A man with right flank pain

Clinical introduction A healthy, obese 38-year-old man had acute flank pain for 2 days. He also complained of a fever for 1 day. He denied haematuria, nausea, vomiting or constipation. A point-of-care abdominal ultrasound was obtained (figure 1). Question What is the diagnosis? Diverticulitis Appendicitis Epiploic appendagitis Urolithiasis Answer: C Epiploic appendagitis (EA) is an inflammation in the epiploic appendages, which is caused by spontaneous torsion or thrombosis of the central draining vein.1 EA is a rare occurrence but a benign and self-limited condition. However, the mimics of EA include appendicitis and diverticulitis.2 The ultrasound may aid the diagnosis with the findings of a non-compressible, hyperechoic ovoid mass with a ‘sonographic central dot sign’ (figure 2). The ‘central dot sign’ is a characteristic finding of EA on CT,3 showing a central hyperattenuating...
Source: Emergency Medicine Journal - Category: Emergency Medicine Authors: Tags: EMJ Image Challenge Source Type: research