Welcome to emergency medicine cases.com. I'm your host, Dr. Anton Helman, bringing you Canada's

brightest minds in emergency medicine from EMC Studios in Toronto. In this episode 18, part two,

more emergency ultrasound pearls, pitfalls, and controversies. You bring back Dr. Greg Hall, Dr. Jordan Shanken, Dr. Paul Hannam, and Dr. Jason Fisher. Dr. Greg Hall is an emergency physician at Brantford General Hospital and assistant professor at McMaster University. He was a chief of the emergency department in Cambridge, Ontario, for five years. He's a co-developer of Eddie II, the Advanced Emergency Department Echo

course. He's a winner of multiple teaching awards, including the clinician of the year for his

ultrasound instruction. Dr. Jordan Chenkin is an emergency physician at Sunnybrook Health

Science Center and an assistant professor at the University of Toronto. He is a master

instructor with the Canadian Emergency Ultrasound Society and an instructor for the Eddie and the

Eddie II ultrasound courses. He's conducted and published research on training for ultrasound assisted procedures.

Dr. Paul Hannam is an emergency physician and chief of emergency services of Toronto East

General Hospital and a lecture at the University of Toronto. He's an instructor for the

Eddie and the Eddie 2 courses and lectures on emergency ultrasound. Dr. Jason Fisher is an emergency physician at

the hospital for sick children in Toronto where he is the physician lead for emergency

ultrasound. He's an assistant professor at the University of Toronto. He's lectured and

instructed physicians internationally on ultrasound and pediatric emergency medicine

and leads the emergency ultrasound program at Sick Kids Hospital.

Let's move on to our next case and talk about pediatric, soft tissue infection and joint infection.

The case is that of an 11-month-old female who presents with a swollen right lower leg around the ankle with a fever. An x-ray is done and it's normal and blood work shows mildly elevated white blood cell count and inflammatory markers.

Sometimes when we're presented with a patient who has warm red swollen skin, it's very

difficult to tell clinically whether they've got cellulitis requiring antibiotics

or whether they've got an underlying abscess that requires incision and drainage or more rarely

if the patient looks sick or is really febrile and a lot of pain, whether there might be necrotizing

fasciitis requiring OR debridement. It's sometimes even difficult to tell clinically if the redness underlying a joint

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