Gout Tophus on POCUS Linear transducer about 1cm away from bone/joint, typical of small joint in a distal extremity. The tophus over the joint suggests gout. Dr. Meghan Herbst @EUSmkh #Gout #Tophus #tophi #clinical #POCUS #ultrasound #msk #rheumatology #labeled

Acute Appendicitis on POCUS A linear transducer is over anterior RLQ. Noncompressible fluid-filled structure >6mm + hot fat concerning for appendicitis. Operator trying to apply compression with transducer. Dr. Meghan Herbst @EUSmkh #Appendicitis #POCUS #clinical #ultrasound #abdominal #labeled

McConnell's sign on POCUS Echocardiogram An otherwise healthy male presents with pleuritic chest pain. Hypokinetic RV with apical sparing (McConnell sign) suggests acute RV strain, most likely from a pulmonary embolism (PE). In the setting of PE, a tricuspid annular plane systolic excursion (TAPSE) of <1.6cm — >poorer prognosis, higher morbidity/mortality. Dr. Meghan Herbst @EUSmkh #McConnells #sign #POCUS #Echocardiogram #clinical #cardiology #labeled

Scrotolith on Scrotal POCUS Srotum & testicle are viewed. Simple anechoic hydrocele & hyperechoic scrotal pearl (scrotolith) w/ posterior acoustic shadowing. Scrotoliths: benign incidental findings w/ prevalence ~3%. Dr. Meghan Herbst @EUSmkh #Scrotolith #Scrotal #POCUS #ultrasound #clinical #urology #labeled

Gallbladder Distension on POCUS Gallbladder viewed in long-axis plane (sagittal on body). Normal gallbladder dimensions are up to 4 x 10cm. Distention may indicate a stone obstructing neck, but also occurs in setting of fasting. This patient had N+V due to pancreatitis unrelated to gallstones. Dr. Meghan Herbst @EUSmkh #Gallbladder #Distension #Distended #POCUS #clinical #ultrasound #labeled

Incarcerated Abdominal Hernia on POCUS Incarcerated hernia causing pain; bowel obstruction causing nausea and vomiting. No additional imaging needed. The problem is right here. Dr. Meghan Herbst @EUSmkh #Incarcerated #Abdominal #Hernia #POCUS #clinical #ultrasound #labeled #bowel

Abscess and Cobblestoning on POCUS Cobblestoning of inflamed fat (“hot” cobblestoning!) and an echogenic abscess. This should be incised & drained +/- discharge with antibiotics. Dr. Meghan Herbst @EUSmkh #Abscess #Cobblestoning #POCUS #clinical #cellulitis #ultrasound #radiology

Fibroid Uterus on POCUS Female pelvis is being viewed in a transverse plane. Fibroids (made of dense tissue—smooth mm & fibrous connective tissue) are seen juxtaposed against less dense tissue create acoustic shadowing within the uterus, giving it an enlarged, heterogenous appearance. Dr. Meghan Herbst @EUSmkh #Fibroid #Uterus #POCUS#clinical #ultrasound #pelvic #transabdominal #obgyn #gynecology #labeled

Pneumonia on POCUS Otherwise healthy 12mo-old w/ fever. Linear & phased array viewing the lung (subpleural & deeper tissue/artifacts, respectively). PoCUS demonstrates consolidation >1cm, supports diagnosis of community-acquired PNA. ABx & dc if no significant hypoxia/wob. No need for additional imaging such as cxr. Dr. Meghan Herbst @EUSmkh #Pneumonia #POCUS #clinical #lung #ultrasound #pediatrics

Spontaneous Echo Contrast ("Smoke") on IVC POCUS Sagittal view of IVC returning blood to RA caudal —> cephalad direction. Hepatic vein plump & draining blood into IVC. The echogenic “debris” within IVC is called “smoke” or “spontaneous echo contrast” indicating slow flow/stasis. Also small R pleural effusion. Dr. Meghan Herbst @EUSmkh #Spontaneous #Echo #Contrast #Smoke #IVC #POCUS #clinical #ultrasound #venacava