SplintER Series: Point Tender

 
A 42-year-old female presents to the emergency department with complaints of worsening finger pain. She reports the pain started 2 days ago with redness at the tip of the finger. Over the past 24 hours, her redness has spread and the finger has become more painful. On arrival, she is afebrile and hemodynamically stable. She has the below exam findings with tenderness along the volar aspect of the finger and pain with passive extension (Figure 1). What is your suspected diagnosis? What is your initial workup? What is your management and disposition?
 

Figure 1: Image obtained from WikEM

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SplintER Series: Between a Rock and a Hard Place

 

A 17-year-old male basketball player presents with right lateral thigh pain for the past 3 weeks. He had a collision with another player 5 weeks ago that resulted in a bruise that has since resolved. He is mildly tender over the lateral mid-thigh in the soft tissues and has a decreased knee flexion. You obtain X-rays (Figure 1). What is your suspected diagnosis? What is your initial workup in the ED? What imaging confirms the diagnosis? What is your management and disposition?
 
AP and lateral x-rays of the knee showing myositis ossificans

Figure 1: AP and lateral radiographs of the right femur

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SplintER Series: Do You Even Lift?

Pectoralis major tendon tear

 

A 35-year-old male presents after injuring his left shoulder while weight lifting two days ago. He describes sudden-onset pain with associated “pop” in his left anterior/medial shoulder and chest as he was bench pressing. On exam, he has ecchymosis over the medial aspect of his humeral shaft and left chest. He has decreased strength with resisted internal rotation of the shoulder. An MRI is obtained and shown above (Image 1: Case courtesy of Dr. Tim Luijkx, Radiopaedia.org, rID: 36975)

 

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SplintER Series: I Declare a Thumb War

Gamekeeper's Thumb

 

A 39-year-old female presents to the emergency department with right thumb pain after falling in a skiing accident. On exam, there is mild swelling and tenderness on the ulnar aspect of the 1st MCP joint. Additionally, there is laxity with valgus stressing of the 1st MCP joint. An x-ray is obtained and shown above (Image 1. Provided by Alex Tomesch, MD).

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SplintER Series: Don’t Go Breaking My Heart

A 45-year-old man presents to the emergency department with chest pain after a high-speed motor vehicle accident where his sternum hit the steering wheel. You notice an area of ecchymosis noted over his sternum, so you decide to get a CT scan (Figure 1).

Figure 1. Case courtesy of Dr Henry Knipe, Radiopaedia.org, rID: 26332

 

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