Ultrasound Cases

Chronic cystitis changes and UB diverticulum

Blood in the urine, beyond the obvious. How point-of-care ultrasound accelerated diagnosis of bladder diverticulum and chronic cystitis while fast-tracking cancer exclusion

Dr Himanshu Gul Mirani

Extrarenal pelvis is usually a normal anatomical variant

Point-of-care ultrasound in suspected renal colic. Recognising extrarenal pelvis as a rare anatomical variant mimicking hydronephrosis

Dr Himanshu Gul Mirani

Wall–Echo–Shadow (WES) Sign suggestive of Gallbladder Stones in a Contracted Gallbladder after GLP‑1 Agonist–Associated Weight Loss: A Point‑of‑Care Ultrasound Case from the Emergency Department

Dr Himanshu Gul Mirani

Images showing hydronephrosis and clot within the urinary bladder

Point-of-Care Ultrasound in Acute Urinary Retention Revealing Post-Renal Acute Kidney Injury Secondary to Bladder Malignancy: A Case Report

Dr Himanshu Gul Mirani

Pre - and post - reduction of distal radius fracture (Colles’ fracture)

Real-Time Ultrasound Guidance for Distal Radius Fracture Reduction in the Emergency Department

Dr Himanshu Gul Mirani

The diagnostic value of point-of-care ultrasound in suspected appendicitis

Dr Himanshu Gul Mirani

Ultrasound findings suggestive of aortic dissection

The role of point-of-care ultrasound in the early recognition of type A aortic dissection

Dr Himanshu Gul Mirani

The Role of POCUS in Diagnosing Achilles Tendon Rupture: A Case Report

Dr Himanshu Gul Mirani

Aortic stenosis on POCUS - qualitative assessment on eyeballing

First presentation of Aortic Stenosis as VF arrest and role of POCUS

Dr Himanshu Gul Mirani

Vegetation seen on valve suggestive of infective endocarditis

POCUS picks up valve vegetations

Dr Himanshu Gul Mirani

CXR showing fluid overload and pleural effusion and POCUS images suggestive of venous congestion

VExUS scan in cardiorenal syndrome

Dr Himanshu Gul Mirani, Consultant in Emergency Medicine, Midland Metropolitan University Hospital, UK

CASE 1 – Complex abscess with no vascular connection seen in transverse and longitudinal planes; CASE 2 – Image 1 - Pseudoaneurysm with swirling blood, Image 2 shows - Yin-Yang Sign on Doppler

Using POCUS to Identify Vascular Structures in Soft-Tissue Presentations in the ED:Tale of 2 cases

Himanshu Gul Mirani , Rena Darbar
Midland Metropolitan University Hospital, United Kingdom

Sternal fracture picked up on POCUS; later confirmed on CT.

A Rare Case of Sternal Insufficiency Fracture Unveiled by POCUS: A Silent Break in the Osteoporotic Chest

Dr Himanshu Gul Mirani, Consultant in Emergency Medicine, Midland Metropolitan University Hospital, United Kingdom

A Tale of Two Cases: A Lines in Abdominal POCUS - Reliable Sign or Potential Pitfall in Diagnosing Pneumoperitoneum?

Dr. Himanshu Gul Mirani, Consultant in Emergency Medicine, Midland Metropolitan University Hospital, SWBH NHS Trust, UK

Type A dissection on POCUS

Dr. Himanshu Gul Mirani; Dr. Christopher Hadden
Nottingham University Hospitals, NHS Trust

CASE 1: Image of carotid vasculature and para tonsillar abscess.
CASE 2: Image of carotid vasculature and para-tonsillar abscess.

Submandibular approach for para tonsillar abscess (PTA)
assessment by POCUS

Amir Mahmood, Gemma Hirons, Amber Bristow, Dr. Himanshu Gul Mirani
Nottingham University Hospitals, NHS Trust

POCUS Of Sternoclavicular Joint To Assess Dislocation

Maria Pia Gauci (ENP), Dr. Himanshu Gul Mirani (ED Consultant)
Nottingham University Hospitals, NHS Trust

Fast-Track Diagnosis: POCUS in SBO for Early Front-Door Referrals from the Ambulance Assessment Bay in today’s crowded ED

Dr Himanshu Gul Mirani, Dr Hind Goriel

‘A Snap, a Dent, and then Sono: The Role of POCUS in Diagnosing Quadriceps Tendon Rupture in the
Emergency Department – A Case Report’

Dr Himanshu Gul Mirani, Dr Ravi Maharaj

Image showing a distended urinary bladder with sediments/ debris often seen in cystitis with a hypoechoic area within the prostrate gland suggestive of being an abscess.

