Image 1 RMYou’ve got a seemingly straightforward complaint. Should you reach for your Foley or your ultrasound probe?

Distended-BladderW RMNew patient is a 5-year-old male with a history of a circumcision three months ago for recurrent UTIs. His mom states he has been having intermittent generalized abdominal pain associated with dysuria and urinary urgency. Despite being potty trained since he was 3, he is now having urinary incontinence as well. There has been no fever or flank or back pain and he is otherwise healthy and not on any medications regularly. Mom states he sometimes starts crying from the pain.

ultrasound-90A 25-year-old female presents to the ED with her boyfriend after she developed sudden onset pelvic pain during sexual intercourse at around 10 pm. The pain gradually worsened and spread to her ribs and she felt bloated and had the urge to defecate, so she got up from bed and went to the bathroom. Unfortunately she fainted on the way there, though she landed on carpet without injury.

ultrasound-90It’s a busy Monday morning, and you watch as a new patient awkwardly limps onto your only open bed. You immediately wonder what is causing him to walk with such a strange gait. After Glancing at the EMR, you find a helpful hint in the nurse’s note about his chief complaint — testicular pain.

ultrasound-90They say that things come in threes, and at least for today, you agree. You just finished sending home three young women with first trimester vaginal bleeding and reassuring bedside ultrasounds. Prior to that you actually had three cardiac arrests, one that you remarkably brought back with tPA after your bedside echo showed a severely dilated right ventricle but normal left ventricle from a presumed acute PE.

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