SAEM Clinical Image Series: Left Ear Mass

A 25-year-old male who was previously healthy presents to the emergency department with a painful left posterior ear mass. The mass began as a “pimple” and has been increasing in size for the last 6 months. He has an associated headache, dizziness, and malaise. He denies fever, trauma, drainage, known insect bite, dysphagia, dyspnea, trismus, and hearing loss. He emigrated to the United States from Honduras 8 months ago. He was seen in the emergency department 4 months prior for a similar complaint, which was diagnosed as lymphadenopathy by point-of-care ultrasound.

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By Gabriela Rivera-Camacho, MD|2026-06-16T16:16:45-07:00Jan 11, 2021|Academic, ENT, Infectious Disease, SAEM Clinical Images|

SplintER Series: We’ve Got A Jumper

A 42-year-old patient is brought in by EMS after jumping off of a two-story building. The primary survey is intact and the secondary survey demonstrates swelling, ecchymosis, and tenderness to the right heel. You obtain foot x-rays and see the following images (Image 1. Lateral view of the right foot. Author’s own images).

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By Ashraf Hussain, MD|2020-12-22T15:07:37-08:00Jan 6, 2021|Expert Peer Reviewed (Clinical), Orthopedic, SplintER|

SAEM Clinical Image Series: Blisters, Bullae, and Badness

A 3-year-old female with a history of epilepsy presents with a rash that began one day ago. The patient started becoming fussy four days ago, saying, “I don’t feel good,” and not wanting to play outside with her siblings or finish her meals. Family noticed the patient rubbing her eyes frequently and crying when she went to the bathroom. She felt warm so they gave her Tylenol and Motrin at home. Yesterday, they noticed a rash was starting to develop with itchy, painful red spots. This morning, the rash progressed to involve some blisters on the face, chest, and back.

Medications include Tylenol, Motrin, and lamotrigine, which was started by her neurologist three weeks ago. Family history is significant for epilepsy on the father’s side of the family.

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By Amanda Gonzalez, MD|2021-01-05T13:23:34-08:00Jan 4, 2021|Academic, SAEM Clinical Images|

SAEM Clinical Image Series: The Hemorrhaging Bifurcated Tongue

A 26-year-old male with no past medical history presented to the emergency department for tongue bleeding for one day. Five days prior he had an elective cosmetic tongue bifurcation completed out-of-state. About two hours prior to arrival, he had been using a swish-and-spit saltwater rinse when he felt a suture break. Ever since he has had copious bleeding, reportedly filling his sink at home with blood. Additionally, he had about 250 milliliters of blood, including large clots, in a container in the emergency department. He denied using any blood thinners. There was no syncope, dizziness, chest pain, nausea, vomiting, shortness of breath, pain of the tongue, or numbness of the tongue. He had some difficulty speaking but said it was due to needing to retrain his bifurcated tongue.

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By Maria Dharini Arulraja, MD|2020-12-20T20:16:29-08:00Dec 21, 2020|Academic, Emergency Medicine, ENT, SAEM Clinical Images|

SAEM Clinical Image Series: Shortness of Breath

A 60-year-old female presented to the emergency department (ED) for respiratory distress. Emergency medical services reports that the patient was in respiratory distress upon arrival, slowly becoming unresponsive en-route. They started the patient on continuous positive airway pressure, but she lost consciousness with oxygen saturation in the thirties and they switched to bag valve mask (BVM) ventilation, which improved saturations up to 100 percent. Narcan was administered without improvement as she was on narcotics following bronchoscopy earlier today at an outside hospital.

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By Najee Abou-Arraj, MD|2021-01-18T19:30:33-08:00Dec 21, 2020|Academic, Emergency Medicine, Pulmonary, SAEM Clinical Images|

SplintER Series: More Than Just a Shoulder Dislocation?

$Anterior inferior shoulder dislocation with a fracture of the greater tuberosity of the humerus.$

An 80-year-old female presents to the Emergency Department with right shoulder pain, deformity, and decreased range of motion after falling down half a flight of stairs. AP and Y-views of the right shoulder were obtained (Images courtesy of Kenneth Chang, DO).

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By Kenneth Chang, DO|2020-12-14T12:41:40-08:00Dec 16, 2020|Expert Peer Reviewed (Clinical), Orthopedic, SplintER|

SAEM Clinical Image Series: Oral Trauma and Mass

A 38-year-old African American male without a significant past medical history presented with an oral mass. He was struck on the mouth by a wrench handle about two prior. Since then he has had a growing mass originating from the gum of his left front upper teeth. He is no longer able to eat solid foods and has to use a straw for all oral intake. The patient denies fevers, chest pain, shortness of breath, and weight loss.

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By Han Wei Zheng, MD|2020-12-11T15:18:37-08:00Dec 14, 2020|Academic, ENT, SAEM Clinical Images|