Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
• VP Shunt Disconnection
• E-cigarette Vaping Associated Lung Injury
• Apical Lung Mass
• Pulmonary Metastasis
• Vascular Ring
Drs. Milam and Thomas's CMC X-Ray Mastery Project: April CasesSean M. Fox
Drs. Claire Milam and Alyssa Thomas are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides on:
• Esophageal Perforation
• Perforated Viscous
• Pneumothorax
• Traumatic Diaphragmatic Hernia
• Pulmonary Contusion
• COVID-19 associated Pneumonia
• COVID-19
• Influenza Like Illness
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: September CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
• Non-accidental Trauma (NAT)
• Hyperinflated Lungs
• Esophageal Foreign Body
• Neonatal Pulmonary Abscess
• Neonatal Pneumatocele
• Tuberculosis
• Interstitial Lung Disease of Prematurity
• Disseminated Neonatal HSV
• Aspirated Foreign Body
Drs. Milam and Thomas's CMC X-Ray Mastery Project: January CasesSean M. Fox
Drs. Claire Milam and Alyssa Thomas are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides on:
• Pneumomediastinum
• Spontaneous Pneumothorax
• Deep Sulcus Sign
• Massive Pericardial Effusion
• Pulmonary Hypertension
• Mitral Stenosis
• Pulmonary Bullae
• Situs Inversus
• Dextrocardia
• Cavitary Lesions
EMGuideWire's Radiology Reading Room on Pediatric Adult Aortic CoarctationSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Pediatric and Adult Aortic Coarctation and is brought to you by Jennifer Potter, MD and Elizabeth Olson, MD.
EMGuideWire's Radiology Reading Room: Septic Pulmonary EmboliSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Septic Pulmonary Emboli and is brought to you by Victoria Serven, MD, Travis Barlock, MD, and Katherine Sillman, NP.
CMC Pediatric X-Ray Mastery: January CasesSean M. Fox
Drs. Kaley El-Arab and Taylor Anderson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
- Pericardial cyst
- Acute chest syndrome
- Cavitary pneumonia
- Non-COVID coronavirus pneumonia with pulmonary arteriovenous malformations
- Multifocal pneumonia with ARDS
- COVID-19 pneumonia
- Round pneumonia
- Lobar pneumonia
- Aspiration pneumonia with parapneumonic effusion
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: May CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
Subcutaneous air
Osteopenia
Bronchiolitis
Constipation
Asthma exacerbation
Alveolar Rhabdomyosarcoma
Aspirated Foreign Bodies
Small Bowel Obstruction
Kyphoscoliosis
Pneumatocele
Cecal Volvulus
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery: February CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
• Myocarditis
• Pulmonary Contusions
• Clavicle Fracture
• Pneumonia
• Acute Chest Syndrome
• Pleural Effusion
Drs. Milam and Thomas's CMC X-Ray Mastery Project: April CasesSean M. Fox
Drs. Claire Milam and Alyssa Thomas are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides on:
• Esophageal Perforation
• Perforated Viscous
• Pneumothorax
• Traumatic Diaphragmatic Hernia
• Pulmonary Contusion
• COVID-19 associated Pneumonia
• COVID-19
• Influenza Like Illness
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: September CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
• Non-accidental Trauma (NAT)
• Hyperinflated Lungs
• Esophageal Foreign Body
• Neonatal Pulmonary Abscess
• Neonatal Pneumatocele
• Tuberculosis
• Interstitial Lung Disease of Prematurity
• Disseminated Neonatal HSV
• Aspirated Foreign Body
Drs. Milam and Thomas's CMC X-Ray Mastery Project: January CasesSean M. Fox
Drs. Claire Milam and Alyssa Thomas are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides on:
• Pneumomediastinum
• Spontaneous Pneumothorax
• Deep Sulcus Sign
• Massive Pericardial Effusion
• Pulmonary Hypertension
• Mitral Stenosis
• Pulmonary Bullae
• Situs Inversus
• Dextrocardia
• Cavitary Lesions
EMGuideWire's Radiology Reading Room on Pediatric Adult Aortic CoarctationSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Pediatric and Adult Aortic Coarctation and is brought to you by Jennifer Potter, MD and Elizabeth Olson, MD.
EMGuideWire's Radiology Reading Room: Septic Pulmonary EmboliSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Septic Pulmonary Emboli and is brought to you by Victoria Serven, MD, Travis Barlock, MD, and Katherine Sillman, NP.
CMC Pediatric X-Ray Mastery: January CasesSean M. Fox
Drs. Kaley El-Arab and Taylor Anderson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
- Pericardial cyst
- Acute chest syndrome
- Cavitary pneumonia
- Non-COVID coronavirus pneumonia with pulmonary arteriovenous malformations
- Multifocal pneumonia with ARDS
- COVID-19 pneumonia
- Round pneumonia
- Lobar pneumonia
- Aspiration pneumonia with parapneumonic effusion
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: May CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
Subcutaneous air
Osteopenia
Bronchiolitis
Constipation
Asthma exacerbation
Alveolar Rhabdomyosarcoma
Aspirated Foreign Bodies
Small Bowel Obstruction
Kyphoscoliosis
Pneumatocele
Cecal Volvulus
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery: February CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
• Myocarditis
• Pulmonary Contusions
• Clavicle Fracture
• Pneumonia
• Acute Chest Syndrome
• Pleural Effusion
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery October CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
• Scoliosis
• Pneumothorax
• Parapneumonic Effusion
• Cardiomegaly
• Vaping associated lung injury
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery November CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
- Tension Pneumothorax
- Atelectasis
- Esophageal Obstruction / Achalasia
- Right Upper Lobe Mass
- Right Upper and Right Middle Lobectomies
- Esophageal Foreign Body
- Transposition of the Great Vessels
Drs. Lena, Avery, and Davis’s CMC Abdominal Imaging Mastery Project: April CasesSean M. Fox
Dr. Kelsey Lena is an Emergency Medicine Resident and Drs. Michael Avery and Joshua Davis are Surgery Residents at Carolinas Medical Center in Charlotte, NC. They are interested in medical education. With the guidance of Drs. Kyle Cunningham and Michael Gibbs, they aim to help augment our understanding of emergent abdominal imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides. This month’s topics include:
- Large Bowel Obstruction
- Blunt Aortic Injury
- Abdominal Aortic Aneurysm with Rupture
EMGuideWire's Radiology Reading Room: COVID 19 Chest X-rays UpdateSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to COVID-19 infections as represented on Chest Radiography. It is brought to you by Nikki Richardson, MD, Claire Milam, MD, Alyssa Thomas, MD, and Shelby Hixson, PA. It has special guest editor, Infectious Disease Specialist, Catherine Passeretti, MD. In addition, this update also includes another special guest editor, Radiologist, Dr. Johnathan Clemente, MD.
