Images James Dent An 80 year old had an unsuccessful cannulation for a CT scan. 4 days later she presented with bruising and tenderness of the left antecubital fossa  and a palpable pulsating mass. This is the US of the area B mode sonography shows a large pseudoaneurysm . The aneurysm is connected to the Read more about Pseudoaneurysm[…]

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

Question 1  Describe symptoms, historical features and US findings in • Testicular torsion • Epididymoorchitis , epididymitis Ultrasound is an essential tool in differentiating between the different causes of testicular pain however ultrasound alone cannot exclude torsion. Initially ultrasound findings in testicular torsion may be unremarkable and then become heterogeneous or diffusely hypo-echoic, mimicking epididymo-orchitis both 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[…]

Intussusception: Left upper quadrant mass

Images Genevieve Carbonatto, text Genevieve Carbonatto An 80 year old lady presents to the Emergency Department with a 4 month history of feeling unwell on and off  associated with a  4 kg weight loss during that time. She presented acutely because  the night before she developed mild abdominal pain and vomiting.  She has been investigated Read more about Intussusception: Left upper quadrant mass[…]

Dr Lichtenstein: Whole body ultrasound

  Dr Daniel Lichtenstein spent a weekend in Australia to talk about whole body ultrasound with a special emphasis on lung ultrasound. It was a fabulous weekend and 12 of us had the opportunity of scanning with him on the wards. Lung ultrasound seems at times so simple, yet when an expert is there to Read more about Dr Lichtenstein: Whole body ultrasound[…]