X-Ray

A Case Report of the Rapid Evaluation of a High-Pressure Injection Injury of a Finger Leading to Positive Outcomes

Nathaniel Hansen, MD* and Colin Danko, MD*

DOI: https://doi.org/10.21980/J8TD2X Issue 7:2 No ratings yet.
On exam the patient was noted to have a punctate wound to the ulnar aspect of his right index finger, just proximal to the distal interphalangeal joint. The finger appeared pale and taut, with absent capillary refill. The patient displayed diminished range of motion with both extension and flexion of the joints of the finger. Sensation was absent and no doppler flow was appreciated to the distal aspects of the finger. X-ray of the hand was obtained and showed many small foreign bodies in the soft tissue and extensive radiolucent material consistent with gas or oil-based material to the palmar aspect of the index finger tracking up to the level of the metacarpal heads.
Current IssueOrthopedicsVisual EM

A Case Report of Epiglottitis in an Adult Patient

Savannah Tan, BS*, Kyle Dornhofer, MD*, Allen Yang, MD*, Shadi Lahham, MD, MS*  and Lindsey C Spiegelman, MD*

DOI: https://doi.org/10.21980/J8QM09 Issue 7:1 No ratings yet.
At the time of presentation to the ED, laboratory results were significant for leukocytosis to 11.8 x 109 white blood cells/L and a partial pressure of carbon dioxide of 52 mmHg on venous blood gas. Computed tomography (CT) of the soft tissue of the neck with contrast showed edematous swelling of the epiglottis and aryepiglottic fold with internal foci of gas (blue arrow) and partial effacement of the laryngopharyngeal airway and scattered cervical lymph nodes bilaterally (Figure 1). Findings were consistent with epiglottitis containing nonspecific air. Additionally, the pathognomonic “thumbprint sign” (yellow arrow) was found on lateral x-ray of the neck (Figure 2). The CT findings as shown in figure 3 illustrate lateral view of the swelling of the epiglottis, gas, and blockage of the airway.
ENTVisual EM

A Case Report of a Large Goiter Resulting in Tracheal Deviation

Thomas Powell, MD* and Geremiha Emerson, MD*

DOI: https://doi.org/10.21980/J80645 Issue 6:3 No ratings yet.
In the image, one can see significant tracheal deviation around the right side of the mass (black arrows). This degree of deviation would make ventilation in a paralyzed patient extremely difficult, if not impossible.
EndocrineVisual EM

A Case Report of a Transected Carotid Artery Caused by a Stab Wound to the Neck

Jennifer Roh, MD* and Kylie Prentice, BS*

DOI: https://doi.org/10.21980/J8BP8M Issue 6:1 No ratings yet.
The post intubation chest x-ray (CXR) showed severe rightward displacement of the trachea (purple arrow). The computed tomography angiogram (CTA) showed transection of the left common carotid artery (LCCA), extensive neck hematoma without extravasation and severe tracheal deviation to the right (blue arrow). The intravenous (IV) contrasted chest computed tomography (CT) image showed a lateral contrast projection from the aortic arch at the level of the isthmus (green and pink arrows). There were no other significant injuries reported on the CT scans of the chest, abdomen and pelvis.
Cardiology/VascularTraumaVisual EM

Posterior Sternoclavicular Dislocation: A Case Report

Stephanie Songey, DO*, Christopher Goodwill, DO* and Kimberly Sokol, MD, MS, MACM*

DOI: https://doi.org/10.21980/J8363Q Issue 6:1 No ratings yet.
Chest X-ray revealed an inferiorly displaced right clavicle at the right sternoclavicular joint (blue arrow). A computed tomography angiogram (CTA) of the chest was therefore obtained and revealed a right posterior sternoclavicular dislocation with resultant compression of the left brachiocephalic vein (purple arrow). Even though the right clavicle is displaced, the anatomy of the brachiocephalic vein is such that it is positioned to the right of midline, placing the left brachiocephalic vein posterior to the right clavicle. The right brachiocephalic and common carotid artery were normal in appearance. The CTA also revealed a comminuted fracture of the left anterior second rib at the costochondral junction that had not been previously seen on the x-ray.
OrthopedicsTraumaVisual EM

Case Report: Traumatic Tension Pneumothorax in a Pediatric Patient

Zachary Tritsch, MD*, Gayle Galan, MD*, Gary Oates, MD* and Janelle Thomas, MD*

DOI: https://doi.org/10.21980/J8ZD1S Issue 6:1 No ratings yet.
Chest X-ray demonstrated significant right-sided pneumothorax (with red outline showing border of collapsed right lung) with cardio mediastinal shift to the left (shown by blue arrows) indicative of a tension pneumothorax
PediatricsRespiratoryTraumaVisual EM

Adult Clavicular Fracture Case Report

Jessica L Sea, PhD*, Nadia Zuabi, MD* and Alisa Wray, MD, MAEd*

DOI: https://doi.org/10.21980/J8FM0TIssue 5:4 No ratings yet.
The patient's chest and clavicular radiographs showed a comminuted displaced acute fracture of the right mid-clavicle (green, blue, yellow). The clavicular fracture was also visible on the chest computed tomography (CT). The remainder of his trauma workup was negative for acute findings.
OrthopedicsTraumaVisual EM

Case Report of Distal Radioulnar Joint and Posterior Elbow Dislocation

Danielle Matonis, MD*, Katelyn Wittel, BS* and Alisa Wray, MD, MAEd*

DOI: https://doi.org/10.21980/J89S6K Issue 5:4 No ratings yet.
Radiographs of the left elbow and wrist were obtained. Left elbow radiographs showed simple posterolateral dislocation of the olecranon (red) without fracture of the olecranon (red) or trochlea (blue). Left wrist lateral radiographs demonstrated DRUJ dislocation with dorsal displacement of the distal ulna (green) without fracture or widening of the radioulnar joint (purple). Post-reduction radiographs demonstrated appropriate alignment of the elbow with the trochlea seated in the olecranon and improved alignment of the DRUJ.
OrthopedicsTraumaVisual EM

A Case Report of Ogilvie’s Syndrome in a 58-year-old Quadriplegic

Rosie Kumar, BS*, Brett Cowan, MD*, Daniel Quesada, MD* and Sage Wexner, MD*

DOI: https://doi.org/10.21980/J82922 Issue 5:4 No ratings yet.
Plain radiograph of the patient's abdomen revealed a gaseous distention of the colon. This is demonstrated as noted in the abdominal x-ray as gaseous distention, most notably in the large bowel (arrows) including the rectal region (large circle). Follow up computed tomography (CT) scan affirmed severe pancolonic gaseous distention measuring up to 11.2 cm, compatible with colonic pseudo-obstruction as noted by the large red arrows. No anatomical lesion or mechanical obstruction was observed, as well as no evidence of malignancy or other acute process.
Abdominal/GastroenterologyVisual EM

Is an X-ray a Useful Test for Esophageal Food Boluses? A Case Report

Meryl M Abrams, MD*, Jennifer L White, MD* and Jeffrey Gardecki, MD*

DOI: https://doi.org/10.21980/J8Q639 Issue 5:3 No ratings yet.
The plain film radiograph of the chest demonstrated a fluid level (yellow arrow) in the distal esophagus with dilation of the esophagus proximal to that point (blue line). Neither of these findings were present on the previous visit.
Abdominal/GastroenterologyVisual EM