Visual EM

Talonavicular Dislocation

Joseph Zakaria, BS^* and Jonathan Peña, MD^*

DOI: https://doi.org/10.21980/J8PG91Issue 3:4 No ratings yet.

The X-rays were significant for a subtalar dislocation. The calcaneus (red) is laterally displaced with respect to the talar head (orange), and the white lines indicate the normal articular surface. Additionally, there was a talonavicular dislocation, as seen in the fourth image: the talus (green) and navicular bone (purple) overlapping suggests a dislocation. In a normally aligned foot, the boundaries of the two bones create a point of articulation.

Orthopedics Visual EM

Endocarditis

Sara Arastoo, BS^* and Sari Lahham, MD, MBA^*

DOI: https://doi.org/10.21980/J8JP73Issue 3:4 No ratings yet.

Upright frontal radiograph of the chest demonstrated large pleural effusion on the left and moderate pleural effusion on the right as shown by the visible menisci on both sides (red arrows) with diffuse bilateral nodular densities (yellow dotted lines), consistent with septic pulmonary emboli. Computed tomography (CT) of the chest demonstrated multiple scattered lung nodules bilaterally containing internal foci of air cavitation (green dotted lines).

Infectious Disease Cardiology/Vascular Visual EM

Facial Fracture Induced Periorbital Emphysema

Hamid Ehsani-Nia, DO^* and Robert Eisenstein, MD^*

DOI: https://doi.org/10.21980/J8F05HIssue 3:4 No ratings yet.

Physical exam showed marked left palpebral subcutaneous crepitus, as well as bulbar and palpebral conjunctival bulging. Visual acuity was normal with intact extraocular movements, and normal pupillary exam. Computed tomography (CT) imaging of the face was obtained and revealed multiple displaced fractures involving the left orbital floor and zygomatic arch associated with moderate periorbital and postseptal extraconal gas, resulting in orbital proptosis.

Trauma ENT Visual EM

Fournier Gangrene

Joseph Zakaria, BS^*, Steve Bunch, MD^* and Victor Cisneros, MD, MPH^*

DOI: https://doi.org/10.21980/J89626Issue 3:4 No ratings yet.

The computed tomography (CT) of the abdomen and pelvis revealed significant subcutaneous gas tracking along the perineum and right gluteal region (orange outline) into the scrotum with associated scrotal edema (yellow arrow) and subcutaneous inflammatory fat stranding of 0.92 cm (red arrow) consistent with Fournier’s gangrene. There is early fluid loculation along the right medial gluteal cleft of 5.85 cm (green arrow) without a sizeable drainable abscess seen.

Infectious Disease Visual EM

Foreign Body in Maxillary Sinus: A Rare Case of Chronic Rhinosinusitis

Richard Barnett, DO^* and Meigra Chin, MD^*

DOI: https://doi.org/10.21980/J85H09Issue 3:4 No ratings yet.

Computed tomography (CT) sinus with contrast demonstrated complete opacification of left paranasal sinuses and nasal cavity, and a linear radiopacity within the left maxillary sinus consistent with a foreign body. There were additional left facial subcutaneous radiopaque opacities.

ENT Visual EM

Brief Review of Intussusception Diagnosis and Management

Claire Thomas, MD^*, Wirachin Hoonpongsimanont, MD^*, Sara Paradise, MD^* and Mohammad Helmy, MD^{^}

DOI: https://doi.org/10.21980/J81P7FIssue 3:4 No ratings yet.

The patient’s abdominal ultrasound revealed intussusception in the right upper abdominal quadrant. The transverse ultrasound view showed a “doughnut sign” (dashed yellow line), telescoping bowel (yellow arrow), and invaginated hyperechoic mesenteric fat with crescent configuration (dashed orange line). The sagittal ultrasound view demonstrated the intussusception formed by the outer recipient bowel loop (yellow arrows), invaginated hyperechoic mesenteric fat (orange asterisks), and telescoping bowel centrally (red arrow).

Abdominal/Gastroenterology Pediatrics Visual EM

Corneal Rust Ring

Joseph Zakaria, BS^* and Jonathan Peña, MD^*

DOI: https://doi.org/10.21980/J8X067Issue 3:4 No ratings yet.

The photograph reveals a limbic metallic foreign body with a surrounding corneal rust ring (arrow) in the three o’clock position of the left cornea.

Ophthalmology Visual EM

Cauliflower Ear Secondary to a Chronic Auricular Hematoma

Nichole Niknafs, DO^*

DOI: https://doi.org/10.21980/J8S63XIssue 3:4 No ratings yet.

On exam, the patient has a gross deformity to the left pinna that was not painful to touch or fluctuant. Findings and history are consistent with cauliflower ear, secondary to a chronic auricular hematoma.

ENT Visual EM

Sialadenitis

Lauren Sylwanowicz, MD^* and Andrew Wong, MD, MBA^{^}

DOI: https://doi.org/10.21980/J8NH0NIssue 3:4 No ratings yet.

The computed tomography (CT) scan demonstrates prominent enlargement and heterogeneous enhancement of the right submandibular gland (single large arrow) compatible with sialadenitis. There is no evidence of a sialolith or obstruction on the CT. There is associated edema (two small arrows) of the right submandibular space, parapharyngeal space and anterior right neck with partial effacement of the right vallecula and right pyriform sinus.

ENT Visual EM

Clinical Evaluation and Management of Pediatric Pericarditis

Sharona Hariri, BA^*, Alisa Wray, MD, MAEd^{^} and Lauren Sylwanowicz, MD^{^}

DOI: https://doi.org/10.21980/J8HP85Issue 3:4 No ratings yet.

An electrocardiogram (ECG) was concerning for ST segment elevation in leads II, III, aVF, and V4, with subtle ST elevations in V5 and V6 (see black arrows). There is also ST segment depression in aVL (see blue arrows).

Cardiology/Vascular Visual EM