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What the Heck 3

So we are scanning the left thorax in a patient with shortness of breath, in an effort to assess for pleural effusion. The following video was obtained: https://gmep.org/media/11997 The operator correctly noted the presence of a pleural effusion, and a bit of lung tissue can be seen towards the left side of the screen floatingRead more

Effusion

Ultrasound is quite sensitive in detecting even very small pleural effusions; it has been demonstrated to perform better than chest x-ray and nearly as well as CT scan. In order to assess for pleural fluid, the transducer should be directed through the liver (Right side) or spleen (Left side) and diaphragm. In a normal thorax,Read more

Case 5

Here’s a quick case. Patient presents with urinary retention, Foley catheter placed, blood-tinged urine output. Initially the patient experiences great relief but gradually develops suprapubic discomfort again. Questions: What’s inside the bladder? What’s the bladder volume? How is that catheter working? What’s that bright echogenic arc coming of the superficial aspect of the Foley bulb?Read more

Artifacts 5: On the sidelines

This right paracolic gutter image is taken from a patient with significant ascites. Notice how bright the bowel walls are (solid purple arrows). This is because the air in the bowel acts as a strong reflector, and because ascites (being fluid) only minimally attenuates the incident and reflected ultrasound beam. Thus, a stronger signal is transmitted thus andRead more

Artifacts 4 – lung pulse

Left lung with lung pulse Right lung with lung pulse The “lung pulse” is an ultrasound sign first described by Dr Daniel Lichtenstein in 2003. Essentially, it is the detection of the subtle cardiac pulsation at the periphery of the lung (parietal pleura to be exact) on the M mode. In a normally ventilating lung,Read more