PMC10155721_01
A sonographic image of the cold abscess using a 12 MHz linear probe showing heterogenous fluid collection (a) in the pectoralis major on the left hemithorax. Thickened periosteum of the first rib (b) with break in the cortex representing osteomyelitis. There is posterior acoustic shadowing below the first rib (c).
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POCUS performed by an ED physician showed a collection of heterogenous material with fluid content (Figure 1) along with hyperechoic, thickened periosteum of the left first rib at the level of the pectoralis major muscle (Figure 2).
A sonographic image of the cold abscess using a 12 MHz linear probe showing fluid collection of mixed echogenicity. There are 'ring lesions' (a) with hyperechoic irregular margins and relatively hypoechoic centre which might represent caseous lymph nodes. There is anechoic fluid (b) and posterior acoustic shadow of the first rib (c) with under lying lung (d).
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POCUS performed by an ED physician showed a collection of heterogenous material with fluid content (Figure 1) along with hyperechoic, thickened periosteum of the left first rib at the level of the pectoralis major muscle (Figure 2).
Axial view of the plain CT thorax showing low density collection in the pectoralis major muscle of the left hemithorax (a) with underlying costochondral junction showing break in cortex (b).
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Subsequent computerised tomographic (CT) scan of his thorax CT confirmed a 66 mm x 30 mm left upper chest wall abscess involving left costochondral junction and engulfing the distal left subclavian vein (Figure 3).