MedPix Medical Image Database COW - Case of the Week Case Contributor: Mark D Travis Affiliation: National Naval Medical Center Bethesda

MedPix No: History Pt Demographics: Age = 23 y.o. Gender = woman A young woman (23 y.o.) went to her physician for several weeks of hip pain. She has been exercising lately; and, she is trying to *get back into shape*. Downloaded by (-1)

MedPix No: EXAM & LABS None performed.

18-week fetus Radiograph of the pelvis demonstrates the skeletal outline of an intrauterine pregnancy. Downloaded by (-1)

18-week fetus Radiograph of the pelvis demonstrates the skeletal outline of an intrauterine pregnancy. Downloaded by (-1)

18-week fetus Radiograph of the pelvis demonstrates the skeletal outline of an intrauterine pregnancy. Downloaded by (-1)

FINDINGS Radiograph of the pelvis demonstrates the skeletal outline of an intrauterine pregnancy.

DIFFERENTIAL DIAGNOSIS What is your Differential Diagnosis? Intrauterine pregnancy - Ectopic pregnancy - Lithopedion

Diagnosis: Intrauterine pregnancy Dx Confirmed by: Radiograph and Pregnancy test

DISCUSSION Patient denied she could be pregnant prior to radiograph of hip. Patient was given option to have a urine dipstick pregnancy test and she declined and signed a waiver stating said fact. Following exposure of the fetus, the patient was given official dosage report/evaluation by the departmental physicist. The fetus/uterus absorbed a dose of 1.7 mGy/170 mrad for an effective dose of 1.1 mSv/110 mrem. - - Exposure in utero from diagnostic xray are lower than 50 mGy/5 rad and have not been demonstrated to produce any significant impact on fetal growth and development Bushberg JT, Seibert JA, Leidholdt Jr. EM, Boone JM. The Essential Physics of Medical Imaging. Second Eddition. Lippincott Williams and Wilkins. Table 24.3, pages , :2002.