What's the Diagnosis? By Dr. Sandhya Ashokkumar
A 68 yo F presents to the ED s/p fall.
A 68 yo F presents to the ED s/p fall.
Back pain. A chief complaint generally not considered among the top 5 most thrilling for EM docs. Hiding among a sea of benign musculoskeletal conditions, however, lurk a handful of diagnoses which will result in irreversible paralysis and severe loss of function for our patients. The trick, of course, is figuring out who needs expensive advanced imaging and who can go home with NSAIDS....read on for a case that definitely falls into the former category....
General:
A 55 yo male presents with left knee pain
LVADs (Left Ventricular Assist Device) are
EM physicians see patients with headaches every day in the ED. The vast majority have a simple primary headache, but a tiny fraction of patients will have a much more serious etiology that might result in death, blindeness, or crippling neurologic complications if not promptly diagnosed. The trick, of course, is picking up on the serious causes of headaches...
History: A 64-year-old woman presents to the ED via EMS after a witnessed seizure lasting less than 1 minute. The patient appeared post-ictal for EMS but is currently alert and oriented. She does not recall what happened.
A 40 yo female presents with knee pain
The overwhelming majority of patients with back pain have a benign etiology and require nothing more than pain control and time to recover fully. A good emergency medicine physician, however, should always keep in mind the "can't miss" diagnoses and take a careful history focusing on "red flag" symptoms and risk factors. Failure to make the diagnosis in our patient today would result in irreversable paraparesis, incontinence, and impotence. Read on to see why!
A 5 yo with a hx of sickle cell disease presents with diffuse pain.
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