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X-Ray

Prosthetic Joint Infection Open Knee Photo AP. JETem 2026

Visual Case Report of a Prosthetic Joint Infection and Chronic Dehiscence following a Total Knee Arthroplasty

Kevin Chao MD*, Alisa Wray MD^ and Danielle Matonis MD^

DOI: https://doi.org/10.5070/M5.52251 Issue 11:3[mrp_rating_result]
Radiographs demonstrated intact prosthetic components (blue) without acute fracture, tibial peri-stem lucency (green) concerning for loosening or infection, as well as joint effusion, and soft-tissue swelling.
Visual EMCurrent IssueInfectious DiseaseOrthopedics
Rapidly Progressive Painless Acute Aortic Dissection. CT Axial Level of the Liver. JETem 2026

Rapidly Progressive Painless Acute Aortic Dissection: A Case Report

Justin Yang, MD, Tyler Rigdon, MD* and Kristin Lewis, MD, MA*

DOI: https://doi.org/10.5070/M5.52348Issue 11:3[mrp_rating_result]
A POCUS of the abdomen at that time demonstrated findings concerning for a dissection flap in the abdominal aorta (green arrows), and a new mild to moderate pericardial effusion was seen on a repeat cardiac POCUS suggesting an evolving aortic dissection (blue arrows). The patient’s CTA revealed a type A AAD with extension from the aortic root to the bilateral external and internal iliac vessels as well as the coronary arteries (red arrows).
Visual EMCardiology/VascularCurrent Issue
Coin Stack. Neck XR Lateral Unannotated. JETem 2026

A Case Report of a Coin Stack Masquerading as a Button Battery

Peyton J Ware, MD*, Carter Ware, MD*^, Amanda H Bjornstad, MD*†, Heather M Kuntz, MD*† and Timothy P Young, MD*†

DOI: https://doi.org/10.5070/53886 Issue 11:3[mrp_rating_result]
The two images provided are OSH AP and lateral XRs of the patient's neck. The OSH AP view demonstrates a halo sign (green arrow), while the lateral view demonstrates a step-off sign (stick figure). These are key findings with BB ingestions. The halo sign is the presence of two concentric rings on an anterior view XR.
Visual EMCurrent IssuePediatricsRespiratory
Occult Pneumoperitoneum. Figure 1 Unannotated. JETem 2026

A-Lines below the Diaphragm – A Case Report of Occult Pneumoperitoneum

Yong Hoon Lee MD* and Michael Dalley DO*

DOI: https://doi.org/10.5070/M5.52389Issue 11:3[mrp_rating_result]
The RUQ POCUS focusing over the left liver lobe shows multiple enhanced peritoneal stripe signs (red arrows) and several reverberation artifacts (yellow arrows). The second RUQ POCUS of the right lobe of the liver and the gallbladder shows reverberation artifacts (yellow arrow) and ring-down artifacts (blue arrow). The chest X-ray shows free air under the right diaphragm (orange arrow), which indicates pneumoperitoneum. The CT abdomen and pelvis show pneumoperitoneum near the porta hepatis (green arrow).
Visual EMAbdominal/GastroenterologyCurrent Issue
Cricket open fracture dislocation. Photo 4. JETem 2026

A Case Report on an Open Fracture Dislocation Injury of the Proximal Phalanx of the Thumb Resulting from Playing Cricket

Michael R Chiang, MD*, Morgan Kemerling, MD*, Rahul Pentaparthi^ and Avi Ruderman, MD*

DOI: https://doi.org/10.5070/M5.52278Issue 11:2[mrp_rating_result]
There was an open injury to the volar aspect of the right thumb at the interphalangeal joint, with exposed bone. There was no active bleeding from the wound. He had intact sensation to the entire thumb and hand. His radial pulse was normal with normal capillary refill in all digits of his right hand. He had intact wrist flexion, extension, abduction, and adduction; however, he was unable to flex or extend his thumb secondary to the injury. He had no other injuries to the rest of his right upper extremity. An x-ray was obtained which showed a right thumb proximal phalanx intra-articular fracture (proximal fracture fragment outlined in yellow, distal fracture fragment outlined in pink) at the interphalangeal joint with dorsal dislocation of the distal phalanx (outlined in red). There were no radiopaque foreign bodies.
Visual EMOrthopedics
SCAD. Angiography. JETem 2026

A Case Report of a 36-year-old Male Diagnosed with a Spontaneous Coronary Artery Dissection

Stephen DeWitt, DO*, Jacob McClinton, MD* and Daniel Jarrell, DO*

DOI: https://doi.org/10.5070/M5.52022Issue 11:1[mrp_rating_result]
The initial ECG obtained from the patient shows subtle ST-segment elevation noted in leads I, aVL, and V2-V5, suggestive of pathology of the left anterior descending artery. The results of the catheterization revealed a spontaneous coronary artery dissection of the distal portion of the left anterior descending coronary artery, which can be seen in the image of the angiogram, with the diseased portion notated between the brackets.
Visual EMCardiology/Vascular
Calcinosis Cutis. Prior Elbow XR Lateral. JETem 2025

Metastatic Calcinosis Cutis in the Emergency Department: A Case Report

Christian Hernandez-Zegada, MD*, Holly Conger, MD* and Brian Milman, MD*

DOI: https://doi.org/10.21980/J87Q00 Issue 10:3[mrp_rating_result]
X-ray imaging was obtained of the left elbow and showed soft tissue calcium deposits. Radiology stated, “massive periarticular calcinosis of renal failure obscures fine osseous detail. Several of the largest calcifications have decompressed since the prior exam and may contribute to the drainage observed clinically. Superimposed infection is not excluded.” X-rays with an asterisk are the comparison images from two months previous to the visit. Areas of decompression are highlighted in blue demonstrating that some of the larger calcified nodules are no longer present.
Visual EMDermatologyRenal/Electrolytes
Dental Free Air CT Coronal Unannotated. JETem 2025

A Case Report of Facial Swelling and Crepitus Following a Dental Procedure

Shady Mikhail, MD*, George Mina, MD^, Alisa Wray MD, MAEd† and Danielle Matonis, MD†

DOI: https://doi.org/10.21980/J83W8H Issue 10:3[mrp_rating_result]
Given the physical exam findings of crepitus on the right neck up to the right lower eyelid, a maxillofacial CT scan without contrast was performed. It revealed diffuse subcutaneous air within the soft tissues of the face and neck and free air within the pre-septal soft tissue of the right eye, appearing as hyperlucent (dark) areas on CT within the soft tissue planes (blue outline). It showed no evidence of post-septal free air. A single-view chest X-ray was also performed and was unremarkable except for incompletely imaged soft tissue gas in the right lower neck (blue outline). On flexible fiberoptic laryngoscopy performed by ENT, the oropharynx appeared diffusely edematous and narrowed.
Visual EMENT
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