Trauma : knife though chest

Trauma : knife though chest

Ultrasound images and text Genevieve Carbonatto A 33  year old man presents to the Emergency Department after having stabbed himself as a suicide attempt. The knife is still in the chest close to the sternum to the left of the sternum in the 5th intercostal space. He is alert and orientated, he says he stabbed Read more about Trauma : knife though chest[…]

Pericardial Tamponade

Pericardial Tamponade

Images : Sarah Vaughan, text Genevieve Carbonatto A 56 year old man presents to the Emergency department short of breath and unwell. He gives a history of 2 hours of shortness of breath and chest pain. He has been recently diagnosed with metastatic adenocarcinoma. These are his vital signs He is hypotensive, his BP arterial Read more about Pericardial Tamponade[…]

Oesophageal intubation : Double tract sign

Oesophageal intubation : Double tract sign

Images and Text Genevieve Carbonatto Tracheal intubation Ultrasound can be used as an adjunct to directly visualising endotracheal tube placement. The linear probe is placed in the transverse position with the index marker pointing to the right on the neck above the sternal notch. The structures are identified. These include the trachea and the oeseophagus. Read more about Oesophageal intubation : Double tract sign[…]

Question 1 : Compare Testicular Torsion, Epididymo-orchitis and Epididymitis

Question 1  Describe symptoms, historical features and US findings in • Testicular tortion • Epididymoorchitis , epididymitis   Symptoms and signs Ultrasound features Testicular torsion Acute scrotal pain Oedema and erythema of testes Often high-riding testicle Absent cremasteric reflex. (most sensitive sign of torsion) Lifting the testes does not abolish pain Transverse position of testicle Read more about Question 1 : Compare Testicular Torsion, Epididymo-orchitis and Epididymitis[…]

Question 2: Trauma to testes

Question  2 Cricket ball to groin in young adult. Describe how you would perform scrotal US on this patient and your possible findings Performing scrotal US in the context of trauma • Private area • Chaperone • Analgesia • Gloved hand • Patient supine • Ample gel and warm if possible • Place towel beneath Read more about Question 2: Trauma to testes[…]

Question 3 : Tender groin and palpable mass

Question 3 :  A 30 year old man presents with a tender groin and palpable mass • List the DD (5 marks) • Describe the E Physician sonographic approach to this problem (10 marks) Differential diagnosis: Inguinal hernia direct or indirect Femoral hernia Lymph node Varicocoele Hydrocoele Femoral artery aneurysm Tumour  of spermatic cord or Read more about Question 3 : Tender groin and palpable mass[…]

Question 4 : Acute left groin pain

Question 4 A 25 year old man presents with acute left groin pain a) Discuss your US evaluation. Include choices of probe/s, the areas that you would examine and your method b) What additional clinical information is important? c) During the examination you cannot find the left testicle in the scrotum I. Discuss your further Read more about Question 4 : Acute left groin pain[…]

Question 5: Groin lump post angioplasty

Question  5 Groin lump after angioplasty. Approach and US findings Approach The lump should be evaluated clinically for pulsatility and for the presence of bruits or palpable thrill. The differential diagnosis includes large haematoma, a pseudo aneurysm AV fistula• Use a 5 -7.5 MHz linear array probe. May need a 3.5 MHz curvilinear if patient Read more about Question 5: Groin lump post angioplasty[…]

Question 1 : Assessment of fluid status with ECHO

Question 1 A haemodynamically decompensating patient requires assessment of the intravascular fluid status. Describe the Doppler echo cardiographic methods that can assist outlining the supportive evidence for their use, in addition to any obvious limitations in their application Assessment of fluid status can be achieved by using the LVOT VTI as a surrogate for stroke Read more about Question 1 : Assessment of fluid status with ECHO[…]

Question 2 : Pericardial disease

Question 2. Discuss the use and value of echocardiography in evaluating pericardial disease of various types Value is to look at the pericardium for structural abnormalities (thickening/calcification), assess associated pericardial effusions (may have strands suggesting inflammatory more chronic problem, may be anechoic, may show swirling cells) , look for haemodynamic signs of pericardial constriction. Pericardial Read more about Question 2 : Pericardial disease[…]