I'm Brian Johnson I'm an Emergency Physician and today we're going to use the clarius pal to look at the ankle specifically we're looking at the ankle to see if there's a joint effusion so what we do is we have the patient lying supine we'll have the msk preset on the clarius app and what we'll do is we'll take the pal and place it over the tibia okay and the tibia is this nice hyperechoic structure you see here and what you do is you slowly March down with the tibia until you reach halus and the tibial tailor joint space is where an effusion will present now this gentleman does not have an effusion you see nice hyperechoic densities within the tibial Taylor joint but if there is an effusion you would see hypokoic or black fluid in this joint space oftentimes it's nice to sort of fan throughout the space just to make sure there's no fluid but you'd see fluid in the tibial Taylor space you can do arthrocentesis of the ankle blind but with an ultrasound it improves your accuracy and it minimizes your complications
