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Acute pulmonary edema following surgery

This patient became acutely short of breath following surgery. Why is this an emergency? The patient has:
  • a. Left lower lobe pneumonia.
  • b. Acute pulmonary edema.
  • c. A large pneumothorax.
  • d. A large pericardial effusion.
  • e. A ruptured gastric ulcer.


Correct Answer: Acute pulmonary edema.

Explanation
There is diffuse airspace disease in both lungs causing almost complete opacification of both lungs. This came on suddenly and is characteristic of pulmonary edema. Other fluids can inhabit the airspaces such as blood or gastric aspirate, but they have different clinical stories and are less common than acute pulmonary edema. This patient had been hypotensive and was suffering from non-cardiogenic pulmonary edema. Vasopressors and diuretics were used in his treatment.

Scaphoid fractures overview

A Scaphoid fracture is the most common type of wrist fracture which is almost always caused by a fall on the outstretched hand..Scaphoid fractures usually cause pain and swelling at the base of the thumb. The pain may be severe when you move the thumb or wrist, or when the patient try to grip something.
Anatomic snuffbox tenderness is a highly sensitive test for scaphoid fracture, whereas scaphoid compression pain and tenderness of the scaphoid tubercle tend to be more specific. Initial radiographs in patients suspected of having a scaphoid fracture should include anteroposterior, lateral, oblique, and scaphoid wrist views..........

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Congenital aortic stenosis in X-ray

In Supravalvular aortic stenosis you can see Aortic knob is often small due to underdevelopment and stenosis of the supravalvular portion of the aorta. Different from the poststenotic aortic dilation that occurs with valvular aortic stenosis.

Congenital aortic stenosis. Small aortic arch with moderate enlargement of the left ventricle.

Indications of Thumbprint sign in Chest & Abdominal X-ray




the thumbprint sign is a finding on a lateral C-spine radiograph that suggests the diagnosis of epiglottitis. The sign is caused by a thickened free edge of the epiglottis, which causes it to appear more radiopaque than normal, resembling the distal thumb.

Thumb’ like epiglottitis. Note the swollen epiglottitis like a thumbprint
" enlarged epiglottis in epiglottitis which, instead of its usual thin fingerlike projection, is stubby, like the thumb "

In an abdominal x-ray, the "thumb print sign" has similar appearance of thumbs protruding into the intestinal lumen, but are in fact caused by thickened edematous mucosal folds. Abdominal thumbprinting a sign of intestinal ischemia.

Thumbprinting-indentation in contrast or air-filled bowel lumen caused by submucosal infiltration and resembling a thumbprint; eg ischemia