Visual EM

Tricuspid Annular Plane Systolic Excursion (TAPSE) in a Patient with Pulmonary Emboli

Nicole Zawada, BS^*, Ethan Kunstadt, MD^* and Maili Alvarado, MD^{^}

DOI: https://doi.org/10.21980/J8M052 Issue 3:1 No ratings yet.

Video 1 and Image 1 show a thrombus in the patient’s IVC. Video 2 and Images 2-3 demonstrate a positive TAPSE of less than 17mm (blue arrow length) with a significantly dilated RV, indicating abnormal excursion of the tricuspid annulus and right ventricular dysfunction.

Point-of-care Ultrasound Detection of Endophthalmitis

James Tucker MD, PhD^*, Jonathan Patane, MD^{^} and Shadi Lahham, MD, MS^{^}

DOI: https://doi.org/10.21980/J8G634 Issue 3:1 No ratings yet.

The patient’s ultrasound revealed an attached retina and a complex network of hyperechoic, mobile, membranous material in the posterior segment.

Ophthalmology Ultrasound Visual EM

Acute Pyelonephritis with Perinephric Stranding on CT

Ronald Goubert^* and Jonathan Peña, MD^*

DOI: https://doi.org/10.21980/J8BH0VIssue 3:1 No ratings yet.

A CT abdomen and pelvis with IV contrast showed neither nephrolithiasis nor diverticulitis, and instead showed heterogeneous enhancement of the left kidney with mild edematous enlargement and striated left nephrogram. Significant perinephric stranding (red arrows) was also noted and was consistent with severe acute pyelonephritis.

Renal/Electrolytes Infectious Disease Visual EM

Empyema

Jonathan Patane, MD^* and Daniel Ritter, BS^{^}

DOI: https://doi.org/10.21980/J86P9RIssue 3:1 No ratings yet.

The chest X-ray shows a large fluid collection in the right lung demonstrated by the opacification that blunts the costophrenic angle on the right side. There is also a meniscus present, which is generally indicative of fluid. Chest computed tomography (CT) demonstrated an infiltrate with a mixture of densities within the same collection, consistent with a loculated effusion and concerning for an empyema.

Respiratory Infectious Disease Visual EM

Bedside Ultrasound for the Diagnosis of Peritonsillar Abscess

Harshal Bhakta, BS,^* Maili Alvarado, MD^{^} and Daryn Towle, MD*

DOI: https://doi.org/10.21980/J8N33N Issue 2:4 No ratings yet.

The first video is an intraoral ultrasound using the high frequency endocavitary probe demonstrating an anechoic fluid collection adjacent to the patient’s enlarged left tonsil. The second video shows real-time ultrasound-guided successful drainage of the PTA.

Ultrasound ENT Infectious Disease Visual EM

Bilateral Hip Dislocation in Unrestrained Driver

Samer Assaf, MD^* and Ghadi Ghanem^*

DOI: https://doi.org/10.21980/J8HD0C Issue 2:4 No ratings yet.

The initial radiograph of the pelvis revealed bilateral hip dislocations. Small bony fragments were noted in the right hip joint, suggestive of an underlying fracture. The sacroiliac joints and the pelvic ring were intact. In the emergency department, bilateral hip reductions were performed using the Captain Morgan technique.1 The post-reduction film showed reduction of the bilateral hip dislocations with extensive comminuted and displaced fractures of the right and left acetabula.

Orthopedics Visual EM

Open Book Pelvic Fracture

Samer Assaf, MD^* and Ghadi Ghanem^*

DOI: https://doi.org/10.21980/J8CK7H Issue 2:3 No ratings yet.

The initial radiograph of the pelvis shows an open-book pelvic fracture deformity with pubic symphyseal dislocation, left greater than right sacroiliac diastases, and fractures of the left superior and inferior pubic rami, right inferior pubic ramus, and left acetabular anterior column. The additional inlet and outlet radiographs of the pelvis after application of a pelvic binder also show an open book fracture with significant improvement of the widened pubic symphysis.

Orthopedics Trauma Visual EM

Oropharynx Ulceration

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

DOI: https://doi.org/10.21980/J87W60 Issue 2:4 No ratings yet.

The photograph demonstrates an area of ulcerative tissue at the left palatine tonsil without surrounding erythema or purulent drainage. The computed tomography (CT) scan shows a large ulceration of the left soft palate and palatine tonsil (red arrow). There is no evidence of skull base osteomyelitis. There is suppurative lymphadenopathy with partial left jugular vein compression due to mass effect (yellow highlight). There is mild nasopharyngeal airway narrowing with architectural distortion (blue arrow), but no other evidence of airway obstruction.

ENT Visual EM

Subcutaneous Emphysema in Non-Necrotizing Soft Tissue Injury

Hamid Ehsani-Nia, MS, DO^* and Lauren Sylwanowicz MD^{^}

DOI: https://doi.org/10.21980/J8432M Issue 2:4 No ratings yet.

X-Rays of the elbow revealed diffuse striated lucencies throughout the soft tissue, consistent with extensive subcutaneous air throughout the superficial and deep tissues. There was no evidence of a fracture.

Infectious Disease Orthopedics Visual EM

An Elderly Male with Amyand’s Hernia

Saema Said, MD^* and Roozbeh Houshyar, MD^{^}

DOI: https://doi.org/10.21980/J80D13 Issue 2:4 No ratings yet.

Ultrasound of the right scrotum shows a right inguinal hernia with an air-containing loop of bowel (white arrow) and a non-compressible appendix (yellow arrow). Coronal and axial views of abdomen-pelvis CT show a right inguinal hernia containing a loop of small bowel (white arrow) and appendix (yellow arrow).

Abdominal/Gastroenterology Visual EM