Independently interpreting plain film imaging is an essential skill for the Emergency Medicine provider. Among the most notorious of injuries likely to be missed is the Maisonneuve fracture. In this post we demonstrate the "can't miss" imaging findings to ensure that you don't make the mistake of thinking this is "just an ankle sprain!"
A 24 year old male presents to your emergency department with severe hand pain after a fall while snowboarding. The patient states that he fell onto an outstretched left hand. On exam the patient has dorsal radial wrist tenderness with decreased range of motion. His XRAY is below. What is the diagnosis?
A 63 yo male presents complaining of severe pain to the right shoulder. He has markedly restricted range of motion in the shoulder, without any overlying erythema, edema, or warmth. You take a cursory glance at the xray as you gather supplies to perform an arthrocentesis for suspected septic arthritis...
Check out this lateral film of the wrist. See the fracture? Look again! Surprise...there is no fracture, but this patient has sustained a serious wrist injury with the potential for long term disability. This week we highlight some of the most common missed orthopedic injuries in the ED and suggest a few strategies to minimize the errors.
Acute compartment syndrome is a surgical emergency. Measurements of compartment pressures are an important adjunct to making the diagnosis. Check out this post for a video demonstration on how to operate the Stryker Device
A 12 year old female is tackled in a soccer game. She arrives with her knee in flexion and her patella laterally displaced. She is neurovascularly intact. Skin is intact. She cannot extend the knee. What is the diagnosis?
A. Patella Dislocation
B. Knee Dislocation
C. Quad Tendon Rupture
D. Patella Tendon Rupture
Answer is A - Patella Dislocation