A patient presents with acute onset of right ankle pain afte…
A patient presents with acute onset of right ankle pain after slipping off the edge of the curb when mowing his lawn. He says his foot turned inward as he fell. His ankle is swollen, and the patient is limping but can tolerate partial weight bearing. What will be the most likely area of tenderness when you palpate the foot?
Read DetailsA 23-year-old female is brought to your ER via EMS following…
A 23-year-old female is brought to your ER via EMS following a MVA in which she was the unrestrained driver of a car which hit a concrete barrier. She is secured on a long spine board with a c-collar in place. She C/O pain to the right forearm, which has obvious angulation midshaft but no open wounds. She also C/O pain to the left hip and knee. On PE you note the left leg to be approx. 1.5 inches shorter than the right. The leg is held slightly flexed at the hip and knee and internally rotated. You note decreased sensation in the S1 dermatome with decreased Achilles tendon reflex. What is the presumed diagnosis at this point regarding the hip?
Read DetailsA 42 year old woman who works as a cashier at Walmart, prese…
A 42 year old woman who works as a cashier at Walmart, presents with low back pain for the past month. There is no history of trauma. She says the pain averages about 6 out of 10 but is relieved on her days off and worse when she works. It feels like a band of pain across her lower back that radiates down into both her thighs. Her toes feel “strange” and almost numb. She has no history of drug or alcohol abuse or of serious systemic illness, but does report loosing ten pounds without dieting this last month. She denies loss of bowel or bladder control. On physical exam you find her to be stiff, with limited range of motion of the spine. Inspection is normal. Palpation of the spine reveals tenderness around the L4 and L5 vertebrae. There is no motor weakness, sensory is symmetric and equal, gait is guarded and slow but balanced, and deep tendon reflexes are diminished (1+) but symmetric. After taking the history and doing the physical exam which feature is a “red flag” and should be most concerning to you?
Read DetailsA 72-year-old female is brought to your ER via ambulance fol…
A 72-year-old female is brought to your ER via ambulance following a slip and fall on ice. She is C/O pain to the right hip. PE shows the right leg to be approx. 1 inch shorter than the left and is held externally rotated and slightly abducted. Treatment for this patient should be:
Read DetailsYou have your patient lie supine on the exam table and place…
You have your patient lie supine on the exam table and place her right foot across her left knee. While stabilizing the pelvis on the left ASIS you press down on the right knee. What test are you performing and what would a positive test indicate?
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