Author: Joanna Cohen

Joanna is originally from NY where she attended medical school at Downstate in Brooklyn. She completed her pediatric residency at Johns Hopkins and made her way south to DC for PEM and ultrasound fellowships. She has remained in DC, making her home in Capitol Hill since 2005. She stays busy mostly attending youth soccer games with her three kids and running.

IOTW: 8 yo F with Vaginal Bleeding

This 8 yo F presented to her PCP with vaginal bleeding and was diagnosed with precocious puberty. She presented to the ED with symptomatic anemia and had a pelvic US which revealed a left ovarian mass consistent with a hormone secreting granulosa cell tumor. Granulosa cell tumors are rare, but do secrete estrogen and this […]

IOTW: Papilledema

17 yo obese F on minocycline with headache. Pt found to have papilledema on ophtho US. Her cranial imaging was normal and she had an LP for presumed idiopathic intracranial hypertension. Her ICP was super high and 35 cc of CSF were removed with resolution of headache. Optic discs are considered elevated if they are […]

IOTW: Free fluid under the diaphragm

This 14 yo F presented with increased work of breathing and was found to have free fluid in her abdomen, small pleural and pericardial effusions. This image shows some free fluid under the diaphragm on the left. “The information in these cases has been changed to protect patient identity and confidentiality. The images are only […]

IOTW: Rib Fracture

Our poor PEM attending had a rib fracture seen clearly here with US. US is a nice substitute for Xray for rib fractures as it can be done quickly at the bedside at a low cost. Since there is basically never any intervention for a simple rib fracture, there is really no need for radiation […]

IOTW: Hydrocephalus and Ventricular Mass

This 3 month old presented to her pediatrician when her parents noticed she could no longer lift her head during “tummy time”. The pediatrician noticed an increase in HC from 40% to >98%. She was referred to the ED where a POCUS revealed enlarged ventricles and a multilobulated right ventricular mass. “The information in these […]