We present a case of a 22-year-old female with a history of intravenous drug abuse and homelessness presenting with four days of vomiting and abdominal pain.
A pleasant 51-year-old gentleman began to experience right chest wall discomfort approximately one month prior to his presentation to the emergency department (ED).
A 38 year old female with a history of a right foot drop after medial facetectomies (L4-L5, L5-S1) and micro-discectomy (L4-L5) eight weeks prior presented to the emergency department (ED) with two weeks of headache and neck pain.
A 34-year-old woman presented to the emergency department (ED) with acute onset of severe abdominal pain and distention with associated diffuse tenderness and guarding.
A five-year-old male presented to the emergency department at 2 a.m. after having bitten through a television power cable and suffering a burn injury to his mouth 20 minutes prior to arrival.
A 93-year-old male presented to a Level I trauma center in hemorrhagic shock after a head-on motor vehicle collision in which he was a restrained driver.
This paper describes ultrasound findings typical of Zika-related congenital malformations that may be incidental findings or detected when examining exposed or concerned patients during routine POCUS testing.
A 32-year-old man sought care at the emergency department for evaluation of a rash on his foot, three weeks after returning from a beach vacation in the Caribbean.
A 38-year-old woman with a history of seasonal allergies presented to the emergency department with sudden onset of left periorbital swelling following nose blowing.
A 62 year old male presented to the emergency department with a complaint of two weeks of isolated left hip pain after slipping down two stairs three weeks prior to presentation. Initially well, the patient began experiencing progressive pain with ambulation. The patient’s history was significant for recurrence of rectal adenocarcinoma treated by surgical resection 10 years prior.
Traumatic injuries to the knee are common in emergency medicine. Bedside ultrasound (US) has benefits in the rapid initial detection of injuries to the patella. In addition, US can also quickly detect injuries to the entire knee extensor mechanism, including the quadriceps tendon and inferior patellar ligament, which may be difficult to diagnose with plain radiographs.
We describe the use of point-of-care ultrasound to localize a retained intravenous drug needle, and subsequent surgical removal without computed tomography.
An 11-year-old previously healthy girl presented to the emergency department (ED) with three weeks of a rapidly progressive swelling underneath her tongue, causing difficulty in talking and eating. Physical examination revealed a 4.5 × 3 cm sublingual mass arising from the base of the tongue, around the midline (Figure 1). The mass was soft, movable and non-tender. The contents had a bluish hue, which was covered with normal appearing mucosa. A point-of-care ultrasound (POCUS) revealed a well-circumscribed homogenous cystic mass, separated from the muscular fibers of the tongue, without extravasation towards the neck (Figure 2) and without intra-cystic flow. A diagnosis of simple ranula was made.
Volume 17, Issue 4, July 2016
Samuel Lam, MD, et al.
In recent years studies have been published on the use of beside ultrasound (BUS) to diagnose appendicitis in the emergency department (ED). Its popularity is likely due to the improving ultrasound skills of emergency physicians, as well as the obvious BUS advantages of no ionizing radiation emission, and ease of performance and interpretation at the bedside. Use of ultrasound in suspected appendicitis is also supported by American College of Radiology recommendations, especially in the pediatric population.
Volume 17, Issue 4, July 2016
John Hall, MD, et al.
Early pregnancy complaints in emergency medicine are common. Emergency physicians (EP) increasingly employ ultrasound (US) in the evaluation of these complaints. As a result, it is likely that rare and important diagnoses will be encountered. We report a case of fetal anencephaly diagnosed by bedside emergency US in a patient presenting with first-trimester vaginal bleeding.
Volume 17, Issue 4, July 2016
Kelly Kesler, MD, et al.
A 29-year-old female with no significant past medical history presented with palpitations, nausea, diaphoresis and lightheadedness. Symptoms began 15 minutes prior to arrival. She reported several similar episodes previously that self-resolved within seconds, but had no previous medical evaluations for these symptoms. Initial vital signs were significant for blood pressure of 93/61, irregular heart rate between 180 and 200, respiratory rate of 18, and oxygen saturation of 99% on room air. Physical examination was otherwise unremarkable. The electrocardiogram (ECG) is shown in Figure 1. This was interpreted as atrial fibrillation with rapid ventricular rate, and the patient was treated with rate control with no effect. The patient later spontaneously converted to normal sinus rhythm and repeat ECG was notable for delta waves concerning for Wolff-Parkinson-White Syndrome (WPW) as seen in Figure 2. She was admitted to cardiology for cardiac ablation.
Volume 17, Issue 4, June 2016
Zachary Dezman, MD, MS, et al.
A sexually active 35-year old woman presented to the emergency department with intermittent vaginal spotting and pelvic cramping over the preceding four weeks. She had an intrauterine device (IUD) placed three months prior and has never been pregnant. The threads of the IUD and a small amount of blood coming from the cervix were seen on pelvic exam. Laboratory testing revealed a β-human chorionic gonadotropin level of 70,000 mIU/mL. Pelvic ultrasound imaging showed the IUD and a viable intrauterine pregnancy.
Volume 17, Issue 2, March 2016.
Timothy D. Roberts, MBChB
An eight-year-old boy presented to the emergency
department (ED) with a 2cm-long laceration over the
prepatellar region of his left knee after falling over and
cutting his knee on broken glass. Physical examination
demonstrated the laceration breached the dermis but
otherwise there was no obvious defect in the deep fascial
layer.
Volume 17, Issue 2, March 2016.
Kristin H. Dwyer, MD, MPH, et al.
A 26-year-old female presented to the emergency
department with three days of subjective fevers, dry cough
and pleuritic chest discomfort. On exam, her vital signs
were significant for a heart rate of 106/minute and oxygen
saturation of 95% on room air. Her lung exam revealed
decreased breath sounds at the right base. A bedside lung
ultrasound and a chest radiograph were performed.
