Emergency Ultrasound in Trauma Patients: Beware of Pitfalls and Artifacts!

Common and Uncommon Errors in Emergency Ultrasound

“…When the US of the primary incident beam passes through a curved interfa high specular reflection capacity (e.g., the diaphragm), the structure close to this in can be reproduced on the US image both in its real position and in a symmetrical o An example is given by the "pseudo-mud" which is observed at the bottom of the bladder or in the gallbladder (Figure 2). In this case, the correct setting of the US image, the focusing and the use of multiple scans allow the image quality to be improved [5,6].…”

“…When the US of the primary incident beam passes through a curved interface with high specular reflection capacity (e.g., the diaphragm), the structure close to this interface can be reproduced on the US image both in its real position and in a symmetrical opposite position, beyond the reflecting surface (e.g., mirror image of the liver, which can be mistaken for a parenchymal consolidation, or the aorta, which can produce a "ghost image") (Figures 3-5). Mirror-image artifacts will disappear when the reflector is scanned with oblique orientation [5,6].…”

“…Diagnostics 2022, 12, x FOR PEER REVIEW position, beyond the reflecting surface (e.g., mirror image of the liver, which can taken for a parenchymal consolidation, or the aorta, which can produce a "ghost (Figures 3-5). Mirror-image artifacts will disappear when the reflector is scann oblique orientation [5,6].…”

“…This occurs because a focus material might cause the beam to deviate from its rectilinear path at an angle that causes a deflection towards the side with the higher resistance (Figure 8). Because this type of artifact can mimic a traumatic kidney rupture, it is recommended that scans are performed with coronal, axial, and sagittal pictures in order to overcome this interpretation deficiency (Figure 9) [5,6].…”

“…Because the US beam is reflected back and forth several times between two highly reflective parallel surfaces ("reverberates"), the US transducer interprets the reflected echoes as happening at deeper structures because they take longer to return to the transducer (Figures 10 and 11) [3]. This very common mistake can be easily solved with a change of the angle of insonation in order to avoid the reverberation between strong parallel reflectors [5,6].…”