Dx: Prostatic Mass

Upon seeing the images on the screen, you notice a tinge of red in your resident’s cheeks as she begins her spiel about the need to perform a prostate exam as part of the work up today. She eloquently explains to the patient that the ultrasound results and his symptoms are concerning for a prostatic mass that is eroding into the base of his urinary bladder (Image 3). On the transverse view of the bladder a hyperechoic mass can be seen along the posterior wall of the bladder. In the longitudinal view, you can see the hypoechoic lumen of the mass originating from the prostate to the lower left of the bladder wall. Your resident decides to order blood work, comprehensive imaging, and admit the patient to the hospital for further evaluation and treatment of a suspected prostate malignancy so that he doesn’t get lost to follow up. Back in the doc box, you remind your resident that this is what residency is all about and we were lucky to have another chance to make the right diagnosis for the patient. Sometimes life is not always about chance, but more so about choice. When provided with a second chance to get it right, try to make the right choice for your patient. Teresa S. Wu (@TeresaWuMD) is the Associate Residency Director, and Director of Ultrasound and Simulation Programs and Fellowships, for the Maricopa EM Program in Phoenix, Arizona. Dr. Wu is the creator of SonoSupport, an ultrasound app for smartphones and tablets. Brady Pregerson (@TheSafetyDoc) manages a fee onlin...
Source: EPMonthly.com - Category: Emergency Medicine Authors: Tags: Uncategorized Source Type: news