The tragic, but darkly humorous, consequences of slipping while trying to jump a wrought-iron fence.
20100823
Ouch
The tragic, but darkly humorous, consequences of slipping while trying to jump a wrought-iron fence.
20100110
Another one
This is another wild and crazy image from the radiology department. This comes from a patient who had a collapsed vertebral body in the thoracic spine. The patient had previously had surgery to repair an aortic aneurysm - the dotted circle is a cross-section of the prosthetic aortic graft. The big grey thing in front of the dotted white circle is the heart.
The needle enters the collapsed vertebral body. We took samples to look for evidence of infection or tumor. In this case, the bone was not so much a sheet of bone as a bunch of bony fragments held loosely together with inflammatory tissue, so it was easy to get the needle through. Had the bone been more solid, we would have used a bigger needle and a mallet.
You can see the spinal cord unusually well - it is the darker area within the lighter area of the spinal canal, looking almost like an eye. This is not what the spinal cord normally looks like on a CT; usually the spinal cord and the fluid surrounding it are nearly identical in color. But, this patient had a myelogram prior to the procedure, in which we do a spinal tap and inject material that shows up well on x-rays. Thus, on this image we get a really good shot of the spinal cord.
The needle enters the collapsed vertebral body. We took samples to look for evidence of infection or tumor. In this case, the bone was not so much a sheet of bone as a bunch of bony fragments held loosely together with inflammatory tissue, so it was easy to get the needle through. Had the bone been more solid, we would have used a bigger needle and a mallet.
You can see the spinal cord unusually well - it is the darker area within the lighter area of the spinal canal, looking almost like an eye. This is not what the spinal cord normally looks like on a CT; usually the spinal cord and the fluid surrounding it are nearly identical in color. But, this patient had a myelogram prior to the procedure, in which we do a spinal tap and inject material that shows up well on x-rays. Thus, on this image we get a really good shot of the spinal cord.
20100108
Not just a pretty picture!
For those who think that radiologists sit around all day looking at pictures, I invite you to consider the attached picture. This is a patient who had a mass in her neck just behind her throat. This is what I did to get a piece of it: under CT guidance, I stuck a needle through her cheek down to the back of her throat just in front of her spine. The following is one of the images from the procedure. It is a slice through the patient's head.
Note that the carotid artery is directly adjacent to the mass. This is not an activity for the faint of heart or the weak of sphincter.
Note that the carotid artery is directly adjacent to the mass. This is not an activity for the faint of heart or the weak of sphincter.
20091216
Food for thought
A sad commentary from a nurse's assessment of a patient in her 60s who is 5'6" and weighs over 400 lbs:
"Patient presents with a pannus that extends past her knees when standing." ("Pannus," for the uninitiated, refers to a roll of fat that hangs down from the abdomen over the lap. It comes from the Latin word for "apron," which is appropriate, though more than slightly disgusting.) "Patient is morbidly obese to the point that she cannot provide basic hygiene beyond washing her face. A strong foul odor fills her room and the surrounding hallway."
The strong foul odor comes from the flesh under her pannus, which is essentially rotting due to being constantly moist and dirty.
This is an example of the unfortunate effect of having easy access to a lot of cheap food that is bad for you. Everywhere else in the world, the poor are thin because they have no food. Here in the US, the poor are fat. And, the concomitant health problems that stem from the obesity epidemic are having and will continue to have serious effects on the cost of health care.
The CDC reports, to nobody's surprise, that the average BMI in the US has increased since 1960 for both men and women from 25 to 28 (click here for the report).
With that appetizing image in mind, Merry Christmas! See you at the salad bar...
"Patient presents with a pannus that extends past her knees when standing." ("Pannus," for the uninitiated, refers to a roll of fat that hangs down from the abdomen over the lap. It comes from the Latin word for "apron," which is appropriate, though more than slightly disgusting.) "Patient is morbidly obese to the point that she cannot provide basic hygiene beyond washing her face. A strong foul odor fills her room and the surrounding hallway."
The strong foul odor comes from the flesh under her pannus, which is essentially rotting due to being constantly moist and dirty.
This is an example of the unfortunate effect of having easy access to a lot of cheap food that is bad for you. Everywhere else in the world, the poor are thin because they have no food. Here in the US, the poor are fat. And, the concomitant health problems that stem from the obesity epidemic are having and will continue to have serious effects on the cost of health care.
The CDC reports, to nobody's surprise, that the average BMI in the US has increased since 1960 for both men and women from 25 to 28 (click here for the report).
With that appetizing image in mind, Merry Christmas! See you at the salad bar...
20091128
Red Ryder
This young man didn't listen when his mother warned him what would happen if he got that BB gun - that he would shoot his eye out.
Fortunately, his vision is still intact, and it doesn't look like his eyeball was penetrated. He does have some retinal hemorrhage, which will hopefully resolve.
20091127
Family togetherness at Thanksgiving
"Patient presents to the Emergency Department with mouth pain after an argument with his sister during which she hit him in the mouth with a bottle. His right three front teeth are chipped. The patient is tearful, but more upset about his appearance than the pain. He admits to drinking alcohol tonight."
20091126
Don Juan
"27-year old patient jumped from a window onto a balcony below when he heard his girlfriend's dad's voice coming to the bedroom." Don Juan here barely even qualifies as young - though his girlfriend still lives at home, so she may be. He broke his ankle very badly on that jump, which is no less than he deserves, the cad. The ten shots of vodka he drank doubtlessly affected his balance.
20091123
Unbelievable...
This is another history from my favorite type of patient:
"Patient in his 40's who 'accidentally' ingested Drano that he thought was alcohol."
And another:
"Woman with psychiatric history was visiting her boyfriend in the ER when she became aggressive and loud, yelling at the nurses, and was placed on a 5150 hold by the Sacramento Police Department."
For the uninitiated, a 5150 hold refers to the section of the California Welfare and Institutions Code that allows a policeman or clinician to place a person under involuntary confinement for up to 72 hours. The person has to be a danger to him or her self, and/or others and/or gravely disabled.
Her boyfriend was a patient in the ER as well, by the way. I am not sure what his issue is. He is probably not the guy who drank the Drano, though.
"Patient in his 40's who 'accidentally' ingested Drano that he thought was alcohol."
And another:
"Woman with psychiatric history was visiting her boyfriend in the ER when she became aggressive and loud, yelling at the nurses, and was placed on a 5150 hold by the Sacramento Police Department."
For the uninitiated, a 5150 hold refers to the section of the California Welfare and Institutions Code that allows a policeman or clinician to place a person under involuntary confinement for up to 72 hours. The person has to be a danger to him or her self, and/or others and/or gravely disabled.
Her boyfriend was a patient in the ER as well, by the way. I am not sure what his issue is. He is probably not the guy who drank the Drano, though.
20091122
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