Runner, 37, nearly DIED after rupturing his oesophagus
The man, who has not been named, felt intense pain after vomiting during the race in California. X-rays revealed Boerhaave's syndrome, which has a high mortality rate, mostly due to sepsis (stock)
ConclusionsIn this qualitative metasynthesis, reasons patients visit the ED over primary care included (1) urgency of the medical condition, (2) barriers to accessing primary care, (3) advantages of the ED, and (4) fulfillment of medical needs and quality of care in the ED.
This study reported a case of an 80-year-old man with a left total knee arthroplasty (TKA) performed eight years before his presentation. He presented with left knee swelling and pain for one month. Knee X-rays showed a normal joint space with no loosening of his prosthesis. His chest X-ray showed miliary disease, and microbiological studies of his sputum and synovial fluid aspirate grew Mycobacteria tuberculosis complex.
ConclusionsThis is the first case description of association of multisegmental lumbar transverse process fractures with notoriously unstable injuries of the major soft-tissue stabilizers of the spine presenting subtle changes on CT images. When a seemingly benign spinal injury is caused by high-energy trauma, careful scrutiny for associated instability is needed. In this case, the standing in-brace X-ray was able to avoid a misdiagnosis and potentially unfavourable outcome.
This article originally appeared on Medium here.
The purpose of this study was to investigate the clinical outcomes of nonsurgically treated proximal humerus fractures that would have been otherwise treated surgically had it not been for reasons precluding surgical treatment. A retrospective search for patients treated nonsurgically for a proximal humerus fracture was performed. Injury x-rays of all patients were reviewed independently by 3 orthopedic surgeons. Patients for whom at least 2 surgeons recommended surgical treatment were included. Of 96 eligible patients, 22 patients completed the data collection. There were six 2-part, seven 3-part, five 4-part fractures, a...
ConclusionLimy bile is a rare clinical entity of unknown etiology but obstruction of the cystic duct may be the most important step in its occurrence. The condition needs cholecystectomy as in most of the cases it is associated with gall stones. There are no reported long term sequelae and long term follows up is not recommended.
Conclusions Using this simple and reliable technique, we obtained 91% union and very good functional results. Metaphyseal core decompression of the distal radius associated with an antegrade scaphoid screw is a reasonable and effective option for the treatment of proximal pole scaphoid nonunions without avascular necrosis in carefully selected patients. Level of Evidence This is Level IV study. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents | Abstract | Full text
CONCLUSIONS: Differential diagnosis of sciatica of extraspinal origin must rule out sacroiliac and hip joint so as deep gluteal space structures. Among these, quadratus femoris muscle is often overlooked as a pain-generator. Ultrasonography-guided intramuscular injections and a program of stretching and strengthening exercises can achieve durable control on the symptoms. PMID: 31282403 [PubMed - as supplied by publisher]
We present a 2-year-old boy with bilateral foot pain that worsened over 6 months. X-rays of the feet showed no obvious abnormalities. Magnetic resonance imaging revealed abnormal bone marrow consistent with an infiltrative process. The patient was found to have precursor B-cell acute lymphoblastic leukemia. Cases such as these highlight the possible future use of magnetic resonance imaging in the early diagnostic workup for bone and muscle pain. PMID: 31384202 [PubMed]
Authors: Rodriguez RM, Ernat JJ Abstract Ultrasonography is a commonly utilized tool in orthopedic surgery for the diagnosis and treatment of a variety of musculoskeletal conditions, including pathology about the wrist. Its value should not be underestimated when other diagnostic resources are unavailable - such as in a combat setting where ultrasounds, but not X-ray, are a standard equipment item. An active duty soldier presented to an orthopedic provider in an austere environment with chronic dorsal wrist pain due to a previous fall. Physical examination and dynamic ultrasound examination allowed the deployed pro...