SAEM Clinical Image Series: Hip Pain

hip pain anterior inferior iliac spine fracture

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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.

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SplintER Series: Ankle and Foot Pain in a Child

iselin disease xray

A 10-year-old female dancer presents with sub-acute onset pain located in her lateral ankle and foot without any history of significant trauma. She has had similar pain occasionally over the past 6 months. Pain is worse while dancing and now has difficulty putting on her shoe. You obtain a foot x-ray and see the adjacent image (photo credit).

What is the most likely diagnosis, differential diagnosis, and appropriate management plan?

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SplintER Series: Funny Looking Finger

right 5th digit xray mallet finger

Figure 1: Terminal extensor tendon avulsion at distal interphalangeal joint of 5th digit

A 17-year-old baseball player presents complaining of finger pain and difficulty straightening his finger after a baseball game. You obtain x-rays and see the following fracture (photo credit).

What is your diagnosis and emergency department management?

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Fascia iliaca nerve block: A hip fracture best-practice

fascia iliaca nerve block hip fracture

An 82-year-old woman presents with left hip pain after a mechanical fall while cleaning the kitchen floor. When EMS arrived, the left leg was foreshortened and externally rotated. The paramedics administered 10 mg of IV morphine, but she is still writhing in pain on arrival. The AP pelvic x-ray demonstrates a left femoral neck fracture (arrow). You consider performing a fascia iliaca nerve block for better pain control.

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By |2020-11-27T19:04:06-08:00Aug 21, 2019|Orthopedic, Ultrasound|

SplintER Series: Ankle Dislocation | Leg Day #4

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. 

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SplintER Series: A Case of Traumatic Wrist Pain After Fall on Outstretched Hand

lunate dislocation xray

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?

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