X-Ray

Button Battery in Esophagus

Sha Yan, DO^* and Ernest Leva, MD^*

DOI: https://doi.org/10.21980/J8FW6VIssue 3:3[mrp_rating_result]

Chest radiograph showed the presence of a round radiopaque foreign body in the mid-chest. It was suspected to be in the esophagus rather than in the trachea due to the en-face positioning of the foreign body. The foreign body demonstrated two concentric ring circles concerning for a “double ring” or “halo" sign, which was suggestive of the presence of a button battery rather than a coin.

Abdominal/Gastroenterology Visual EM

Pediatric Foreign Body Aspiration

Sha Yan, DO^* and Uchechi Azubuine, MD^{^}

DOI: https://doi.org/10.21980/J8B648Issue 3:3[mrp_rating_result]

Chest radiograph showed increased radiolucency (red arrow) and flattening of the diaphragm on the right side (blue arrow) consistent with hyperinflation of the right lung, as well as left mediastinal shift (green arrow), indicating obstruction.

Pediatrics Respiratory Visual EM

Achalasia: An Uncommon Presentation with Classic Imaging

Joseph Adamson, BS^*, Mina Altwail, MD^{^} and Shanna Jones, MD^{^}

DOI: https://doi.org/10.21980/J86D2BIssue 3:3[mrp_rating_result]

The chest X-ray demonstrated a markedly widened mediastinum (red brackets), raising concern for thoracic aortic aneurysm/aortic dissection, which prompted labs and contrast-enhanced computed tomography (CT) of the chest. The CT revealed a dilated proximal esophagus that narrowed distally (yellow tracing and red arrow), with particulate material, mass-effect on the trachea (purple outline), and bilateral patchy opacities suggesting aspiration. Barium esophagram showed a drastically dilated esophagus filled with contrast (yellow arrow), terminating into the classic “bird’s beak sign” (red arrow) at the lower esophageal sphincter (LES). Esophageal manometry later confirmed achalasia, proving that widened mediastina can have unexpected etiologies.

Abdominal/Gastroenterology Visual EM

Lateral Epicondyle Fracture

Valerie Lew, BS^*, John Costumbrado, MD, MPH^* and Curtis Knight, MD^*

DOI: https://doi.org/10.21980/J8J05F Issue 3:2[mrp_rating_result]

Radiographs of the right elbow revealed an acute fracture through the lateral epicondyle with dislocation of the radial head inferiorly. Radiographs of the left elbow revealed a slightly angulated fracture through the lateral epicondyle.

Orthopedics Visual EM

Glass Foreign Body Hand Radiograph

Hamid Ehsani-Nia, DO^* and Joshua Bucher, MD^*

DOI: https://doi.org/10.21980/J8W92HIssue 3:2[mrp_rating_result]

History of present illness: A 27-year-old female sustained an injury to her left hand after she tripped and fell on a vase. She presented to the emergency department (ED) complaining of pain over the laceration. Upon examination, patient presented with multiple small abrasions of the medial aspect of the left 5thdigit that are minimally tender. Additionally, she has one 0.5cm

Trauma Ultrasound Visual EM

Acromioclavicular joint separation

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

DOI: https://doi.org/10.21980/J8C91G Issue 3:2[mrp_rating_result]

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

Pediatric Pulmonary Abscess

Kyle Barbour^* and Jonathan Peña, MD^*

DOI: https://doi.org/10.21980/J83S6QIssue 3:2[mrp_rating_result]

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[mrp_rating_result]

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

$Acute comminuted intertrochanteric hip fracture 18$

Acute comminuted intertrochanteric hip fracture

Samuel Kaplan, BS^* and Jonathan Peña, MD^*

DOI: https://doi.org/10.21980/J8QK9C Issue 3:2[mrp_rating_result]

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

Pneumomediastinum After Cervical Stab Wound

Chad Correa, BS^* and Emily Ma, MD^{^}

DOI: https://doi.org/10.21980/J87P79 Issue 3:1[mrp_rating_result]

Anteroposterior (AP) chest X-ray showed subcutaneous emphysema of the neck, surrounding the trachea (red arrows), right side greater than left, and a streak of gas adjacent to the aortic arch (white arrow). Computed tomography angiogram (CTA) of the neck showed air outside of the trachea, positive for pneumomediastinum (blue arrows).

Trauma Respiratory Visual EM