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A Case Report of Right Atrial Thrombosis Complicated by Multiple Pulmonary Emboli: POCUS For the Win!
DOI: https://doi.org/10.21980/J8TM07Pulmonary POCUS was performed by the ED physician (GE Venue, C1-5-RS 5MHz curvilinear transducer), and lung examination was unremarkable with no pleural effusion, pneumothorax, or infiltrate. Subxiphoid views (GE Venue, 3Sc-RS 4MHz phased-array transducer) were obtained because this patient’s COPD with severe pulmonary hyperexpansion made parasternal and apical 4-chamber views suboptimal. A large thrombus can be seen within the right atrium (movie 1, images 1, 2). This has a serpiginous, rounded appearance and is mobile, appearing to swirl within the right atrium with intermittent extrusion through the tricuspid valve. A pacemaker wire is also visible within the right ventricle as a non-moving, hyperechoic, linear structure with posterior enhancement artifact. Pericardial effusion is not present.
Retropharyngeal Abscess in an Adult Patient Presenting with Neck Fullness and Dysphagia: A Case Report
DOI: https://doi.org/10.21980/J8M36GContrast-enhanced CT soft tissue of the neck showed evidence of a prevertebral/retropharyngeal fluid collection, extending from the odontoid tip to the inferior C4 vertebral body margin, measuring 5.4 x 1.0 x 3.3 centimeters (cm) in size (yellow lines) without gross airway narrowing.
The Advantage of Using Video Laryngoscope in Puncture and Incisional Drainage of Peritonsillar Abscess: A Case Report
DOI: https://doi.org/10.21980/J8G935Incision of the peritonsillar abscess was performed with the assistance of the C-MAC video laryngoscope which provided a clear, illuminated, and unobstructed view of the incision site. Local anesthesia with 1% xylocaine was administered, and the abscess was incised with a scalpel and drained with a forceps.
A Case Report on an Elusive Incident of Erythema Multiforme
DOI: https://doi.org/10.21980/J8BM0WHer physical exam was notable for multiple scattered tense vesicles on an erythematous base along the left and right lower extremities and right upper extremity. The lesions were excoriated and in different stages of evolution. No oral, mucosal, or conjunctival lesions were found. Physical exam was otherwise unremarkable.
A Case Report on Dermatomyositis in a Female Patient with Facial Rash and Swelling
DOI: https://doi.org/10.21980/J8506DThe physical exam revealed significant periorbital swelling, facial edema, and a maculopapular rash across the upper chest, symmetrically across the extensor surfaces of the hands and the bilateral arms and thighs. The photograph of her face shows light-red to violaceous macules and patches, with inclusion of the nasolabial folds as well the forehead and upper eyelids with periorbital edema (heliotrope sign). The other rash images show “Shawl sign” (photograph of back showing erythema over the posterior aspect of the upper back), V sign (photograph of chest showing light-red violaceous plaque on mid-chest), Gottron's papules (photograph of hands showing light red scaly papules overlying the right proximal interphalangeal joint [R PIP] and the metacarpophalangeal joint [MCP], and holster sign (photograph of thigh showing light red patches on bilateral lateral thighs). This distribution of rashes is pathognomonic for DM.
Computed Tomography Findings in Non-Obstetric Vulvar Hematoma: A Case Report
DOI: https://doi.org/10.21980/J8194HBedside ultrasound was first used to evaluate for evidence of abscess or cyst formation. Ultrasound demonstrated a hypoechoic area within the right labia without evidence of a cyst or abscess wall. Based on these findings, an angiogram CT of the pelvis was obtained which revealed a vulvar hematoma with evidence of active arterial extravasation. In both the coronal and axial view, there is an asymmetric area of isodensity in the right labia representing a hematoma (blue circled area). Angiography may show areas of active extravasation, which appears as hyperdensity within the area of hematoma (see red arrow in coronal plane).
A Man With Chest Pain After An Assault – A Case Report
DOI: https://doi.org/10.21980/J8J93SOn exam, we found a suspected chest wall abscess with surrounding erythema (blue arrow). The patient underwent CT of the chest which showed a comminuted displaced midsternal fracture (yellow arrow) with moderate fluid and air anteriorly (red arrow), consistent with an abscess. His laboratory results had no significant abnormalities.
A Case Report of Lateral Subtalar Dislocation: Emergency Medicine Assessment, Management and Disposition
DOI: https://doi.org/10.21980/J8SS8PIn a lateral subtalar dislocation, the navicular bone (red bone in 3D anatomy image) and the calcaneus (yellow bone in 3D anatomy image) dislocate laterally in relation to the talus (lavender bone in 3D anatomy image). Plain film oblique and lateral X-rays demonstrate the initial dislocation (talus in red, navicular in blue). It is clear in the initial lateral view that there is loss of the talar/navicular articulation (noted by red arrow). The anterior-posterior x-ray is more challenging to discern the anatomy; however, the talus (red dot) is laterally displaced in comparison to the navicular (blue dot).
A Case Report of Dermatographia
DOI: https://doi.org/10.21980/J8P05PPhysical examination was unremarkable except for the urticaria on the right aside of her abdomen (white arrow) with overlying excoriations (stars). Of note, there were no burrows, papules or vesicles in the typical locations including the webs of the fingers, wrists, axillae, areolae, or genitalia. Examination of the linear dermatographia clearly revealed superficial wheals, versus underlying serpiginous lesions.
A Case Report of Acute Compartment Syndrome
DOI: https://doi.org/10.21980/J87061Inspection of the extremity revealed significant swelling with dark discoloration and multiple bullae (pre-operative photograph). Furthermore, notable swelling of the right foot was noted, which felt cold to palpation. Radiographs of pelvis, bilateral knees, tibia, fibula, and feet demonstrated no fractures or dislocations. The bilateral tibia and fibula X-ray revealed soft tissue swelling in the proximal legs, particularly evident in the right leg's AP view, which also showed numerous ovoid radiodensities in the anterior compartment, likely related to soft tissue injury. Post operative images are also provided demonstrating the patients’ four compartment fasciotomies which were loosely closed using staples.