Ultrasound Teaching Cases

Ultrasound of the Week # 14 Case Continued

"The case of the enlarged shoulder..."

In total, three views of the shoulder were obtained, and showed no evidence of fracture or dislocation.

A bedside ultrasound was performed to clinch the diagnosis:

Lateral shoulder view, directed at deltoid muscle:

Superior aspect of lateral shoulder:

A bedside ultrasound exam was performed using a GE 8.0 MHz linear array probe in the coronal, transverse and sagittal planes. A large anechoic fluid collection was noted between the humeral head and the overlying deltoid musculature, representing a traumatic deltoid hematoma.

The patients activated partial thromboplastin time came back at 74.7, most likely from over-heparinization from dialysis (patient was prescribed no regular anticoagulants). FFP was administered to the patient in the ED, and he was admitted to the trauma service. Ortho consultation recommended placement in a sling, and followup a week later. Reportedly, he was doing well.