Core ultrasound findings

Background

• ED ultrasounds are focused point-of-care studies utilized to answer basic questions
• The majority of these questions are yes/no or present/absent

Findings on Classic Exams

Aorta

• Greatest diameter in cm (complete study is from celiac to bifurcation)

Bladder

• Volume calculated with measurements on 3 axes

Cardiac

• Pericardial effusion
  • None, Small (<1cm), Mod (1-2cm), Large (>2cm)
• Squeeze
  • Poor, Mod, Good, Hyperdynamic
• RV:LV ratio
  • <1:1, 1:1, >1:1
• Aortic root in cm (measured outside to inside)

DVT

• Identify noncompressible vessels
  • Greater Saph DVT, Fem DVT, Pop DVT

E-FAST

• Free fluid
  • None, Morison’s, LUQ, Pelvic
• Pericardial effusion
• Pneumothorax
  • None, R, L, B/L
• Hemothorax
  • None, R, L, B/L

Gallbladder

• Gallstones/sludge
  • Present, Absent
• Pericholecystic fluid
  • Present, Absent
• Gallbladder wall thickening
  • Present, Absent
• Sonographic Murphy’s
  • Present, Absent

IVC

• Diameter measured 2cm caudal from hepatic vein
  • <1.5cm, 1.5-2.5cm, >2.5cm
• IVC collapse
  • No collapse, <50% collapse, >50% collapse

MSK

• Identify presence of absence of exam indication
  • Fracture, Joint effusion, Complete tendon rupture or Partial tendon rupture

Pelvic (Transabdominal)

• Definitive pregnancy
  • NDIUP or IUP
• Free Fluid
  • No significant, Small, Mod, Large
• Fetal heart rate in BPM

Pelvic (Transvanginal)

• Definitive pregnancy
  • NDIUP or IUP
• Free Fluid
  • No significant, Small, Mod, Large
• Fetal heart rate in BPM
• Ovary assessment
  • No cysts, Simple cyst, Complex cyst

Renal

• Hydronephrosis
  • No significant, Mild, Mod, Severe
• Stones
  • Present, Absent
• Ureteral jets
  • Not visualized, R, L, B/L

Ocular

• Describe abnormal findings
  • No posterior echoes, Retinal detachment, Vitreous detachment, Posterior echoes of uncertain etiology
• Optic nerve sheath diameter in mm

Soft Tissue

• Cobblestoning
  • Present, Absent
• Abscess
  • Present, Absent
• Foreign body
  • Present, Absent

Thoracic

• B lines
  • <3, ≥3
• Pneumothorax
  • None, R, L, B/L
• Pleural effusion
  • None, R, L, B/L
• Consolidation
  • None, R, L, B/L

Authors

Neil Young, Daniel Ostermayer