Issue 3:2

Osborn Waves in a Severely Hypothermic Patient

Jon Van Heukelom, MD^*

DOI: https://doi.org/10.21980/J8H34SIssue 3:2 No ratings yet.

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/Vascular Visual EM

Acromioclavicular joint separation

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

DOI: https://doi.org/10.21980/J8C91G Issue 3:2 No ratings yet.

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

Orthopedics Visual EM

Torsades de Pointes

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

DOI: https://doi.org/10.21980/J87K91 Issue 3:2 No ratings yet.

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/Vascular Visual EM

Pediatric Pulmonary Abscess

Kyle Barbour^* and Jonathan Peña, MD^*

DOI: https://doi.org/10.21980/J83S6QIssue 3:2 No ratings yet.

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).

Respiratory Infectious Disease 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

$Acute comminuted intertrochanteric hip fracture 14$

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