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This elderly patient had fallen and was struggling to bear weight. What acute sign can you see on this Xray? And what does it mean? 
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Zika Virus (ZIKV) has recently featured in the news as it is associated with microcephaly in some children when the mother contracted the virus during pregnancy. Originating in Africa it has now spread through central and southern America. It's mosquito borne, although there is one case of sexual transmission recorded. It is only relevant within 2 weeks of travel (symptoms usually develop in 3-12 days). The detailed PHE information is here.
Typical symptoms include: A low-grade fever, joint pain (with possible swelling mainly in the smaller joints of the hands and feet), rash (sometimes itchy), conjunctivitis/red eyes, headache, muscle pain and eye pain. Main areas of transmission are: Central and Southern America (above Argentina and Chile) up to and including Mexico. Full list is here. Management of pregnant patients who may have ZIKV are here. The key things is that possible cases DO NOT need to be isolated (although being pregnant you may want to put them in a side room anyway) Any questions, ask Simon. A middle aged patient presents with increasing back pain. It had started fairly recently and they had been sent for an X-Ray a few days before. Now it is worsening.  The report states that they have a wedge fracture, and asks if there has been a history of trauma. A medical student asked whether the patient had any red flags? Can you name them all? The Physio then mentioned Yellow flags. I looked blank at this point.
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