Visual EM
Oropharynx Ulceration
DOI: https://doi.org/10.21980/J87W60The 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.
Subcutaneous Emphysema in Non-Necrotizing Soft Tissue Injury
DOI: https://doi.org/10.21980/J8432MX-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.
An Elderly Male with Amyand’s Hernia
DOI: https://doi.org/10.21980/J80D13Ultrasound 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).
Point-of-care Ultrasound for the Diagnosis of Ectopic Pregnancy
DOI: https://doi.org/10.21980/J8VK7VThe transabdominal pelvic ultrasound shows an empty uterus (annotated) with free fluid and a right sided extrauterine gestational sac representing an ectopic pregnancy (red arrow).
Erythema Migrans
DOI: https://doi.org/10.21980/J8QW7QHistory of present illness: A 28-year-old male presented to the emergency department with a chief complaint of two weeks of headache, chills, and numbness in his hands. He reported removing a tick from his upper back approximately two weeks ago, but did not know how long the tick had been embedded. His review of symptoms was otherwise unremarkable. Significant findings:
Spontaneous Pneumothorax
DOI: https://doi.org/10.21980/J8M33BInitial chest radiograph showed a 50% right-sided pneumothorax with no mediastinal shift, which can be identified by the sharp line representing the pleural lung edge (see arrows) and lack of peripheral lung markings extending to the chest wall. While difficult to accurately estimate volume from a two-dimensional image, a 2 cm pneumothorax seen on chest radiograph correlates to approximately 50% volume.1 The patient underwent insertion of a pigtail pleural drain on the right and repeat chest radiograph showed resolution of previously seen pneumothorax. Ultimately the pigtail drain was removed and chest radiograph showed clear lung fields without evidence of residual pneumothorax or pleural effusion.
Pediatric Esophageal Foreign Body
DOI: https://doi.org/10.21980/J8GD1FA radiopaque foreign body was visualized in the proximal esophagus at the thoracic inlet on the chest and neck radiographs. The foreign body appeared to be metallic with visualized concentric rings consistent with a coin.
Acetabular Fracture
DOI: https://doi.org/10.21980/J8BK8KThe non-contrast CT images show a minimally displaced comminuted fracture of the right acetabulum involving the acetabular roof, medial and anterior walls (red arrows), with associated obturator muscle hematoma (blue oval).