Let's move onto the final part in the osteo series - treatment. Editors note: small corrections were made on 3-14-14 with the addition of information of ortho consultation and the delay of antibiotics and changing cephalexin to cefazolin. Thanks to Dr. Indi Trehan for alerting me to the errata. Choosing the right antibiotic If you think its osteo, then start [...]
By now you've likely seen parts one, two and three. Moving in a logical direction part four will focus on imaging, As you'd imagine, radiographic studies are supremely important in the diagnosis of osteo. Let's take a look by modality shall we? Plain films The bottom line is that it can take up to 2-3 weeks for the typical osteo [...]
If you've been following along with parts 1 and 2, then part 3 is the next logical step- because, um, counting? Let's look at laboratory studies in osteo. It may come as no surprise that the initial labs that end up being most helpful are CRP, ESR and blood culture. Pääkkönen et al noted that both ESR and CRP were highly sensitive at [...]
Welcome back to the Osteo series - Whereas part one focused mainly on etiology, part 2 delves into making the diagnosis with a good history and physical. I should really say that your history and physical helps increase your index of suspicion - since osteo can be quite elusive especially in the early stages. Harkening back to part one, it [...]
Thus begins the PEMBlog series on Osteomyelitis. In each edition I'll tackle a different question - ranging from diagnosis to therapy and hopefully review most of the finer points. There is no better place to begin than at the start. Osteo as it will now be known (because I don't feel like typing the myelitis part) is a bacterial infection [...]
People punch things. Sometimes they break their hands. This post is about those people.
The Case An 18 year old football player presents to the ED 2 days after a thumb injury. He says he hyperextended it while trying to make a tackle. He saw his PMD the next day, and despite pain in his thumb, the X-Rays were read as negative by his PMD. He was cleared to return to play, but had [...]
Ted Brenkert loves the sound of his own voice - that's why he keeps recording excellent educational podcasts over at PEM Currents. The latest episode focuses on fractures of the form, one of the most common orthopedic injuries seen in the pediatric emergency department. You can check it out on iTunes via the link below, or stream it magically over [...]
I recently had a discussion with a group of colleagues after we saw our third nursemaid's of the night. They wanted to know whether or not I thought that one maneuver was better than the other. I explained that I had been taught flexion supination, but changed my ways after reading the following article. And yes, I realize that it [...]
Seriously, I can never manage to remember the differences between Monteggia and Galeazzi fractures - especially when it shows up on standardized tests. So, this edition of Fracture Fridays focuses on differentiating the two. Essentially, when one forearm bone breaks and is displaced, angulated and foreshortened something happens to the other one - usually a fracture - but sometimes a [...]
