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SonoKids MSK infect

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Stephanie G Cohen, Sierra C Beck
A 4-year-old girl presented to the emergency department for evaluation of finger swelling after a dog bite. Point-of-care ultrasound was used to diagnose pyogenic flexor tenosynovitis of the digit after visualizing a fluid collection within the flexor tendon sheath. The patient underwent emergent incision and drainage of the digit with good outcome.
November 2015: Pediatric Emergency Care
Geoffrey E Hayden, Jana E Upshaw, Stephanie Bailey, Daniel B Park
Skin and soft tissue infections are common disease presentations to the pediatric emergency department, and rapid and accurate identification of potentially serious skin and soft tissue infections is critical. In cases of atraumatic musculoskeletal pain with systemic complaints, a bacterial etiology must be ruled out. Point-of-care ultrasonography is increasingly common in the pediatric emergency department and assists in rapid and accurate identification of a variety of disease processes. We present a case of a 14-year-old adolescent boy with atraumatic right knee pain to illustrate the benefits of point-of-care ultrasonography in the timely diagnosis of musculoskeletal and soft tissue pathology...
September 2015: Pediatric Emergency Care
Kevin Padrez, Jennifer Bress, Brian Johnson, Arun Nagdev
Infectious flexor tenosynovitis (FTS) is a serious infection of the hand and wrist that can lead to necrosis and amputation without prompt diagnosis and surgical debridement. Despite the growing use of point-of-care ultrasound (POCUS) by emergency physicians there is only one reported case of the use of POCUS for the diagnosis of infectious FTS in the emergency department setting. We present a case of a 58 year-old man where POCUS identified tissue necrosis and fluid along the flexor tendon sheath of the hand...
March 2015: Western Journal of Emergency Medicine
Jennifer C Laine, Jaime R Denning, Anthony I Riccio, ChanHee Jo, Jeanne M Joglar, Robert L Wimberly
In the assessment of septic arthritis of the hip in a pediatric population, ultrasound is a safe and easily conducted method to confirm an effusion. The need for MRI to further evaluate the patient for adjacent infection before treatment is debatable. Once an effusion is confirmed on ultrasonography, we have found that septic arthritis of the hip does not need advanced imaging before arthrotomy and debridement. Patients who fail to clinically respond to an initial hip arthrotomy and appropriate antibiotics may benefit from an MRI for the identification of concomitant infections that may require surgical intervention...
March 2015: Journal of Pediatric Orthopedics. Part B
Brett A Marvel, Gavin R Budhram
BACKGROUND: The red, swollen, infected hand can be a diagnostically challenging presentation in the emergency department (ED). Hand infections are a relatively uncommon ED complaint, and diagnoses may range from simple cellulitis to deep space abscess, and even to suppurative flexor tenosynovitis. The accurate differentiation of these clinical entities is of paramount importance to healing and recovery of function. CASE SERIES: In this case series, we review 4 patients with similar presenting complaints of a red, swollen hand, but with much different diagnoses and eventual treatment strategies...
January 2015: Journal of Emergency Medicine
Peter J Emiley, John L Kendall, Jennifer W Bellows
BACKGROUND: Osteomyelitis is a challenging and commonly considered diagnosis in the emergency department. Early recognition and treatment with appropriate antibiotic therapy is crucial to prevent complications. OBJECTIVE: This case reviews relevant literature and typical ultrasound features of osteomyelitis. It highlights a previously undescribed and practical application of emergency department bedside ultrasonography, adding to the diagnostic armamentarium for this disease process...
January 2015: Journal of Emergency Medicine
Allison Sauler, Turandot Saul, Resa E Lewiss
Pyomyositis (PM) is an infection of skeletal muscle, often associated with an abscess. Patients typically have predisposing risk factors or are immune compromised. The disease is often misdiagnosed, mistreated,and goes undetected until late in the patient's clinical course.We present a case of a patient without obvious predisposing risk factors who complained of right thigh pain, swelling, redness, and fevers for 4 days.Point-of-care ultrasound revealed muscle edema and subcutaneous emphysema without signs of an overlying cellulitis...
March 2015: American Journal of Emergency Medicine
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