Visual EM

Dental Free Air CT Coronal Unannotated. JETem 2025
Visual EM, ENT

A Case Report of Facial Swelling and Crepitus Following a Dental Procedure

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Given the physical exam findings of crepitus on the right neck up to the right lower eyelid, a maxillofacial CT scan without contrast was performed. It revealed diffuse subcutaneous air within the soft tissues of the face and neck and free air within the pre-septal soft tissue of the right eye, appearing as hyperlucent (dark) areas on CT within the soft tissue planes (blue outline). It showed no evidence of post-septal free air. A single-view chest X-ray was also performed and was unremarkable except for incompletely imaged soft tissue gas in the right lower neck (blue outline). On flexible fiberoptic laryngoscopy performed by ENT, the oropharynx appeared diffusely edematous and narrowed.

Uvular Necrosis Photo. Unannotated. JETem 2025
Visual EM, ENT

Case Report of Post-Operative Uvular Necrosis Following Intubation

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The distal portion of her uvula was necrotic with a clear demarcation approximately halfway up the uvula. She had no trauma to the anterior oropharyngeal structures, tonsils, or adenoids. There were no lesions to the hard or soft palate. She had no carotid bruits or thrills, and no tenderness over the anterior portion of the neck.

Incarcerated Gastric Volvulus and Splenic Herniation. Abdominal Radiograph. Unannotated. JETem 2025
Visual EM, Abdominal/Gastroenterology, Pediatrics

Case Report of Incarcerated Gastric Volvulus and Splenic Herniation in Undiagnosed Congenital Diaphragmatic Hernia in an Infant

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An upper gastrointestinal series (UGI) showed an enteric tube with its tip in the stomach and side-port in the esophagus. There was a large amount of air in the stomach and a small volume of scattered distal bowel gas. The tip of an enteric tube was seen in the stomach (red arrow). Contrast partially filled the stomach, and the greater curvature was visualized superior to the lesser curvature in the left upper quadrant (blue arrow). The body of the stomach was herniated into the right chest through a Bochdalek hernia (blue star). There was a large amount of air in the stomach and a small volume of scattered distal bowel gas. These findings were consistent with mesenteroaxial gastric volvulus.

Mycoplasma Associated Acute Transverse Myelitis. MRI. Unannotated. JETem 2025
Visual EM, Neurology, Pediatrics

Beware of the Pediatric Limp: A Case of Mycoplasma Associated Acute Transverse Myelitis

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An MRI with contrast, T2 sequence was performed. In Figures a-d, the MRI of the patient’s brain and spinal cord on admission shows abnormal signals in the patient’s pons (lack of symmetrical gray-white differentiation on cross-section) along with hyperintensity (sagittally shown as brightness in what should be homogenously intense spinal cord) and significant central cord edema (with swelling seen as increased width) starting from C5 and continuing to the conus medullaris around L1/L2.

Iatrogenic Bowel Perforation Following Dental Procedure. CT. Unannotated. JETem 2025
Visual EM, Abdominal/Gastroenterology

Case Report: Iatrogenic Bowel Perforation Following Dental Procedure

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The patient’s abdominal CT demonstrated a metallic foreign body in the left side of the abdomen within the small bowel, without surrounding induration or abscess. Radiology questioned whether the metallic foreign object perforated the bowel. Seen in the cross-sectional CT image, there is a hyperdense linear structure transversing the small intestinal wall, given that a portion of the structure was located outside of the lumen of the bowel.

CSpine Fracture CT Axial Unannotated. JETem 2025
Visual EM

A Case Report of an Unstable C-spine Fracture in the Emergency Department

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The initial workup in the ED showed an acute displaced fracture of the left occipital condyle (CT-coronal, fracture of the left occipital condyle, red arrow; displacement, orange line), a shattered left lateral mass with involvement of the vertebral canal (CT-axial, red arrow), and malalignment of the craniocervical junction (CT-sagittal, red outline). The CT angiogram head and neck showed a possible irregularity in the left vertebral artery. The CT head without contrast had no significant findings.

Myasthenia Gravis Eyes Taped Open. JETem 2025
Visual EM, Neurology

Eye-Opener: A Case Report of Eyelid Taping as Presenting Symptom of Myasthenia Gravis

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Physical exam was significant for a very pleasant, well-appearing female in no acute distress, noted to have clear plastic tape attached to her bilateral eyelids and brows (Image 1). When the tape was removed, she had bilateral ptosis, more significantly in the left eye (Image 2). She had no conjunctival injection or pallor. Her airway was patent and protected. She had no neck masses or carotid bruits. Her heart and lung exams were normal, with no evident respiratory distress. Her neurologic exam was further significant for limited extra-ocular movement (EOM). Her most notable deficits were with lateral and upward gaze (Video 1) indicative of weakness at the muscles innervated by cranial nerves III and VI. Her pupillary response was symmetric and brisk bilaterally. She had no additional cranial nerve deficits, slurred speech, or asymmetry in her strength or sensation throughout.

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