Prostatic abscess picked up incidentally on POCUS as a cause of urosepsis

Dr Himanshu Gul Mirani
Nottingham University Hospitals, NHS Trust

Posterior shoulder dislocation on POCUS

Emily Rowe , Dr Himanshu Gul Mirani
Nottingham University Hospitals, NHS Trust

Posterior shoulder dislocation identification and confirmation of reduction using POCUS

Dr Himanshu Gul Mirani, Specialty Doctor, A&E, QMC
Nottingham University Hospitals, NHS Trust

Right femoral vessel scan image showing clot burden in both artery and vein.
DVT compression test was positive.
Left femoral vessel scan image which was positive for DVT on compression test.

POCUS SAVED LIMB IN CASE PARADOXICAL EMBOLI

Dr Himanshu Gul Mirani, Specialty Doctor, A&E, QMC
Nottingham University Hospitals, NHS Trust

Images showing positive DVT study on left leg; features of right heart strain on ECHO and Saddle PE confirmed on CTPA

POCUS IN PULMONARY EMBOLISM

Dr Himanshu Gul Mirani, Specialty Doctor, A&E, QMC
Nottingham University Hospitals, NHS Trust

POCUS in evaluation of ‘hot joint’

Dr Himanshu Gul Mirani, Specialty Doctor, A&E, QMC
Nottingham University Hospitals, NHS Trust

Rib fracture as seen on POCUS image with fracture suggested by the discontinuous / step in the ribcortex. Image acquired on the site of maximal clinical tenderness.

POCUS IN BLUNT CHEST INJURY

Dr Himanshu Gul Mirani, Specialty Doctor, A&E, QMC
Nottingham University Hospitals, NHS Trust

POCUS FOR EARLY DIAGNOSIS OF FINGER TENOSYNOVITIS

Dr Himanshu Gul Mirani, Specialty Doctor, A&E, QMC
Nottingham University Hospitals, NHS Trust

Necrotizing fasciitis on bedside ultrasound using STAFF criteria

Dr. Himanshu Gul Mirani
Nottingham University Hospitals, NHS Trust

Rare case of Morel-Lavallee Lesion identified on POCUS in ED

Dr Himanshu Gul Mirani, Clare Tomlinson

Right chest subpleural changes
Right chest air bronchograms on POCUS

CASE OF USELESS XRAY IN SEPSIS...POCUS COMES TO RESCUE

Dr Himanshu Gul Mirani, Specialty Doctor, A&E, QMC
Nottingham University Hospitals, NHS Trust

Grossly distended stomach with normal caliber aorta in the far field

Incidentally diagnosed gastric outlet obstruction while doing AAA scan

Dr. Himanshu Gul Mirani, Specialty Doctor, A&E, QMC
Nottingham University Hospitals, NHS Trust

Gastric Ultrasound in ED Procedural Sedation: A Game-Changer for Aspiration Risk Assessment?

Dr Himanshu Gul Mirani (Emergency Medicine Consultant),
Mr Prabhjeet Singh (Orthopaedics Registrar)

Focal Myositis Diagnosed Using Point-of-Care Ultrasound (POCUS): A Case Report

Dr Himanshu Gul Mirani

Subcostal view of the heart showing the epicardial fat and pericardial effusion

Epicardial fat masquerading as hemopericardium in a post PCI patient

Dr Himanshu Gul Mirani
Nottingham University Hospital, NHS Trust

Right hip transverse view: Demonstrates effusion
Right hip longitudinal view: Demonstrates effusion
Left hip longitudinal view: No effusion

Early Detection of Hip Joint Infections Using Point-of-Care Ultrasound (POCUS): A Case Series

Dr. Himanshu Gul Mirani Mr. Jaspreet Sehmbi
Midland Metropolitan University Hospital, Emergency Department, SWBH NHS Trust, UK

Bony spur in midfoot seen on POCUS. Spur seen on X-Ray. Inflamed flat with deep facial fluid and air in subcutaneous tissue, Subcutaneous air with thickening of subcutaneous tissue, CT confirms subcutaneous gas locules.

