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241-245 of 245 results with category "Visual Diagnosis"

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Title: What's the diagnosis?

Category: Visual Diagnosis

Posted: 3/28/2011 by Haney Mallemat, MD (Updated: 3/28/2011)

Question

25 year old male presents after falling from 10 feet and landing on right shoulder. Diagnosis?

Show Answer

Yes...the shoulder is dislocated, but did you notice anything else? (see figure 1)

 

Glenoid Fossa Fracture: (Image submitted by Dr. George Kochman)

 

Fractures of the glenoid fossa occur when the head of the humerus collides with the glenoid margin; classically, by a laterally directed force. Although less than 10% of glenoid fossa fractures result in significant displacement, surgical repair is indicated if: 

  • Fracture displacement >10mm
  • >33% involvement of posterior glenoid fossa
  • >25% involvement of anterior glenoid fossa
  • Persistent humeral head subluxation

Show References

Schmidt, J. Scapular Fracture. eMedicine. January 12, 2011.

http://emedicine.medscape.com/article/826084-overview

 



Title: What's the daignosis? Written by Sanober Shaikh, MD

Category: Visual Diagnosis

Keywords: lung, ultrasound, pneumonia, hepatization, sonogram, air bronchograms (PubMed Search)

Posted: 3/14/2011 by Haney Mallemat, MD

Question

 

65 yo female with breast cancer presents with dyspnea and CXR shown below. Diagnosis? Can anything help clarify the diagnosis? 

Show Answer

 

The CXR shows an opaque right hemithorax, consistent with a pleural effusion, a large consolidation, or both. Ultrasound of the lung can clarify this ambiguity.  

Consolidation of lung parenchyma (e.g., pneumonia) appears isoechoic to liver tissue on ultrasound and air bronchograms appear as hyperechoic areas within the consolidated lung parenchyma (Image 1). Together these findings are termed "hepatization" of the lung as consolidated lung appears similar to liver parenchyma on ultrasound (Image 2). 

Show References

Durant, A.  Nagdev, A. Ultrasound detection of Lung Hepatization. West J Emerg Med. 2010 September; 11(4): 322-323.



Title: What's the daignosis? Written by Adam Brenner, MD

Category: Visual Diagnosis

Keywords: ultrasound, ectopic, free fluid, hypotension, pregnancy (PubMed Search)

Posted: 2/28/2011 by Haney Mallemat, MD (Updated: 8/28/2014)

Question

24 yo woman presents with syncope, abdominal pain, and normal menses 4 days prior. Urine HCG(+) and quantitative beta-HCG is 1300 with the transvaginal ultrasound seen below. Diagnosis?

Show Answer

Ectopic Pregnancy Pearls

  1. Considering the history above, transvaginal ultrasound should be performed regardless of quantitative beta-HCG; even if below the discriminatory zone (<1500-1800)
  2. Transvaginal ultrasound suggests ectopic pregnancy (as in the case above), with an empty uterus and free pelvic fluid (Figure 1).
  3. The above history plus free abdominal fluid on FAST exam also suggests the diagnosis and should expedite management (Figure 2). 
  4. Please remember that ~15% of ectopic pregnancies present with normal menses.

 

Show References

Tintinalli, Judith, et al.  Tintinalli’s Emergency Medicine:  A Comprehensive Study Guide, 7th Edition.  2011, McGraw-Hill Companies, Inc, China



Title: 50 year-old s/p fall.....what's the diagnosis?

Category: Visual Diagnosis

Posted: 2/21/2011 by Rob Rogers, MD

Question

Show Answer

Luxatio Erecta-inferior glenohumeral dislocation
 

A rare shoulder dislocation caused by a hyperabduction injury to the arm.

Show References




Title: What's wrong with this picture? (Don't scroll too far down)

Category: Visual Diagnosis

Keywords: boxer's, fracture, orthopedics, hand, brawler's, radiology, xray (PubMed Search)

Posted: 1/17/2011 by Haney Mallemat, MD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Boxer's (or Brawler's) Fracture

  • Fifth metacarpal neck fracture, usually secondary to a direct blow or closed-fist impact.
  • Potentially an unstable fracture and difficult to maintain reduction due to tension from tendons and muscles in the hand.
  • Up to forty degrees of angulation can be tolerated without repair, although there is potential for reduced hand function without repair. Any rotational deformity, however, must be corrected.
  • Non-displaced fractures: RICE therapy, gutter splint, and Ortho follow-up.
  • Displaced, rotated, or angulated fractures (>40 degrees): closed reduction may be attempted but surgical fixation usually required.

Show References

Many thanks to Dr. George Kochman for submitting this case!



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