Case of the month #2 (no narration)

What's the diagnosis?
See the answer at: kzbin.info/www/bejne/eYjYiYpmocmlY9U
By Matthew Lipton, MD, FACEP.
Board certified EM physician, advanced EM US fellowship trained, CCEeXAM testamur, and POCUS enthusiast.
Credit to @RyanWalshmd for acquiring most of these images.