Ultrasound: Soft tissue: Difference between revisions

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===Findings===
===Findings===
*FB can show 2 different signs
**Acoustic shadow - Ring down appearance
***Common with wood and splinters


**Reverberation
***Common with metal such are retained insulin needle
===Pearls and Pitfalls===
*U/S is no sensitive for FB (U/S will miss a substantial amount of FBs)
**Xray or other modality may be needed for look during negative exams
*Real-time U/S can aid in FB removal
*Water baths may be helpful for extremities
*Scar tissue may mimic FB


==External Links==
==External Links==

Revision as of 17:08, 5 January 2015

Background

  • Soft tissue u/s can help with differentiating abscess from cellulitis
  • Many types of foreign bodies can be visualized

Abscess

  • Novice sonographers can predict a positive I&D with SN 0.97 and SP 0.67 (vs clinical exam 0.76 and 0.83)[1]

Images

Instructions

  1. Select linear probe (high freq probe)
  2. Scan area of concern (orientation of probe not as important)
  3. Rotate 90° over area of concern
  4. If hypoechoic area is identified, apply gentle pressure over area

Findings

Cellulitis

Images

Instructions

  1. Select linear probe (high freq probe)
  2. Scan area of concern (orientation of probe not as important)
  3. Rotate 90° over area of concern

Findings

Foreign Body

Images

Instructions

  1. Select linear probe (high freq probe)
  2. Scan area of concern (orientation of probe not as important)
  3. Rotate 90° over area of concern

Findings

  • FB can show 2 different signs
    • Acoustic shadow - Ring down appearance
      • Common with wood and splinters
    • Reverberation
      • Common with metal such are retained insulin needle

Pearls and Pitfalls

  • U/S is no sensitive for FB (U/S will miss a substantial amount of FBs)
    • Xray or other modality may be needed for look during negative exams
  • Real-time U/S can aid in FB removal
  • Water baths may be helpful for extremities
  • Scar tissue may mimic FB

External Links

Sources

  1. Berger, T, et al. Bedside ultrasound performed by novices for the detection of abscess in ED patients with soft tissue infections. Am J Emerg Med. 2012; 30(8):1569-73. doi: 10.1016/j.ajem.2011.08.002.