The case:
40-year-old man presented to the Emergency Department with a laceration after an iron bed frame fell on his knee 1 day prior. On exam, the patient had a horizontal 4-5 cm laceration on the anterior-medial aspect of his right knee with significant swelling and erythema around the joint. The wound appeared dirty, with purulent, foul smelling discharge and the knee was warm to palpation. Range of motion was limited due to pain. Radiographs were negative. Considering the overlying laceration and evidence of septic arthritis, antibiotics were administered, a CT was ordered, and the Orthopedics service was consulted. CT demonstrated no air within the joint, but the patient was taken the operating room for surgical I&D of his knee. Traumatic arthrotomy was confirmed intraoperatively.
Read MoreCase vignette: A 24yo M with no past medical history presents with a "boil" on his lower back that he noticed a couple days ago. The boil has been slowly increasing in size and becoming more tender. He denies fever, chills, nausea, vomiting, or history of previous abscesses. On exam there is a 3cm cutaneous abscess with confirmed fluid pocket on ultrasound, and there is minimal surrounding erythema or induration. You decide to incise and drain (I&D) the abscess, including probing to break up loculations and manual decompression, but you are not sure whether you need to irrigate the cavity.
Read MoreA 41 year-old man presents to the ED with right wrist pain after flipping off of his bicycle. On examination, there is obvious deformity and edema of the right wrist with significant tenderness to palpation of wrist. Radiographs are obtained.
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