Acute Upper Extremity Arterial Occlusion Diagnosed on POCUS in the Emergency Department

Derrick Huang, MD; Jacob Ruzicka, MD; Leoh León, MD; Latha Ganti, MD, MS, MBA, FACEP – Upper extremity acute limb ischemia (ALI) is a limb-threatening and potentially lethal pathology that is most commonly caused by vascular embolization. Outcomes of limb ischemia are time-sensitive due to the correlation between a longer time from symptom onset to intervention with a vastly higher risk of amputation. In this report, point of care ultrasound (POCUS) was utilized to rapidly diagnose a patient with a proximal right brachial artery embolic occlusion, prompting expedited surgical consultation and successful embolectomy.

Sonographic Features of a Tuberculous Cold Abscess:A Case Report and Literature Review

Figure 3: Axial view of the plain CT thorax showing low density collection in the pectoralis major muscle of the left hemithorax (a) with underlying costochondral junction showing break in cortex (b). – Tuberculosis (TB) remains a global public health concern; most notably in endemic countries where there is a rise in its incidence. Although primary pulmonary involvement accounts for the majority of TB cases, extrapulmonary tuberculosis (EPTB) is rapidly growing in high income countries.

Virtual Supervision of Third Year Medical Students Using Handheld POCUS Devices and Cloud-based Image Archiving Provides Opportunity for Feedback and Skill Improvement

Sydney Murray, BSc; Krista Trinder, MSc; Linden Kolbenson, MD; Jeremy Katulka, MD; Paul Olszynski, MD, MEd – Feedback on Point of Care Ultrasound (POCUS) skills is essential for skill development. Providing feedback can be difficult in a large province with several distributed medical education sites. Use of handheld POCUS devices and a cloud-based image archiving enables virtual supervision. We evaluated the quality of uploaded images as well as feedback provided to students.

POCUS for Diastolic Dysfunction: A Review of the Literature

Samantha A. King, MD; Alexis Salerno, MD; Jessica V. Downing, MD; Zachary R. Wynne, MD; Jordan T. Parker, MD; Taylor E. Miller, MD; Semhar Z. Tewelde, MD – Emergency and critical care physicians frequently encounter patients presenting with dyspnea and normal left ventricular systolic function who may benefit from early diastolic evaluation to determine acute patient management. The current American Society of Echocardiography Guidelines approach to diastolic evaluation is often impractical for point of care ultrasound (POCUS) evaluation, and few studies have evaluated the potential use of a simplified approach.

Hickam’s Dictum Incarnate: A Case of Simultaneous Left-Sided Urolithiasis and Ruptured Iliac Artery Aneurysm  

Melissa Bouwsema, MD; Colin Bell, MD – A 51-year-old man with a history of nephrolithiasis presented to the Emergency Department after a sudden onset of left-sided groin pain and syncope. At presentation, he described his pain as similar to prior renal colic episodes. At his initial assessment, point of care ultrasound (POCUS) was used, which revealed findings consistent with obstructive renal stones, as well as a substantially enlarged left iliac artery.

Point of Care Ultrasound (POCUS) in Bedside Diagnosis of Pyomyositis  

Olusegun Oduyoye, MBBS, MSc, FHEA, FRCPE; Euan Thomas, BSc, MSc
– Pyomyositis is an acute bacterial infection of skeletal muscle that results in localised abscess formation presenting with symptoms, including pain, swelling, erythema, and fever. It is usually associated with tropical climates; however, there has been an increasing number of cases presenting with pyomyositis in patients with a history of intravenous drug use [1-3].

The Takotsubo Syndrome: Clinical Diagnosis Using POCUS  

Josu López Libano, MD; Lorenzo Alomar Lladó, MD; Leire Zarraga López – Takotsubo syndrome is a cardiomyopathy that can mimic an acute heart attack, in terms of clinical presentation, electrocardiographic changes, and findings on echocardiogram. Point-of-care-ultrasound (POCUS) can be used to detect this condition, even though the definitive diagnosis is made angiographically.

Impact of Point-of-Care Ultrasound in Medical Decision Making: Informing the Development of an Internal Medicine Global Health POCUS Curriculum  

Michelle Fleshner, MD MPH; Steve Fox, MD; Thomas Robertson, MD; Ayako Wendy Fujita, MD; Divya Bhamidipati, MD; Thuy Bui MD – Point-of-care Ultrasound (POCUS) is particularly useful in low-middle income countries (LMICs) where advanced imaging modalities and diagnostics are often unavailable. However, its use among Internal Medicine (IM) practitioners is limited and without standard curricula. This study describes POCUS scans performed by U.S. IM residents rotating in LMICs to provide recommendations for curriculum development.