POCUS And Its Utility in the Rapid Diagnosis of Acute Cholecystitis

A 48-year-old female with a past medical history of hypertension and hyperlipidemia and no past surgical history presented to the ED with constant, sharp, and burning epigastric pain. The pain started two weeks ago and was initially intermittent, centered in the epigastric region. Over the past day or so, the pain worsened and began traveling to the right side of her chest and around to the back. The pain was daily, usually after meals, and made worse by fatty foods. The patient felt slightly better after taking antacids. She reported the pain was 8/10 at worst, typically lasting several hours at this intensity, and receded to 3/10 at its best. She had some nausea but no vomiting. She denied changes in stool consistency/frequency or dark or bloody stools. She denied chest pain, sweating, or palpitations. She reported a subjective fever last night and into this morning, but no chills or change in weight. She had been compliant with her home medications.

Ultrasound, RadiologyToby NicholsonJanuary 15, 2021Cholecystitis, Bedside UltrasoundComment

Errors in Emergency Medicine Radiology

An elderly man reported to the emergency room after a fall down 15 stairs at home. He was more confused than his baseline but otherwise did not have any specific complaints. Vitals and labs were within normal limits. A non-contrast CT of the brain and C-spine was performed and read as normal…

Neurology, Radiology, TraumaAustin QuinnNovember 16, 2020Emergency Radiology, Medical Error, Clinical Images

Diverticulitis? Guess Again.

A 50-year-old female presents to the emergency department complaining of two days of gradually worsening left lower quadrant abdominal pain. She endorses anorexia and multiple episodes of vomiting. She is slightly tachycardic, but afebrile. She is noted to have tenderness to palpation to the left lower quadrant but no significant rebound or guarding. Given her presentation, diverticulitis becomes the leading differential diagnosis, although renal colic is also a possibility. For that reason a non-contrast CT scan of the abdomen/pelvis is ordered for further evaluation…

Radiology, GI, GastroenterologyMichael WilkJune 5, 2020Emergency RadiologyComment

This is Not the Appendix You're Looking For

A previously healthy 11 year-old male presents to the ED with three days of lower abdominal pain. The patient was evaluated at an urgent care center prior to arrival and was sent to the ED to “rule out appendicitis.” The patient reports intermittent “stabbing” pain that was initially suprapubic, but moved to the right lower quadrant today. The patient states the pain comes and goes without a clear trigger, but he has been able to eat normally and go to school. His mom became concerned today when they were about to eat dinner and the patient had an episode of severe pain that caused him to lie down. His mom gave him acetaminophen with some relief. He has not had fever, nausea, vomiting, or diarrhea. He has no sick contacts. He denies dysuria and penile discharge…

Radiology, GU, Pediatrics, UltrasoundJessie WernerNovember 29, 2019Emergency Radiology, UrologyComment

Subtalar Dislocations

Orthopedics, Trauma, Radiology, ProceduresAlexandra SchickMarch 29, 2019OrthopedicsComment

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