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11

Cardiac Tamponade - The Original Kings of County

The Case: 60 yo M PMH metastatic lung cancer, HTN, DM, former smoker presents to the ED with acute onset shortness of breath. Vitals in triage revealed tachypnea and tachycardia. Initial work-up revealed low voltage on EKG, enlarged cardiac silhouette on chest x-ray, bedside ECHO with pericardial effusion without tamponade, and CTA with large left lobe mass and segmental pulmonary embolism. The patient was anticoagulated with heparin infusion. While boarding in CCT and awaiting a non emergent pericardial window, he became acutely dyspneic with elevated heart rate and subsequently asystolic. Pericardiocentesis was performed bedside with return of spontaneous circulation. The patient was brought to the OR for pericardial window and admitted to the ICU. A short while later the patient expired.  
blog.clinicalmonster.com
over 4 years ago
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30

Knee X-ray interpretation – Don't Forget the Bubbles

Remember that the knees of younger children will look different, as the patella forms, and the ossification centres form.  
dontforgetthebubbles.com
over 4 years ago
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Elbow Xray Interpretation

http://youtu.be/hxQVeN7nlhE NOTE: for non-displaced radial head fractures, managment includes early mobilization and use of a sling instead of splint, along with early ortho follow up  
emin5.com
over 4 years ago
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How to Read Hip and Pelvis X-Rays

As a continuation of our radiology lecture series, take a look at the excellent instructional modules created by Dr. Anita Goel, PGY-1 resident at the University of Cincinnati Department of Emergency Medicine residency training program.  Dr. Goel takes us through the basic anatomy, the particular features of the many different views that can be obtained in hip and pelvis plain film radiography, and a systematic approach to reading these often complicated radiographs.  
tamingthesru.com
over 4 years ago
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18

Pigtail Insertion - Emergency Physicians Monthly

It’s a typical busy Saturday night in your ED. The next chart you pick up is a 15-year-old male with cough shortness of breath and chest pain for one day. He is tall, with normal vitals and in no distress, and you note decreased breath sounds on his right side. Chest X-ray confirms it: pneumothorax.  
epmonthly.com
over 4 years ago
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Imaging Case of the Week 149

The following frontal chest x-ray from a 80 year old was obtained as part of a pre-operative work up prior to lower limb surgery. What radiological sign can be noted?  
emergucate.com
over 4 years ago
Holly leaf sign 150x64
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Imaging Case of the Week 149 Answer

The chest x-ray shows pleural plaques more prominent on the right midzone, in the shape of a leaf. This is called the Holly leaf sign, seen in asbestosis. The bizarre plaques are bordered by calcified edges.  
emergucate.com
over 4 years ago
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Imaging Case of the Week 148 Answer

The chest x-rays show a thick walled cavity in the right middle lobe and an airspace opacity in the left upper lobe with cavity. There is a patchy opacity in the left lingular lobe. There is no pneumothorax or pleural effusion and the cardiomediastinal contour appears normal.  
emergucate.com
over 4 years ago
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Imaging Case of the Week 148

These chest x-rays are from a 21 year old presenting with a fever, cough and dyspnoea. He has no past medical illness and he is not an intravenous drug user. What can be discerned from the images?  
emergucate.com
over 4 years ago
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15

SGEM#36: Mac and CCBs (Macrolides and Calcium Channel Blockers)

Case Scenario: 67 year-old woman presents with a one week history of productive cough and no fever. She is a non-smoker and has no history of lung disease. Her past medical history is positive for hypertension and she is taking a calcium channel blocker. She has no allergies to medication. On exam she has no fever, oxygen saturation is 97% on room air, and has clear air entry. Xrays is reported as slight patchy infiltrate in right lower lobe possible early pneumonia.  
thesgem.com
over 4 years ago
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15

Podcast#5: Does Johnny “kneed” an X-ray? (Ottawa Knee Rules)

