Search Our Scientific Publications & Authors

Ann Emerg Med 2019 09 27;74(3):372-380. Epub 2019 Mar 27.

Department of Emergency Medicine and Department of Medicine, Division of Infectious Diseases, Olive View-UCLA Medical Center, Sylmar, CA.

Study Objective: We examine the utility of emergency department (ED) ultrasonography in treatment of skin and soft tissue infections.

Methods: We enrolled ED patients with skin and soft tissue infections and surveyed clinicians in regard to their pre-ultrasonography certainty about the presence or absence of an abscess, their planned management, post-ultrasonography findings, and actual management. We determined sensitivity and specificity of ultrasonography and clinical evaluation, and assessed appropriateness of management changes based on initial clinical assessment and outcomes through 1-week follow-up. Read More

J Emerg Med 2019 May 10;56(5):536-539. Epub 2019 Feb 10.

Department of Pediatrics, Awaji Medical Center, Sumoto City, Hyogo Prefecture, Japan.

Background: Although fractures of the sternum are rare in young children, owing to the compliance of the chest wall, these fractures are still possible and require thorough examination. We present a case that emphasizes the usefulness of point-of-care ultrasound in the diagnosis of a pediatric sternal fracture complicated by a subcutaneous abscess.

Case Report: A 5-year-old boy presented with tenderness of the sternum, with diffuse swelling extending bilaterally to the anterior chest wall. Read More

Emerg Radiol 2016 Feb 3;23(1):29-33. Epub 2015 Oct 3.

Department of Radiology, University of Michigan Health System, 2910H Taubman Center, 1500 E. Medical Center Dr., SPC 5326, Ann Arbor, MI, 48109-5326, USA.

In our study, we sought to report the management, clinical outcomes, and follow-up rates of patients who presented for evaluation of breast abscess in the Emergency Department (ED) after hours. A retrospective search of ultrasound reports at our institution identified all patients from January 1, 2009 to June 30, 2013 who were scanned in the ED after hours to evaluate for breast abscess. Patient demographics, clinical information, imaging findings, follow-up rates, and outcomes were reviewed. Read More

J Emerg Med 2015 Jan 12;48(1):63-8. Epub 2014 Oct 12.

Department of Emergency Medicine, Tufts University School of Medicine, Baystate Medical Center, Springfield, Massachusetts.

Background: The red, swollen, infected hand can be a diagnostically challenging presentation in the emergency department (ED). Hand infections are a relatively uncommon ED complaint, and diagnoses may range from simple cellulitis to deep space abscess, and even to suppurative flexor tenosynovitis. The accurate differentiation of these clinical entities is of paramount importance to healing and recovery of function. Read More

J Emerg Med 2015 Jan 18;48(1):e15-7. Epub 2014 Sep 18.

Department of Emergency Medicine, Denver Health Medical Center, Denver, Colorado; University of Colorado School of Medicine, Aurora, Colorado.

Background: Osteomyelitis is a challenging and commonly considered diagnosis in the emergency department. Early recognition and treatment with appropriate antibiotic therapy is crucial to prevent complications.

Objective: This case reviews relevant literature and typical ultrasound features of osteomyelitis. Read More

J Emerg Med 2014 Aug 28;47(2):e49-51. Epub 2014 May 28.

Department of Emergency Medicine, Naval Medical Center, San Diego, California.

Background: Sialolithiasis with salivary gland obstruction can mimic more frequently occurring illnesses such as facial and dental infection and abscess. It is often difficult to discern the etiology of facial pain and swelling on physical examination alone, requiring advanced imaging in the emergency department.

Case Report: We describe the case of a 37-year-old man who presented with 5 days of worsening unilateral facial pain and swelling. Read More

Crit Care Clin 2014 Apr 18;30(2):243-73, v. Epub 2014 Jan 18.

