Page 149 - Journal of Special Operations Medicine - Fall 2017

An Ongoing Series

To Cut or Not to Cut

That Is an Ultrasound Question!

1
William H. Poston, 18D ; Katarzyna (Kasia) Hampton, MD *
2

our ODA is on a training mission in the southern Philip- Figure 1 Sonographic findings of cellulitis.
Ypine islands. While conducting base defense improvements
and inspections your engineering sergeant (18C) has an acci-
dent resulting in a large splinter impaled into his right upper
thigh. You remove it and 2 days later the 18C complains of
pain, swelling, warmth, and redness around the initial punc-
ture wound. On physical examination, the patient is well-
appearing and afebrile. All his vital signs are within normal
limits. The upper portion of the right anterior thigh and his
right groin are red, tender to touch, warm, and the skin is
indurated. You palpate a tender lump in the right groin. Your
junior medic is already preparing for the incision and drainage
procedure. However, your sixth sense is telling you to grab an
ultrasound probe first!

1. What typical sonographic findings of cellulitis do we ob-
serve in Figure 1 (image on the left)?
2. What treatment and procedures are indicated?
Join us at SOFsono.org for further case discussion.

*Correspondence to sofsono.org@gmail.com
1 SFC Poston is a Special Forces Medical Sergeant (18D) and is currently the director of the Special Operations Forces Austere Care Course
(SOFACC), which is conducted by the Office of Special Warfare (OSW). He previously served in Charlie and Bravo Companies, 2nd Battalion,
10th Special Forces Group. 2Dr Hampton is an emergency physician and a volunteer subject matter expert ultrasound instructor for the military
medical community. She is currently practicing at the Landstuhl Regional Medical Center, Germany (U.S. Army Medical Department).

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