Finding the Balance: The Point-of-Care Ultrasound Diagnosis of Pseudoaneurysm

A 49-year-old male with recent intravenous drug use presents to the Emergency Department with right arm swelling. He states this lump in his arm is painless and has been slowly growing for months. Vitals are BP 109/72, HR 78, SpO2 99% on room air, and T 36.9C. Physical exam shows a golf ball-sized mass in the right antecubital fossa (Figure 1) without overlying skin changes or distal neurovascular deficits. Point-of-care ultrasound (POCUS) was performed utilizing a water bath with visualization of bidirectional swirling in a round cavity adjacent to the brachial artery (Figure 2; Video 1).  Given hemodynamic stability and chronicity of symptoms, no additional imaging was required, and he was discharged with outpatient vascular surgery follow-up and counseled on the risk of exsanguination.
Source: The Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: Visual Diagnosis in Emergency Medicine Source Type: research