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: October CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
- Tuberculosis
- Button Battery Ingestion
- Constipation
- Hirschprung's Disease
- Aspiration Pneumonia
- Generalized Lymphatic Anomaly
- Pediatric Acute Respiratory Distress
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery week 1Sean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team as they post these weekly educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics!
Drs. Lorenzen and Barlock’s CMC X-Ray Mastery Project: January CasesSean M. Fox
Drs. Breeanna Lorenzen and Travis Barlock are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
Perforated gastric ulcer with tension hemoperitoneum
Pulmonary arterial hypertension
Ruptured diaphragm
Cavitary tuberculosis
Pneumocystis pneumonia with spontaneous pneumothorax
Lower rib fractures and an associated splenic injury
EMGuideWire's Radiology Reading Room: Peripartum CardiomyopathySean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Peripartum Cardiomyopathy and is brought to you by Kaley El-Arab, MD, Blaire Langa, NP, Claire Lawson, NP, and Ashley Moore Gibbs, DNP. It is has the special guest editors: Richard Musialowski, MD and Laszlo Littmann, MD.
EMGuideWire's Radiology Reading Room: Pericardial EffusionSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Spontaneous Pericardial Effusion and is brought to you by Chelsea Wilson, MD, and Emily Lipsitz, PA-C.
EMGuideWire's Radiology Reading Room: PneumoniaSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Pneumonia and is brought to you by Elissabeth Hagler, MD and Tom Shuman, MD. Guest Editor is Michael Leonard, MD, Infectious Disease specialist.
EMGuideWire's Radiology Reading Room: PneumomediastinumSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Pneumomediastinum and is brought to you by Jacob Leedekerken, MD and Chelsea Wilson, MD.
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery August CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including: Tetralogy of Fallot, Pneumonia, Bronchiolitis, Esophageal Foreign Body, Pneumothorax, ECMO
Drs. Milam and Thomas's CMC X-Ray Mastery Project: December CasesSean M. Fox
Drs. Claire Milam and Alyssa Thomas are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides on: Cryptococcal Pneumonia, Coarctation of the Thoracic Aorta, Pulmonary Contusion, Ruptured Left Hemidiaphragm, Septic Pulmonary Emboli
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: August CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
- Pneumatocele
- Croup
- Pulmonary Contusion
- Blast Injury
- Bowel Obstruction
- Lobar Pneumonia
- Cavitary Lung Lesions
- Ileus
- Malposition of Central Line
EMGuideWire's Radiology Reading Room: Spontaneous PneumothoraxSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Spontaneous Pneumothorax and is brought to you by Elizabeth Olson, MD, and Janet Lorenz, NP.
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: July CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
• Aortic Aneursym
• Aortic Coarctation
• Aspirated Foreign Body
• Ingested Foreign Body
• VP Shunt Malfunction
• Hemopneumothorax
• COVID-19 pneumonia and pneumothorax
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: August CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
• Aortic Coarctation
• Tension pneumothorax
• Pneumonia
• COVID-19
• Tetralogy of Fallot
• L-Transposition of the Great Vessels
• Pediatric ARDS
• MIS-C
• Foreign Body Aspiration
• Aspiration Pneumonia
• Corner fracture
• Non-accidental Trauma
EMGuideWire's Radiology Reading Room: Pleural EffusionsSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Pleural Effusions and is brought to you by Gabriela Rivera Camacho, MD and Emily Griffith, NP-C.
Drs. Milam and Thomas's CMC X-Ray Mastery Project: June CasesSean M. Fox
Drs. Claire Milam and Alyssa Thomas are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides on:
• Pneumothorax
• Non-cardiogenic Pulmonary Edema
• COVID – 19
• Right Lower Lobe Pneumonia
• Diaphragmatic Hernia
• Lung Abscess
• Miliary Tuberculosis
• Asbestosis
Drs. Lorenzen and Barlock’s CMC X-Ray Mastery Project: May CasesSean M. Fox
Drs. Breeanna Lorenzen and Travis Barlock are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
Pneumonia
Lung Masses
Pulmonary Nodules
Hilar Lymphadenopathy
Aorto-enteric Fistula
Diaphragmatic Hernia
Intra-aortic Balloon Pump
Pacemaker
Impella
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery January CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
• Swallowed Magnets
• Complex Left Lower Lobe Pneumonia
• Empyema
• Right Middle Lobe Pneumonia
• Pulmonary Hemorrhage
• Multifocal Pneumonia + Influenza
• Pectus Excavatum
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery December CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
• Esophageal foreign body
• Mucus plugging
• Pneumonia
• Atelectasis
• Bronchiolitis
• E-cigarette vaping associated lung injury (EVALI)
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery October CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
• Scoliosis
• Pneumothorax
• Parapneumonic Effusion
• Cardiomegaly
• Vaping associated lung injury
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery November CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
- Tension Pneumothorax
- Atelectasis
- Esophageal Obstruction / Achalasia
- Right Upper Lobe Mass
- Right Upper and Right Middle Lobectomies
- Esophageal Foreign Body
- Transposition of the Great Vessels
Drs. Lena, Avery, and Davis’s CMC Abdominal Imaging Mastery Project: April CasesSean M. Fox
Dr. Kelsey Lena is an Emergency Medicine Resident and Drs. Michael Avery and Joshua Davis are Surgery Residents at Carolinas Medical Center in Charlotte, NC. They are interested in medical education. With the guidance of Drs. Kyle Cunningham and Michael Gibbs, they aim to help augment our understanding of emergent abdominal imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides. This month’s topics include:
- Large Bowel Obstruction
- Blunt Aortic Injury
- Abdominal Aortic Aneurysm with Rupture
EMGuideWire's Radiology Reading Room: COVID 19 Chest X-rays UpdateSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to COVID-19 infections as represented on Chest Radiography. It is brought to you by Nikki Richardson, MD, Claire Milam, MD, Alyssa Thomas, MD, and Shelby Hixson, PA. It has special guest editor, Infectious Disease Specialist, Catherine Passeretti, MD. In addition, this update also includes another special guest editor, Radiologist, Dr. Johnathan Clemente, MD.
