CT

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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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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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Oropharynx Ulceration

Lauren Sylwanowicz, MD* and Andrew Wong, MD, MBA*

DOI: https://doi.org/10.21980/J87W60 Issue 2:4[mrp_rating_result]
The 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. 
ENTVisual EM
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An Elderly Male with Amyand’s Hernia

Saema Said, MD* and Roozbeh Houshyar, MD^

DOI: https://doi.org/10.21980/J80D13 Issue 2:4[mrp_rating_result]
Ultrasound 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).
Abdominal/GastroenterologyVisual EM
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Acetabular Fracture

Chad Correa* and Sari Lahham, MD^

DOI: https://doi.org/10.21980/J8BK8K Issue 2:4[mrp_rating_result]
The 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).
OrthopedicsVisual EM
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Choledocholithiasis

Jonathan Peña, MD*

DOI: https://doi.org/10.21980/J8Q62X Issue 2:3[mrp_rating_result]
Computed tomography (CT) was significant for two large gallstones measuring 1.1 centimeters impacted at the level of the pancreatic head with associated common bile duct (CBD) dilatation.
Abdominal/GastroenterologyVisual EM
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Volvulus

Sari Lahham, MD, MBA*, Kathryn Bennett, BS* and Mohammad Helmy, MD†

DOI: https://doi.org/10.21980/J8JH0Q Issue 2:3[mrp_rating_result]
Upright and supine frontal radiographs of the abdomen demonstrate gas dilation of the large bowel from the level of the cecum to the sigmoid colon with air fluid levels (yellow arrows). There is a swirled configuration of the distal descending to sigmoid colon indicating the level of the volvulus (dashed yellow line) and giving rise to the classic “coffee bean” sign (dotted white tracing). Note the elevated left hemidiaphragm on the upright view reflecting abdominal distention with increased intra-abdominal pressure (red arrow).
Abdominal/GastroenterologyVisual EM