POCUS journal最新文献

{"title":"Fibromatosis Colli on Point of Care Ultrasound (POCUS): A Case Report.","authors":"Jeff Yang, Christine Rizkalla","doi":"10.24908/pocusj.v10i01.17787","DOIUrl":"https://doi.org/10.24908/pocusj.v10i01.17787","url":null,"abstract":"<p><p>Fibromatosis colli is a rare benign fibrosis of the sternocleidomastoid (SCM) muscle which manifests clinically as congenital muscular torticollis, or an ipsilateral head tilt with contralateral turning of the neck. Though benign, care must be taken not to miss other etiologies with similar clinical presentations, such as malignancies or abscesses. Point of care ultrasound (POCUS) offers a rapid, low-cost, and accessible option for adjunct imaging. In this case report, a 26-day-old boy presented to the pediatric emergency department for evaluation of a nontender, firm left-sided neck mass with preferential turning of his head to the right. POCUS showed a noncompressible, homogenous, well-defined mass in the left SCM without increased vascularity consistent with fibromatosis colli. The patient was discharged from the emergency department with outpatient follow-up. His follow-up course required no further imaging or testing, and the patient's symptoms resolved with physical therapy.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 1","pages":"196-199"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interrater Agreement of Physicians Identifying Lung Sliding Artifact on B-Mode And M-Mode Point of Care Ultrasound (POCUS).","authors":"Ross Prager, Hans Clausdorff Fiedler, Delaney Smith, Derek Wu, Robert Arntfield","doi":"10.24908/pocusj.v10i01.17807","DOIUrl":"https://doi.org/10.24908/pocusj.v10i01.17807","url":null,"abstract":"<p><strong>Background: </strong>Chest point of care ultrasound (POCUS) is a first-line diagnostic test to identify lung sliding, an important artifact to diagnose or rule out pneumothorax. Despite enthusiastic adoption of this modality, the interrater reliability for physicians to identify lung sliding is unknown. Additionally, the relative diagnostic performance of physicians interpreting B-mode and M-mode ultrasound is unclear. We sought to determine the interrater reliability of physicians to detect lung sliding on B-mode and M-mode POCUS.</p><p><strong>Methods: </strong>We performed a cross-sectional interrater agreement study surveying acute care physicians on their interpretation of 20 B-mode and M-mode POCUS clips. Two experienced clinicians determined the reference standard diagnosis. Respondents reported their interpretation of each POCUS B-mode clip or M-mode image. The primary outcome was the interrater agreement, determined by an intra-class correlation coefficient (ICC).</p><p><strong>Results: </strong>From September to November 2023, there were 20 survey respondents. Fourteen (70%) respondents were resident physicians. Respondents were confident or very confident in their skill performing chest POCUS in 14 (70%) cases, with 19 (90%) performing chest POCUS every week or more frequently. The ICC on B-mode was 0.44 and for M-mode was 0.43, indicating moderate agreement. There were no significant differences in interrater reliability between subgroups of confidence or experience.</p><p><strong>Conclusion: </strong>There is only moderate interrater reliability between clinicians to diagnose lung sliding. Clinicians have superior accuracy on B-mode compared to M-mode clips.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 1","pages":"92-98"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of the Cardiovascular Point of Care Ultrasound (POCUS) Exam by Internal Medicine Residents.","authors":"Christopher Chew, Katherine Lang, Manuel De La Rosa, Amanda K Bertram, Ariella Apfel Stein, Apurva Sharma, Timothy M Niessen, Brian T Garibaldi","doi":"10.24908/pocusj.v10i01.17791","DOIUrl":"https://doi.org/10.24908/pocusj.v10i01.17791","url":null,"abstract":"<p><strong>Background: </strong>Few studies have examined internal medicine residents' performance using cardiovascular point of care ultrasound (POCUS).</p><p><strong>Methods: </strong>From 2019 to 2022, first-year residents from two academic medical centers in Baltimore participated in the Assessment of Examination and Communication Skills (APECS). Interns examined a single patient with aortic insufficiency and were assessed on physical exam and POCUS technique, identifying physical exam and POCUS findings, generating a differential diagnosis, clinical judgment, and maintaining patient welfare. Spearman's correlation test was used to describe associations between clinical domains. Preceptor comments were examined to identify common errors in physical exam and POCUS exam technique and in identifying correct findings.</p><p><strong>Results: </strong>Fifty-three first-year residents (interns) performed a cardiovascular POCUS exam. Of these, 44 (83%) scored either \"unsatisfactory\" or \"borderline\" on their POCUS technique with a mean score of 29.5 (out of 100). Seventeen (32%) interns were able to correctly obtain a parasternal-long axis (PLAX) view with only 26 (52%) attempting an apical four-chamber (AP4) or subcostal (SUBC) view. Of the 11 participants who correctly obtained both PLAX and parasternal-short views (PSAX), 10 were able to properly identify a normal ejection fraction and the absence of a pericardial effusion. POCUS technique was statistically significantly associated with physical exam technique, identifying the correct POCUS findings, and generating a correct differential diagnosis (r=0.46, p<0.01; r=0.41, p=<0.01; r=0.60, p=<0.01, respectively).