Images In Emergency Medicine

Would You Reduce this Knee?

Mohebbi, MD, et al.

A 46-year-old male with a history of knee replacement presented with pain and decreased range of motion of the left knee. He had felt a pop in his left knee when putting on his pants three days previously.

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Traumatic Facial Nerve Palsy

Derksen, MD, et al.

A two-year-old female presented to the emergency department with facial lacerations after an attack by the family canine (Boxer breed).

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Female with Abdominal Wall Mass

Koo, MD, et al.

A 32-year-old female with a past surgical history of a low transverse Cesarean section presented to the emergency department with a left lower quadrant abdominal mass and pain.

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Man with Scrotal Rupture

Perechocky, MD, et al.

A 55-year-old male presented to the emergency department (ED) with scrotal pain and swelling. He reported that four months prior, he fell and sustained minor trauma to his scrotum.

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Frontal Headache – An Unusual Presentation of Pneumomediastinum

Root, DO, et al.

A 45-year-old woman with past medical history of asthma presented to the emergency department with four days of pulsatile, frontal headache, different in character and intensity from her usual tension-type headaches. She reported the onset of pain as gradual without an inciting event.

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An Unexpected Diagnosis Presenting as Hip Pain After a Fall

Sauer, MD, MS, et al.

A 62 year old male presented to the emergency department with a complaint of two weeks of isolated left hip pain after slipping down two stairs three weeks prior to presentation. Initially well, the patient began experiencing progressive pain with ambulation. The patient’s history was significant for recurrence of rectal adenocarcinoma treated by surgical resection 10 years prior.

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A Case of Syncope

Dwyer, MD, MPH, et al.

An 88-year-old female presented to the emergency department (ED) after a syncopal event. Upon arrival, the patient was awake and complaining of chest pain. An electrocardiogram was performed showing an inferior ST-elevation myocardial infarction (STEMI).

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Severe Bilateral Ear Pain

Canine, DO, MS, et al.

A 23-year-old female presented to the emergency department five weeks post-partum for headache, severe bilateral ear pain, and left ear drainage. Seven days prior she had been diagnosed with left otitis externa.

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Posterior Tibial Tendon Tenosynovitis Diagnosed by Point-of-Care Ultrasound

Bellew, MD, et al.

A 48-year-old woman presented with right ankle pain that began while running two days prior. She noted that the ankle hurt with even light touch and the pain was unrelieved with ibuprofen. She denied a history of trauma. She was seen in the emergency department for this condition the day prior with a negative radiograph, but she returned because of increased ongoing pain.

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Nystagmus Associated with Carbamazepine Toxicity

Wirfs, BS, et al.

A 42-year-old male with past medical history significant for epilepsy presented to the emergency department (ED) complaining of dizziness, difficult ambulation, and blurred vision. Vitals were only significant for a blood pressure of 143/89 mm Hg.

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Hematuria Following Rapid Bladder Decompression

Gabriel, BS, et al.

A 52-year-old man with prostatic hyperplasia presented to the emergency department with complaints of lower abdominal pain worsening over three days and inability to urinate. Abdominal examination revealed a protuberant, distended bladder.

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Post-Cholecystectomy Syndrome

Moore, MD, et al.

A 32-year-old female with a history of cholecystectomy three years prior, presented to the emergency department with epigastric pain. The patient subsequently underwent an endoscopic retrograde cholangio-pancreatography with removal of one stone and sphincterotomy.

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Aortic Pseudo-dissection

Huesgen, MD, et al.

A 21-year-old female with a past medical history significant for asthma and oral contraceptive use presented complaining of shortness of breath and wheezing. Symptoms started after contact with a dog. She came to the emergency department (ED) after home albuterol treatments failed to provide relief.

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A Case of Erythema Nodosum with Coccidioidomycosis

Said, BS, et al.

Erythema nodosum (EN) is associated with many systemic diseases and infections. This case report provides an image of erythematous nodules, an overview of the various causes of EN, and the laboratory tests and imaging that can be done in the emergency department to narrow its broad differential diagnosis.

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Paratracheal Cysts

Mohebbi, MD, et al.

A 38-year-old male with no significant past medical history presented to the emergency department with pain and swelling on the left mandibular area and the right upper quadrant of the abdomen after a reported assault in which he was punched in the face and kicked in the right chest wall during a fight at a bar.

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Moyamoya: A Rare Cause of Cerebral Vascular Accident

Merritt, BS, et al.

A 20-year-old Caucasian female presented with an altered mental status that began one day prior to arrival. The patient claimed to know the answers to questions, but was only able to reply with the answers of “yes” or “I don’t know.” Her past medical history consisted of aortic insufficiency.

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Right Atrial Thrombus or Chiari Network?

Fredericks, BS, et al.

A 31-year-old African-American male with known sickle cell disease presented to the emergency department (ED) with a one-week history of chest pain and bilateral leg pain. Physical examination showed an afebrile and hemodynamically stable but uncomfortable appearing male.

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Aortoesophageal Fistula

Roten, DO, et al.

A 90-year-old female presented after sudden collapse with a Glasgow Coma Score of 3, and profound hypotension. Shortly after endotracheal intubation, the patient developed significant hematemesis, and massive transfusion protocol was subsequently instituted.

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A Man with Cyanotic Digits

Wiskel, MD, et al.

A 37-year-old right-handed male auto mechanic with a 40 pack-year smoking history presented to the emergency department with progressive digital pain, cyanosis and paresthesias to his right hand over the prior month.

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Contact Information

WestJEM/ Department of Emergency Medicine
UC Irvine Health

333 The City Blvd. West, Rt 128-01
Suite 640
Orange, CA 92868, USA
Phone: 1-714-456-6389
Email: westjem@gmail.com

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WestJEM
ISSN: 1936-900X
e-ISSN: 1936-9018

CPC-EM
ISSN: 2474-252X

Our Philosophy

Emergency Medicine is a specialty which closely reflects societal challenges and consequences of public policy decisions. The emergency department specifically deals with social injustice, health and economic disparities, violence, substance abuse, and disaster preparedness and response. This journal focuses on how emergency care affects the health of the community and population, and conversely, how these societal challenges affect the composition of the patient population who seek care in the emergency department. The development of better systems to provide emergency care, including technology solutions, is critical to enhancing population health.