X-Ray

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Spontaneous Pneumothorax

John Costumbrado, MD, MPH* and Steven Kim, MD*

DOI: https://doi.org/10.21980/J8M33BIssue 2:4[mrp_rating_result]
Initial chest radiograph showed a 50% right-sided pneumothorax with no mediastinal shift, which can be identified by the sharp line representing the pleural lung edge (see arrows) and lack of peripheral lung markings extending to the chest wall. While difficult to accurately estimate volume from a two-dimensional image, a 2 cm pneumothorax seen on chest radiograph correlates to approximately 50% volume.1 The patient underwent insertion of a pigtail pleural drain on the right and repeat chest radiograph showed resolution of previously seen pneumothorax. Ultimately the pigtail drain was removed and chest radiograph showed clear lung fields without evidence of residual pneumothorax or pleural effusion.
RespiratoryVisual EM
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Pediatric Esophageal Foreign Body

Samer Assaf, MD* and Ryan Gibney, BS*

DOI: https://doi.org/10.21980/J8GD1F Issue 2:4[mrp_rating_result]
A radiopaque foreign body was visualized in the proximal esophagus at the thoracic inlet on the chest and neck radiographs. The foreign body appeared to be metallic with visualized concentric rings consistent with a coin.
Abdominal/GastroenterologyPediatricsVisual EM
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Acetabular Fracture

Chad Correa* and Sari Lahham, MD^

DOI: https://doi.org/10.21980/J8BK8K Issue 2:4[mrp_rating_result]
The non-contrast CT images show a minimally displaced comminuted fracture of the right acetabulum involving the acetabular roof, medial and anterior walls (red arrows), with associated obturator muscle hematoma (blue oval).
OrthopedicsVisual EM
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Volvulus

Sari Lahham, MD, MBA*, Kathryn Bennett, BS* and Mohammad Helmy, MD†

DOI: https://doi.org/10.21980/J8JH0Q Issue 2:3[mrp_rating_result]
Upright and supine frontal radiographs of the abdomen demonstrate gas dilation of the large bowel from the level of the cecum to the sigmoid colon with air fluid levels (yellow arrows). There is a swirled configuration of the distal descending to sigmoid colon indicating the level of the volvulus (dashed yellow line) and giving rise to the classic “coffee bean” sign (dotted white tracing). Note the elevated left hemidiaphragm on the upright view reflecting abdominal distention with increased intra-abdominal pressure (red arrow).
Abdominal/GastroenterologyVisual EM
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Re-expansion Pulmonary Edema

Kathryn Bennett, BS, BA* and Benjamin Feldman, MD*

DOI: https://doi.org/10.21980/J8WS6V Issue 2:3[mrp_rating_result]
Initial chest X-ray (chest X-ray 1) showed a right-sided pleural effusion with compressive atelectasis of the mid to lower right lung. Repeat chest X-ray immediately after evacuation (chest X-ray 2) shows improvement of the pleural effusion and a new trace apical right pneumothorax measuring 6.7 mm. When the patient became tachypneic, a third X-ray (chest X-ray 3) showed persistent trace apical right pneumothorax measuring 6.7 mm.
RespiratoryVisual EM
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Open Pneumothorax

Bart Paull, MD*, Zachary Jarou, MD* and David Richards, MD*

DOI: https://doi.org/10.21980/J88036 Issue 2:3[mrp_rating_result]
A large chest wound was clinically obvious. A chest radiograph performed after intubation showed subcutaneous emphysema, an anterior rib fracture, and a right-sided pneumothorax. He was then taken to the operating room for further management.
TraumaRespiratoryVisual EM
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Supracondylar Fracture

Jessica Andrusaitis, BS, MS* and Ben Feldman, MD*

DOI: https://doi.org/10.21980/J8492P Issue 2:3[mrp_rating_result]
History of present illness: A 15-year-old male presented to the emergency department with right elbow pain after falling off a skateboard.  The patient denied a decrease in strength or sensation but did endorse paresthesias to his hand.  On exam, the patient had an obvious deformity of his right elbow with tenderness to palpation and decreased range of motion at the
OrthopedicsVisual EM
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Bowel Perforation complicating an incarcerated inguinal hernia

Adam Sigal, MD* and Jamie Slotkin, DO^

DOI: https://doi.org/10.21980/J8D30BIssue 2:2[mrp_rating_result]
The AP and lateral pelvis x-rays revealed two sewing needles, 60 mm in length, within the soft tissue over the anterior right lower hemipelvis. In addition, the AP view showed emphysema involving the right hemiscrotum (arrow), concerning for perforated bowel.
Abdominal/GastroenterologyVisual EM