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: October CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
- Tuberculosis
- Button Battery Ingestion
- Constipation
- Hirschprung's Disease
- Aspiration Pneumonia
- Generalized Lymphatic Anomaly
- Pediatric Acute Respiratory Distress
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery week 1Sean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team as they post these weekly educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics!
Drs. Lorenzen and Barlock’s CMC X-Ray Mastery Project: January CasesSean M. Fox
Drs. Breeanna Lorenzen and Travis Barlock are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
Perforated gastric ulcer with tension hemoperitoneum
Pulmonary arterial hypertension
Ruptured diaphragm
Cavitary tuberculosis
Pneumocystis pneumonia with spontaneous pneumothorax
Lower rib fractures and an associated splenic injury
EMGuideWire's Radiology Reading Room: Peripartum CardiomyopathySean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Peripartum Cardiomyopathy and is brought to you by Kaley El-Arab, MD, Blaire Langa, NP, Claire Lawson, NP, and Ashley Moore Gibbs, DNP. It is has the special guest editors: Richard Musialowski, MD and Laszlo Littmann, MD.
EMGuideWire's Radiology Reading Room: Pericardial EffusionSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Spontaneous Pericardial Effusion and is brought to you by Chelsea Wilson, MD, and Emily Lipsitz, PA-C.
EMGuideWire's Radiology Reading Room: PneumoniaSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Pneumonia and is brought to you by Elissabeth Hagler, MD and Tom Shuman, MD. Guest Editor is Michael Leonard, MD, Infectious Disease specialist.
EMGuideWire's Radiology Reading Room: PneumomediastinumSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Pneumomediastinum and is brought to you by Jacob Leedekerken, MD and Chelsea Wilson, MD.
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery August CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including: Tetralogy of Fallot, Pneumonia, Bronchiolitis, Esophageal Foreign Body, Pneumothorax, ECMO
Drs. Milam and Thomas's CMC X-Ray Mastery Project: December CasesSean M. Fox
Drs. Claire Milam and Alyssa Thomas are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides on: Cryptococcal Pneumonia, Coarctation of the Thoracic Aorta, Pulmonary Contusion, Ruptured Left Hemidiaphragm, Septic Pulmonary Emboli
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: August CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
- Pneumatocele
- Croup
- Pulmonary Contusion
- Blast Injury
- Bowel Obstruction
- Lobar Pneumonia
- Cavitary Lung Lesions
- Ileus
- Malposition of Central Line
EMGuideWire's Radiology Reading Room: Spontaneous PneumothoraxSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Spontaneous Pneumothorax and is brought to you by Elizabeth Olson, MD, and Janet Lorenz, NP.
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: July CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
• Aortic Aneursym
• Aortic Coarctation
• Aspirated Foreign Body
• Ingested Foreign Body
• VP Shunt Malfunction
• Hemopneumothorax
• COVID-19 pneumonia and pneumothorax
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: August CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
• Aortic Coarctation
• Tension pneumothorax
• Pneumonia
• COVID-19
• Tetralogy of Fallot
• L-Transposition of the Great Vessels
• Pediatric ARDS
• MIS-C
• Foreign Body Aspiration
• Aspiration Pneumonia
• Corner fracture
• Non-accidental Trauma
EMGuideWire's Radiology Reading Room: Pleural EffusionsSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Pleural Effusions and is brought to you by Gabriela Rivera Camacho, MD and Emily Griffith, NP-C.
Drs. Milam and Thomas's CMC X-Ray Mastery Project: June CasesSean M. Fox
Drs. Claire Milam and Alyssa Thomas are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides on:
• Pneumothorax
• Non-cardiogenic Pulmonary Edema
• COVID – 19
• Right Lower Lobe Pneumonia
• Diaphragmatic Hernia
• Lung Abscess
• Miliary Tuberculosis
• Asbestosis
Drs. Lorenzen and Barlock’s CMC X-Ray Mastery Project: May CasesSean M. Fox
Drs. Breeanna Lorenzen and Travis Barlock are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
Pneumonia
Lung Masses
Pulmonary Nodules
Hilar Lymphadenopathy
Aorto-enteric Fistula
Diaphragmatic Hernia
Intra-aortic Balloon Pump
Pacemaker
Impella
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery January CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
• Swallowed Magnets
• Complex Left Lower Lobe Pneumonia
• Empyema
• Right Middle Lobe Pneumonia
• Pulmonary Hemorrhage
• Multifocal Pneumonia + Influenza
• Pectus Excavatum
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery December CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including:
• Esophageal foreign body
• Mucus plugging
• Pneumonia
• Atelectasis
• Bronchiolitis
• E-cigarette vaping associated lung injury (EVALI)
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: April CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
• Tension pneumothorax
• MIS-C
• Fungal Pneumonia
• Systemic JIA
• Large Pericardial Effusion
• Post-obstructive Pulmonary Edema
• Normal Thymus
• Pneumonia
CMC Pediatric X-Ray Mastery: 27th Case SeriesSean M. Fox
Dr. Bradley Harris is interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Mary Grady and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
• Clavicle Fracture
• Congenital Diaphragmatic Hernia
• Thymic Shadow
• Duodenal Atresia
• Hirschsprung’s Disease
• Malpositioned lines and tubes
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: December CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
- Hemopneumothorax
- COVID Pneumonia
- Metastatic Testicular Cancer
- Tension Pneumothorax
- Acute Chest Syndrome
- Status Asthmaticus
- Severe Anemia
- Pulmonary Infarct and Pulmonary Embolism
Running head SKIN CONDITIONS AND DIFFERENTIAL DIAGNOSIS 1SKIN.docxjeanettehully
Running head: SKIN CONDITIONS AND DIFFERENTIAL DIAGNOSIS 1
SKIN CONDITIONS AND DIFFERENTIAL DIAGNOSIS 7
Skin Conditions and Differential Diagnosis
Adesola Turner
Walden University
NURS-6512N-17
Advanced Health Assessment.
