The case A preschooler was riding his big sister's "girl" bike, crashed it and landed on his outstretched hand. A true FOOSH if you will (fell on outstretched hand). His mom brought him to the ED because he was having trouble holding his iPad with the injured arm. An X-Ray is obtained. The Diagnosis This is a buckle or torus [...]
Did you know that there is a regular feature on PEMBlog called Fracture Fridays? Did you know that these posts are about fractures, and that they are released on Fridays? OK, so that last question was a bit pandering, of course you did. Well then, why don't you check out a few of my favorite posts from the past couple [...]
The Case An athlete presents to the ED with an injured pinky finger. He says that he struck it on a teammate during practice and "it bent back." The pinky finger is abducted and jutting out at an extreme angle. It is making dad nauseous. The XRay shows the following: Diagnosis This is a Salter-Harris II fracture of the proximal [...]
I know that performing an accurate and efficient joint exam in the ED can be challenging. Reviewing an ideal example in a "just in time" fashion can be a wonderful way to prepare for an upcoming patient. With that in mind I wanted to direct you to an excellent online resource from the Heart of England Foundation Trust’s Emergency Department. [...]
The case(s) You are seeing a pair of siblings that crashed into each other while jousting on their bikes. They were wearing helmets but both sustained forearm injuries. Both have swollen, tender forearms and you get X-Rays. And, no, there is not a BOGO discount. The Diagnosis Both patients have forearm fractures. Patient A has a buckle, or torus fracture. This [...]
Check out this video that I made that reviews basic splinting technique. This can be applied to any number of splints.
This edition of PEMCurrents takes a crack at clavicle fractures. The old dictum about broken collarbones states that if both ends of the bone are in the same room it'll heal fine. For the most part this is true - at least in prepubescent patients. New literature in adults has suggested that outcomes are better for athletes when patients with [...]
The Case After successfully reducing the shoulder of a young athlete - his fourth, your first. He says the the last 2 times he dislocated it was reduced by his team trainer on the sidelines. You obtain XRays and note the following. Courtesy of Wikipedia The Diagnosis This is a Bankart lesion. Note the abnormality in the inferior [...]
You may have noticed that many editions of PEM Currents align themselves closely with posts on the blog. This is by design! I want to make sure that I share the content in as many formats as possible in order to reach the widest audience. It goes without saying that recognizing osteomyelitis can be challenging. Treating it doesn’t have to be [...]
Here are the links for the entire five-part series on osteomyelitis. PART 01 / ETIOLOGY PART 02 / HISTORY + PHYSICAL EXAM PART 03 / LABS PART 04 / IMAGING PART 05 / TREATMENT
