Images In Emergency Medicine

New Onset Nystagmus in a Patient with Multiple Sclerosis

Daugherty, MS, et al.

A 50-year-old White male with a history of multiple sclerosis presented to the emergency department with fatigue, lightheadedness, and dizziness, exacerbated with sitting upright and worsening over the prior one to two days. He stated his last flare was approximately two years prior, and presented with aphasia as his primary symptom.

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A Young Boy with Fever and Grunting

Shapiro, MD, et al.

A 16-month-old healthy boy presented to the emergency department with a temperature of 99°Fahrenheit (F) (down from 102°F at home after antipyretics), tachypnea, and grunting.

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A Piercing Diagnosis – Occult Foreign Body as the Cause of Acute Inguinal Pain

Bays-Muchmore, BS, et al.

A 35-year-old woman presented to the emergency department with severe right inguinal pain. Her medical history was non-contributory and there was no known trauma or injury to the region. Amid concern for an incarcerated inguinal hernia, a computed tomography was obtained revealing a linear foreign body (FB) lateral to the femoral vessels.

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Male with Altered Mental Status

Kondrat, DO, et al.

A 62-year-old male presented to the emergency department with altered mental status and fever. Computed tomography of the head showed enlargement of the left lateral ventricle. Magnetic resonance imaging demonstrated debris and purulence in the ventricle along with edema and transependymal flow of cerebrospinal fluid surrounding both ventricles.

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Ultrasonography of a Helical Left Common Carotid Artery

Busack, MD, et al.

For at least two decades, point-of-care ultrasound has become the standard of care for placing central venous lines. This surprising anatomical orientation is rare and cautions physicians to fully explore a patient’s anatomy prior to placing central lines.

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55 year-old Female with Hematuria

Long, MD, et al.

A 55 year-old female presented to the emergency department with left sided abdominal pain and hematuria. Computed tomography scan of her abdomen and pelvis demonstrated a large left renal mass with extension into the left ureter, left renal vein, and inferior vena cava.

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Disseminated Gonorrhea

Estrada, DO, et al.

Sexually transmitted infections have risen sharply over the last decade in the United States. The incidence of gonorrhea has risen to 172 reported cases per 100,000 people over the past year.

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A Hidden Complication of Pigtail Catheter Insertion

Garcia de Alencar, MD, et al.

We report a case of a 92-year-old male who presented with dyspnea and shock, noted to have a pneumothorax requiring tube thoracostomy. Computed tomography demonstrated pigtail within the lung parenchyma. We discuss the implications of this occurrence.

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Endotracheal Metastasis Causing Airway Obstruction

Yano, MD, et al.

Endotracheal metastasis, a critical complication of primary lung cancer, is an extremely rare lesion. A 73-year-old woman who had previously received treatment for lung cancer presented to our emergency department with dyspnea.

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Diabetic Muscle Infarction

Ahmed, MD, et al.

A 58-year-old male with past medical history of diabetes mellitus presented with pain to the bilateral groin for six weeks. Magnetic resonance imaging of the patient’s lower extremities revealed acute myoedema, and he was diagnosed with myositis secondary to diabetic muscle infarction.

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Pseudo-duplication of the Gallbladder

Adamski, DO, et al.

Correct identification of Phrygian cap and pseudo-duplication should trigger a careful survey of the gallbladder in its entirety to rule out pathology. These anatomic variants may lead to partial under-distension of the gallbladder and can cause the gallbladder wall to appear falsely thickened.

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Pseudoatrial Flutter: When the Problem Lies Outside the Heart

Ceruti, MD, et al.

If these disorders are not promptly recognized, consequences can lead to hospitalization and execution of unnecessary diagnostic tests, thereby increasing the costs and clinical risks such as nosocomial infections and thromboembolism. We present a pseudoatrial flutter generated by a Parkinson’s-like movement.

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WestJEM/ Department of Emergency Medicine
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Email: editor@westjem.org

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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.