Case 1: Focussed Echo in Life Support(FELS)

CASE 1 (Case and images courtesy of Jay Perera, text Jay Perera and Genevieve Carbonatto) Triage: 30F presents with 2/7 of worsening palpitations, worse post Salbutamol. She has a history  of PTSD and anxiety. HR 78 regular. Further history: 3 years of fatigue and lethargy Complains of intermittent palpitations and dyspnoea. Trialled on Salbutamol by Read more about Case 1: Focussed Echo in Life Support(FELS)[…]


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[…]

Question 1 : Purchase of ultrasound machine and credentialing

Question 1  You have been asked to assist in the purchase of a new ultrasound machine for your department. a) Describe five (5) steps you would take to gather information for this purchase. (5 marks) 1. Decide on your needs: Size of machine, complexity (Doppler/2D), image quality, ability to store images, ease of use (quick Read more about Question 1 : Purchase of ultrasound machine and credentialing[…]

Question 2 : Renal colic

Question 2 You are a consultant in charge in a tertiary emergency department at 2300 hrs. You overhear a junior medical officer who recently commenced night shift- asking a nursing staff member to arrange the discharge of a 72 year-old man, whom he has diagnosed with renal calculi. Nursing staff express their concerns with you as Read more about Question 2 : Renal colic[…]