A 24-year-old man presents to urgent care with first-time renal colic. He is stable, tolerating oral intake, and has no signs of infection. Does he need a CT scan or emergency department referral?

In this Southern Medical Association case article, we explore how renal point-of-care ultrasound (POCUS) identified mild hydronephrosis at the bedside, allowing safe outpatient management without CT imaging or ED transfer. The article reviews key renal ultrasound findings, common pitfalls, evidence supporting a POCUS-first approach, and the broader impact on radiation exposure, healthcare utilization, and cost.

Learn how POCUS can help clinicians rapidly risk stratify patients with suspected renal colic while improving patient-centered care.

A 41-year-old woman presents to the emergency department with a sudden onset of dyspnea and pleuritic chest pain for two hours. She appears mildly anxious and diaphoretic. She denies fever, cough, trauma, or recent illness. She takes oral contraceptives and has no significant past medical history.

Vital signs reveal HR 113 bpm, RR 24, O₂ saturation 94% on room air, and BP 110/74 mmHg.

Her lung exam is clear. Cardiac exam reveals tachycardia without murmurs.