Consider the Probe - Traumatic Lens Dislocation Identified on Ocular Ultrasound

March 28, 2023

The Case:

The patient is a 61-year-old male with non-insulin dependent diabetes, hypertension, coronary artery disease status post CABG in 2019 who presented with blurry vision of the left eye after being hit on the face with a blunt object by his roommate approximately ten days prior to presentation. The patient reports that over the past year his roommate had been abusing him physically. Ten days prior to presentation, the patient was hit in the face with an unknown blunt object, causing him to lose consciousness for an unknown period. He awoke with left eye swelling and blurry vision in the left eye which he has had since. He denies headache, dizziness, eye pain, tearing or discharge, foreign body sensation, or double vision.

Jordyn Cohen, MD

Image 1: X-ray AP and and lateral thumb views

Ortho Pearls -High Pressure Injection Injury

March 20, 2023

The Case:

A 42-year-old right hand dominant male with no known past medical history presents with pain in his right thumb. He works as a painter and was using an industrial paint sprayer when he injected a water-based paint into his right distal thumb pad. He states he had significant pain initially, but it quickly settled to a dull throbbing. He waited five days from the injury to visit his primary care doctor who instructed him to come directly to the ED. His vital signs are within normal limits. There is a small punctate wound on the volar surface of the distal right thumb that is mildly tender to palpation without surrounding erythema, swelling, or drainage. There is no tenderness more proximally. Compartments of the hand and forearm are soft and compressible. The digit is neurovascularly intact excluding an area of decreased sensation at the tip of the thumb. X-ray of the right hand and thumb are shown below.

Adam Roussas, MD

Ortho Pearls - Metacarpal Fracture Management

June 2, 2022

The Case:

A 40-year-old male with no past medical history presented to the emergency department after he was assaulted with closed fists just prior to arrival. The patient’s injuries included a blow to the back of his right hand. On exam he was found to have swelling and tenderness to the dorsal aspect of his right hand. He had brisk capillary refill and normal sensation to light touch in all fingers. There was no malrotation of fingers with a closed fist.

Matthew Hughes, MD

the County Consult