September 2, 2010

The Ocular Ultrasound Challenge

normal eye ultraound

Eyes are filled with fluid. This means they are the perfect organ for ultrasound assessment in the emergency department. Think you know all about ocular ultrasound? Let’s find out…

Condom Inhalation

2811556

With the Flu season upon us the Utopian College of Emergency for Medicine (UCEM) would like to remind all fondling members of their duty to take a full and appropriate past medical history. This includes a past sexual history…

Bone and Joint Bamboozler 004

Bennett Fracture

A 27 year-old amateur martial artist needs your help after smashing his fist through a plank of wood. Can you diagnose and manage his injury?

Bone and Joint Bamboozler 003

Volar Bartons Fracture Eponymous Fractures

A 50 year-old woman took a tumble down some steps and injured her left wrist. Can you correctly diagnose and manage her injury?

Fever in a spinal patient

Anisocoria

A woman had a spinal injury from a car crash at 2 years of age; she since had spinal surgery and has a baclofen pump. Now she has a fever – what’s the cause?

CT Safety and Radiation Risk

Is a cancer epidemic be looming over the horizon? The universality of CT as the investigation du jour, and growing concerns about the risks of radiation.

Radiological Pin-Up Calendar

Jan

EIZO medical imaging produce high precision displays for the examination and diagnosis of radiographs. They recently collaborated with German advertising agency BUTTER to produce a ‘What you see is what you get’ 2010 Pin-Up calendar leaving little to the imagination…

More Loathing in WA

Bang Head Here

Western Australia’s radiology image viewing system is making many doctors unhappy. Stress reduction kit provided.

Radiological Oddity #019

Radiological Oddity 019_2

There is something strange about this chest radiograph of a neonate who has just arrived in ICU from the operating theatre. What is the oddity and what are the implications?

Search Satisficing and Premature Closure

recent CXR_2

At handover in ICU a junior resident mentions that an intubated and ventilated 68 year-old man 3 days post-cardiac surgery has developed an increasing FiO2 requirement. He says this is explained by a new left lower zone opacity on the patient’s chest radiograph. He has been placed on appropriate antibiotics to cover a hospital acquired pneumonia. You review the films… What has been missed? What cognitive bias contributed to the error?

Something’s not right…

CXR-Right-aortic-arch

A benign clinical history leads to an unusual chest radiograph finding and questions regarding its significance.

Prof Staghorn joins UCEM

Prof Staghorn in his Vale tudo heyday

Professor Inglebert Struvite Staghorn hails from the village of Calyxia nestled on the anaconda-infested shores of the Amazon River. Although the young Staghorn’s missionary parents encouraged him to study the healing arts, he instead discovered a taste for the art of no-holds-barred fighting…

Clinical Images Online

Rake foot

An index of useful clinical image collections for use primarily by doctors in emergency medicine and intensive care medicine. Includes clinical photographs, dermatology, ophthalmology, radiology, ultrasonography, pathology and microbiology.

Pulmonary Puzzle 006

Chest radiograph 1

A 36 year-old immunosuppressed male was infected with swine-origin influenza virus requiring mechanical ventilation. Overnight the inspiratory pressures needed to maintain his tidal volume had progressively increased and his face had become markedly swollen.

Radiology Oddity #016

Abdominal CT scan

It is another busy night in ED. The ‘Bat-Phone’ rings, gently pricking the ear to attention in anticipation of the next code…

We are bringing in a 60 year old lady with profuse diaphoresis, hypotensive with a systolic of 70 and altered conscious state…

Top 10 Foreign Bodies

Feeling Thirsty?

From time to time little things get lost. Whether you are playing billiards naked in the dark; counting money with your tongue; battling with an electric rolling pin….or just ‘slipping’ whilst in the shower….you may be unlucky enough to find yourself in the emergency department desperately trying to manifest a more tangible excuse for foreign body concealment.

Radiological oddity #015

ECMO_bad_lungs3

A 32 year-old male with no previous medical problems, other than a history of smoking cigarettes, was infected by swine-origin influenza virus (SOIV) and developed severe ‘FLAAARDS’ (‘flu’-A associated acute respiratory distress syndrome) requiring treatment with ECMO (extra-corporeal membrane oxygenation). His chest and abdominal radiographs are shown. Q1. Describe the findings on the chest and [...]

My chest is burning!

Man with burning chest pain

The Minerva section of the British Medical Journal was probably the only part of any medical journal I used to look at when I was a medical student. It has taken me sometime to find it, but the following chest radiograph of a West Indian man with severe burning chest pain must be seen to be believed.

Radiological Oddity #013

Unlucky for her

A 35 year old lady is brought to the emergency department in the company of 3 large men.  Can you tell why they’re with her?

Radiological Oddity #011

Faecoma

A long-term inpatient from a Psychiatric hospital presents to the Emergency Department with gradual onset of abdominal swelling over four weeks and acute generalised abdominal pain over the last 24 hours. Can you spot what might be causing his discomfort?