December 22, 2019.
Introduction
The number 2 graphic (figure below) is characterized as Cherry angiomas that appear in older adults. With time cherry angiomas turn dark, though after infection it is identified by round tiny bright ruby red papules. As age numerically increase Dunphy et al (2015) argues that the disease virtually occurs to everyone above the age of 30 years. One of the ways in which I would perform differential diagnosis is by observing the skin of a patient who is 70 years of age.
Graphic #2
Patient Initials: AB Age: 70 Gender: male
SUBJECTIVE DATA:
Chief Complaint (CC): AB comes in clinic complaining about development of hard red bumps on the chest
History of Present Illness (HPI): Patient AB who is 70 years old comes in the hospital with complaints of having red bumps on his chest that appeared 2 weeks ago. He states that he wants to be done aa physical examination to be performed. AB says that last year he developed at least 4 new bumps on his chest that formed gradually. He is filled with anxiety because upon doing a Google search about his condition, he found that it could some tumors that are developing on his chest. He deniesrefutes any bleeding, painful and itchy bumps, exudation, or any climate variations. The bumps are located around the chest and the abdomen. AB says he has not come into contact with an irritant, denies having a fever, or does he take medications. Also, he reports he is neither under stress nor lifestyle changes. He claims, no one in his family lineage has ever been diagnosed with skin cancer.
Medications: none
Allergies: NKDA
Past Medical History (PMH): identified with stage 4 blood pressure Hypertension and the age of 60 which was well managed.
Past Surgical History (PSH): At age 40, his left shoulder was repaired from a torn rotator cuff.
Sexual/Reproductive History: Married and not sexually active.
Personal/Social History: denies smoking, taking alcohol, substance abuse, or under any influence of ETOH
Immunization History: His immunizations are current. In 2017, he got immunized of Pneumococcal vaccines and influenza vaccine
Significant Family History: Living with no parents who perished from a car accident. Living with his healthy daughter whom he got at his 30s
Social History: Live with her daughter and his 3 grandchildren. Being a widow for 8 years, he has been working as an engineer before he retired. In his free time, he does light exercises. Every day he attends catholic mass and then joins his 6 friends for breakfast at the local diner.
Review of Systems (ROS):
General: Mr. AB is a well-organized and neat man. He is alert and corporate during the discussion. He responds t ...
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery September CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including: Tetralogy of Fallot, Congenital Diaphragmatic Hernia, Clavicle Fracture, Lung Agenesis, Ingested Foreign Body, Truncus Arteriosus.
CMC Pediatric X-Ray Mastery: February CaseSean M. Fox
Drs. Kaley El-Arab and Neha Ray are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
• Acute chest syndrome (review)
• Traumatic diaphragmatic hernia
• Cervical distraction injury
• Traumatic pneumothorax
• Pelvic fractures from GSW
• Lung whiteout from mucous plug
• Scapula fracture and subclavian artery injury from GSW
• Pulmonary contusions
• Pneumomediastinum
• Post-op pneumothorax
• Pulmonary contusions, femur fracture, and pelvic fractures
• Lines and tubes practice
Drs. Milam and Thomas's CMC X-Ray Mastery Project: September CasesSean M. Fox
Drs. Claire Milam and Alyssa Thomas are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides on: Septic Pulmonary Emboli, Severe Rib Fractures, Left Lower Lobe Resection, Pneumonia, Esophageal Stent, COPD, Hyperinflation, Pulmonary Contusion, Aortic Dissection, Tuberculosis
A presentation given by Prof. David Croaker & Eunice Gribben at the CHA Cofnerence in October 2012, The Journey, in the 'innovations in supporting chronically unwell children, young people and their families' stream.
Drs. Olson’s and Jackson’s CMC Pediatric X-Ray Mastery: March CasesSean M. Fox
Drs. Olson and Jackson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
• Acute Chest Syndrome
• Pneumothorax
• Tuberculosis
• Small Bowel Obstruction
• Intra-abdominal Abscess
• COVID-19
• Subcutaneous Emphysema
• Pneumoperitoneum
• Pneumomediastinum
• ECMO
• Pleural Effusions
• Cavitary Lung Lesions
Drs. Pikus, Blackwell, Baumgarten, and Malloy-Posts’s CMC X-Ray Mastery Proje...Sean M. Fox
Drs. Angela Pikus, Alex Blackwell, Mark Baumgarten, Rosa Malloy-Post are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
• Naloxone-Associated Aspiration Pneumonitis & Pulmonary Edema
• Superior Vena Cava Syndrome
• Pulmonary Aspergillosis And The “Air Crescent Sign”
• Needle-Chest Decompression & Recent Pneumothorax Literature
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery Cases #2Sean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team as they post these weekly educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including: Diaphragmatic Hernia, Pneumomediastinum, Right Mainstem Intubation, Left Lung Collapse, Coarctation of the Aorta, Right Upper Lobe Pneumonia, Right Lower Lobe Pneumonia
EMGuideWire's Radiology Reading Room: COVID 19 Chest X-raysSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to COVID-19 infections as represented on Chest Radiography. It is brought to you by Claire Milam, MD and Alyssa Thomas, MD. It has special guest editor, Infectious Disease Specialist, Catherine Passeretti, MD.
