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23 year old male presents with a painful foot following an inversion injury. NAD on ankle examination. Tender cuboid and base of 5th MT. This is what the XR shows. What do you think? 
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As a change from the usual teaching, I thought I'd raise the subject of astronomy. Bear with me, all will become clear.  Which one allows you to navigate north? Why do you need to know for safe medical practice in the ED? Read on...
A lady in her late 70's attends the ED with generalised abdominal pain, worse centrally, all day. She is obese and has multiple co-morbidities - including a history of constipation, hypertension, Type 2 diabetes and two NSTEMI. She has an abdo XR performed at the request of the surgical team and is later discharged with a diagnosis of constipation, after the pain improved with analgesia. What does the XRay show?  Hand or foot are often underestimated. After all, there's not much there; so as long as there's no fracture we can just clean and close, no? Consider a case where a man drops a heavy ceramic item onto his foot and sustains a laceration. Not unlike this one: 
And this is his X-ray. What must we consider before we close, and what actions do we take? 
Here is a primary survey X-ray done on a patient in their early teens. Request form states; “pedestrian vs car.”
What do you think? |
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