Sinai Faculty Watch
Drs. Nelson, Baumlin and Basavaraju wrote up an interesting case that was featured in the Correspondence section of the September 2006 Annals of Emergency Medicine (Vol. 48, No. 3, pp339-340). The letter was titled, Sonographic Diagnosis of Axillary Artery Aneurysm Presenting As Painful Axillary Mass and features some vivid photos. The summary is excerpted below:
Although the assessment of abdominal aortic aneurysms has long been a standard indication for bedside ultrasound, this case represents a previously unreported presentation (possible abscess) of a rare condition (axillary artery aneurysm). In this case, rapid assessment using bedside ultrasonography was able to unequivocally exclude abscess from the differential diagnosis, and allow the proper consultants to become involved earlier in the course of the ED visit. Furthermore, identification of the axillary artery aneurysm led to obtaining a computed tomography scan which revealed a larger and potentially lethal aortic aneurysm. Although it is unlikely that an emergency physician would have attempted to incise and drain a pulsatile “abscess,” it is useful to distinguish a mass impinging on a vessel from a mass which is a vessel.
Incidentally, the letter to Annals immediately following this one is from a former classmate. It is indeed a small EM world.