</p><p><strong>Conclusion: </strong>Internal medicine interns showed variable skill in performing and interpreting a cardiovascular POCUS exam. Further emphasis on teaching cardiovascular POCUS skills would likely increase ability to identify relevant cardiovascular findings and improve patient care.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 1","pages":"38-44"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Sound of Safety: DIVOT (Doppler Imaging for Vascular Orientation in Thoracic Procedures) Protocol.","authors":"Amy Fraser, Daniel S Brenner, Matthew Coghlan, Heather Andrade, Maya Haouili, William Graham Carlos, Edwin Jackson","doi":"10.24908/pocusj.v10i01.18071","DOIUrl":"https://doi.org/10.24908/pocusj.v10i01.18071","url":null,"abstract":"<p><p>Each year, more than 200,000 thoracentesis and percutaneous chest tube thoracostomy procedures are performed in the United States [1-4]. In both procedures, the initial step involves advancing a needle over the superior aspect of the rib into the intercostal space to access the pleural cavity. Traditional teaching suggests that this technique avoids the neurovascular bundle, which is typically shielded by the inferior border of the rib. However, this technique does not guarantee safety. Computed tomography studies have shown that the intercostal arteries (ICAs) are highly tortuous, with positions that can vary significantly within the intercostal space [5-7]. This variability can lead to ICA laceration even with an optimal traditional technique [8-9]. Significant hemorrhage into the pleural space may initially go unnoticed but can progress to hemorrhagic shock or even tension hemothorax physiology [10-12]. Improved procedural guidance is needed to enhance safety and achieve the goal of zero patient harm. We propose the DIVOT (Doppler Imaging for Vascular Orientation in Thoracic procedures) protocol using a combination of high-frequency linear ultrasound, color, and Power Doppler (PD) to identify an ICA and its collaterals before needle insertion. This can reduce the risk of accidental vascular injury during thoracentesis or percutaneous chest tube thoracostomy.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 1","pages":"83-87"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inside the April 2025 10 Year Anniversary Issue.","authors":"","doi":"10.24908/pocusj.v10i01.19279","DOIUrl":"https://doi.org/10.24908/pocusj.v10i01.19279","url":null,"abstract":"","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of Pediatric Retrocecal Appendicitis Using Point of Care Ultrasound (POCUS).","authors":"Carl Kaplan, Raizada Vaid, Michael Secko","doi":"10.24908/pocusj.v10i01.17744","DOIUrl":"https://doi.org/10.24908/pocusj.v10i01.17744","url":null,"abstract":"<p><p>Acute appendicitis is the most common pediatric surgical emergency. Diagnosis may be made by targeted point of care ultrasound (POCUS) of the right lower quadrant (RLQ) abdomen. This can be performed by trained emergency physicians and has similar accuracy to ultrasound performed by radiology technologists and interpreted by radiologists (RADUS) [1,2]. Pediatric patients with appendicitis may present without classical clinical signs and symptoms. Retrocecal appendicitis is often diagnosed late at perforation due to the anatomical position limiting diagnosis with ultrasound, despite the high prevalence of retrocecal appendix as an anatomic variation (up to 65%). Given the limited sensitivity for ultrasound in the diagnosis of appendicitis in patients with retrocecal appendix, these patients often undergo advanced imaging with computed tomography (CT) or magnetic resonance imaging (MRI), especially when increased abdominal wall thickness and/or high Body Mass Index (BMI) further limit the ultrasound examination [4-6]. We present a case series of retrocecal appendicitis imaged and diagnosed with POCUS, using novel transducer and patient positioning. In addition to standard graded compression of the RLQ with POCUS, this technique may add to the diagnostic accuracy of patients presenting atypically with anatomic variants.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 1","pages":"192-195"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Lies Beneath? Using Point of Care Ultrasound (POCUS) to Identify Soft Tissue Foreign Bodies in Children and Adults: A Literature Review.","authors":"David McCreary, Bhaskar Sarvesh, Maria Munir","doi":"10.24908/pocusj.v10i01.18072","DOIUrl":"https://doi.org/10.24908/pocusj.v10i01.18072","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to evaluate and appraise the existing evidence on the use of point of care ultrasound (POCUS) for identifying soft tissue foreign bodies (FBs).