The Case:
A 15-year-old presented with right index finger pain. He states he was catching a football and it hit the tip of his right index finger and forcibly flexed it causing pain at his DIP joint. He was initially seen in triage and right hand radiographs were obtained and read by the radiology resident as negative (Figure 1). On examination, the patient had tenderness over the dorsal aspect of the DIP joint with weak extension. Based on the exam and suspicion of a fracture seen on the hand radiographs, the patient was sent back to get dedicated radiographs of the involved digit (Figure 2). Soon after, the radiologist called to report an intra-articular Mallet fracture. The patient’s DIP joint was splinted in extension and sent for orthopedic follow-up.
Scott Sherman, MD
Read MoreThe Case:
25 year old man with no past medical history presents to the ED with acute left shoulder pain. He was playing soccer, jumped up for a header, and fell onto his left side 1 hour ago. On exam, his left upper extremity is adducted, internally rotated, and flexed at the elbow. He is neurovascularly intact, and range of motion is significantly limited secondary to pain. He otherwise has no obvious humerus deformity and no pain with palpation of humerus, elbow, forearm or wrist. You suspect a shoulder dislocation. Radiology is called to conduct bedside x-ray prior to reduction. However, they are busy in trauma with a multi-victim motor vehicle accident and say it may take up to 1 hour to obtain x-rays given they are short staffed today. So, you reach for your ultrasound…
Ramin Chitsaz, MD
Read MoreThe 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
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