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…)
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?
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.
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…)
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…)
Chief complaint: Left hip pain
History of Present Illness: A healthy right leg-dominant 13-year-old male athlete presents with left hip pain after kicking a soccer ball.
He states that he kicked the ball awkwardly and experienced hip pain immediately afterwards. He did not feel a pop or cracking sensation but could not stand after the kick and fell to the ground. He can ambulate but only with significant pain.
He now has 8/10 sharp, non-radiating left hip pain that is worse with movement, weight-bearing and palpation.