SplintER Series: Pain in the Palm

Hook of Hamate Fracture on Carpal Tunnel view

A 17 year-old left hand dominant high school baseball player presents with severe, sharp pain in his right hand at the hypothenar eminence with associated numbness and tingling of his 4th and 5th digits. The pain and tingling began after he swung his bat and hit a ground ball. You obtain x-rays and see an abnormality. What is the most likely diagnosis, differential diagnosis, and management plan?

(more…)

ALiEM AIR | Orthopedics Lower Extremity 2019 Module

Welcome to the AIR Orthopedics Lower Extremity Module! After carefully reviewing all relevant posts from the top 50 sites of the Social Media Index, the ALiEM AIR Team is proud to present the highest quality online content related to orthopedic lower extremity emergencies. 5 blog posts within the past 12 months (as of July 2019) met our standard of online excellence and were curated and approved for residency training by the AIR Series Board. We identified 1 AIR and 4 Honorable Mentions. We recommend programs give 2.5 hours (about 30 minutes per article) of III credit for this module.

(more…)

SplintER Series: A Case of Knee Pain

segond fracture xray

A 45-year-old male presents with right knee pain after he pivoted and felt a “pop” while making a move playing pickup basketball. You obtain knee x-rays and see a lateral irregularity in the AP view (photo courtesy of Dr. Gerry Gardner at Radiopaedia.org).

What is the most likely diagnosis, commonly associated injury, and appropriate management plan?

(more…)

SAEM Clinical Image Series: Left Shoulder Pain

Left shoulder pain

[Click for larger view]

Chief complaint: Arm pain

History of Present Illness: A 30-year-old obese male presents to the ED after a ground level fall onto his left arm with immediate isolated left shoulder pain. He did not lose consciousness and denies dyspnea, numbness, weakness, vomiting, and chest pain.

(more…)

2019-09-23T09:58:20-07:00

EMRad: Can’t Miss Elbow Injuries

lateral elbow fat pads

Have you ever been working a shift at 3 am and wondered, “Am I missing something? I’ll just splint and instruct the patient to follow up with their PCP in 1 week.” This is a reasonable approach, especially if you’re concerned there could be a fracture. But we can do better. Enter the “Can’t Miss” series: a series organized by body part that will help identify injuries that ideally should not be missed. This list is not meant to be comprehensive review of each body part, but rather to highlight and improve your sensitivity for these potentially catastrophic injuries. To begin: “Can’t Miss” adult elbow injuries.

(more…)
2019-09-13T09:18:01-07:00

EMRad: Radiologic Approach to the Traumatic Elbow

 elbow lateral xray normal

Radiology teaching during medical school is variable, ranging from informal teaching to required clerkships.​1​ Many of us likely received an approach to a chest x-ray, but approaches to other studies may or may not have not been taught. We can do better! Enter EMRad, a series aimed at providing approaches and improving interpretation of commonly ordered radiology studies in the emergency department. When applicable, it will provide pertinent measurements specific to management, and offer a framework for when to get an additional view, if appropriate. To begin: the elbow. 

(more…)
2019-09-13T09:28:50-07:00