BACKGROUND Chest pain is one of the most common symptoms with which a patient presents to a doctor.Differentials include,but are not limited to,cardiac pulmonary,gastrointestinal,psychosomatic and musculoskeletal caus...BACKGROUND Chest pain is one of the most common symptoms with which a patient presents to a doctor.Differentials include,but are not limited to,cardiac pulmonary,gastrointestinal,psychosomatic and musculoskeletal causes.In our case,ultrasound of the chest wall paved the way for the diagnosis of multiple myeloma,which occultly presented with chronic chest pain.CASE SUMMARY Here we report a case of 50-year-old man with chronic chest pain without anemia or renal failure who was diagnosed with multiple myeloma,despite negative bence jones protein and M band electrophoresis.An ultrasound of the chest wall showed cortical irregularities along with a hypoechoic mass in the sternum and left 5th rib,which helped us in clinching the diagnosis.CONCLUSION Ultrasound of bone can often aid in reaching a diagnosis indirectly if not directly.展开更多
Dear Editor,Fluid therapy is the mainstay of treatment in patients with acute circulatory failure causing intravascular volume expansion resulting in increased cardiac output,tissue perfusion,and oxygen delivery.The“...Dear Editor,Fluid therapy is the mainstay of treatment in patients with acute circulatory failure causing intravascular volume expansion resulting in increased cardiac output,tissue perfusion,and oxygen delivery.The“early goal-directed therapy”highlighted the importance of early resuscitation with intravenous fluids in patients with septic shock.[1]Nevertheless,later,it was realized that the effect of volume expansion on cardiac output is inconsistent.展开更多
文摘BACKGROUND Chest pain is one of the most common symptoms with which a patient presents to a doctor.Differentials include,but are not limited to,cardiac pulmonary,gastrointestinal,psychosomatic and musculoskeletal causes.In our case,ultrasound of the chest wall paved the way for the diagnosis of multiple myeloma,which occultly presented with chronic chest pain.CASE SUMMARY Here we report a case of 50-year-old man with chronic chest pain without anemia or renal failure who was diagnosed with multiple myeloma,despite negative bence jones protein and M band electrophoresis.An ultrasound of the chest wall showed cortical irregularities along with a hypoechoic mass in the sternum and left 5th rib,which helped us in clinching the diagnosis.CONCLUSION Ultrasound of bone can often aid in reaching a diagnosis indirectly if not directly.
文摘Dear Editor,Fluid therapy is the mainstay of treatment in patients with acute circulatory failure causing intravascular volume expansion resulting in increased cardiac output,tissue perfusion,and oxygen delivery.The“early goal-directed therapy”highlighted the importance of early resuscitation with intravenous fluids in patients with septic shock.[1]Nevertheless,later,it was realized that the effect of volume expansion on cardiac output is inconsistent.
