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

2. MedPix No: 10207 - 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)

3. MedPix No: 10207 - EXAM & LABS None performed.

4. 18-week fetus Radiograph of the pelvis demonstrates the skeletal outline of an intrauterine pregnancy. Downloaded by (-1)

5. 18-week fetus Radiograph of the pelvis demonstrates the skeletal outline of an intrauterine pregnancy. Downloaded by (-1)

6. 18-week fetus Radiograph of the pelvis demonstrates the skeletal outline of an intrauterine pregnancy. Downloaded by (-1)

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

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

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

10. 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 795-841,853- 861:2002.