Visual EM

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Perianal Abscess

Luke Walls-Smith, BS* and Jonathan Peña, MD*

DOI: https://doi.org/10.21980/J8QP81Issue 3:1[mrp_rating_result]
Computed Tomography (CT) of the Pelvis with intravenous (IV) contrast revealed a 5.7 cm x 2.4 cm air-fluid collection in the right perianal soft tissue along the right gluteal cleft, with surrounding fat stranding, consistent with a perianal abscess with cellulitis.
Abdominal/GastroenterologyInfectious DiseaseVisual EM
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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[mrp_rating_result]
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.  
RespiratoryCardiology/VascularVisual EM
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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[mrp_rating_result]
The patient’s ultrasound revealed an attached retina and a complex network of hyperechoic, mobile, membranous material in the posterior segment.
OphthalmologyUltrasoundVisual EM
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Acute Pyelonephritis with Perinephric Stranding on CT

Ronald Goubert* and Jonathan Peña, MD*

DOI: https://doi.org/10.21980/J8BH0VIssue 3:1[mrp_rating_result]
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/ElectrolytesInfectious DiseaseVisual EM
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Empyema

Jonathan Patane, MD* and Daniel Ritter, BS^

DOI: https://doi.org/10.21980/J86P9RIssue 3:1[mrp_rating_result]
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.
RespiratoryInfectious DiseaseVisual EM
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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[mrp_rating_result]
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.
UltrasoundENTInfectious DiseaseVisual EM
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Bilateral Hip Dislocation in Unrestrained Driver

Samer Assaf, MD* and Ghadi Ghanem*

DOI: https://doi.org/10.21980/J8HD0C Issue 2:4[mrp_rating_result]
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.
OrthopedicsVisual EM
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Open Book Pelvic Fracture

Samer Assaf, MD* and Ghadi Ghanem*

DOI: https://doi.org/10.21980/J8CK7H Issue 2:3[mrp_rating_result]
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.
OrthopedicsTraumaVisual EM