Gallstones on CT (Cholelithiasis)

This abdominal CT shows the presence of gallstones within the gallbladder (see yellow box).
Note: CT is NOT the gold standard for diagnosing either gallstones (cholelithiasis) or infection of the gallbladder (cholecystitis). RUQ Ultrasound is typically the test of choice. With biliary colic (stones without cholecystitis) you see stones and perhaps biliary sludge on US. With cholecystitis you see gallbladder wall thickening, pericholecystic fluid, sonographic Murphy's sign, possibly air within the gallbladder wall (this later finding with emphysematous cholecystitis).

Open Tibia Fracture

This represents an open tibia fracture (left lower extremity) with concomitant large anterior tissue avulsion. Fortunately, the vasculature to the lower leg remained intact. The orthopedic injury was repaired with rigid internal fixation and the missing overlying tissue required reconstruction (in this case a free flap was utilized).

Cleft lip and palate

This infant has complete cleft lip and palate. You can observe the extension of the cleft into the nasal cavity.
Clefts occur more commonly on the left side and in boys.
This child has an appliance in place to bring the major and minor segements of the maxilla in close approximation. This helps facilitate repair of the lip and palate and may allow for bone to form between the gap (after gingivoperiosteoplasty).
This photo provided courtesy of Dr. E. McMahon.

Lipoma (forehead)

A lipoma is a benign fatty growth. It is the most common soft-tissue neoplasm.

Here is one of the right forehead that was excised.

The diagnosis was confirmed pathologically following excision.

See also: http://www.emedicine.com/med/topic2720.htm

Lymphoma of the mediastinum

Lymphoma of the mediastinum.

This chest X-ray shows a radioopacticty (large white area) in continuity with the left heart border. The mediastinum is enlarged secondary to lymphoma.

Read more about the mediastinum, lymphoma, or chest radiographs.
http://www.emedicine.com/med/topic1366.htm

Trephination

Trephination.

The hole in this skull was purposely created using a process termed "trephination."
This technique was used in many ancient cultures to allow for the exiting of "evil spirits." It may also have been successful in treating/evacuating a subdural hematoma. Meningitis is a concern when performed in such unsterile conditions though.

The location is on the right parietal bone, near the function of the frontal bone. Note that the hole likely does not cross the midline. These cultures must have discovered the sagittal venous sinus runs in the midline and damage could result in death.

Nail gun to cheek

Nail gun to cheek

Mishap with a nail gun -- nail fired into nail causing recoil of the nailgun up and turning 180 degrees -- resulting in the release of the nail into his face.

Fortunately all vital structures were avoided and the nail was retrieved with the aid of fluoroscopic guidance. Structures to be concerned with in the area include the facial artery, facial venous network, duct from the parotid salivary gland (Stenson's), and the facial nerve.

Luckily too, the nail bounced off the bone and was not lost into the sinus.

Dehisced Spinal Wound

Dehisced Spinal Wound.

A frequent surgical approach to the spine is along the midline of the back. In the setting of malnutrition and infection such an incision can open up, fail to heal, or develop prolonged infection.

Read about wound healing, surgical site infections, spinal fusion procedures, or laminectomy.

Avulsed teeth

Avulsed teeth.

Avulse = from the Latin avuls: "to pluck off, to tear away, to forcibly pull."

These teeth have been traumatically removed from an individual who fell from a balcony, landing face first.

If your child ever traumatically avulses his/her teeth you should place the tooth/teeth in saline, milk (some say), or saliva and go to the dentist or emergency room promptly. If they are adult teeth (permanent teeth) they can be replanted and secured with some success (depending on the timing).

Remember, primary/"baby" teeth should NOT be replanted, as they may injure the developing permanent teeth underneath.

Search to read more about avulsed teeth.

Syndactyly

Syndactyly, following correction.

Fingers fail to separate into individual appendages.
This can occur in isolation or in the setting of an associated syndrome (eg, Apert syndrome).

Read more about syndactyly at: http://www.emedicine.com/orthoped/topic563.htm