X-Ray

Pseudogout and Calcium Pyrophosphate Disease

Andrew Williamson, MD*

DOI: https://doi.org/10.21980/J8QG66Issue 2:1 No ratings yet.

Radiographs of the knee showed multiple radio-dense lines paralleling the articular surface (see red arrows) consistent with calcium pyrophosphate crystal deposition within the joint often seen in calcium pyrophosphate disease (CPPD) also known as pseudogout.

Orthopedics Visual EM

Ventriculoperitoneal Shunt Migration

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

DOI: https://doi.org/10.21980/J8G019Issue 2:1 No ratings yet.

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/Gastroenterology Visual EM

Lunate Dislocation

Jonathan Peña, MD^*

DOI: https://doi.org/10.21980/J86K56Issue 2:1 No ratings yet.

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.

Orthopedics Trauma Visual EM

Pediatric Supracondylar Fracture

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

DOI: https://doi.org/10.21980/J8T88TIssue 2:1 No ratings yet.

Plain film radiography showed a displaced supracondylar fracture with disrupted anterior and posterior periostea, consistent with a type 3 supracondylar fracture.

Orthopedics Visual EM

Calcaneal Fractures and Böhler’s Angle

Lindsey Spiegelman, MD^* and Mohammed Helmy, MD^{^}

Issue 2:1 No ratings yet.

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).

Orthopedics Visual EM

Gastric Bezoar

Samer Assaf MD^*

DOI: https://doi.org/10.21980/J85K5WIssue 2:1 No ratings yet.

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/Gastroenterology Visual EM

Monteggia Fracture in an Assault Patient

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

DOI: https://doi.org/10.21980/J81S3ZIssue 2:1 No ratings yet.

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).

Orthopedics Visual EM

Hill-Sachs Deformity

Jessa Baker^* and Shannon Toohey, MD^*

DOI: https://doi.org/10.21980/J8Z59DIssue 1:2 No ratings yet.

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.

Orthopedics Visual EM

Perforated Duodenal Ulcer

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

DOI: https://doi.org/10.21980/J8TG64Issue 1:2 No ratings yet.

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/Gastroenterology Visual EM

Trimalleolar Fracture

Christopher Gilani^* and Shannon Toohey, MD, MA^*

DOI: https://doi.org/10.21980/J8PP46 Issue 1:2 No ratings yet.

Anteroposterior (AP), lateral, and oblique x-ray views were obtained. The AP view revealed a displaced spiral fracture of the lateral malleolus (red) and a vertical fracture of the medial malleolus (blue). The lateral view revealed a displaced fracture of the posterior malleolus, tibial plafond (yellow), and the oblique view showed widening of the distal tibiofibular syndesmosis (green). CT scans confirmed trimalleolar fracture, annotated with the same colored lines (red, lateral malleolus; blue, medial malleolus; yellow, posterior malleolus).

Orthopedics Visual EM