Loran Hatch, DO

What's the Diagnosis? By Dr. Loran Hatch

A 35 yo M presents to the ED complaining of R hand pain after punching a wall in an upward motion. He denies any numbness or paresthesias. On exam, he has an obvious deformity of the dorsum of the R hand, but is neurovascularly intact. Xray is shown below.  What's the diagnosis?  (scroll down for answer)

 

 

Answer: Carpo-metacarpal dislocation (4th and 5th in this case)

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An Interesting Case of Ingestion by Dr. Loran Hatch

A 20 year-old female presents with an intentional overdose. Her mother reports that 30 tablets of Meloxicam 15mg missing. Patient alert and she complaints of generalized abdominal pain and nausea. Vitals are initially stable, but then she becomes hypotensive 50s/20s while she is alert. Her ECG is NSR and wide QRS (146ms) and prolong QTc (762ms). The patient eventually admits to also taking her mother’s Plaquenil.
 
 
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