A hypothetical 7 month-old infant presents to the emergency department for mild respiratory distress. There is no recent illness or symptoms to explain the infant’s tachypnea and mild hypoxia. There is no visible bruising on exam. The parent states that the infant is starting to pull to stand but does not yet cruise. They have had several falls onto their tile kitchen floor. The CXR (below) is read by the radiologist left posterior rib fractures in ribs 4-8…
Read MoreA 19 year-old male presents to the emergency department with a complaint of right shoulder pain. He was tackled from behind in a rugby game three days prior to presentation and has been experiencing pain over the anterior aspect of his right shoulder since that time. Physical exam is notable for tenderness over the right acromioclavicular (AC) joint and pain with both active and passive range of motion of the right shoulder. X-rays (Figure 1) show “no obvious fracture or subluxation.” However, based on your exam and clinical suspicion, closer inspection reveals abnormal alignment between the clavicle and the acromion consistent with AC joint injury…
Read MoreThe patient is a 11 y.o. male with no past medical history who presents as trauma activation after MVC. Patient was the restrained front seat passenger in a head on collision. Denies LOC. Per EMS, patient was found in police cruiser on arrival, patient states he walked at scene. +Seatbelt sign. Vitals stable. Patient states his pain is worst in his neck, rates pain 6/10. Denies numbness/tingling…
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