Journal of clinical ultrasound : JCU
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To evaluate clinical and imaging outcomes after ultrasound (US)-guided 3% polidocanol (POL) foam-sclerotherapy of venous malformations (VMs). ⋯ US-guided sclerotherapy with 3% POL foam is safe and effective. Lesions with up to 50% anechoic areas had better resolution, without correlation with patient satisfaction.
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Case Reports
Ultrasound-guided dorsal penile nerve block performed in a case of zipper entrapment injury.
Injury to the penis resulting from zipper entrapment is a painful condition that presents a unique anesthetic challenge to the emergency physician and may even require procedural sedation for removal. In this case report, we describe successful removal of zipper entrapment from the penis of a 34-year-old patient after the application of an ultrasound-guided dorsal penile nerve block. We discuss the anatomy, sonographic features, and steps required for the nerve block procedure. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:589-591, 2017.
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We report the case of a 22-year-old athlete who sustained a blunt thoracic trauma to the right chest causing a costal cartilage fracture. Plain radiographs revealed no abnormalities while sonographic (US) examination performed a week later because of persistent pain led to the diagnosis of a displaced fracture of the right tenth costal cartilage. ⋯ We recommend the use of US in patients with persisting pain after thoracic trauma with negative plain radiographs of the ribs to rule out radiographically occult costal cartilage fractures. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:605-607, 2017.
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Point-of-care ultrasound (POCUS) is integral to the practice of emergency medicine (EM). Furthermore, EM-performed POCUS (EM-POCUS) offers consultants the opportunity to avoid delays in care due to wait times for confirmatory imaging studies. This study is the first to describe the perception of POCUS to consulting services at a single institution where EM-POCUS is routinely performed. ⋯ Study respondents demonstrated limited confidence and utilization of EM-POCUS in this institution. Increased understanding of EM-POCUS training and expanded image availability may improve consultant utilization. Future studies, performed nationally, should further describe the value of EM-POCUS to consultant services. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:408-415, 2017.
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Sonographic-guided tibial nerve block allows for rapid anesthetization of the heel and plantar regions of the foot. We describe a variant technique for tibial nerve regional anesthesia utilizing perineural injection of the medial plantar nerve proximal to the sustentaculum tali where the nerve is superficial and readily accessed, with resultant retrograde flow of local anesthetic proximally. Perineural injection of the medial plantar nerve at the inframalleolar level provides a simple, safe, and effective alternative method to achieve tibial nerve block for regional anesthesia in a variety of procedures. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:134-137, 2017.