ultrasound — Brown Emergency Medicine Blog — BROWN EMERGENCY MEDICINE BLOG

Sclerochoriodal calcification - What is it and what is its clinical significance?

…3 days of floaters and “lightning bolt” white flashes in the temporal field of her right eye in the absence of eye trauma. She also reported right periorbital pain. She did not have blurry vision, diplopia, loss of vision, scalp tenderness, jaw claudication, fevers, chills, or weight loss. She denied photophobia despite wearing sunglasses in the Emergency Department. Her mother had died from choroidal melanoma, but the patient had not seen an ophthalmologist in 15 years.

Her uncorrected visual acuities were 20/60 OD and 20/40 OS. Intraocular pressure, pupillary reaction, and extraocular movements were normal. Point of care ultrasound (POCUS) revealed three hyperechoic, solid lesions with posterior acoustic shadowing in her right eye….

Using POCUS for Ejection Fraction Estimation

…The differential diagnosis included acute coronary syndrome, CHF exacerbation, pneumonia, and cardiac amyloidosis.

EKG showed sinus tachycardia with low voltage. Laboratory evaluation was unremarkable, with a negative troponin and high normal BNP. Chest radiograph showed bilateral infiltrates concerning for mild pulmonary congestion.

POCUS was obtained….

Ultrasound, Radiology, CardiologySean BilodeauSeptember 3, 2021ultrasound, cardiac amyloidosis, left ventricular ejection fraction, LVEF, EPSSComment

BrownSound: Foreign Bodies

She goes to see the patient, a 27 year old male with no past medical history who spent the afternoon surfing. He was walking back to his car barefoot and stepped on something that made him jump. He has no idea what it could be but “it’s still in there doc!” …

Ultrasound, RadiologyFahad AliApril 30, 2021ultrasound, foreign body, Emergency RadiologyComment

Brown Sound: (Almost) Scared to Death by Takotsubo Cardiomyopathy

A 75 year-old female with a past medical history of hypertension, hyperlipidemia, SVT, chronic kidney disease, diabetes, lung cancer status post partial right lung resection, and remote history of breast cancer status post resection presented with chest pain. She awoke in the middle of the night after hearing a loud crash and found her husband lying on the ground unresponsive. She thought he was dead and felt an overwhelming sensation of fear, followed immediately by the onset of substernal chest pain radiating to the back associated with some shortness of breath. She denied fever, diaphoresis, nausea, vomiting, or palpitations. She denied any history of angina. Upon arrival to the emergency department she was given nitroglycerin with a subsequent improvement in her chest pain…

Cardiology, UltrasoundDanielle KerriganJanuary 5, 2021ultrasound, echocardiography, Takotsubo, cardiomyopathyComment

Bround Sound: Ultrasound to Assess Extraocular Movements and Pupillary Light Reflex

The assessment of extraocular movement (EOM) and pupillary light reflex can be used to evaluate for ocular injury post-trauma. However, many patients with ocular trauma can present with significant orbital edema or pain that limits assessment due to the physician being unable to retract the eyelids. Ocular ultrasound provides a unique way to assess the eyes in the event of a trauma without causing significant pain or harm to the patient. This blog post provides techniques on how to perform ocular ultrasound to assess EOM and pupillary light reflex…

Opthalmology, UltrasoundMeagan KozhimalaDecember 22, 2020ultrasound, ocular, traumaComment

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