Visual EM

Scaphoid Fracture

Esther Kim, BS^* and Justin Yanuck, MD^*

DOI: https://doi.org/10.21980/J80344Issue 3:2 No ratings yet.

The anteroposterior (AP) plain film of this patient demonstrates a full thickness fracture through the middle third of the scaphoid (red arrow), with some apparent displacement (yellow lines) and subtle angulation of the fracture fragments (blue line).

Orthopedics Visual EM

Type 1 Brugada Syndrome

Sha Yan, DO^*, Grant Wei, MD^* and Chirag Shah, MD^*

DOI: https://doi.org/10.21980/J8V91T Issue 3:2 No ratings yet.

ECG shows an incomplete right bundle branch block (blue arrow) with coved ST segment elevation and an inverted T wave in V1 (red arrow) and ST segment elevation in V2 (black arrow).

Cardiology/Vascular Visual EM

$Acute comminuted intertrochanteric hip fracture 6$

Acute comminuted intertrochanteric hip fracture

Samuel Kaplan, BS^* and Jonathan Peña, MD^*

DOI: https://doi.org/10.21980/J8QK9C Issue 3:2 No ratings yet.

History of present illness: A 69-year-old male presented to the emergency department (ED) with left hip pain after he was rear-ended on his bicycle by a vehicle traveling 10-15 miles per hour. He had normal vital signs. On exam, his left lower extremity was externally rotated and shortened with trochanteric point tenderness. His pelvis was stable. His lower extremity compartments

Orthopedics Visual EM

Radial Nerve Palsy

Richard Barnett, DO^* and Amy Church, MD^*

DOI: https://doi.org/10.21980/J8KS7F Issue 3:2 No ratings yet.

On physical exam, the patient was unable to extend his right wrist, thumb, and fingers, and had no sensation of his 1stdorsal interosseous muscles up to the proximal dorsal radial aspect of his forearm. The patient also had slight weakness in thumb abduction. Triceps strength was preserved.

Neurology Visual EM

Osborn Waves

James Elliot Karz, DO^*, Grant Wei, MD^* and Chirag Shah, MD^*

DOI: https://doi.org/10.21980/J8G34G Issue 3:2 No ratings yet.

The initial ECG shows a junctional rhythm with Osborn waves (or J point elevations/J waves) in the lateral precordial leads, as well as the limb leads (Image 1). The second ECG, 49 minutes later, shows an improving ventricular rate and Osborn wave height decrease of approximately 50% (Image 2).

Cardiology/Vascular Visual EM

Rare Rapidly Growing Thumb Lesion in a 12-Year-Old Male

Alana J Arnold, MD, MBA^*

DOI: https://doi.org/10.21980/J8B92J Issue 3:2 No ratings yet.

History of present illness: A 12-year-old male presented to the emergency department with right thumb pain and a mass for four months (see images). He denied fevers, chills, change in appetite, or fatigue. He noted that the lesion was growing and “bleeds easily if bumped.” He denied any trauma to the thumb, except “hitting it” months ago while in football

Hematology/Oncology Orthopedics Visual EM

Large Ventral Hernia

Meryl Abrams, MD^*, Raymond Feuga, MD^*, Nicholas Governatori, MD^* and Jennifer White, MD^*

DOI: https://doi.org/10.21980/J86K9QIssue 3:2 No ratings yet.

Computed tomography (CT) scan with intravenous (IV) contrast of the abdomen and pelvis demonstrated a large pannus containing a ventral hernia with abdominal contents extending below the knees (white circle), elongation of mesenteric vessels to accommodate abdominal contents outside of the abdomen (white arrow) and air fluid levels (white arrow) indicating a small bowel obstruction.

Abdominal/Gastroenterology Visual EM

Elderly female with acute abdominal pain presenting with Superior Mesenteric Artery Thrombus

Sassan Ghassemzadeh, MD^*

DOI: https://doi.org/10.21980/J82W52 Issue 3:2 No ratings yet.

Computed tomography (CT) angiogram of the abdomen and pelvis revealed a superior mesenteric artery (SMA) thrombosis 5 cm from the origin off of the abdominal aorta. As seen in the sagittal view, there does not appear to be any contrast 5 cm past the origin of the SMA. On the axial views, you can trace the SMA until the point that there is no longer any contrast visible which indicates the start of the thrombus. The SMA does not appear to be reconstituted. There was normal flow to the celiac artery. (See annotated images).

Abdominal/Gastroenterology Cardiology/Vascular Visual EM

Biceps Tendon Rupture

Daniel M Polvino, MD^*and Grant Wei, MD^*

DOI: https://doi.org/10.21980/J8RP8B Issue 3:1 No ratings yet.

Physical exam was significant for ecchymosis and mild swelling of the right bicep. When the right arm was flexed at the elbow, a prominent mass was visible and palpable over the right bicep. Right upper extremity strength was 4/5 with flexion at the elbow.

Orthopedics Visual EM

Hutchinson’s Sign

Lawrence Lau, MD^*, Hannah Mirzakhani, BA^{^} and Nicholas Governatori, MD^*

DOI: https://doi.org/10.21980/J8N040 Issue 3:1 No ratings yet.

The unilateral distribution of vesicular lesions over the patient's left naris, cheek, and upper lip are consistent with Herpes zoster reactivation with Hutchinson's sign. Hutchinson's sign is a herpes zoster vesicle present on the tip or side of the nose.1 It reflects zoster involvement of the 1st branch of the trigeminal nerve, and is concerning for herpes zoster ophthalmicus.1 Herpes zoster vesicles may present as papular lesions or macular vesicles on an erythematous base.2,3 Emergent diagnosis must be made to prevent long-term visual sequelae.4

Infectious Disease Dermatology Visual EM