Beyond the Clinical Eye: POCUS as the Critical Differentiator in Emergency Skin and Soft Tissue Infection Management

Dr. Himanshu Gul Mirani
Midland Metropolitan University Hospital, Emergency Department, SWBH NHS Trust, UK

AIRWAY POCUS IN RESUSCITATION

Dr. Himanshu Gul Mirani, Specialty Doctor, EM, QMC
Dr. Andrew Lindsay, Consultant EM,QMC
Nottingham University Hospitals, NHS Trust

Sonographic Demonstration of Chilaiditi Sign in an Elderly Patient with Respiratory Distress and Abdominal Pain

Dr Himanshu Gul Mirani

COPD exacerbation vs Acute Heart Failure

Dr Himanshu Gul Mirani, QMC, Nottingham University Hospitals, NHS Trust

The patient was managed along standard sepsis guidelines with intravenous antibiotics and fluids. Her hemodynamics stabilized and she was admitted under urology team.

Emphysematous cystitis on POCUS: A lines in the bladder wall – A rare case

Dr Himanshu Gul Mirani

Ultrasound Cases

Blood in the urine, beyond the obvious. How point-of-care ultrasound accelerated diagnosis of bladder diverticulum and chronic cystitis while fast-tracking cancer exclusion

Point-of-care ultrasound in suspected renal colic. Recognising extrarenal pelvis as a rare anatomical variant mimicking hydronephrosis

Wall–Echo–Shadow (WES) Sign suggestive of Gallbladder Stones in a Contracted Gallbladder after GLP‑1 Agonist–Associated Weight Loss: A Point‑of‑Care Ultrasound Case from the Emergency Department

Point-of-Care Ultrasound in Acute Urinary Retention Revealing Post-Renal Acute Kidney Injury Secondary to Bladder Malignancy: A Case Report

Real-Time Ultrasound Guidance for Distal Radius Fracture Reduction in the Emergency Department

The diagnostic value of point-of-care ultrasound in suspected appendicitis

The role of point-of-care ultrasound in the early recognition of type A aortic dissection

The Role of POCUS in Diagnosing Achilles Tendon Rupture: A Case Report

First presentation of Aortic Stenosis as VF arrest and role of POCUS

POCUS picks up valve vegetations

VExUS scan in cardiorenal syndrome

Using POCUS to Identify Vascular Structures in Soft-Tissue Presentations in the ED:Tale of 2 cases

A Rare Case of Sternal Insufficiency Fracture Unveiled by POCUS: A Silent Break in the Osteoporotic Chest

A Tale of Two Cases: A Lines in Abdominal POCUS - Reliable Sign or Potential Pitfall in Diagnosing Pneumoperitoneum?

Type A dissection on POCUS

Submandibular approach for para tonsillar abscess (PTA) assessment by POCUS

POCUS Of Sternoclavicular Joint To Assess Dislocation

Fast-Track Diagnosis: POCUS in SBO for Early Front-Door Referrals from the Ambulance Assessment Bay in today’s crowded ED

‘A Snap, a Dent, and then Sono: The Role of POCUS in Diagnosing Quadriceps Tendon Rupture in theEmergency Department – A Case Report’

Prostatic abscess picked up incidentally on POCUS as a cause of urosepsis

Posterior shoulder dislocation on POCUS

Posterior shoulder dislocation identification and confirmation of reduction using POCUS

POCUS SAVED LIMB IN CASE PARADOXICAL EMBOLI

POCUS IN PULMONARY EMBOLISM

POCUS in evaluation of ‘hot joint’

POCUS IN BLUNT CHEST INJURY

POCUS FOR EARLY DIAGNOSIS OF FINGER TENOSYNOVITIS

Necrotizing fasciitis on bedside ultrasound using STAFF criteria

Rare case of Morel-Lavallee Lesion identified on POCUS in ED

CASE OF USELESS XRAY IN SEPSIS...POCUS COMES TO RESCUE

Incidentally diagnosed gastric outlet obstruction while doing AAA scan

Gastric Ultrasound in ED Procedural Sedation: A Game-Changer for Aspiration Risk Assessment?

Focal Myositis Diagnosed Using Point-of-Care Ultrasound (POCUS): A Case Report

Epicardial fat masquerading as hemopericardium in a post PCI patient

Early Detection of Hip Joint Infections Using Point-of-Care Ultrasound (POCUS): A Case Series

Beyond the Clinical Eye: POCUS as the Critical Differentiator in Emergency Skin and Soft Tissue Infection Management

AIRWAY POCUS IN RESUSCITATION

Sonographic Demonstration of Chilaiditi Sign in an Elderly Patient with Respiratory Distress and Abdominal Pain

COPD exacerbation vs Acute Heart Failure

Emphysematous cystitis on POCUS: A lines in the bladder wall – A rare case

Submandibular approach for para tonsillar abscess (PTA)
assessment by POCUS

‘A Snap, a Dent, and then Sono: The Role of POCUS in Diagnosing Quadriceps Tendon Rupture in the
Emergency Department – A Case Report’