Visual EM
A Case Report on an Elusive Incident of Erythema Multiforme
DOI: https://doi.org/10.21980/J8BM0WHer physical exam was notable for multiple scattered tense vesicles on an erythematous base along the left and right lower extremities and right upper extremity. The lesions were excoriated and in different stages of evolution. No oral, mucosal, or conjunctival lesions were found. Physical exam was otherwise unremarkable.
A Case Report on Dermatomyositis in a Female Patient with Facial Rash and Swelling
DOI: https://doi.org/10.21980/J8506DThe physical exam revealed significant periorbital swelling, facial edema, and a maculopapular rash across the upper chest, symmetrically across the extensor surfaces of the hands and the bilateral arms and thighs. The photograph of her face shows light-red to violaceous macules and patches, with inclusion of the nasolabial folds as well the forehead and upper eyelids with periorbital edema (heliotrope sign). The other rash images show “Shawl sign” (photograph of back showing erythema over the posterior aspect of the upper back), V sign (photograph of chest showing light-red violaceous plaque on mid-chest), Gottron's papules (photograph of hands showing light red scaly papules overlying the right proximal interphalangeal joint [R PIP] and the metacarpophalangeal joint [MCP], and holster sign (photograph of thigh showing light red patches on bilateral lateral thighs). This distribution of rashes is pathognomonic for DM.
Computed Tomography Findings in Non-Obstetric Vulvar Hematoma: A Case Report
DOI: https://doi.org/10.21980/J8194HBedside ultrasound was first used to evaluate for evidence of abscess or cyst formation. Ultrasound demonstrated a hypoechoic area within the right labia without evidence of a cyst or abscess wall. Based on these findings, an angiogram CT of the pelvis was obtained which revealed a vulvar hematoma with evidence of active arterial extravasation. In both the coronal and axial view, there is an asymmetric area of isodensity in the right labia representing a hematoma (blue circled area). Angiography may show areas of active extravasation, which appears as hyperdensity within the area of hematoma (see red arrow in coronal plane).
A Man With Chest Pain After An Assault – A Case Report
DOI: https://doi.org/10.21980/J8J93SOn exam, we found a suspected chest wall abscess with surrounding erythema (blue arrow). The patient underwent CT of the chest which showed a comminuted displaced midsternal fracture (yellow arrow) with moderate fluid and air anteriorly (red arrow), consistent with an abscess. His laboratory results had no significant abnormalities.
A Case Report of Lateral Subtalar Dislocation: Emergency Medicine Assessment, Management and Disposition
DOI: https://doi.org/10.21980/J8SS8PIn a lateral subtalar dislocation, the navicular bone (red bone in 3D anatomy image) and the calcaneus (yellow bone in 3D anatomy image) dislocate laterally in relation to the talus (lavender bone in 3D anatomy image). Plain film oblique and lateral X-rays demonstrate the initial dislocation (talus in red, navicular in blue). It is clear in the initial lateral view that there is loss of the talar/navicular articulation (noted by red arrow). The anterior-posterior x-ray is more challenging to discern the anatomy; however, the talus (red dot) is laterally displaced in comparison to the navicular (blue dot).
A Case Report of Dermatographia
DOI: https://doi.org/10.21980/J8P05PPhysical examination was unremarkable except for the urticaria on the right aside of her abdomen (white arrow) with overlying excoriations (stars). Of note, there were no burrows, papules or vesicles in the typical locations including the webs of the fingers, wrists, axillae, areolae, or genitalia. Examination of the linear dermatographia clearly revealed superficial wheals, versus underlying serpiginous lesions.
A Case Report of Acute Compartment Syndrome
DOI: https://doi.org/10.21980/J87061Inspection of the extremity revealed significant swelling with dark discoloration and multiple bullae (pre-operative photograph). Furthermore, notable swelling of the right foot was noted, which felt cold to palpation. Radiographs of pelvis, bilateral knees, tibia, fibula, and feet demonstrated no fractures or dislocations. The bilateral tibia and fibula X-ray revealed soft tissue swelling in the proximal legs, particularly evident in the right leg's AP view, which also showed numerous ovoid radiodensities in the anterior compartment, likely related to soft tissue injury. Post operative images are also provided demonstrating the patients’ four compartment fasciotomies which were loosely closed using staples.
Vaginal Bleeding Due to Iatrogenic Uterine Perforation – A Case Report
DOI: https://doi.org/10.21980/J83643The bedside transabdominal US of the pelvis showed a heterogeneous mixture of hypoechoic and hyperechoic endometrial thickening extending to the lower uterine segment (blue arrow), which was thought to represent active hemorrhage. Computed tomography of the abdomen and pelvis showed evidence of a large amount of endometrial hyperdensity (red arrow) suggestive of hemorrhagic contents within a grossly enlarged uterus. There was relative decreased enhancement of the uterine body and fundus, concerning for devascularization. There was also active extravasation along the left lateral uterus (yellow arrow).