January 2017

First place

Dr. Angela Wild

Prize: $15 Starbucks gift certificate

JCB: "Case: 42 yo M bed bound, PEG/Trach, from NH (remote GSWs) p/w fever, hypoxia, tachycardia. 

-in the first clip the probe is held in a coronal axis at the diaphragm level mid axillary line on the right side. This labelled graphic might help. Importantly, spine sign (this graphic) extends cephalad above the diaphragm indicating that sono waves are transmitting through whatever is in the thorax (in this case a dense consolidated lung). This could also occur in pleural effusion but when normal lung occupies the whole thorax, the scattering from lung air stops the spine sign at the level of the diaphragm. 

-in the second clip you can see textbook images of hyperechoic air moving through patent airways within the surrounding consolidated and mid-echogenic lung parenchyma causing what we call sonographic air bronchograms. THIS IS BEAUTIFUL!"

Winning Bedside Thoracic Ultrasound 

Another Clip

CXR 1

CXR 2

 

runner-up

?Mystery Resident

Prize: Glory and Fame

JCB: "Another interesting case to discuss: 92 F arrived hypotensive, borderline hypoxia, bed bound, leg swelling. 

a. You can see a massive RV on PLAX & PSSA with septal bowing toward the LV and subsequent decrease LV volume. 

b. LV function is hyper dynamic (endocardium touching during systole) and small chamber 2/2 bowing of septum

c. Tricuspid regurgitation jet is seen and measured using doppler with Max Velocity seen as approximately 130cm/sec (1.3 m/s) suggesting low velocity (categorized as less than 3.7 m/s) and therefore probable ACUTE RV dysfunction. " 

PLAX

PSSA

A4

Doppler of Tricuspid Regurg Max Velocity