ACR Case In Point

Wednesday, May 16, 2012

A 46-year-old woman with a history of rheumatoid arthritis and recurrent esophageal strictures (status post multiple esophageal dilatations with the most recent occurring in 2009) presents with abdominal pain, nausea, and vomiting.The patient was admitted to an outside hospital for gastric outlet obstruction per the CT examination findings. An esophagogastroduodenoscopy (EGD) was performed, demonstrating a massively distended stomach and increased volume of gastric secretions, and 900 mL of gastric fluid was later aspirated. Selective intubation of the duodenum was not possible secondary to increased volume of secretions, and the procedure was terminated.Following the EGD, the patient developed a distinctly different severe abdominal pain, and a subsequent kidney-ureter-bladder image demonstrated pneumoperitoneum. The patient was immediately taken to the operating room for exploratory laparotomy. The surgical team identified a tear along the lesser curvature of the stomach, which was then repaired.

Tuesday, May 15, 2012

A 47-year-old woman presents with a 3-month history of right areolar discoloration and painful palpable right breast firmness.

Monday, May 14, 2012

A 65-year-old man presents with foot pain.

Friday, May 11, 2012

A patient presents with withheld history.

Thursday, May 10, 2012

A patient presents with withheld history.

Thursday, May 10, 2012

The patient, with papillary thyroid cancer, underwent thyroidectomy 6 weeks prior to this exam. The patient is 7 days status post I-131 therapy.

Wednesday, May 9, 2012

A 50-year-old female marathon trainer with a history of breast cancer presents for left femur MRI.

Tuesday, May 8, 2012

An 89-year-old woman presents to the emergency department with altered mental status and ataxia.

Monday, May 7, 2012

An 82-year-old man presents to the emergency department with fever and a 5-day history of right upper quadrant abdominal pain.

Friday, May 4, 2012

A 27-year-old woman presents with complaints of right hip pain.

Thursday, May 3, 2012

A 21-year-old woman with no significant past medical history presents with the chief complaint of shortness of breath.

Wednesday, May 2, 2012

A 46-year-old woman is referred to a breast health center after direct trauma to the right subclavicular area. She subsequently developed a palpable abnormality with associated pain upon elevating her arms.

Tuesday, May 1, 2012

A 7-year-old girl presents with recurrent left small-finger swelling and a prior history of remote trauma to the region.