Case | Mount Sinai Emergency Medicine Ultrasound

XRS – 1

X-Ray Sucks #1: Finger Injury

In this new series we will highlight cases where ultrasound proved more useful than x-ray.

A seven year old boy presented with distal phalanx pain, tenderness after a fall.

The following x-ray was performed:

XRS1 x ray XRS 1 What is your diagnosis? Can ultrasound help? How would you perform an ultrasound on such a superficial structure?

The following ultrasound of the distal finger was performed (probe marker towards fingertip):

XRS1 phalanx fx XRS 1 What is your diagnosis now? Read the rest of this entry »

Posted by Bret On May - 21 - 2010 XRS cases

54M with h/o HTN, DM, Tobacco and Focal Segmental Glomerulosclerosis presents with neck mass. He looks dyspneic and uncomfortable at triage and has an obvious mass above his left clavicle to the degree that his head is tilted a bit to the right. Concerned, the triage RN defers the EKG and A-Side attending consult and rolls the patient into your formerly mellow cardiac room shift. Although overall he looks gaunt, his face is swollen and dark colored (“facial plethora”). You go through your IV/O2/Monitor/ABCDEFGHIJKLMNOPQRST and then grab the ultrasound machine.

After turning on the machine, you obtain the following images of the left neck.

Without Compression

With Compression

What do you think the patient has and whatcha going to do about it?

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Posted by Phil On December - 3 - 2009 cases

Case 2

This 16 year old patient presents to the Emergency Department you have just started at in Menominee Michigan. All of today’s patients have been on their way home this last day of hunting season. You suspect this patient will be more interesting, as she is wearing a PETA shirt and not a shred of orange or leather. Although her chief complaint was nausea and vomiting, her urine pregnancy test was positive, prompting the ultrasound evaluation which revealed this image:

What is your diagnosis and what is the next step for this patient?

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Posted by Phil On November - 25 - 2009 cases

7 year old with abdominal pain

Right Lower Quadrant 7 year old child with abdominal pain presented with pain, nausea. Noted to be febrile. RLQ tender. Linear transducer applied to point of maximal tenderness.