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Yes, You CAN See Gout on Ultrasound!

Case 63 year old male presented to the ED  with left elbow swelling for a few days. The patient was  afebrile but the erythema was concerning for cellulitis and a collection around the medial aspect of the elbow. The ultrasound showed a small pocket containing hyperechoic tophi, suggestive of gout, although no drainable collection was […]

Thoracentesis- No X-ray required!

  Case: 88 year female with a history of ovarian cancer presented to the ED for shortness of breath. Two weeks prior, she was admitted with a similar presentation, was found to have a pleural effusion that was drained in hospital as well as a pneumonia that was successfully treated with antibioticstore.online. Her pleural effusion […]

Posterior Tibial Nerve block

Case: A 20 year old female presented to the ED after having stepped on a sewing needle 3 days earlier, having it now buried in the plantar surface of her left foot. She described pain when she walked, but no fevers, chills or other systemic symptoms. Her vital signs were normal and she was well […]

Why does my patient need to be flat?

With a recent N of 2, and with conversations about airway management, the RAMP position, and “defending physiology” ringing in my ears, I now have a new question: “I need to do a neck line. Does my patient need to be flat?” N of 1: Bad COPD, PNA, sick, no IV access. The pt. has bilat inguinal […]

Achilles Tendon Rupture, by Dr. Joshua Guttman

Case: A 58 year old male with no significant past medical history presented to the ED complaining of pain to the back of the left ankle for 2 weeks. He is on no medications and is a non-smoker. His injury occurred when playing handball 2 weeks earlier, where he felt a sudden pain to his […]

A case of asymmetric gallbladder wall thickening

Case:   A 50 year old female with a history of only iron deficiency anemia presented to the ED with 5 hours of a gradual onset of epigastric pain radiating into the chest as well as nausea, associated with one episode of vomiting. She had never experienced similar pain. Her ECG was normal and her […]