation and is convinced that the patient has a baker’s cyst. She is moderately obese and physical examination reveals no definitive... Posted Jan 03 2007, 05:02 AM by Rob with | with no comments Filed under: Beginner, Intermediate, Case, Musculoskeletal, DVT

• Case of the Week - Case # 8

  An 8-year-old male presents presents from the pediatric clinic with painful swelling of the right groin. He had been seen also in the clinic by pediatric surgery and he was referred to the ED for further evaluation since the diagnosis could not be made... Posted Dec 20 2006, 10:00 AM by Rob with | with no comments Filed under: Beginner, Musculoskeletal, Abscess, Foreign body