University of Arizona College of Medicine-Phoenix, 550 E. Van Buren, Phoenix, AZ 85004, USA; Emergency Medicine Ultrasound Program & Fellowship, Maricopa Integrated Health Care System, 2601 East Roosevelt, Phoenix, AZ 85008, USA; Simulation Based Training Program & Fellowship, Maricopa Integrated Health Care System, 2601 East Roosevelt, Phoenix, AZ 85008, USA; Emergency Medicine Residency Program, Maricopa Medical Center, 2601 East Roosevelt, Phoenix, AZ 85016, USA.

Bedside sonography for the evaluation of soft tissue and musculoskeletal conditions has become indispensible for physicians caring for patients in critical, emergency, and urgent care settings. This article reviews indications, techniques, and imaging appearances of common conditions encountered in clinical practice. Read More

Neurol Res 2013 Mar;35(2):149-58

Department of Anesthesiology, Critical Care and Pain Medicine, Section of Neuroanesthesia and Neurocritical Care, Sapienza University of Rome, Rome, Italy.

Objective: To analyze the diagnostic, monitoring, and procedural applications of ultrasound (US) imaging in neurocritical care (NCC) patients.

Method: US imaging has been extensively validated in various subset of critically ill patients, but not specifically in the NCC population. We reviewed the clinical applications of US imaging for heart, vascular, brain, and lung evaluation and for possible procedural uses in NCC patients. Read More

Am J Emerg Med 2011 Sep 1;29(7):790-5. Epub 2010 May 1.

Department of Emergency Medicine, University of Nebraska Medical Center, Omaha, NE 68198-1150, USA.

Objective: The purpose of the study was to compare bedside ultrasound (US) and panorex radiography in the diagnosis of a dental abscess in emergency department (ED).

Methods: A retrospective review of ED records of adult patients with atraumatic facial pain, swelling, and toothache who received a panorex x-ray and bedside US was performed. Medical records were reviewed for ED evaluation and disposition. Read More

Gastrointest Endosc 2008 Jun 18;67(7):1180-4. Epub 2008 Apr 18.

Division of Gastroenterology-Hepatology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama 35294, USA.

Background: Although the role of bedside endoscopy for the provision of emergent diagnosis and therapy is well known, the concept of bedside EUS requires further validation.

Objective: To evaluate the concept of bedside EUS and assess its impact on patient management.

Design: A prospective study. Read More

Clin Exp Rheumatol 2006 May-Jun;24(3):229-32

Cattedra di Reumatologia, Università di Roma La Sapienza, Roma, Rome, Italy.

Ultrasonography (US) is a reliable and useful diagnostic tool for the assessment of hip pathology. It depicts changes within the coxo-femoral joint (synovitis, erosions, osteophytes) and in the adjacent peri-articular tissues (calcifications, tendonitis, enthesitis, bursitis) in many rheumatic diseases (rheumatoid arthritis, spondyloarthritis, osteoarthritis, polymyalgia rheumatica ) and in some orthopaedic disorders (septic arthritis, trauma, abscess, painful hip after arthroplasty). It is commonly used both in adults and in children. Read More

Acad Emerg Med 2005 Jul;12(7):601-6

Department of Emergency Medicine, University of California, Irvine, Orange, CA 92868, USA.

Objectives: Soft tissue infections are a common presenting complaint in the emergency department (ED). The authors sought to determine the utility of ED bedside ultrasonography (US) in detecting subcutaneous abscesses.

Methods: Between August 2003 and November 2004, a prospective, convenience sample of adult patients with a chief complaint suggestive of cellulitis and/or abscess was enrolled. Read More

Am J Emerg Med 2004 Nov;22(7):589-93

Department of Emergency Medicine, Medical College of Georgia, 1120 15th Street, Atlanta, GA 30912-4007, USA.

Researchers have described the use of bedside emergency ultrasound as an effective way to evaluate for and accurately drain potential abscesses. Similarly, descriptions exist of long bone fracture evaluation in the wrist and hands. Tendon injury can also be detected with ultrasound and exploration can be obviated or at least focused. Read More

Radiologe 2005 Jan;45(1):34-43

Institut für Diagnostische & Interventionelle Radiologie, Universitätsklinikum, Essen.

