Issue 2:4

Bilateral Hip Dislocation in Unrestrained Driver

Samer Assaf, MD^* and Ghadi Ghanem^*

DOI: https://doi.org/10.21980/J8HD0C Issue 2:4 No ratings yet.

The initial radiograph of the pelvis revealed bilateral hip dislocations. Small bony fragments were noted in the right hip joint, suggestive of an underlying fracture. The sacroiliac joints and the pelvic ring were intact. In the emergency department, bilateral hip reductions were performed using the Captain Morgan technique.1 The post-reduction film showed reduction of the bilateral hip dislocations with extensive comminuted and displaced fractures of the right and left acetabula.

Orthopedics Visual EM

Open Book Pelvic Fracture

Samer Assaf, MD^* and Ghadi Ghanem^*

DOI: https://doi.org/10.21980/J8CK7H Issue 2:3 No ratings yet.

The initial radiograph of the pelvis shows an open-book pelvic fracture deformity with pubic symphyseal dislocation, left greater than right sacroiliac diastases, and fractures of the left superior and inferior pubic rami, right inferior pubic ramus, and left acetabular anterior column. The additional inlet and outlet radiographs of the pelvis after application of a pelvic binder also show an open book fracture with significant improvement of the widened pubic symphysis.

Orthopedics Trauma Visual EM

Oropharynx Ulceration

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

DOI: https://doi.org/10.21980/J87W60 Issue 2:4 No ratings yet.

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.

ENT Visual EM

Subcutaneous Emphysema in Non-Necrotizing Soft Tissue Injury

Hamid Ehsani-Nia, MS, DO^* and Lauren Sylwanowicz MD^{^}

DOI: https://doi.org/10.21980/J8432M Issue 2:4 No ratings yet.

X-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.

Infectious Disease Orthopedics Visual EM

An Elderly Male with Amyand’s Hernia

Saema Said, MD^* and Roozbeh Houshyar, MD^{^}

DOI: https://doi.org/10.21980/J80D13 Issue 2:4 No ratings yet.

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/Gastroenterology Visual EM

Point-of-care Ultrasound for the Diagnosis of Ectopic Pregnancy

Ahmed Farhat, BS^*, Jessica Hoffmann, MD^* and Maili Alvarado, MD^{^}

DOI: https://doi.org/10.21980/J8VK7VIssue 2:4 No ratings yet.

The transabdominal pelvic ultrasound shows an empty uterus (annotated) with free fluid and a right sided extrauterine gestational sac representing an ectopic pregnancy (red arrow).

Ob/Gyn Ultrasound Visual EM

Erythema Migrans

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

DOI: https://doi.org/10.21980/J8QW7QIssue 2:4 No ratings yet.

History 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:

Dermatology Infectious Disease Visual EM

Spontaneous Pneumothorax

John Costumbrado, MD, MPH^* and Steven Kim, MD^*

DOI: https://doi.org/10.21980/J8M33BIssue 2:4 No ratings yet.

Initial 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.

Respiratory Visual EM

Pediatric Esophageal Foreign Body

Samer Assaf, MD^* and Ryan Gibney, BS^*

DOI: https://doi.org/10.21980/J8GD1F Issue 2:4 No ratings yet.

A 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.

Abdominal/Gastroenterology Pediatrics Visual EM

Acetabular Fracture

Chad Correa^* and Sari Lahham, MD^{^}

DOI: https://doi.org/10.21980/J8BK8K Issue 2:4 No ratings yet.

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).

Orthopedics Visual EM