X-Ray

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Ventriculoperitoneal Shunt Migration

Justin P Puller, MD* and Jonathan T Miller, MD*

DOI: https://doi.org/10.21980/J8G019Issue 2:1[mrp_rating_result]
An immediate post-op abdominal x-ray performed after the patient’s VP shunt revision 30 days prior to this ED visit reveals the VP shunt tip in the mid abdomen. A CT of the abdomen performed on the day of the ED visit reveals the VP shunt tip interposed between the spleen and the diaphragm.
Abdominal/GastroenterologyVisual EM
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Lunate Dislocation

Jonathan Peña, MD*

DOI: https://doi.org/10.21980/J86K56Issue 2:1[mrp_rating_result]
Plain film of the right wrist showed the classic “spilled teacup” consistent with a lunate dislocation. There is a loss of the normal articulation between the distal radius and lunate.
OrthopedicsTraumaVisual EM
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Pediatric Supracondylar Fracture

Jonathan Peña, MD* and John R. Marshall, MD*

DOI: https://doi.org/10.21980/J8T88TIssue 2:1[mrp_rating_result]
Plain film radiography showed a displaced supracondylar fracture with disrupted anterior and posterior periostea, consistent with a type 3 supracondylar fracture.
OrthopedicsVisual EM
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Calcaneal Fractures and Böhler’s Angle

Lindsey Spiegelman, MD* and Mohammed Helmy, MD^

Issue 2:1[mrp_rating_result]
The right ankle lateral radiograph shows a comminuted, non-displaced fracture of the posterior calcaneus (red arrow) in addition to fracture fragments along the heel pad margin (blue arrow). The left ankle lateral radiograph shows a displaced, comminuted fracture of the mid to posterior calcaneus with extension into the subtalar joint posteriorly (purple arrow). There is subcutaneous air seen anteriorly to the tibiotalar joint space (green arrow) in addition to a joint effusion. Of note, the Böhler’s angle in the left x-ray is 16 degrees which is consistent with a fracture (see red annotation showing Böhler’s angle).
OrthopedicsVisual EM
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Gastric Bezoar

Samer Assaf MD*

DOI: https://doi.org/10.21980/J85K5WIssue 2:1[mrp_rating_result]
In the abdominal radiograph, a nonspecific and non-obstructive bowel gas pattern with no air-fluid level was noted, however the stomach was distended with soft tissue. The CT abdomen/pelvis revealed a distended stomach with undigested heterogeneous contents (presumed bezoar).
Abdominal/GastroenterologyVisual EM
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Monteggia Fracture in an Assault Patient

John Jiao, MHS* and Shannon Toohey, MD, MAEd*

DOI: https://doi.org/10.21980/J81S3ZIssue 2:1[mrp_rating_result]
On the axial elbow x-ray, the radial head (red arrow) is dislocated anteriorly from the humerus; the humeroulnar articulation is intact. On the AP forearm x-ray, there is a closed, displaced, comminuted fracture of the ulna (blue arrow).
OrthopedicsVisual EM
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Hill-Sachs Deformity

Jessa Baker* and Shannon Toohey, MD*

DOI: https://doi.org/10.21980/J8Z59DIssue 1:2[mrp_rating_result]
In the post-reduction film, there is a lateral depression in the humeral head (arrow, a Hill-Sachs deformity). A Hill-Sachs deformity is a cortical depression (fracture) in the humeral head that forms as the humeral head hits the glenoid rim during the dislocation.
OrthopedicsVisual EM
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Perforated Duodenal Ulcer

Jessa Baker*, Jonathan Patane, MD* and Carrie Chandwani, MD*

DOI: https://doi.org/10.21980/J8TG64Issue 1:2[mrp_rating_result]
In the chest radiograph, there was obvious free air under the both the right diaphragm (above the liver) and the left diaphragm, consistent with pneumoperitoneum.
Abdominal/GastroenterologyVisual EM