An unusual ultrasound...

Heterotopic pregnancies are very rare indeed, occurring in approximately 1:30,000 pregnancies; the incidence is much higher due to assisted reproduction as it rises to 1:7,000 overall and can be as high as 1:900 with ovulation induction. They are defined as the co-existence of intrauterine and extrauterine gestation...

US and Ortho?

A 45 year old man presented to UHB fast track with a chief complaint of right knee pain. His pain began 4 days ago after a hyperflexion injury. He had immediate pain and swelling and has had difficulty walking since....

Concerned for ectopic?
Then US the RUQ

A 20 something female is brought over after a witnessed syncopal episode in triage. According to the nurse, who is now just as diaphoretic as the patient, her chief complaint was syncope. You have no vital signs, the patient is perspiring and perseverating and finally blurts out, “I’m 8 weeks pregnant"...

US vs. THEM:
An Uncommon Finding in a Common Diagnosis

In a fictional hospital nearby, a healthy 20 something year old female is seen for chest pain x 5 days. As if reciting from a textbook, she tells you she recently had a cold. She reports gradually resolving cough and runny nose that were replaced by a centrally located chest pain that occasionally radiates to the back...

US vs. the RUQ

A 45 year old female presents to your hospital with a complaint of epigastric and RUQ pain, subjective fever, nausea and vomiting x 3 days. She tells you her twin sister had to have her gallbladder removed after an episode that seemed exactly like the illness she is having...

More Ultrasound, Less Cowbell

A 45 year old female presents to your hospital with a complaint of epigastric and RUQ pain, subjective fever, nausea and vomiting x 3 days. She tells you her twin sister had to have her gallbladder removed after an episode that seemed exactly like the illness she is having...

Of Course, US Only for Kidney Stones...

It’s a slow Sunday afternoon in the mythical ED that all of our blog posters seem to work in and you see a 70 year old male with a history of HTN, HLD and renal stones. He is mildly hypertensive and reports sharp flank, occasional abdominal pain and hematuria. These symptoms, he tells you, feel “just like kidney stones"...

PE or not PE,
That is the Question...

Echocardiography and evaluation of right ventricular strain or dysfunction may heighten one’s suspicion of a clinically significant PE. Patients with unexplained hypotension or shock, secondary to PE will show signs of RV dysfunction. The absence of such findings on echo, should lead the provider to seek an alternative explanation for the patient’s instability...

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