Ultrasound
Ruptured Hemorrhagic Ovarian Cyst Mimicking Ruptured Ectopic Pregnancy in a Post-Transplant Patient: A Case Report
DOI: https://doi.org/10.5070/M5.52390A formal transvaginal ultrasound was ordered in the setting of the positive beta-hCG levels, which demonstrated a moderate volume of debris-containing free pelvic fluid layering in the posterior cul-de-sac (yellow highlighting), without sonographic evidence of an intrauterine gestational sac or yolk sac. Additionally, the left ovary contained a 2.8 cm cystic structure consistent with a hemorrhagic ovarian cyst (blue highlighting).
Case Report: Sonographic Detection of Chorionic Hemangiomas in Sturge-Weber Syndrome
DOI: https://doi.org/10.5070/M5.52314Ocular point-of-care ultrasound (POCUS) was performed using a linear 12-3 MHz probe on a Sonosite PX system. Examination of the symptomatic right eye revealed a complete retinal detachment. The detached retina appeared thickened, consistent with chronic detachment. Deep to the retina, the choroid was markedly thick with the widest portion observed in the posterior wall of the globe near the optic nerve. Sonographically, the choroid was isoechoic to the retina in the near field, hyperechoic to the retina in the far field (secondary to posterior acoustic enhancement) and homogenous. In the colorized image of the right eye, the red color denotes the choroid, labeled C, and the green color denotes the retina, labeled R. The left eye was also examined, shown in the last case image, and was grossly normal. No color doppler imaging was utilized for either eye. Optic nerve sheath diameter (ONSD) was 0.54 cm bilaterally.
Point-of-Care Ultrasound Findings of Ovarian Hyperstimulation Syndrome: A Case Report
DOI: https://doi.org/10.5070/M5.52324Transabdominal POCUS in the right upper quadrant revealed clearly delineated pockets, the hypoechoic appearance being consistent with ascites, surrounding the liver and the gallbladder (Figure 1). A view of the left upper quadrant revealed a similar hypoechoic fluid collection that filled the space below the diaphragm and surrounded the spleen (Figure 2). A transabdominal pelvic view revealed enlarged ovaries, identifiable by the numerous, large, and well-delineated hypoechoic collections within that represent the enlarged follicles (Figure 3). The extent of the hypoechoic free fluid collections and the enlargement of the ovaries and their follicles is more apparent when viewed dynamically (Video).
Rapidly Progressive Painless Acute Aortic Dissection: A Case Report
DOI: https://doi.org/10.5070/M5.52348A POCUS of the abdomen at that time demonstrated findings concerning for a dissection flap in the abdominal aorta (green arrows), and a new mild to moderate pericardial effusion was seen on a repeat cardiac POCUS suggesting an evolving aortic dissection (blue arrows). The patient’s CTA revealed a type A AAD with extension from the aortic root to the bilateral external and internal iliac vessels as well as the coronary arteries (red arrows).
A Case Report of Rare Bilateral Quadriceps Tendon Rupture Diagnosed by Point of Care Ultrasound (POCUS)
DOI: https://doi.org/10.5070/M5.52334Musculoskeletal assessment with POCUS revealed disruption of the left quadriceps tendon (blue arrows) indicated by a large hypoechoic gap (red arrow) with significant surrounding fluid throughout the quadriceps as well as a sizable left knee effusion (orange highlighting). The right lower extremity had a disrupted and retracted quadriceps tendon (yellow arrow) with associated fluid near the injury site and a small right knee joint effusion (orange highlighting). Therefore, he was diagnosed with bilateral quadriceps tendon ruptures.
A-Lines below the Diaphragm – A Case Report of Occult Pneumoperitoneum
DOI: https://doi.org/10.5070/M5.52389The RUQ POCUS focusing over the left liver lobe shows multiple enhanced peritoneal stripe signs (red arrows) and several reverberation artifacts (yellow arrows). The second RUQ POCUS of the right lobe of the liver and the gallbladder shows reverberation artifacts (yellow arrow) and ring-down artifacts (blue arrow). The chest X-ray shows free air under the right diaphragm (orange arrow), which indicates pneumoperitoneum. The CT abdomen and pelvis show pneumoperitoneum near the porta hepatis (green arrow).
A Woman’s Infertility Journey Complicated by Severe Ovarian Hyperstimulation Syndrome – A Case Report
DOI: https://doi.org/10.5070/M5.52309Computed tomography (CT) of the abdomen and pelvis demonstrated pleural effusions in the lung bases (blue stars), ascites (blue stars), and enlarged ovaries with multiple cysts/follicles (white arrows). A formal pelvic US also demonstrated large volume ascites (white diamonds) and bilateral ovarian enlargement with numerous cysts. A CT angiogram (CTA) of the chest demonstrated small bilateral pleural effusions and no obvious pulmonary embolism.
A Case Report of Right Atrial Thrombosis Complicated by Multiple Pulmonary Emboli: POCUS For the Win!
DOI: https://doi.org/10.21980/J8TM07Pulmonary POCUS was performed by the ED physician (GE Venue, C1-5-RS 5MHz curvilinear transducer), and lung examination was unremarkable with no pleural effusion, pneumothorax, or infiltrate. Subxiphoid views (GE Venue, 3Sc-RS 4MHz phased-array transducer) were obtained because this patient’s COPD with severe pulmonary hyperexpansion made parasternal and apical 4-chamber views suboptimal. A large thrombus can be seen within the right atrium (movie 1, images 1, 2). This has a serpiginous, rounded appearance and is mobile, appearing to swirl within the right atrium with intermittent extrusion through the tricuspid valve. A pacemaker wire is also visible within the right ventricle as a non-moving, hyperechoic, linear structure with posterior enhancement artifact. Pericardial effusion is not present.