Implanted Devices - VP Shunts: EMGuidewire's Radiology Reading RoomSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Ventriculoperitoneal Shunts and their Complications and is brought to you by Brandon Friedman, MD, Kelsey Patterson, and L. Erin Miller MD. It is has special guest editor: Scott Wait, MD
Sternal Fractures & Dislocations - EMGuidewire Radiology Reading RoomSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Sternal Fractures and Dislocations and is brought to you by Carrie Bissell, MD, Aaron Fox, MD, Kendrick Lim, MD, Stephanie Jensen, MD, and Olivia Rice, MD. It is has special guest editor: Sean Dieffenbaugher, MD and Laurence Kempton, MD
Diaphragmatic Injuries - Radiology Reading RoomSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Diaphragm Injury and is brought to you by Kylee Brooks, MD, Parker Hambright, MD, Alexis Holland, MD, and William Lorenz, MD. It is has special guest editor: Kyle Cunningham, MD
Acute Chest Syndrome - EMGuidewire's Radiology Reading RoomSean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Acute Chest Syndrome and is brought to you by Angela Pikus, MD, Mark Baumgarten, MD, Andres Gil Bustamante, and Ahmed Mashal, MD. As always, Michael Gibbs, MD serves as the projects editor.
Adult Orthopedic Imaging Series: Presentation #2 Native Hip DislocationsSean M. Fox
Drs. Carrie Bissell, Aaron Fox, and Kendrick Lim are Emergency Medicine Residents at Carolinas Medical Center and are interested in emergency medicine and medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine and Dr. Laurence Kempton, an Orthopedic Surgeon, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides that focus on Adult Orthopedic cases. This set will cover:
- Hip Dislocations
Neuroimaging Mastery Project: Presentation #5 Subdural HematomasSean M. Fox
Drs. Faith Meyers, Madison Watts and Steven Perry are Emergency Medicine Residents at Carolinas Medical Center who are interested in medical education. Dr. Rebecca DeCarlo, MD is a Neurosurgical resident at Carolinas Medical Center. Along with the guidance of Dr. Michael Gibbs (Chair of Emergency Medicine), Dr. Jonathan Clemente (Chief of the Department of Radiology and Neuroradiology specialist), Dr. Christa Swisher (Neurocritcal Care Intensivist), and Dr. Scott Wait (Chief of Pediatric Neurosurgery) they aim to help educate us on Neuroimaging. In this presentation they will address Subdural Hematomas. Follow along with the EMGuideWire.com team as they post the CMC Neuroimaging Case Studies.
- Subdural Hematomas
Neuroimaging Mastery Project Presentation #4: Acute Epidural HematomasSean M. Fox
Drs. Faith Meyers, Madison Watts and Steven Perry are Emergency Medicine Residents at Carolinas Medical Center who are interested in medical education. Along with the guidance of Dr. Michael Gibbs (Chair of Emergency Medicine), Dr. Jonathan Clemente (Chief of the Department of Radiology and Neuroradiology specialist), Dr. Christa Swisher (Neurocritcal Care Intensivist), and Dr. Scott Wait (Chief of Pediatric Neurosurgery) they aim to help educate us on Neuroimaging. In this presentation they will address Atraumatic Neurosurgical Intracranial Infections. Follow along with the EMGuideWire.com team as they post the CMC Neuroimaging Case Studies.
- Acute Epidural Hematomas
Pediatric Orthopedic Imaging Case Studies #7 Pediatric Elbow FracturesSean M. Fox
Dr. Haley Dusek is an Emergency Medicine Resident and interested in pediatric emergency medicine and medical education. Dr. Ainsley Bloomer is an Orthopedic resident at Carolinas Medical Center. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, and supervision of Dr. Danielle Sutton, a Pediatric Emergency Medicine specialist, and Dr. Virginia Casey, a Pediatric Orthopedic Surgeon, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
•Lateral condyle
•Medial epicondyle
•Monteggia
•Posterior dislocation
•Transphyseal separation
Adult Orthopedic Imaging Mastery Project - Pelvic Ring FracturesSean M. Fox
Drs. Carrie Bissell, Aaron Fox, and Kendrick Lim are Emergency Medicine Residents at Carolinas Medical Center and are interested in emergency medicine and medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine and Dr. Laurence Kempton, an Orthopedic Surgeon, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides that focus on Adult Orthopedic cases. This set will cover:
- Pelvic Ring Fractures
Neurosurgical Intracranial Infections - FINAL 10-17-23.pptxSean M. Fox
Drs. Faith Meyers and Steven Perry are Emergency Medicine Residents and Trent VanHorn is a Neurosurgical Resident at Carolinas Medical Center who are interested in medical education. Along with the guidance of Dr. Michael Gibbs (Chair of Emergency Medicine), Dr. Jonathan Clemente (Chief of the Department of Radiology and Neuroradiology specialist), Dr. Christa Swisher (Neurocritcal Care Intensivist), and Dr. Scott Wait (Chief of Pediatric Neurosurgery) they aim to help educate us on Neuroimaging. In this presentation they will address Atraumatic Neurosurgical Intracranial Infections. Follow along with the EMGuideWire.com team as they post the CMC Neuroimaging Case Studies.
This set will cover:
Atraumatic Neurosurgical Intracranial Infections
Subdural Empyema and Brain Abscess
CMC Neuroimaging Case Studies - Cerebral Venous Sinus ThrombosisSean M. Fox
Drs. Faith Meyers, Steven Perry, Madison Watts, and Brandon Friedman are Emergency Medicine Residents at Carolinas Medical Center and interested in medical education. Along with the guidance of Dr. Michael Gibbs (Chair of Emergency Medicine), Dr. Jonathan Clemente (Chief of the Department of Radiology and Neuroradiology specialist), Dr. Christa Swisher (Neurocritcal Care Intensivist), and Dr. Scott Wait (Chief of Pediatric Neurosurgery) they aim to help educate us on Neuroimaging. In this presentation they will address Cerebral Venous Sinus Thrombosis. Follow along with the EMGuideWire.com team as they post the CMC Neuroimaging Case Studies.
