Image 1: skin and soft tissue POCUS
A young child presented with swelling to the posterior head for 1 week. Physical exam showed a 2x2 cm diameter area of soft, non-tender swelling to the occiput.
Soft tissue POCUS (image 1 above) demonstrated soft tissue mass with bony erosion. Given findings on ultrasound, the decision made to obtain an MRI rather than CT in conjunction with neurosurgical consult. The MRI demonstrated the occipital mass with bony erosion (Image 2 below), returned for neurosurgical removal and was diagnosed Langerhans cell histiocytosis.
POCUS Pearl: Soft tissue masses have broad differentials. POCUS can be used to narrow the differential and guide further decisions on imaging.
Image 2: MRI with occipital mass