Visual EM

Shockingly Unreliable: A Case Report of Failure of Synchronized Cardioversion Device to Capture, Resulting in Ventricular Fibrillation and Cardiac Arrest

Clifford J Buckley, MD*^, Bradley J McClintic, MD*, Andrew L Juergens II, MD*^ and Shea Standley, DO*

DOI: https://doi.org/10.5070/M5.53094Issue 11:4[mrp_rating_result]
The initial electrocardiogram (ECG) demonstrated wide-complex tachycardia (WCT) at 150 BPM (Pre-Cardioversion ECG).
Visual EMCardiology/VascularCurrent IssueProcedures
Infectious Flexor Tenosynovitis. Photo 3. JETem 2026

Infectious Flexor Tenosynovitis of the Lower Extremity: A Case Report

Daniela Usuga, MD* and Dustin Harris, MD*

DOI: https://doi.org/10.5070/M5.52282Issue 11:4[mrp_rating_result]
X-rays of the foot, ankle, and tibia-fibula were obtained which showed no acute fractures or dislocations. A CT of the right lower extremity with IV contrast demonstrated fluid along the flexor hallucis longus and flexor digitorum longus tendons with scattered foci of air, and the hypodensities on the plantar aspect of the foot (red highlight), were concerning for infectious tenosynovitis. The CT scan also showed diffuse soft tissue edema, the dark attenuation on imaging (blue highlighted), predominantly along the dorsal midfoot.
Visual EMCurrent IssueInfectious DiseaseOrthopedics
Prosthetic Joint Infection Open Knee Photo AP. JETem 2026

Visual Case Report of a Prosthetic Joint Infection and Chronic Dehiscence following a Total Knee Arthroplasty

Kevin Chao MD*, Alisa Wray MD^ and Danielle Matonis MD^

DOI: https://doi.org/10.5070/M5.52251 Issue 11:3[mrp_rating_result]
Radiographs demonstrated intact prosthetic components (blue) without acute fracture, tibial peri-stem lucency (green) concerning for loosening or infection, as well as joint effusion, and soft-tissue swelling.
Visual EMInfectious DiseaseOrthopedics
Rapidly Progressive Painless Acute Aortic Dissection. CT Axial Level of the Liver. JETem 2026

Rapidly Progressive Painless Acute Aortic Dissection: A Case Report

Justin Yang, MD, Tyler Rigdon, MD* and Kristin Lewis, MD, MA*

DOI: https://doi.org/10.5070/M5.52348Issue 11:3[mrp_rating_result]
A POCUS of the abdomen at that time demonstrated findings concerning for a dissection flap in the abdominal aorta (green arrows), and a new mild to moderate pericardial effusion was seen on a repeat cardiac POCUS suggesting an evolving aortic dissection (blue arrows). The patient’s CTA revealed a type A AAD with extension from the aortic root to the bilateral external and internal iliac vessels as well as the coronary arteries (red arrows).
Visual EMCardiology/Vascular
Cerebral Venous Thrombosis. CT Coronal Unannotated. JETem 2026

Computed Tomography Findings of Cerebral Venous Thrombosis: A Case Report

Alex Y Koo, MD*^, Samuel Shulimson, DO*^, and Joelle Borhart, MD*^

DOI: https://doi.org/10.5070/M5.52331Issue 11:3[mrp_rating_result]
The emergency physician ordered a non-contrast head CT and CT venogram of the head given worsening symptoms with disequilibrium and CVT risk factors of postpartum coagulopathy. The non-contrast head CT demonstrated a hyperdensity occlusion of the left transverse sinus (blue arrow). This serpiginous hyperdensity is called the “cord” or “string” sign, which is thrombosis within the vein. The CT venogram of the head demonstrated occlusion of the left transverse (red arrows) and sigmoid sinus (yellow arrow).
Visual EMCardiology/VascularNeurology
Bilateral Quadriceps Tendon Rupture. Right Long Knee US. JETem 2026

A Case Report of Rare Bilateral Quadriceps Tendon Rupture Diagnosed by Point of Care Ultrasound (POCUS)

Joel Hines, DO*, Christopher Blanton, MD*, Jodi Jones, MD* and

Prayag Mehta, MD*

DOI: https://doi.org/10.5070/M5.52334Issue 11:3[mrp_rating_result]
Musculoskeletal assessment with POCUS revealed disruption of the left quadriceps tendon (blue arrows) indicated by a large hypoechoic gap (red arrow) with significant surrounding fluid throughout the quadriceps as well as a sizable left knee effusion (orange highlighting). The right lower extremity had a disrupted and retracted quadriceps tendon (yellow arrow) with associated fluid near the injury site and a small right knee joint effusion (orange highlighting). Therefore, he was diagnosed with bilateral quadriceps tendon ruptures.
Visual EMOrthopedics
Hematoma Hemarthrosis and Hemotympanum. Sublingual Hematoma. JETem 2026

Hematoma, Hemarthrosis, and Hemotympanum: A Case Report of Acquired Hemophilia A

Andrea Wolff, MD*, Ivy Dahlen, BS* and Arun Singavi, MD, MS^

DOI: https://doi.org/10.5070/M5.52344Issue 11:3[mrp_rating_result]
Non-contrast computed tomography (CT) scan of the left knee confirmed a small to moderate suprapatellar joint effusion with Hounsfield unit measurements suggestive of blood products (+47 Hounsfield units), consistent with acute hemarthrosis. The hemarthrosis appears as a gray, fluid-density collection slightly darker than the surrounding tissues that conforms to the suprapatellar space anterior to the femur, continuing distally between the femur and the patella.
Visual EMDermatologyHematology/OncologyOrthopedics
Coin Stack. Neck XR Lateral Unannotated. JETem 2026

A Case Report of a Coin Stack Masquerading as a Button Battery

Peyton J Ware, MD*, Carter Ware, MD*^, Amanda H Bjornstad, MD*†, Heather M Kuntz, MD*† and Timothy P Young, MD*†

DOI: https://doi.org/10.5070/53886 Issue 11:3[mrp_rating_result]
The two images provided are OSH AP and lateral XRs of the patient's neck. The OSH AP view demonstrates a halo sign (green arrow), while the lateral view demonstrates a step-off sign (stick figure). These are key findings with BB ingestions. The halo sign is the presence of two concentric rings on an anterior view XR.
Visual EMPediatricsRespiratory