Visual EM

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A Case of Otomastoiditis

Chad Correa, BS* and Claire Thomas, MD^

DOI: https://doi.org/10.21980/J8RK89Issue 3:2[mrp_rating_result]
The patient underwent computed tomography (CT) of the head which revealed opacification of the left middle ear (red arrow) and mastoid air cells (red circles). Additionally, there was thickening of the soft tissues of the external auditory canal (blue arrowhead), likely reflecting concurrent otitis externa. Based on the imaging, he was admitted for findings consistent with acute otomastoiditis.
ENTInfectious DiseaseVisual EM
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Osborn Waves in a Severely Hypothermic Patient

Jon Van Heukelom, MD*

DOI: https://doi.org/10.21980/J8H34SIssue 3:2[mrp_rating_result]
The initial EKG shows marked elevation of the J-point (point where the QRS segment joins the ST segment), otherwise known as an “Osborn Wave” (see black arrows).  A subsequent EKG obtained after active rewarming, showed resolution of the Osborn waves.
Cardiology/VascularVisual EM
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Acromioclavicular joint separation

Devan Pandya, BS* and John Costumbrado, MD, MPH^

DOI: https://doi.org/10.21980/J8C91G Issue 3:2[mrp_rating_result]
History of present illness: A 30-year-old male was brought in by ambulance to the emergency department as a trauma activation after a motorcycle accident. The patient was the helmeted rider of a motorcycle traveling at an unknown speed when he lost control and was thrown off his vehicle. He denied loss of consciousness, nausea, or vomiting. The patient’s vital signs
OrthopedicsVisual EM
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Torsades de Pointes

Richard J Chen, MD*, Grant Wei, MD* and Chirag Shah, MD*

DOI: https://doi.org/10.21980/J87K91 Issue 3:2[mrp_rating_result]
The patient was found to be in a polymorphic ventricular tachycardia; he was alert, awake and asymptomatic. A rhythm strip showed a wide complex tachycardia with the QRS complex varying in amplitude around the isoelectric line consistent with Torsades de Pointes.
Cardiology/VascularVisual EM
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Pediatric Pulmonary Abscess

Kyle Barbour* and Jonathan Peña, MD*

DOI: https://doi.org/10.21980/J83S6QIssue 3:2[mrp_rating_result]
Upright posterior-anterior plain chest films show a left lower lobe consolidation with an air-fluid level and a single septation consistent with a pulmonary abscess (white arrows). A small left pleural effusion was also present, seen as blunting of the left costophrenic angle and obscuration of the left hemidiaphragm (black arrows).
RespiratoryInfectious DiseaseVisual EM
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Scaphoid Fracture

Esther Kim, BS* and Justin Yanuck, MD*

DOI: https://doi.org/10.21980/J80344Issue 3:2[mrp_rating_result]
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).
OrthopedicsVisual EM
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Type 1 Brugada Syndrome

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

DOI: https://doi.org/10.21980/J8V91T Issue 3:2[mrp_rating_result]
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/VascularVisual EM
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Acute comminuted intertrochanteric hip fracture

Samuel Kaplan, BS* and Jonathan Peña, MD*

DOI: https://doi.org/10.21980/J8QK9C Issue 3:2[mrp_rating_result]
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
OrthopedicsVisual EM