</p><p><strong>Methods: </strong>We searched PubMed, Medline, CINAHL, and Cochrane databases for prospective and retrospective studies evaluating the reliability of POCUS in identifying soft tissue FBs. Our primary intention was to review the paediatric-specific evidence base. However, due to a paucity of literature in this area, we also included relevant adult studies and case reports.</p><p><strong>Results: </strong>We identified a total of 42 unique articles with relevance to our study objective, of which 3 were paediatric cohort studies and 5 were cohort studies involving paediatric patients. There were two paediatric case series and six individual case reports relating to paediatric patients. The remaining studies either involved adults, did not specify the age of their subjects, or were relevant in-vitro studies.</p><p><strong>Conclusion: </strong>POCUS-users regard it as an effective tool for detecting soft tissue FBs. However, the existing evidence base for POCUS use in paediatric patients is limited. Evidence in adults is also relatively lacking compared with other areas of POCUS research, with few large studies evaluating its reliability. This literature review highlights the need for a large prospective paediatric study in order to confirm its effectiveness compared to traditional radiological imaging.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 1","pages":"110-118"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Point of Care Transesophageal Echocardiogram-guided CPR: Area of maximal compression.","authors":"Yannis Amador","doi":"10.24908/pocusj.v10i01.18111","DOIUrl":"https://doi.org/10.24908/pocusj.v10i01.18111","url":null,"abstract":"<p><p>During cardiopulmonary resuscitation (CPR), chest compressions are critical for augmenting cardiac output, primarily through left ventricular (LV) compression. However, achieving optimal compression without direct visualization can be challenging. Point of care transesophageal echocardiography (TEE) serves as an invaluable tool for real-time guidance, ensuring accurate chest compression positioning over the LV apex. In this case, initial compressions were misaligned over the left ventricular outflow tract (LVOT) and aortic valve (AV). TEE assessment enabled real-time identification and precise repositioning of compressions to the LV apex, resulting in marked improvements in arterial pressure waveforms and end-tidal CO₂ (ETCO₂)-both reliable indicators of CPR quality. This case highlights the critical role of TEE in cardiac arrest management, offering real-time diagnostic insights and optimizing compression mechanics. Integrating TEE into resuscitation protocols enhances the quality of chest compressions, supports hemodynamic stability, and may ultimately improve patient outcomes.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 1","pages":"61-63"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Point of Care Ultrasound (POCUS) Used to Diagnose Infective Endocarditis Following Multiple Negative Echocardiograms.","authors":"Adriano Sanjuan, Daniel S Brenner, Heather Andrade, Alyson Bundy, Philip Clapham, Nathan Markus, Irina K Hariri, Edwin Jackson","doi":"10.24908/pocusj.v10i01.17855","DOIUrl":"10.24908/pocusj.v10i01.17855","url":null,"abstract":"<p><p>Infective endocarditis (IE) is a life-threatening condition often diagnosed using the modified Duke's criteria, including bacteremia and pathognomonic echocardiographic findings. However, up to 30% of cases yield inconclusive results with transthoracic echocardiograms (TTE) or transesophageal echocardiograms (TEE). We present a case of a 68-year-old man with methicillin-susceptible <i>Staphylococcus aureus</i> (MSSA) bacteremia and recurrent fevers, in which multiple echocardiograms failed to detect valvular vegetations. However, an advanced cardiac point of care ultrasound (POCUS) examination identified a vegetation on the aortic valve, later confirmed by TTE and TEE. Although generalization is limited due to operator expertise and patient characteristics, this case demonstrates the utility of advanced cardiac POCUS in diagnosing IE in critically ill patients with negative initial echocardiograms. Incorporating advanced cardiac POCUS into routine diagnostic workflows may improve diagnostic accuracy and patient outcomes. Increasing use of advanced cardiac POCUS also highlights the importance of expanding proficiency among intensivists.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 1","pages":"72-77"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Man with Abdominal Bloating, Weight Loss.","authors":"Sara Greenwald, Mario Ramos, Brian Kohen","doi":"10.24908/pocusj.v10i01.18109","DOIUrl":"https://doi.org/10.24908/pocusj.v10i01.18109","url":null,"abstract":"<p><p>Point of care ultrasound (POCUS) is useful in diagnosing intussusception. In this case file, we describe a 69-year-old man presenting with nausea, vomiting, left upper quadrant abdominal pain and recent weight loss who had findings concerning for intussusception on POCUS. This led the emergency provider to order computed tomography (CT) which confirmed the diagnosis.</p>","PeriodicalId":74470,"journal":{"name":"POCUS journal","volume":"10 1","pages":"123-124"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}