Welcome to Leg Day #4 of the SplintER Series! Ankle dislocations are an emergent condition in the Emergency Department (ED) that requires expert-level examination and management. We review the pertinent and subtle sports medicine examination and management techniques that will help you feel in control from time of presentation to disposition.
(more…)
A 46 year-old male presents with wrist pain after sustaining a mechanical fall and catching himself on his outstretched hand. An anteroposterior (left) and lateral (right) plain films of the wrist are obtained (photo credit).
What is the diagnosis (hint – there are 2 findings), injury classification system, associated findings, and the recommended management plan?
A 45 year old woman presents with several days of gradually worsening right shoulder pain and stiffness. Her shoulder is very warm to the touch but not erythematous. You obtain shoulder x-rays and see a linear density in the AP view (photo credit).
What is the most likely diagnosis, the differential diagnosis, and management plan?
A 22 year-old male was playing football when he fell, landing on his outstretched left arm with his thumb flexed. He now has pain at the base of his thumb. This AP view of the hand best demonstrates the injury (photo credit).
What is this fracture, what additional imaging is needed, and what should be the management plan?
Welcome to Leg Day #3 of the SplintER Series! Performing a fast and focused history and physical examination of a patient with an acute knee injury is an important skill that has the potential to be overlooked in our busy Emergency Departments. Our hope is that after reviewing this post and with enough practice you will be able to complete your exam within 2 minutes! These are can’t-miss points and expert tips on the knee exam for your next shift in the ED.
Read more
Welcome to Leg Day #2 of the SplintER Series. Following up with the Leg Day #1’s primer on tibial plateau fractures, another key orthopedic injury of the leg is hip dislocation. A hip dislocation occurs when there is separation of the head of the femur from the acetabulum of the pelvis in either an anterior or posterior direction.1
A 70-year-old female with no past medical history was hit by a motor vehicle while crossing the street. She experienced no head strike or loss of consciousness, however she was unable to ambulate at the scene, and upon arrival to the ED, complained of left knee pain. The emergency physician noted moderate swelling on exam with intact skin and distal pulses. She was tender to palpation over the proximal tibia. Portable 2-view radiographs were obtained and interpreted as “no acute fracture.” On repeat examination, however, the patient continued to have pain and was now unable to bear weight on the affected extremity. Is there a role for point-of-care ultrasound (POCUS) in this situation?