Ultrasound: Soft tissue: Difference between revisions
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===Findings=== | ===Findings=== | ||
===Pearls and Pitfalls=== | |||
==Foreign Body== | ==Foreign Body== | ||
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
- Select linear probe (high freq probe)
- Scan area of concern (orientation of probe not as important)
- Rotate 90° over area of concern
- If hypoechoic area is identified, apply gentle pressure over area
Findings
Cellulitis
Images
Instructions
- Select linear probe (high freq probe)
- Scan area of concern (orientation of probe not as important)
- Rotate 90° over area of concern
Findings
Pearls and Pitfalls
Foreign Body
Images
Instructions
- Select linear probe (high freq probe)
- Scan area of concern (orientation of probe not as important)
- Rotate 90° over area of concern
Findings
- FB can show 2 different signs
- Acoustic shadow - Ring down appearance
- Common with wood and splinters
- Acoustic shadow - Ring down appearance
- Reverberation
- Common with metal such are retained insulin needle
- Reverberation
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
- ↑ 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.