Contributor Disclosures
Contributors
Dr. Jennifer Martin is an Ultrasound Fellow in the Department of Emergency Medicine at St. Luke’s Roosevelt Hospital in New York. Dr. Lorraine Ng is a Pediatric Emergency Medicine Fellow at Children’s Hospital at Montifiore Medical Center in New York. Dr. Turandot Saul is Fellowship Director and an Ultrasound Fellow in the Department of Emergency Medicine at St. Luke’s Roosevelt Hospital. Dr. Resa Lewiss is Division Director and an Ultrasound Fellow in the Department of Emergency Medicine at St. Luke’s Roosevelt Hospital.
Dr. Robert Solomon is the Medical Editor of ACEP News and editor of the Focus On series, core faculty in the emergency medicine residency at Allegheny General Hospital, Pittsburgh, and Assistant Professor in the Department of Emergency Medicine at Temple University School of Medicine, Philadelphia.
Disclosures
Dr. Martin, Dr. Ng, Dr. Saul, Dr. Lewiss, and Dr. Solomon have disclosed that they have no significant relationships with or financial interests in any commercial companies that pertain to this article.
Disclaimer
ACEP makes every effort to ensure that contributors to College-sponsored programs are knowledgeable authorities in their fields. Participants are nevertheless advised that the statements and opinions expressed in this article are provided as guidelines and should not be construed as College policy. The material contained herein is not intended to establish policy, procedure, or a standard of care. The views expressed in this article are those of the contributors and not necessarily the opinion or recommendation of ACEP. The College disclaims any liability or responsibility for the consequences of any actions taken in reliance on those statements or opinions.
Pearls and Pitfalls
When performing musculoskeletal ultrasound, comparison views are important to help differentiate between a potential pathologic process and an anatomical variant. Bilateral effusions are possible, especially in patients with transient synovitis, where they occur in up to one-fourth of patients ultimately diagnosed with this disease entity.7
Ensuring that the probe is positioned perpendicular to the skin will help avoid anisotropy, which is an artifact that can falsely suggest fluid when none is present. This is especially important in toddlers, who have a large hypoechoic cartilaginous zone between the ossified nucleus of the femoral head and the joint capsule.9
Missing slipped capital femoral epiphysis is a theoretical pitfall when performing hip ultrasound on the older child with a painful hip or limp. The physician should additionally consider obtaining plain radiography in this clinical setting.7
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