Complimentary to orthotopic liver transplantation (OLT), living donor liver transplantation (LDLT) is increasingly considered a therapeutic option in the therapy of end-stage liver disease. Accurate pre- and postoperative imaging is crucial for the transplantation success and represents an established part of the current evaluation algorithms. This article summarizes the most important requirements and the current imaging standards. Read More

Am J Emerg Med 2004 Jul;22(4):315

Curr Probl Surg 2001 Mar;38(3):141-212

Emory University School of Medicine, Department of Surgery, Trauma/Surgical Critical Care, Grady Memorial Hospital, Atlanta, Georgia, USA.

As the role of the general surgeon continues to evolve, the surgeon's use of ultrasound imaging will surely influence practice patterns, particularly for the evaluation of patients in the acute setting. With the use of real-time imaging, the surgeon receives "instantaneous" information to augment the physical examination, to narrow the differential diagnosis, or to initiate an intervention. With select ultrasound examinations, the surgeon can rapidly evaluate adult and pediatric patients with an acute abdomen, especially those patients who are hypotensive. Read More

Rontgenpraxis 2000 ;52(10-12):322-9

Universitätsklinik für Radiodiagnostik der Universität Wien, AKH-Wien, Osterreich.

Purpose: To assess the diagnostic value of thoracic CT-scans in comparison with conventional chest radiographs in ICU-patients.

Methods: Chest radiographs and corresponding thoracic CT-scans of 25 consecutive surgical ICU-patients were reviewed and interpreted independently by two radiologists. We analyzed the additional information provided by CT-scans and the diagnostic and therapeutic relevance of these findings. Read More

Semin Respir Infect 1999 Mar;14(1):31-8

Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.

Radiology plays a central role in the evaluation and management of pleural space infections. Conventional radiographs, including decubitus films, remain the primary radiological study in the detection of parapneumonic pleural effusions. Loculated collections develop as a result of visceral-to-parietal pleural adhesions and appear radiographically as longitudinally oriented, lenticular-shaped opacities. Read More

Surg Clin North Am 1998 Apr;78(2):337-64

Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.

As the role of the general surgeon continues to evolve, the surgeon's use of ultrasound will surely influence practice patterns, particularly for the evaluation of patients in the acute setting. With the use of real-time imaging, the surgeon receives "instantaneous" information to augment the physical examination, narrow the differential diagnosis, or initiate an intervention. With select ultrasound examinations, the surgeon can rapidly evaluate adult and pediatric patients who present with an acute abdomen, especially those in shock. Read More

Crit Care Clin 1994 Apr;10(2):321-39

Department of Radiology, Wayne State University School of Medicine, Detroit, Michigan.

In one's attempt to arrive at the most accurate diagnosis in the critically ill, the selection of the most efficacious and rapid imaging modality can be problematic to clinicians, especially if the clinical presentation is confusing. The selection most often, is between US and CT. In general, US is advantageous in that it can be performed at bedside and is a faster and less costly examination. Read More

Neurol Med Chir (Tokyo) 1989 Aug;29(8):740-5

Twenty-five patients underwent bedside ultrasonographic examination through a postoperative skull defect, and the images were compared with axial computed tomography (CT) scans. The patients included 12 with cerebrovascular disease, two with brain tumor, one with a brain abscess, and 10 with head injury. Clear ultrasonographic images were obtained in all patients except one who had undergone a suboccipital craniectomy. Read More

AJNR Am J Neuroradiol 1982 Jul-Aug;3(4):431-4

Real-time sonographic findings in 20 infants with bacterial meningitis are reported. The spectrum of features included normal scans, ventricular enlargement, focal areas of increased cortical echogenicity, ventricular bands, and cerebral abscess. Areas of increased cortical echogenicity on sonography representing meningoencephalitis corresponded to areas of contrast enhancement seen on computed tomography (CT). Read More