31yo, previously healthy woman, 2 months Post partum, seen at the ED for dyspnea and anasarca, What is your diagnosis?

Perfomed by Dr Dumerjuste

This ultrasound, performed by Dr. Dumerjuste, PGY-1 EM resident at HUM, on a 19 yr old female who presented with fever,  right flank pain and right lumbar pain for 5 days.  While initially concerned for pyelonephritis, the ultrasound demonstrates a large, well-defined, hypoechoic complex fluid filled structure cleared located within the liver.

This ultrasound was performed by Dr. Menager, PGY-1 EM resident at HUM, on a 9 month old male with 9 days of abdominal pain and blood diarrhea.  The study nicely demonstrates the “target sign,” the classic sonographic finding for intussusception.

Of note, this bedside study was performed in the PEDIATRICS ward.   The patient did receive an ultrasound in the ED which did not show intussusception.   At that time, the patient had intermittent pain.  He was placed on ceftriaxone for presumed bacterial enterocolitis however his pain and bloody diarrhea continued and he was eventually admitted.  On the ward, the patient continued to have pain and Dr. Menager, who was on his pediatrics rotation, cleverly decided to repeat the ultrasound study leading to the correct diagnosis.  The patient was then taken to the operating room where the diagnosis of intussusception was confirmed and the appropriate treatment provided.   GREAT WORK!

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Dr. Menager, PGY-1 EM resident at HUM, performed this ultrasound on a young woman who presented with dysuria and right-sided constant flank pain.  Continue reading →

Kanavel’s FOUR signs of flexor tendon sheath infection:

1. Fusiform swelling   2. Finger held in slight flexion  3. Pain with passive extension of the digit  4. Tenderness along the flexor tendon sheath