SplintER Series: Patellar Tendon Rupture

A 46-year-old female with a history of diabetes and morbid obesity presents to the emergency department (ED) with difficulty walking after she tripped on a curb and fell onto her right knee. You obtain X-rays (Figure 1). What is your suspected diagnosis? What is your initial workup in the ED? What is your management and disposition?

Figure 1. AP/lateral x-ray of the right knee. Author’s own images.

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SplintER Series: Don’t forget about the (tibial) spine!

A 13-year-old patient presents to the Emergency Department after sustaining a twisting knee injury while playing soccer. There was a pop, and the patient was subsequently unable to bear weight due to pain and knee instability. The swelling and pain increased in the hours after the injury occurred. On examination, there is a large knee effusion and a positive Lachman test. You obtain imaging (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?
 

Figure 1: AP and lateral radiographs of the left knee. Case courtesy Dr. Jeremy Jones, Radiopaedia.org, rID: 27372

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SplintER Series: Hip, Hip, Hooray!

 
A 67-year-old male with a history of bilateral total hip arthroplasties (THA) several years ago presents with left hip pain after a fall. He was walking downstairs and slipped, twisting his leg internally and with adduction and flexion of the hip to catch himself. He denies falling but felt an immediate pop in his left hip and could no longer bear weight. AP and lateral radiographs of the pelvis and left hip were obtained and are shown above (Image 1. Case courtesy of Dr Andrew Taylor, Radiopaedia.org, rID: 67457).   (more…)

SplintER Series: The Hidden Post

posterior malleolar fracture

A 23-year-old male presents to the emergency department with right ankle pain after he rolled his ankle while walking down the stairs. An ankle exam reveals ecchymosis over the posterior ankle and tenderness of the distal tibia. His neurovascular exam is intact. The radiograph above was obtained (Image 1. X-ray right ankle. Original image provided by Justine Ko, MD).

 

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SplintER: Pop, Lock & Drop It

Shoulder

A 38-year-old female presents to the ED with right shoulder pain after a fall directly onto that shoulder. She noticed immediate pain and difficulty moving the arm associated with mild tingling in her right fingers. The radiographs above were obtained in the ED (Image 1. AP and lateral radiographs of the right shoulder, author’s own images).

 

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SplintER Series: Let the Feet Drop

A 20-year-old male distance runner who was jogging and happened to be running past the emergency department presented with severe bilateral leg pain, foot pain, and foot numbness that had resolved by the time he was evaluated in the ED. The x-ray above was obtained (Image 1. X-ray of the leg. Case courtesy of Andrew Murphy, Radiopaedia.org, rID: 41408).

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