Moderator EMEDPA Posted June 24, 2015 Author Moderator Share Posted June 24, 2015 a few new ones. #1 is a 45 yr old guy who fell off a roof and has ankle pain. #2 is a 67 yr old lady who twisted her knee and can no longer extend it. Quote Link to comment Share on other sites More sharing options...
jmj11 Posted June 24, 2015 Share Posted June 24, 2015 I'm guess on # 2 as a quadricep Femoris Tendon - avulsion Quote Link to comment Share on other sites More sharing options...
cop to pa Posted June 24, 2015 Share Posted June 24, 2015 #2- patella dislocation? #1- I'm missing anything ankle-wise, but I believe I see a calcaneus feature. Quote Link to comment Share on other sites More sharing options...
jmj11 Posted June 24, 2015 Share Posted June 24, 2015 #2- patella dislocation? #1- I'm missing anything ankle-wise, but I believe I see a calcaneus feature. I agree with # 1 but what is that artifiact with in the superior - posterior calcaneus? Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted June 24, 2015 Author Moderator Share Posted June 24, 2015 #1 is a calcaneal fx #2 is a patellar tendon rupture. the proximal chunk is a torn off piece of the patella. Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted June 24, 2015 Author Moderator Share Posted June 24, 2015 I agree with # 1 but what is that artifiact with in the superior - posterior calcaneus? nonpathologic variant. os trigonum. up to 15% of folks have it. https://search.yahoo.com/yhs/search?p=os+trigonum&ei=UTF-8&hspart=mozilla&hsimp=yhs-002 Quote Link to comment Share on other sites More sharing options...
jmj11 Posted June 25, 2015 Share Posted June 25, 2015 #1 is a calcaneal fx #2 is a patellar tendon rupture. the proximal chunk is a torn off piece of the patella. Okay, I get credit for # 2. That was what I was saying. Quote Link to comment Share on other sites More sharing options...
medic25 Posted June 25, 2015 Share Posted June 25, 2015 75yo male presented with chest pain and hypotension. I performed a bedside echo; this is a still from a PSLA view. Quote Link to comment Share on other sites More sharing options...
jmj11 Posted June 25, 2015 Share Posted June 25, 2015 Echo.jpg 75yo male presented with chest pain and hypotension. I performed a bedside echo; this is a still from a PSLA view. Aortic stenosis to me . . . but I haven't read one in years. Quote Link to comment Share on other sites More sharing options...
medic25 Posted June 27, 2015 Share Posted June 27, 2015 No AS, but I know it can be tough to call valvular issues with a still image. EM uses a different probe orientation than cardiology when performing an echo; here's a labelled image in case that throws some people. Quote Link to comment Share on other sites More sharing options...
bike mike Posted June 27, 2015 Share Posted June 27, 2015 pericardial effusion with tamponade? Quote Link to comment Share on other sites More sharing options...
medic25 Posted June 30, 2015 Share Posted June 30, 2015 pericardial effusion with tamponade? No, there was a trace pericardial effusion but not clinically significant. Take a look at the aortic root; elderly patient with sudden, sharp chest pain and hypotension. Which of the 5 E's of emergency echo does he have a problem with? Effusion (is there a significant one?) Ejection (how is the squeeze?) Equality (is the RV > LV?) Exit (thoracic aorta) Entrance (IVC) Quote Link to comment Share on other sites More sharing options...
jtmathew Posted July 6, 2015 Share Posted July 6, 2015 Aortic dissection/aneurysm? I see a hugely dilated aortic root. Quote Link to comment Share on other sites More sharing options...
medic25 Posted July 6, 2015 Share Posted July 6, 2015 Aortic dissection/aneurysm? I see a hugely dilated aortic root. You've got it. Dilated aortic root (~6.5cm), with an intimal flap, consistent with a Stanford type A aortic dissection. Quote Link to comment Share on other sites More sharing options...
jtmathew Posted July 8, 2015 Share Posted July 8, 2015 beautiful pic Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted September 20, 2015 Author Moderator Share Posted September 20, 2015 a few new ones. Quote Link to comment Share on other sites More sharing options...
cop to pa Posted September 20, 2015 Share Posted September 20, 2015 Not sure on number one, but two appears to be an Ulner fx. If I'm not mistaken, those maybe bits of metal fragmentation. GSW? *edit* Is one a left sided diaphragm rupture? Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted September 20, 2015 Moderator Share Posted September 20, 2015 1) hilar lymphadenopathy ? 2) comminuted ulnar fracture with opaque foreign body and soft tissue swelling possible representing blood extravasation. Recommend clinical correlation. Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted September 20, 2015 Author Moderator Share Posted September 20, 2015 L side is widened mediastinum with big thoracic aneurysm. r side is accidental self inflicted gsw at close range from cleaning loaded 9 mm with 1 in the pipe and magazine out... Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted September 20, 2015 Moderator Share Posted September 20, 2015 1) or is that a calcified aneurysm? Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted September 20, 2015 Author Moderator Share Posted September 20, 2015 1) or is that a calcified aneurysm? bingo. huge. guy didn't want surgery. 1 Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted September 20, 2015 Moderator Share Posted September 20, 2015 Hope his bucket list is complete Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted September 20, 2015 Moderator Share Posted September 20, 2015 L side is widened mediastinum with big thoracic aneurysm. r side is accidental self inflicted gsw at close range from cleaning loaded 9 mm with 1 in the pipe and magazine out... Swear I was typing before you posted this! Quote Link to comment Share on other sites More sharing options...
JohnnyM2 Posted September 21, 2015 Share Posted September 21, 2015 L side is widened mediastinum with big thoracic aneurysm. r side is accidental self inflicted gsw at close range from cleaning loaded 9 mm with 1 in the pipe and magazine out...Jeesh! People like that give gun ownership a bad name. Someone should teach him to clear his weapon. Quote Link to comment Share on other sites More sharing options...
jmj11 Posted September 22, 2015 Share Posted September 22, 2015 Let me guess, the GSW was "It is Nothing" triaged to urgent care? Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You can post now and register later. If you have an account, sign in now to post with your account.