Archives

Steal Phenomenon with Tonsillar Arteriovenous Malformation

Amin, DO, et al.

Cranial vascular malformations can cause symptoms of headache, stroke, transient ischemic attack, or other cerebrovascular disorders due to steal phenomenon. Subclavian steal phenomenon is a localized change in cerebral perfusion from a cranial arteriovenous malformation (AVM).

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Tethered Cord Syndrome

Catmull, DO, et al.

Tethered spinal cord syndrome refers to signs and symptoms of motor and sensory dysfunction related to increased tension on the spinal cord due to its abnormal attachment; it has classically been associated with a low-lying conus medullaris.

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Twiddler’s Syndrome

Lesnick, MD, et al.

Twiddler’s syndrome refers to a rare condition in which a pacemaker or automatic implantable cardioverter-defibrillator (AICD) malfunctions due to coiling of the device in the skin pocket and resultant lead displacement.

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Munson’s Sign: An Obvious Finding to Explain Acute Vision Loss

Gold, MD, et al.

We present here a case of this little-known cause of acute vision loss, and an example of Munson’s sign, which is a v-shaped protrusion of the lower eyelid on downward gaze that is characteristic of advanced keratoconus. We hope to highlight Munson’s sign as a simple identifier of keratoconus in an otherwise undiagnosed individual suspected of having acute corneal hydrops.

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Computed Tomography Imaging in Aortic Dissection

Westfall, MD, et al.

This case highlights the importance of obtaining CT angiography dedicated to the aorta in the setting of high clinical suspicion for aortic disease if initial CT pulmonary angiogram is negative for aortic disease.

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Asteroid Hyalosis Seen on Ocular Point-of-Care Ultrasound

Arthurs, BS, et al.

We present a case of a patient who underwent ultrasound evaluation for potential blunt ocular trauma. She was found to have multiple, freely mobile, scintillating hyperechoic opacities within the vitreous that was diagnosed as asteroid hyalosis, a rare but benign condition easily confused with vitreous hemorrhage, retinal detachment, lens dislocation, or foreign body on ocular ultrasound.

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Apparent Pacer Spikes in a Patient with Back and Chest Pain

Lulla, MD, et al.

A 74-year-old female with a history of diabetes mellitus, hypertension, atrial fibrillation (on warfarin, diltiazem and metoprolol) presented with chest and back pain. A 12-lead electrocardiogram (ECG) was ordered at triage demonstrating possible aberrant pacemaker activity (Image 1).

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Atypical Fungal Rash

Adel, MD, et al.

A 73-year-old man with rheumatoid arthritis on prednisone (10 milligrams [mg] daily routinely, and increased to 40 mg daily during frequent exacerbations) presented to the emergency department with chills and a leg rash.

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A Man with Severe Right Knee Pain

Takeda, MD, et al.

A 29-year-old man with no significant medical history presented to the emergency department with severe pain, swelling, and inability to move his right knee.

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The Aquarium Sign: Another Opportunity for Detection of Perforated Viscus

Gorgone, DO, et al.

A 61-year-old male with history of alcohol abuse and presumed cirrhosis presented to the emergency department with generalized weakness and right facial droop. He was found to be profoundly hypotensive and hypothermic with subsequent rapid decompensation requiring intubation and continuous norepinephrine infusion.

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Identifying a Disc-shaped Foreign Body

Lee, MD, et al.

A four-year-old girl presented to the emergency department vomiting after a foreign body ingestion. An anteroposterior plain radiograph demonstrated a disc-shaped foreign body.

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Young Male with Seizures

Ayyan, MD, et al.

A 30-year-old Asian male presented with a history of generalized tonic-clonic seizures an hour before presenting to emergency department.

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WestJEM/ Department of Emergency Medicine
UC Irvine Health

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Orange, CA 92868, USA
Phone: 1-714-456-6389
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.