65 y/o AAM presents to the ED with complaints of elevated blood sugar and lethargy. Pt denies pain, SOB, N/V/D, or trauma.
PMHx: DM, HTN
PSHx: none
Meds: ASA, Norvasc, HCTZ, Lisinopril, Insulin
Allergies: NKDA
FamHx: none
SocHx: none
PE: BP 109/77, P 86, R 16, T 98.1, POx 96% (RA)
GEN: thin, lethargic
HEENT: PERR, dry MM, no JVD
CHEST: CTA B, nonlabored
CV: RRR, no M/R/G
ABD: soft, NTND, + BS
EXT: no C/C, + edema to R arm extending from wrist to mid humerus, min TTP, no ecchymosis or erythema, ROM difficult to assess secondary to lethargy
Bedside ultrasound of the RU Ext performed. What is the diagnosis? Thanks to Dustin Brimblecom for submitting this case!