Pelvic Xrays are a key component of trauma, fractures and dislocations seen every day in the ED, but when is the last time you went back over the anatomy and radiographic tips and tricks of the pelvic radiograph? Join Dr. Mand's thorough break down of this commonly used ED diagnostic - the Pelvic XR.Read More
In March 2015, Dr. Renne did a Grand Rounds lecture on soft tissue neck radiographs, which offers a great review of normal anatomy and systematic approach to reading films (“CHESS”). Yet, in my small, informal (not scientific at all) poll of some of our residents, none had ever ordered a soft tissue neck film. Are soft tissue neck radiographs useful? You be the judge.Read More
Ever have a patient present with foot or ankle pain? In case you have, here is a refresher on the radiographic anatomy of the foot as well as the test characteristics and viability of the use of the Ottawa Rules in the ED setting by Dr. Golden.Read More
We seek to find diagnoses, however not infrequently we find incidental findings of unclear significance. Dr. Merriam describes a case of hers that resulted in diagnosing a pheochromocytoma and discusses the rare but serious condition.Read More
There isn't a day that goes by in the ED that a patient does not get a chest x-ray. Whether the indication is chest pain, shortness of breath, cough, or line placement or intubation, interpreting chest radiographs is a critical, necessary skill for anyone working in the Emergency Department. Here you will find a brief video explaining how to interpret CXRs and 6 practice cases.Read More
Any way you slice it, foot x-rays are a pain to read. Complicated by a number of overlapping bones, joints, the presence of multiple sesamoid bones, and multiple radiographic views, it's easy to get lost in the weeds trying to sort out normal variant from pathology. Take a look at this short Blendspace module by PGY-1 Lauren Titone, MD and get a better understanding of the normal anatomy and a systematic approach to reading foot x-rays.Read More
SBIRT (Screening, Brief Intervention, Referral, & Treatment) for Substance Abuse
Why should we care?
- Prevalence of this disease is impressive with greater than 33,000 deaths attributed to alcohol in 2012 alone (287,000 MVC's in Ohio alone attributable to alcohol)
- Medical problems attributable to alcohol use costs the US $100,000,000,000 annually (from health care bills to lost productivity)!
- Approximately 33% of inpatient admissions in a country hospital population were attributable to alcohol
- One in five Americans can be defined as at risk drinkers
A 43 year old female presents to the ED after "rolling" her ankle while gardening. She states that she was stepping down on a shovel when her ankle rolled. <She describes to you and inversion type injury.> Being a diligent, studious physician, you quickly run through the Ottawa Ankle Rules while you obtain the remainder of you history and physical. She was unable to bear weight immediately after the accident and is, likewise, unable to do so here in the ED. She has no pain with palpation over the medial malleolus but does have significant pain and tenderness with palpation of the lateral malleolus. You quickly decide that this patient will need ankle radiographs to further investigate the possibility of fracture.
But, what views should you order? And, once you get the films back, how do you interpret them. