Image of the Undefined Period

Patient came in with new lump in the forearm that was a little painful. Scan showed an acute thrombus in a superficial forearm vein. Here it is in transverse - you can see a spongy hypoechoic signal inside the vessel.

And here it is longitudinally. Note how the vein has dilated to try to accommodate blood flow past the thrombus.

Acute clots tend to be 1) less hyperechoic, 2) less well attached to vessel wall, 3) more deformable, and 4) associated with acute venous dilation. Chronic clots are generally 1) bright, 2) well attached, 3) not compressible, and 4) associated with collaterals - sometimes they're hard to see because the vessel has collapsed around them and they take on the echogenicity of surrounding tissue.

This is a paracolic gutter view of ascites secondary to peritoneal carcinomatosis - that's fluid in the gut from a cancer process, often ovarian. Normally ascites is plain appearing and anechoic (just black on the grey scale), but sometimes you can see flecks of neoplastic cells floating in the fluid like here. It gives the fluid a twinkling appearance. The bright structures in the image are bowel floating around in the intra-abdominal fluid, sort of lava lamp-esque.

This is a right upper quadrant image of a patient with a right lower lobe empyema (big pocket of pus between the lung and chest wall). It's on an abdominal preset so the resolution isn't great (low frequency means good penetration but grainier images), but you can still make out some septations in the fluid collection. The patient was on their back - you would expect a transudative pleural fluid collection to sink a bit and yield a positive spine sign in the background (though I'm fanned a bit anteriorly here to catch the empyema).