May 2022: GUSI – Music, Medicine and Movement.
“Music brings a warm glow to my vision, thawing mind and muscle from their endless wintering.” – Haruki Murakami
Music is important to us at GUSI, and not just because we love making musical TikToks that share our love of POCUS! We strongly believe in the healing power of music – one of the most ancient and powerful medicines available to mankind.
POCUS and music work well together for many reasons. For example, there is a special kind of rhythm and flow that can be generated from POCUS exams, especially those that require multiple views such as FASH exams and Echo exams. There are specific anatomy markers, hand movements, scanning and fanning that generate beautiful POCUS images – a real musical collaboration between clinician and patient!
Music also shares commonality with the science behind POCUS. Low frequency probes such as the abdominal probe are used to “see” objects that are further away (e.g., the liver). Just as the bass in a song can travel (like in an annoying neighbor’s stereo system); low-frequency ultrasound probes zoom in on anatomy for the clinician to examine. Conversely, high-frequency probes have surface-level views. Clinicians may only see the nerves, vasculature, and bones, as opposed to organs that are further away.
In this month’s theme, Music, Medicine, and Movement, we also want to introduce our newest POCUS course now available online – Musculoskeletal Ultrasound!
Our course features 40+ lectures on high-yield topics in Primary Care Musculoskeletal Ultrasound, such as rotator cuff evaluations, carpal tunnel diagnosis, plantar fasciitis and much more! Also learn how to more safely perform common ultrasound guided musculoskeletal injections.
Check out this month’s POCUS cases that speak to our theme of Music, Medicine, and Movement.
CASE STUDY #1
A 50 year old man presents to your clinic with right shoulder pain. This pain has been steadily progressing over the last several months. He works in construction and often has to limit heavy tools and work with his arms extended overhead (e.g., installations). In your clinic, you note pain with both active and passive range of motion on your shoulder physical exam. Your shoulder POCUS exam shows the following:
Rotator Cuff Injury
Based upon the ultrasound findings, you are able to refer the patient to physical therapy and recommend NSAIDs.
Read more about the diagnostic accuracy of US versus MRI and MRA for rotator cuff injuries here.
CASE STUDY #2
A 15 year old patient presents to your clinic after an awkward fall onto his ankle while at a trampoline park two days ago. While playing with his friends, he describes an inversion injury. He was able to continue jumping, but his mother noticed swelling in the ankle later in the evening. Since then, he has been wincing whenever he tries to put weight on it. His mother tried to give him Tylenol and Motrin but she is concerned that he may have broken his ankle. Rather than send him to the local Emergency Department for radiographs, you decide to perform a musculoskeletal POCUS exam in your clinic.
Distal Fibular Avulsion Fracture
Pediatric fractures can be difficult to diagnose on traditional radiography. In particular, this study showed good specificity in the diagnosis of fractures, especially in the setting of negative radiographs.
CASE STUDY #3
A 25 year old woman presents to your clinic. She has been training for a marathon. For the last week, her left knee has been swelling and is not improving with rest, ice, and compression (RICE treatment). In your clinic, you note that the knee is markedly swollen and the anatomy appears distorted. She presents with reduced range of motion secondary to pain. You decide to perform a diagnostic arthrocentesis.
POCUS has become the standard of care during arthrocentesis procedures. It is important for patient safety to guide needle placement, as compared to traditional anatomical landmark guidance. Read more here.
And read more about the approach to synovial fluid analysis here.
In this Faculty Spotlight we highlight faculty who are experts in POCUS and Musculoskeletal:
Dr. Devon Hutton grew up in rural Colorado, which instilled a love of the outdoors. After having to use her EMT skills in the backcountry more than a few times through guiding and ski patrolling, she decided to expand her medical knowledge and skills. This is how she found her way to medicine. Dr. Hutton went to the University of Minnesota Medical School and then moved back to rural Colorado for residency at St. Mary’s Family Medicine. She completed her training at Oregon Health & Science University in the Primary Care Sports Medicine Fellowship where she fell in love with musculoskeletal ultrasound. She took the opportunity to move to Bend, Oregon to work at a high acuity urgent care clinic and to spend the winter weekends working at the ski clinic at Mt. Bachelor resort. Missing sports medicine, she recently moved back to the Twin Cities to work Sports Medicine Urgent Care at TRIA Orthopedics. She continues to teach ultrasound at American Medical Society for Sports Medicine conferences and integrate point of care ultrasound into sideline care. Her passions outside medicine include all sports sliding on snow, trail running with her dog, and landscaping.
POCUS Training is for Everyone
We are so thankful to everyone who joined us for our April Flagship In-Person course, POCUS for Primary Care in San Francisco – which sold out! Check out this highlights video of the course:
Recent POCUS Course with the Montage Medical Group
We also just had a wonderful in-person POCUS course with the Montage Medical Group in Monterey, California. This course had 20 students, including physicians and APPs from Family Medicine, Infectious Disease, and Pulmonology.
GUSI Teaching in the Community – All Women’s Instructor Team, Monterey, California (Left to Right – Dr. Leticia Moedano, Dr. Ryann Milne-Price, Dr. Opal Taylor, Dr. Mena Ramos)
We asked the participants to share their thoughts of POCUS and clinical medicine at the end of the course, and here are a few of their thoughts:
“I feel so much more confident in performing POCUS. I believe that my competence has improved as well as my desire to start scanning patients that I am seeing on service” – Hospitalist
“The content was high yield and the instructors are knowledgeable, approachable and easy to learn from!”– Family Med Doctor
Our next flagship in-person course, POCUS for Primary Care, will be October 20-21, 2022 in San Francisco! Registration will open soon.
GUSI on the Move: Webinars
- Register today for our webinar: Starting a POCUS Program in your Residency: Panel Discussion and Q&A, June 22, 12pm EST, 9a PST
- Don’t miss future webinars!
GUSI has been named among 50 Best Companies to Watch 2022 by The Silicon Review!
Health Equity Residency Exchange (HERE)
The Health Equity Research Exchange (HERE) program is the latest way that GUSI is living up to its promise to share POCUS with medical professionals from around the world. For every resident who signs up to learn with GUSI, we will extend a full scholarship to a resident practicing in a low- or moderate-income country.
Learn more and sign up to participate here.
GUSI in the Community
GUSI Teaching in the Community – Northwell Family Medicine Residency, Long Island, New York) (Left To Right – Dr. William Hui, Dr. Tochi Iroku-Malize, Dr. Barbara Keber, Dr. Mena Ramos, Dr. Keasha Guerrier, Dr. Neubert Philippe)
Kevin, Mena, & the GUSI Education Team
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