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.
M. Bryan Dalla Betta, DO; Dasia Esener, MD; William Swanson, MD; Andrew Kaddis, MD; Felipe Aguayo Romero, MD; J. Matthew Fields, MD – Sepsis is a syndrome characterized by infection, widespread inflammation and organ dysfunction affecting millions of people in the United States and across the globe each year. Despite recent improvements in sepsis care, it is still associated with high rates of morbidity and mortality, accounting for nearly 270,000 deaths and treatment costs over $20 billion in the United States annually.
Hadiel Kaiyasah, CABS FACS ESCP; Lamis Abufool, MBBS; Labib Al Ozaibi, CABS ESCP – Pilonidal sinus is a common problem encountered in proctology clinics. It has a wide spectrum of clinical picture ranging from a single asymptomatic pit to a more complex disease with multiple sinuses and secondary openings.
Salman Naeem, MBBS, Dip IMC, PG Cert Medical ultrasound; Christopher Edmunds, MBChB, FRCEM, FFICM, FIMC2; Thomas Hirst, MA, MBBS, MSc, Dip IMC; Julia Williams, PhD, BSc FCPara FEA4; Amir Alzarrad; James Ronaldson; Jon Barrat, RAMC, FRCEM, FIMC, DMCC; East Anglian Air Ambulance Research, Audit, Innovation and Development (RAID) Group; PreHospital Trainee Operated Research Network (PHOTON) – Point of care ultrasound (POCUS) has become a common practice in prehospital care over the last 10 years. There is lack of literature on its use and governance structure in United Kingdom (UK) prehospital care services.
Jacob E. Sundberg, MD; Ankit Mehta, MD – Point of care ultrasound (POCUS) is a reliable diagnostic tool for the evaluation of a patient with dyspnea. This case provides an example of an acutely dyspneic patient in which standard evaluation failed to elucidate the true etiology of the patient’s dyspnea.
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.
Brian Kohen, MD; Michael Halperin, MD MPH; Gloria Felix, MD; Trevor Dixon, MD; Michelle Montenegro, MD; Fenil Patel, MD – Necrotizing fasciitis is a life-threatening polymicrobial skin and soft tissue infection that requires prompt diagnosis and treatment. Delays in diagnosis and treatment can result in an increase in morbidity and mortality . Necrotizing fasciitis has historically been a clinical diagnosis. Patients with a high clinical suspicion for necrotizing fasciitis generally receive antibiotics and undergo emergent surgical debridement.
Cassidy Miller, OMS-III; Louisa Weindruch, OMS-III; John Gibson, MD –
Andrew A. Moses, MD MA; Hilda E. Fernandez, MD – Advances in the use of ultrasonography can enhance our ability to better characterize acute kidney injury (AKI). AKI is a clinical syndrome characterized by a rapid decrease in kidney excretory function with the accumulation of products of nitrogen metabolism and other clinically unmeasured waste products, and may proceed to include clinical manifestations including decreased urine output, development of metabolic acidosis, and electrolyte abnormalities.
Randi Connor-Schuler, MD; Jonathan Suarez, MD – Acute kidney injury (AKI) is a significant problem for patients admitted to the intensive care unit (ICU), both due to the high incidence and associated mortality with rates of AKI requiring renal replacement therapy (RRT) of over 5%, and mortality rates with AKI of over 60%.