Possible Differential diagnoses include Appendicitis Terminal ileitis Intussusception Crohn’s disease Abscesses Mesenteric adenitis Diverticulitis Caecal carcinoma Infectious colitis Hernias (inguinal/femoral/surgical/ventral) Vascular causes (AAA/ iliac aneurysms) Testicular (tortion/ epididimitis) Gyne/obstetric (ectopic, hydrosalpinx/ovarian cyst rupture/ endometriosis) Biliary colic Renal colic, UTI Psoas abscess Herpes Zoster Ascites/ free fluid/ pancreatitis US technique Examine the patient first in the Read more about Question 1 : A patient presents with RIF pain. Discuss the ultrasound technique for this complaint and US findings of appendicitis and Crohn’s disease[…]

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 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 :  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 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 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[…]

Text Genevieve Carbonatto The following is a summary of what you need to know before sitting the fellowship exam about ultrasound. I have put it in a table form so that it is easier to read. It is not exhaustive but will enable you to answer almost any question   Image optimisation Machine Choose correct Read more about Revision Table for Part II exam[…]

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 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[…]