Revisiting pleural effusion
Identification of pleural effusions is one of the basic applications of Internal Medicine and Nephro POCUS. As previously discussed, pleural fluid appears as an anechoic area above the diaphragm surrounding […]
Hemodynamic POCUS in cirrhosis: think beyond the IVC
In nephrology practice, acute kidney injury (AKI) in patients with cirrhosis often poses a diagnostic challenge owing to multitude of etiologic possibilities and overlapping presentations. Most such patients end up […]
A case of hydronephrosis
An elderly gentleman was seen in the nephrology clinic for acute kidney injury (AKI) on underlying chronic kidney disease stage III. Estimated glomerular filtration rate (eGFR) was 18 ml/min at […]
Intravenous fluids in septic shock: should we be content with the blanket approach?
Recently, the findings of CLASSIC trial were published in the NEJM, which demonstrated that among adult patients with septic shock in the ICU, intravenous fluid (IVF) restriction did not result […]
Left atrial ridge
This apical 4-chamber view obtained from a patient with end-stage kidney disease during physical examination demonstrates some hyperechoic structure in the left atrium resembling a Q-tip. Is it abnormal? It […]
Point-of-care ultrasound in Hyponatremia
Nephrologists are often consulted for evaluation of hyponatremia. While there can be a lot of causes, the basic approach to diagnosis is simple. First, look at serum osmolality. Serum sodium […]
Hemodynamic phenotypes in Nephrology
This table (from our KI reports article) summarizes common POCUS findings in various hemodynamic phenotypes that we encounter in day-to-day nephrology practice. Basic POCUS (without cardiac Doppler) cannot differentiate between […]
Hiatal hernia on Focused Cardiac Ultrasound
This apical 4-chamber view is obtained from a patient with shortness of breath being managed with escalation of diuretic therapy, which eventually led to hypovolemic hyponatremia. What does it show? […]
Checklist for interpreting kidney ultrasound
In our experience, checklists help novice users to systematically interpret the sonographic findings and reduce errors. So, I made SECONDS checklist for interpretation of nephrologist-performed renal ultrasound. Simply, it prompts […]
Gartner’s duct cyst
A middle-aged woman was seen in the nephrology clinic for chronic kidney disease. She also had a history of recurrent urinary tract infections. Physical exam (POCUS) revealed an anechoic/hypoechoic structure […]