990624_Challenging Cases & Journal Reading
Transcript of 990624_Challenging Cases & Journal Reading
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EUS_990624
Challenging cases & Journal Reading
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US is superior to radiography for
diagnosing sternal fracture
J Clin Ultrasound 2010; 38:135137
Sternal fracture: 24/36 patients
Sensitivity and specificity
Plain radiographs: 70.8%; 75.0%
US: both 100%
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Comparison of Web-versus Classroom-Based Basic
Ultrasonographic and EFAST Training in 2 European Hospitals
Ann Emerg Med. 2010. In press
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Bedside ultrasonographic measurement of caval
index greater than or equal to 50% is strongly
associated with a low central venous pressure
Ann Emerg Med. 2010;55:290-295
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Bedside ultrasonographic measurement of caval
index greater than or equal to 50% is strongly
associated with a low central venous pressure
Caval index: (IVCe
IVCi )/IVCe Ann Emerg Med. 2010;55:290-295
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US for CVC_CLEAR databaseCentral Line Emergency Access Registry Database
AJEM 2010; 28, 561567
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US for CVC_CLEAR databaseCentral Line Emergency Access Registry Database
AJEM 2010; 28, 561567
1. did not observe improved success with the use of
ultrasound for CVC cannulation on the first attempt
2. observe a reduced number of total punctures per attempt
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An initial description of a sonographic sign that
verifies intrathoracic chest tube placement
AJEM 2010; 28, 626630
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Disappearance/Intrathoracic,
Continuation/ Extrathoracic (DICE) sign
Sensitivity 100%; Specificity 100% AJEM 2010; 28, 626630
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Ultrasound-guided femoral nerve
blocks are feasible to perform in the ED
AJEM 2010 28, 7681N=13; Median age: 82
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Significant and sustained decreases in
pain scores were achieved
AJEM 2010 28, 7681
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Needle tip visualization during ultrasound-guided
vascular access: short-axis vs long-axis approach
9/39, 23%
AJEM 2010;28: 343347
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Needle tip visualization during ultrasound-guided
vascular access: short-axis vs long-axis approach
24/39, 62%
AJEM 2010;28: 343347
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Kinetic Echography in the
Evaluation of Retinal Detachment
ACAD EMERG MED June 2010
Video clip: right eye
Video clip: left eye
http://retinal%20detachment/sm001_rihgt%20eye.movhttp://retinal%20detachment/sm002_left%20eye.movhttp://retinal%20detachment/sm002_left%20eye.movhttp://retinal%20detachment/sm001_rihgt%20eye.mov -
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Emergency Ultrasound
Identification of Pneumoperitoneum
ACAD EMERG MED 2010
http://ppu/sm002_PPU.movhttp://ppu/sm001_PPU.mov -
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Soft Tissue Ultrasound and the
Comet Tail Artifact
ACAD EMERG MED 2010
http://comet%20tail%20artifact/sm001_comet%20tail%20artifact.movhttp://comet%20tail%20artifact/sm001_comet%20tail%20artifact.mov -
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Needle Aspiration of Spontaneous
Pneumothorax
Video Clip S1. Absent pleural sliding
Video Clip S2. Aspiration PTX
Video Clip S3. Repeat ultrasound examination
demonstrated partial resolution of the
pneumothorax, with lung point sign
Video Clip S4. Confirmation of return of normalpleuralsliding anteriorly
http://ptx/sm001_PTX.movhttp://ptx/sm002_PTX.movhttp://ptx/sm003_PTX.movhttp://ptx/sm004_PTX.movhttp://ptx/sm004_PTX.movhttp://ptx/sm003_PTX.movhttp://ptx/sm003_PTX.movhttp://ptx/sm002_PTX.movhttp://ptx/sm001_PTX.mov -
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Diagnosis ofLemierres Syndrome
by Bedside Sonography
ACAD EMERG MED 2010
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Challenging Cases
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68F_abdominal pain with leukocytosis
http://emphysematous%20cystitis_68f_03776507/CT_1_01.jpghttp://emphysematous%20cystitis_68f_03776507/Emphysematous%20cystitis_68F_03776507.wmvhttp://emphysematous%20cystitis_68f_03776507/CT_1_01.jpg -
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79F, c/o whole abdominal pain
http://ileus_79f_05600743_diverticulitis%20rupture/05600743_20100531_CT_1_01.jpghttp://ileus_79f_05600743_diverticulitis%20rupture/Free%20air_diverticulitis%20rupture_79F_05600743.wmvhttp://ileus_79f_05600743_diverticulitis%20rupture/05600743_20100531_CT_1_01.jpg -
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70M, RLQ pain
SKH_ER
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32M, RLQ pain
http://terminal%20ileum%20diverticulitis_32m_16478615/CT_1_01.jpghttp://terminal%20ileum%20diverticulitis_32m_16478615/Terminal%20ileum%20diverticulitis_32M_16478615.wmvhttp://terminal%20ileum%20diverticulitis_32m_16478615/CT_1_01.jpg -
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55F, LLQ pain
http://epiploic%20appendagitis_55f_16465469/CT_1_01.jpghttp://epiploic%20appendagitis_55f_16465469/Epiploic%20appendagitis_56F_16465469.wmvhttp://epiploic%20appendagitis_55f_16465469/CT_1_01.jpg -
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18M, severe epigastralgia
http://ppu_18m_16452446/16452446_20100419_CR_1_1.jpghttp://ppu_18m_16452446/PPU_18m_16452446.wmvhttp://ppu_18m_16452446/16452446_20100419_CR_1_1.jpghttp://ppu_18m_16452446/16452446_20100419_CR_1_1.jpg -
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45F, right 3rd finder swollen
SKH_ER
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67F, persistent fever
SKH_ER
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Cases of this month
1. Emphysematous cystitis
2. Diverticulitis rupture & pneumoperitoneum
3. Appendicitis rupture
4. Terminal ileum diverticulitis
5. Epiploic appendagitis
6. PPU with pneumoperitoneum
7. Finger abscess
8. Psoas muscle abscess