Archives

Sonographic Crepitus, a Point-of-Care Ultrasound Finding  

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 [1]. 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.

Diagnosing Paget-Schroetter Syndrome Using Point of Care Ultrasound (POCUS)  

Khaled Taha, MD, MSc, MRCP, MRCEM; Tomás Breslin, MD, MRCP, FRCEM; John M. Moriarty, MD, FSIR; Shammy Ali, MBBS, MD; Bernhard Louw, MBChB, DipPEC (SA) – Paget-Schroetter Syndrome, or effort thrombosis, is a relatively rare disorder. It refers to axillary-subclavian vein thrombosis (ASVT) that is associated with strenuous and repetitive activity of the upper extremities [1]. Anatomical abnormalities at the thoracic outlet and repetitive trauma to the endothelium of the subclavian vein are key factors in its initiation and progression. Doppler ultrasonography is the preferred initial test, but contrast venography is the gold standard for diagnosis [1,2].

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.

Avulsion Fracture of the Anterior Superior Iliac Spine in a Young Athlete Detected by Point-Of-Care Ultrasound  

Takaaki Mori, MD, MRCPCH, MSc; Takateru Ihara, MD; Osamu Nomura MD, MA, PhD – Pelvic avulsion fractures (PAFs) are rare and specific to adolescents and young athletes [1, 2]. Owing to their stage of musculoskeletal development, forceful contractions of muscles or tendons during sports activities frequently cause a PAF to occur in any of four anatomical sites, including the iliac crest, anterior superior iliac spine (ASIS), anterior inferior iliac spine (AIIS), and ischial tuberosity [1, 2].

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.

Ultrasound Image Quality Comparison Between a Handheld Ultrasound Transducer and Mid-Range Ultrasound Machine  

Nayema Salimi, MD; Antonio Gonzalez Fiol, MD; N. David Yanez, PhD; Kristen L. Fardelmann, MD; Emily Harmon, MD; Katherine Kohari, MD; Sonya Abdel Razeq, MD; Urania Magriples, MD; Aymen Alian, MD – Not all labor and delivery floors are equipped with ultrasound machines which can serve the needs of both obstetricians and anesthesiologists. This cross-sectional, blinded, randomized observational study compares the image resolution (RES), detail (DET), and quality (IQ) acquired by a handheld ultrasound, the Butterfly iQ, and a mid-range mobile device, the Sonosite M-turbo US (SU), to evaluate their use as a shared resource. 

E-Point Septal Separation Accuracy for the Diagnosis of Mild and Severe Reduced Ejection Fraction in Emergency Department Patients  

José Atilio Núñez-Ramos, MD, MSc; María Camila Pana-Toloza, MD, MSc; Sheyla Carolina Palacio-Held, MD – Chest pain, dyspnea and syncope are among the most common reasons to seek care in the Emergency Department (ED). Chest pain accounts for more than a thousand visits per year [1], dyspnea and syncope represent approximately 7 to 8% of ED consults [2,3]. At this moment, a thorough cardiovascular evaluation cannot be accomplished only with physical examination. Valvular disease and systolic dysfunction diagnosis improve when evaluated with a physical exam along with cardiac ultrasound [4].

Can Medical Students Learn and Perform POCUS in the Pediatric Emergency Department? Implementation of a Short Curriculum  

Michael  C. Cooper, MD; Jodi Jones, MD; Mandy Pascual, MD; Steven Field, DO; Juan M. Rendon, MD; Christine Kulstad, MD; Bryant Dixon, MD; Kristie Pham Tu; Aman Narayan; Hunter Pyle; Khiem Hoang; Anthony Han; Dalbir Bahga MD; Aman Pandey, MD; Lynn Roppolo, MD – Point-of-care ultrasound (POCUS) is used by emergency physicians to make rapid critical diagnoses in the emergency department (ED) [1]. POCUS is now being incorporated into medical student patient assessment curricula [2, 3]. Several studies have demonstrated the feasibility of medical students using POCUS and have included teaching multiple POCUS applications to medical students simultaneously [2,4,5]. However, there are few studies demonstrating medical students’ ability to accurately perform POCUS on pediatric patients and these studies have typically included one POCUS application taught at a time [6-9].