This set will cover:
- Cerebral Venous Sinus Thrombosis
Abdominal Imaging Case Studies #27.pptxSean M. Fox
Drs. Kylee Brooks and Parker Hambright are Emergency Medicine Residents and Drs. Alexis Holland and William Lorenz are Surgery Residents at Carolinas Medical Center in Charlotte, NC. They are interested in medical education. With the guidance of Drs. Kyle Cunningham, Brent Matthews, and Michael Gibbs, they aim to help augment our understanding of emergent abdominal imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides. This month’s cases include:
• Iatrogenic Esophageal Perforation
• Emphysematous Cystitis
• Meckel’s Diverticulum
• Paraesophageal Hernia
Blood Can Be Very Very Bad - CMC Neuroimaging Case StudiesSean M. Fox
Drs. Faith Meyers and Steven Perry are Emergency Medicine Residents at Carolinas Medical Center and interested in medical education. Along with the guidance of Dr. Michael Gibbs (Chair of Emergency Medicine), Dr. Jonathan Clemente (Chief of the Department of Radiology and Neuroradiology specialist), and Dr. Scott Wait (Chief of Pediatric Neurosurgery) they aim to help educate us on Neuroimaging. In this initial educational slideset, they are also joined by Dr. Andrew Perron, the creator of the “Blood Can Be Very Bad” Head CT interpretation framework. Follow along with the EMGuideWire.com team as they post the CMC Neuroimaging Case Studies.
This set will cover:
- The Neuroimaging Framework “Blood Can Be Very Very Bad.”
Drs. Angela Pikus, Alex Blackwell, Mark Baumgarten, Rosa Malloy-Post are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
• Abnormalities of the Thoracic Aorta
o Traumatic aortic disruption
o Thoracic aortic aneurysm with acute dissection
Medical Device Imaging Mastery Project #4: Extracorporeal Membrane OxygenationSean M. Fox
Drs. Kaley El-Arab and Brandon Friedman are Emergency Medicine Residents at Carolinas Medical Center and interested in medical education and Critical Care. They have teamed with Ms. Emily Lipitz a PA with the Sanger Heart & Vascular Institute. Along with the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, and Dr. John Symanski, a cardiologist from the Sanger Heart & Vascular Institute, they aim to help augment our understanding of emergent imaging of implanted devices. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
- Extracorporeal Membrane Oxygenation
Drs. Brooks, Hambright, Holland, and Lorenz’s CMC Abdominal Imaging Mastery P...Sean M. Fox
Drs. Kylee Brooks and Parker Hambright are Emergency Medicine Residents and Drs. Alexis Holland and William Lorenz are Surgery Residents at Carolinas Medical Center in Charlotte, NC. They are interested in medical education. With the guidance of Drs. Kyle Cunningham, Brent Matthews, and Michael Gibbs, they aim to help augment our understanding of emergent abdominal imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides. This month’s cases include:
- Pyogenic Liver Abscess
- Bladder Rupture
- Sigmoid Volvulus
Dr. Haley Dusek’s CMC Pediatric Orthopedic X-Ray Mastery Project: #6 Presenta...Sean M. Fox
Dr. Haley Dusek is an Emergency Medicine Resident and interested in pediatric emergency medicine and medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, and supervision of Dr. Danielle Sutton, a Pediatric Emergency Medicine specialist, and Dr. Virginia Casey, a Pediatric Orthopedic Surgeon, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
• Tufts fracture
• Mallet fracture
• Seymour fracture
• Volar Plate Injury
• Base fracture
• Phalangeal neck
• Condyle fracture
• Phalanx dislocations
Drs. Pikus, Blackwell, Baumgarten, and Malloy-Posts’s CMC X-Ray Mastery Proje...Sean M. Fox
Drs. Angela Pikus, Alex Blackwell, Mark Baumgarten, Rosa Malloy-Post are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
• Peripartum Cardiomyopathy
• Left Ventricular Assist Devices
• Pleural Effusions
Drs. Escobar, Pikus, and Blackwell’s CMC X-Ray Mastery Project: 43rd Case SeriesSean M. Fox
Drs. Daniel Escobar, Angela Pikus, and Alex Blackwell are Emergency Medicine Residents and interested in medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
- Traumatic Pneumothorax
- Flail Chest And Surgical Rib Fixation
- Traumatic Pulmonary Pseudocyst
- Stab Wound To The Heart
CMC Pediatric X-Ray Mastery: 26th Case SeriesSean M. Fox
Drs. Kaley El-Arab and Taylor Anderson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Drs. Nikki Richardson, Mary Grady, and Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology. This month’s topics include:
- Penetrating Chest Trauma
- Meconium Aspiration Syndrome
- Respiratory Distress Syndrome
- Pneumothorax
- Pneumatosis
- Rickets of prematurity
- Disseminated HSV
- VACTERL
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
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Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery: April Cases
1. Pediatric Chest X-Rays Of The Month
Nikki Richardson MD & Jennifer Potter MD
Department of Emergency Medicine
Carolinas Medical Center & Levine Children’s Hospital
Michael Gibbs MD, Faculty Editor
Chest X-Ray Mastery Project
April 2020
2. Disclosures
This ongoing chest X-ray interpretation series is proudly sponsored by the
Emergency Medicine Residency Program at Carolinas Medical Center.
The goal is to promote widespread mastery of CXR interpretation.
There is no personal health information [PHI] within, and ages have been
changed to protect patient confidentiality.
3. Process
Many are providing cases and these slides are shared with all contributors.
Contributors from many CMC departments, and now… Tanzania and Brazil.
Cases submitted this week will be distributed monthly.
When reviewing the presentation, the 1st image will show a chest X-ray
without identifiers and the 2nd image will reveal the diagnosis.
