manta ray sign | Figure 1

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Superior inferior left pubic ramus fracture after being thrown from a horse.](https://app.figure1.com/case-detail/00ba5c49-5fc4-4942-936e-53b704da87ec)

What you are seeing is a pelvic fracture opened up like a butterfly. Pt bleed almost 2L before showing real signs of instability. Massive transfusion protocol commenced along with a pelvic binder](https://app.figure1.com/case-detail/0c6d9d74-727b-4f1a-973f-7f011ee60444)

Hardware from previous case.](https://app.figure1.com/case-detail/2aac1997-ba63-47a8-8a13-03635a3aae37)

This is what happens when a horse falls on top of you. 24 yr old falls off while riding his horse only to have the horse land on top of him. Vitals were stable, but a pelvic binder was applied before patient went to surgery. Thankfully no bleeding was involved within the pelvic region.](https://app.figure1.com/case-detail/71326b00-0e28-4faf-9a2f-69f85a7ca0a4)

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A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.](https://app.figure1.com/case-detail/ae0fe999-6875-4474-94f0-ad823dbb9b3a)

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.](https://app.figure1.com/case-detail/c271070f-2bc7-4052-9895-635277e1a7d5)

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.](https://app.figure1.com/case-detail/48f41642-b9db-4089-b120-a94ee52328de)

Patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?](https://app.figure1.com/case-detail/2af390e1-ace8-40ed-ba1c-98fb2d72f4c5)