Archives

Asteroid Hyalosis: A Mimicker of Vitreous Hemorrhage on Point of Care Ultrasound: A Case Report.

Eniola C. Gros; Lauren R. McCafferty – Ocular point of care ultrasound (POCUS) can help make timely recognition of multiple emergent ocular conditions and differentiate these from more benign conditions. While asteroid hyalosis (AH) is benign, it can easily mimic the more potentially serious vitreous hemorrhage on ocular POCUS, as both consist of numerous echogenic opacities within the vitreous with a classic “washing machine” appearance with eye movement.

The Use of Point of Care Ultrasound in Diagnosis of Peritonsillar Abscess

Brian Kohen; Melanie Perez; Jheanelle McKay; Rolando Zamora; Curtis Xu – The use of point of care ultrasound (POCUS) for diagnosis and treatment of peritonsillar abscess (PTA) is increasing [1]. Proven advantages include improved diagnostic accuracy and treatment success rates as well as decreased otolaryngology consultation, computed tomography (CT) usage, return visits to the emergency department (ED), and length of stay [1]. We present a case of a patient with a PTA that was diagnosed and successfully treated utilizing POCUS, avoiding the need for otolaryngology consultation and CT.

Acute Type A Aortic Dissection Diagnosed by POCUS in a 29-year-old Man

Vladimir Cárdenas López; Pablo Blanco – Aortic dissection (AD) is a medical emergency with a poor prognosis if not recognized early and treated promptly. In this setting, clinical data may be equivocal, while electrocardiogram, laboratory tests, and chest radiography often show nonspecific findings. In contrast, cardiac point of care ultrasound (POCUS) has proven useful in the diagnosis and detection of complications of AD. We present the case of a 29-year-old man with marfanoid habitus presenting with chest pain and acute heart failure, in whom cardiac POCUS aided in the rapid diagnosis of type A AD and pulmonary edema.

Cough Causing Abdominal Pain? A Rapid POCUS Diagnosis of Rectus Sheath Hematoma

William Noel; Brian B. Donahue – A 59-year-old man with past medical history including obesity status post gastric banding surgery and atrial fibrillation on rivaroxaban, presented to the emergency department with a complaint of focal pain to his right abdomen along with areas of visible bruising. He noted that since his diagnosis of COVID-19 a week prior, he had been having paroxysms of coughing. During one episode of coughing a few days prior to seeking medical care, the patient recalled a “ripping” sensation in his right abdomen followed by intermittent achiness and bruising to that area.

The Importance of Serial POCUS Exams – Dual Pathologies in Play

Rahul Nair; Jonathan Zuo; Ariel L. Shiloh – Serial point of care ultrasound (POCUS) exams are essential to assess acute pericardial effusions which can rapidly evolve into cardiac tamponade. A typical presentation includes dyspnea, tachycardia, and chest pain. Importantly, serial cardiac exams in such high-risk patients can detect other concurrent pathologies. We present an unusual case of a patient who initially presented with an acute circumferential pericardial effusion and upon serial POCUS exams developed an unexpected Takotsubo cardiomyopathy in the setting of cardiac tamponade.

Optimizing Care for High-Risk Multiple Pregnancy with POCUS – A Case of Quadruplet Pregnancy Early Diagnosis

Bernardo Vidal Pimentel; Christopher Tsoutsoulas; Kristin Lythgoe; Frank Myslik – Managing multiple pregnancies is challenging and requires careful evaluation. Point of care ultrasound (POCUS) has emerged as a potentially crucial tool in assessing suspected first-trimester pregnancies. However, its role in evaluating multiple pregnancies remains uncertain. We present the case of a 36-year-old Ghanaian female who presented with acute vaginal bleeding after undergoing in vitro fertilization. A bedside transabdominal POCUS identified four intrauterine gestations with fetal poles and cardiac activity, suggesting a quadruplet viable pregnancy. A subsequent transvaginal ultrasound confirmed the findings.

Role of POCUS in Assessing an Acute Aortic Thrombus

Zachary Boivin; Emily Mensel; Trent She – A 67-year-old female patient with a past medical history of hypertension presented to the emergency department (ED) with abdominal pain. She reported intermittent palpitations for the past three months, fevers for one week, and a recent admission three days prior for a pleural effusion and atrial fibrillation.

Renal Transplant Artery Stenosis and Kinking: An Unusual Association

R. Haridian Sosa Barrios; V. Burguera Vion; E. Casillas Sagrado; D. Villa Hurtado; S. Jiménez Álvaro; I. Martín Capón; M. Fernández Lucas; Maite E. Rivera Gorrín – Renal artery stenosis of the kidney allograft is an infrequent finding, as is mechanical kinking of the artery. The right renal artery’s greater length in comparison to the vein, limited space within the iliac fossa, and post-operative shifting in graft components all increase the likelihood of kinking. Renal artery stenosis and kinking can either coexist or kinking can result in stenosis. Nevertheless, since both these abnormalities can be corrected with timely treatment, early diagnosis is crucial to prevent permanent to the renal allograft.

Troubleshooting Paracentesis Using POCUS

Angelina Voronina; Nachele Aurelien; Edward Bergin; Paula Roy-Burman – Paracentesis is a procedure routinely performed at the bedside in the evaluation and management of ascites. While point of care ultrasound (POCUS) assistance during paracentesis is known to reduce the risk of procedure-related complications, intraprocedural POCUS to overcome commonly occurring issues, such as obstructed flow through the centesis catheter, remain poorly described.

Twinkle Artifact Observed During POCUS of a Human Myiasis Caused by the Dermatobia hominis Botfly

David Jerome; Matthew Stacey; Joseph Newbigging – An 81-year-old man presented to urgent care for assessment of an area of erythema and tenderness on his right thigh after recent travel to Belize. Point of care ultrasound (POCUS) revealed a hyperechoic structure with acoustic shadowing in the subcutaneous tissue. Colour Doppler assessment of the structure produced a twinkle artifact. The structure was removed and pathology identified the object as a Dermatobia hominis larva (human botfly).