5. HPI: 8-year-old male with
history of TBI and VP shunt
presents for vomiting and
increased head banging
(which he usually does
when upset or in pain). On
exam vital signs are within
normal limits and patient
nontoxic appearing.
6. VP shunt coiled in abdomen
No VP shunt in neck or chest
HPI: 8-year-old male with
history of TBI and VP shunt
presents for vomiting and
increased head banging
(which he usually does
when upset or in pain). On
exam vital signs are within
normal limits and patient
nontoxic appearing.
7. Dx: VP Shunt Disconnection
VP shunt coiled in abdomen
No VP shunt in neck or chest
HPI: 8-year-old male with
history of TBI and VP shunt
presents for vomiting and
increased head banging
(which he usually does
when upset or in pain). On
exam vital signs are within
normal limits and patient
nontoxic appearing.
9. HPI: 16-year-old presents
with 4 days of fever, chills,
cough, chest pain. On
exam, the patient is febrile,
tachypneic and tachycardic.
No focal findings on lung
auscultation.
10. Dx: Pneumonia
Bilateral opacities
HPI: 16-year-old presents
with 4 days of fever, chills,
cough, chest pain. On
exam, the patient is febrile,
tachypneic and tachycardic.
No focal findings on lung
auscultation.
11. Patient was admitted to
the hospital and later
developed an increasing
oxygen requirement. On
further discussion, the
patient admits to vaping
intermittently - last use 2
weeks prior.
A chest CT was obtained.
12. Dx: E-cigarette vaping
associated lung injury (EVALI)
Diffuse subpleural ground glass
opacities
16-year-old with a history
of intermittent vaping
develops worsening
hypoxia.
14. Latest Outbreak Information
Updated every Thursday
This complex investigation spans almost all states, involves over a thousand patients, and a wide variety o
brands and substances and e-cigarette, or vaping, products. Case counts continue to increase and new ca
being reported, which makes it more difficult to determine the cause or causes of this outbreak.
As of October 22, 2019, 1,604* cases of e-cigarette, or vaping, product use associated lung injury (EVALI) h
been reported to CDC from 49 states (all except Alaska), the District of Columbia, and 1 U.S. territory.
Thirty-four deaths have been confirmed in 24 states: Alabama, California (3), Connecticut, Delaware,
Georgia (2), Illinois (2), Indiana (3), Kansas (2), Massachusetts, Michigan, Minnesota (3), Mississippi, M
Montana, Nebraska, New Jersey, New York, Oregon (2), Pennsylvania, Tennessee, Texas, Utah, and Vi
More deaths are under investigation.
The median age of deceased patients was 49 years and ranged from 17 to 75 years.
Among 1,358 patients with data on age and sex (as of October 15, 2019)(as of October 15, 2019):
70% of patients are male.
The median age of patients is 23 years and ages range from 13 to 75 years.
17. HPI: 6-week-old presents with
cough and difficulty breathing
for 3 weeks. There is no fever.
The mother reports that the
patient becomes sweaty with
breastfeeding. On exam, the
patient requiring supplemental
oxygen, heart sounds are more
prominent on right, distant
breath sounds with a “gurgling”
noise on the left.
Many thanks to our friends in Tanzania for this case!
18. HPI: 6-week-old presents with
cough and difficulty breathing
for 3 weeks. There is no fever.
The mother reports that the
patient becomes sweaty with
breastfeeding. On exam, the
patient requiring supplemental
oxygen, heart sounds are more
prominent on right, distant
breath sounds with a “gurgling”
noise on the left.
Rightward mediastinal shift
Loops of bowel in left chest
Dx: Diaphragmatic hernia
19. HPI: 6-year-old presents
with left elbow pain and
fatigue since yesterday.
Mother noticed left eye
drooping at approximately
01:00 this morning. On
exam, the patient has pupil
asymmetry with L < R as
well as swelling of the left
arm.
20. HPI: 6-year-old presents
with left elbow pain and
fatigue since yesterday.
Mother noticed left eye
drooping at approximately
01:00 this morning. On
exam, the patient has pupil
asymmetry with L < R as
well as swelling of the left
arm.
Dx: Left apical mass
6.5 cm x 5.5 cm Mass
21. CT performed as an
inpatient to further
characterize the mass.
Differential: Neuroblastoma,
lymphoma, germ cell tumor,
thymoma
Mass arising out of the superior
and middle mediastinum
Mass effect on the trachea
Pathologic Dx: Neuroblastoma
22. HPI: 4-year-old with a past
medical history of renal
mass s/p resection
presents to the ED for 7
days of cough. The patient
became progressively
worse at home and parents
were concerned about
increased work of
breathing. On exam, the
patient is tachypeic and
tachycardic.
23. HPI: 4-year-old with a past
medical history of renal
mass s/p resection
presents to the ED for 7
days of cough. The patient
became progressively
worse at home and parents
were concerned about
increased work of
breathing. On exam, the
patient is tachypeic and
tachycardic.
Dx: Pulmonary metastasis
secondary to primary Wilm’s
tumor
Innumerable bilateral pulmonary
nodules
24. Most Common Primary Sites of Pulmonary
Metastatic Disease in Children
• Wilms tumor
• Neuroblastoma
• Rhabdomyosarcoma
• Osteosarcoma
• Ewing sarcoma
https://radiopaedia.org/articles/pulmonary-metastases?lang=us
Image Shutterstock
26. VISUAL DIAGNOSIS
Dx: Endotracheal tube in the
right mainstem bronchus
ETT terminates in right
bronchus
Completely opacified left lung
fields
27. What’s With These Kids?
For the next section, we will review a series of cases/images with a
unifying diagnosis. Try to identify the similarities and come up with the
diagnosis! After each series of cases, we will discuss the
pathophysiology and imaging characteristics of the diagnosis.
These images and cases have been graciously shared with us from our
collogues in the pediatric cardiovascular surgery department. We thank
you for your continued support of this project!
28. HPI: 10-year-old male with
history of multiple
hospitalizations for URIs
presents for near syncope
after getting out of water
where he was holding his
breath. Mother also notes
that patient has had noisy
breathing his whole life
and intermittent apnea.
