POCUS - Pyomyositis - Long Axis - A collection that is not

POCUS - Pyomyositis - Transverse Axis - A collection that is not acute may not appear purely anechoic. However, there ought to be asymmetry when compared to the contralateral hip. A large mass like collection was identified in this patient. It was initially assumed to be a large joint effusion, but on further evaluation it was less clear if the collection was within the joint capsule or just outside the capsule. I believed the collection was just outside the joint and likely pyomyositis. #Clinical #EM #Radiology #Ortho #POCUS #Hip #Pyomyositis #Transverse #SonoStuff

To evaluate the hip for an effusion with POCUS begin just medial to the ASIS, in a slightly oblique-sagittal plane. This will give you a longitudinal view of the hip joint. Identify the femoral head and acetabulum, followed by the femoral neck inferiorly. Hip effusions typically appear as an anechoic collection at the femoral head that extends to the femoral neck. You may also visualize effusions from the lateral position of the patient. #Clinical #Anatomy #EM #Radiology #Ortho #POCUS #Hip #Longitudinal #Pyomyositis #SonoStuff

A similar hypoechoic, enlarged region was identified in the right posterior calf with a very small discrete anechoic area. Dr. Michael Schick @UltrasoundStuff - UC Davis Emergency Medicine #Clinical #MSK #POCUS #Calf #Transverse #Pyomyositis #SonoStuff

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An area within the posterior thigh muscles that was clearly hypoechoic compared to the unaffected leg appeared in view. The superficial soft tissue appeared to be largely unaffected. The muscle became increasingly hypoechoic as we scanned proximal in the thigh. The affected muscle was larger in size compared to the unaffected leg and a discrete anechoic region was found with irregular borders. Dr. Michael Schick @UltrasoundStuff - UC Davis Emergency Medicine #Clinical #MSK #POCUS #Thigh #Transverse #Pyomyositis #SonoStuff

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A transverse still image of the upper airway using the high frequency, linear transducer at the level just cephalad of the vocal cords and arytenoids. Asymmetry is identified with a hyperechoic fullness of the left side of the airway (right side of the image). This was immediately confirmed as subglottic edema at the level just cephalad of the vocal cords by indirect fiberoptic laryngoscopy. #Clinical #EM #Radiology #PCC #POCUS #Trachea #Subglottic #Edema #SubglotticEdema #Transverse #SonoStuff

Left Forearm Abscess on Point of Care Ultrasound (POCUS) Our patient was a 19-year-old male with past medical history of IVDU who presented to the emergency department with complaints of left elbow pain. The images demonstrated an area of hypoechogenicity within the skeletal muscle of the forearm and subsequent hand surgery consult and follow-up CT scan confirmed the presence of a fluid collection within the muscle belly of the flexor digitorum superficialis. This led to the diagnosis of pyomyositis. #Pyomyositis #Forearm #Abscess #MSK #POCUS #Ultrasound #Clinical

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Klebsiella Thigh Abscess on Point of Care Ultrasound (POCUS) Redness over the thigh. POCUS shows this. Soft tissue air/gas, very worrisome for necrotizing fasciitis. Interestingly this was a false positive. Plastics took to the OR and found it was actually an abscess growing Klebsiella. - Dr. Dan Kim @dan___kim #Thigh #Abscess #Pyomyositis #POCUS #MSK #Clinical #Klebsiella

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QA of the Day: Not a lava lamp, HUGE complex hydrocele #Clinical #EM #Radiology #Urology #POCUS #Scrotom #ScrotalUS #Complex #Hydrocele #SonoStuff

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A transverse still image of the upper airway taken with a high frequency, linear transducer at the level of the arytenoid cartilage. Sternocleidomastoid muscle (SM) and thyroid cartilage (T) are re-demonstrated. The false vocal cords (FV) are visualized with noted asymmetry, edema on the patient’s left side (right side of the image). #Clinical #EM #Radiology #PCC #POCUS #Trachea #Arytenoid #False #Cords #Transverse #SonoStuff

Humeral Avulsion of the Inferior Glenohumeral Ligament (HAGL) • Imaging Findings: • Large defect of the inferior glenohumeral ligament/joint capsule at the humeral attachment consistent with a capsule tear. • Intra-articular contrast is extravasating through the defect outside of the joint capsule. Case description: • Humeral Avulsion of the Glenohumeral Ligament (HAGL) can be a cause of anterior shoulder instability from the defective joint capsule. • Axillary pouch changes from a fluid-filled U-shaped structure to a "J-Shaped structure." • The IGHL sags inferiorly to form "J-shape." o Usually anterior shoulder dislocation WITHOUT Bankart lesion. Differential diagnosis: • Reverse HAGL (RHAGL) lesion: Posterior capsuloligamentous injury. • Bony Humeral Avulsion of the IGHL (BHAGL): Avulsion fracture at the inferior glenohumeral ligament/joint capsule attachment. • Glenoid Avulsion of the Glenohumeral Ligament (GAGL): "Reverse J sign." Avulsion of the joint capsule/IGHL from the inferior pole of the glenoid. No tear of the labrum. Dr. Donald von Borstel @DrvonBorstel #HAGL #Humeral #Avulsion #Glenohumeral #Ligament #shoulder #clinical #mri #clinical #Radiology #diagnosis #msk