10 year old Johnny was playing hockey last night. Twisted his knee but could not finish the game. Mom brings him in after asking for an xray.  
thesgem.com
over 4 years ago
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Podcast#3: To X-ray or not to X-ray (Ottawa Ankle Rules)

8 year old girl brought into ED by mother after twisting her ankle on a trampoline. She was able to walk on it but has become very swollen. The mother wants to know if she should get an xray to see if her daughter broke the ankle.  
thesgem.com
over 4 years ago
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Bedside Clinics in Surgery

This second edition brings trainees fully up to date with the latest advances in general surgery. Each section has been fully revised and covers numerous disorders within each specialty. The new edition features an additional section on surgical anatomy and an extended section on operative surgery. More than 800 clinical photographs, X-rays, diagrams and figures enhance learning. Colour images illustrate clinical signs and instruments for laparoscopic surgery, with schematic diagrams used in the first edition, now replaced by photographs. Key points Second edition presenting recent advances in general surgery Fully revised with addition of two new sections Includes more than 800 clinical photographs and diagrams Previous edition published in 2004  
books.google.co.uk
over 4 years ago
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Childbirth, X-rays, Community

Hi I’m the radiologist. Years ago if we were watching “Scrubs” side by side on the couch, I would have been like, “Hey, …  
medium.com
over 4 years ago
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Surgical treatment compared to non-surgical treatment (braces, exercise, or observation) for teens with idiopathic scoliosis | Cochrane

Scoliosis is a condition where the spine is curved in three dimensions (from the back the spine appears to be shaped like a 'c' or an 's'). It is often idiopathic, or of unknown cause. The most common type of scoliosis, adolescent idiopathic scoliosis (AIS), is discovered around 10 years of age or older, and is defined as a curve that measures at least 10 degrees (known as a Cobb angle, which is measured on an x-ray).  
cochrane.org
over 4 years ago
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Imaging Case of the Week 151

The following x-rays, from three different patients, all show a particular radiological sign. Which common radiological sign can you observe?  
emergucate.com
over 4 years ago
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Imaging Case of the Week 150 Answer

The left ankle x-rays, at the outset, look like a simple medial malleolar fracture with significant soft tissue swelling around the ankle. However, upon close inspection of the fracture, there is a serious injury pattern that necessitates an urgent orthopaedic referral from the ED.  
emergucate.com
over 4 years ago
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Imaging Case of the Week 150

The following left ankle x-rays are from a 52 year old who has experienced a twisting injury to her left ankle and is unable to weight-bear. What can be seen?  
emergucate.com
over 4 years ago
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Do vaginal packing, tranexamic acid, interventional radiology or other interventions control vaginal bleeding in women with advanced cervical cancer? | Cochrane

Background: Cervical cancer (cancer of the neck of the womb) is the second most common cancer among women throughout the world, accounting for about 500,000 new detected cases and 273,000 deaths every year. Women more commonly present with advanced disease in the developing world, where access to cervical screening programmes is limited. Advanced cancer of the cervix may not be curable and women often need treatment to control distressing symptoms (palliation), such as vaginal bleeding. Bleeding can be severe enough to be life threatening in women with advanced cervical cancer. Management of vaginal bleeding often poses a challenge, especially in the developing world, where access to radiotherapy is limited. Options for palliative treatment of severe vaginal bleeding include interventional radiology treatment (using x-rays to guide the insertion of 'plugs' into blood vessels supplying the cancer) or vaginal packing (where gauze is compacted into the vagina to absorb the blood and apply pressure directly to the cervix), although these are often only partly effective and may cause harm. Vaginal packs can be soaked with formalin, which is a preservative chemical. Other options for treating severe vaginal bleeding include tranexamic acid (a medicine that reduces bleeding that can be given by mouth or by injection) and radiotherapy (high-energy x-ray treatment).  
cochrane.org
over 4 years ago
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Imaging Case of the Week 153

The following right knee x-rays are from a 16 year old with knee pain and swelling following a twisting injury to the knee. What can be seen?  
emergucate.com
over 4 years ago