Exam reveals noisy
breathing but lungs clear to
auscultation
29. HPI: 6-year-old female with
history of tonsillectomy
and adenoidectomy
presents to urgent care for
increased work of
breathing and stridor.
Mother reports that
patient has been seen
almost yearly for similar
complaints. Physical exam
with tachypnea and
expiratory stridor.
30. HPI: 8-month-old male
presents for vomiting with
almost every feeding of
solid food. Gaining weight
appropriately. Mother
reports that patient had an
echo performed soon after
birth but she cannot recall
the results. Physical exam
is unremarkable.
31. HPI: 2-month-old male
presents for noisy
breathing. Noisy breathing
has been present since
birth. Expiratory stridor on
exam, otherwise
unremarkable.
32. HPI: 4-month-old
diagnosed with right aortic
arch and left ductus
arteroisus in utero presents
with cough, congestion and
noisy breathing. On exam,
patient with increased
work of breathing and
expiratory stridor.
34. Vascular Ring
• Anatomic variants of the aortic
arch encircle the trachea and/or
esophagus
• Symptoms are produced by the
extrinsic compression on the
trachea (stridor) or esophagus
(dysphagia)
• 12% are associated with
congenital heart disease
Backer, Carl L., et al. “Vascular Rings.” Seminars in Pediatric Surgery, vol. 25, no. 3, 2016, pp. 165–175., doi:10.1053/j.sempedsurg.2016.02.009.
Photo: https://www.chop.edu/conditions-diseases/vascular-ring
35. Vascular Ring: Embryology
• Remember this?!?
• Vascular rings develop because
of a failure of specific arches to
involute OR involution of the
incorrect arch
• Right aortic arch is most often
secondary to failure of right 4th
arch to involute
• Double arch occurs when left 4th
arch also remains patent
Poletto, Erica, et al. “Imaging Review of Aortic Vascular Rings and Pulmonary Sling.” Journal of the American Osteopathic College of Radiology , vol. 6, no. 2,
2017.
Backer, Carl L., et al. “Vascular Rings.” Seminars in Pediatric Surgery, vol. 25, no. 3, 2016, pp. 165–175., doi:10.1053/j.sempedsurg.2016.02.009.
36. Vascular Ring: Clinical Presentation
History
• Infants
• Noisy breathing
• Toddlers
• Difficulty swallowing food
• Noisy breathing with illness
• Older Children
• Recurrent URIs
Physical Exam
• Expiratory stridor
Poletto, Erica, et al. “Imaging Review of Aortic Vascular Rings and Pulmonary Sling.” Journal of the American Osteopathic College of Radiology ,
vol. 6, no. 2, 2017.
37. Vascular Ring: ED Evaluation
• Not all stridor is croup or airway
foreign body!
• History and Chart review
• Multiple presentations for stridor
with URI symptoms
• Physical Exam
• Listen to phase of stridor
• If expiratory, consider vascular ring
• Imaging
• Chest XR; PA and lateral
• Consider CT angiography chest if
significant distress
CT reconstructions from
Pediatric Cardiovascular
Surgery Department at
Levine’s Children’s Hospital
38. • 95% of patients with vascular
ring have a visible abnormality
on CXR
• Segmental tracheal deviation
• Anterior tracheal bowing on the
lateral projection
• Right sided aortic arch
• Absent left aortic contour
Poletto, Erica, et al. “Imaging Review of Aortic Vascular Rings and Pulmonary Sling.” Journal of the American Osteopathic College of Radiology , vol. 6, no. 2, 2017.
Knipe, Henry, and Francis Deng. “Vascular Rings and Slings: Radiology Reference Article.” Radiopaedia, radiopaedia.org/articles/vascular-rings-and-slings?lang=us.
Vascular Ring: CXR
39. Vascular Ring: CXR Limitations
• Atretic or hypoplastic arch may
be too small to cause visible
displacement
• Thymus can cover aortic arches
• Lack of lateral view due to acute
illness/portable CXR
• If suspicion is high and patient
with respiratory distress,
consider CT angiography to
make diagnosis
Poletto, Erica, et al. “Imaging Review of Aortic Vascular Rings and Pulmonary Sling.” Journal of the American Osteopathic College of Radiology , vol. 6, no. 2, 2017.
40. Vascular Ring: Preoperative Studies
• CT angiography OR MRI of the
chest
• Preoperative planning
• Echocardiogram
• 12% have associated congenital
heart defect
• Bronchoscopy
• Assess for tracheomalacia or other
tracheal pathology
Backer, Carl L., et al. “Vascular Rings.” Seminars in Pediatric Surgery, vol. 25, no. 3, 2016, pp. 165–175., doi:10.1053/j.sempedsurg.2016.02.009.
41. Vascular Ring: Surgical Repair
Backer, Carl L., et al. “Trends in Vascular Ring Surgery.” The Journal of Thoracic and Cardiovascular Surgery, vol. 129, no. 6, 2005, pp. 1339–1347.,
doi:10.1016/j.jtcvs.2004.10.044.
• Based on data from 209 cases at Children’s Memorial Hospital at Northwestern
• Muscle sparing left thoracotomy; right sided approach can be used as anatomy on CT or MRI dictates
• If double arch anatomy, the lesser or atretic arch should be divided to release the vascular ring. If equally balanced, the
site of division is chosen by clamping one arch and measuring the blood pressure in the lower extremities. The
clamped arch that produces the lower blood pressure is then divided
• If Kommerrell diverticulum is present it should be resected and the left subclavian artery (LSA) should be transferred to
the left carotid artery (LCA)
• Tube thoracostomy is no longer recommended postoperatively
42. Summary Of This Month’s Diagnoses
• VP shunt disconnection
• E-cigarette vaping associated lung
injury
• Diaphragmatic hernia
• Apical lung mass: Neuroblastoma
• Innumerable pulmonary metastasis
secondary to Wilms Tumor
• Endotracheal tube in right mainstem
bronchus
• Vascular ring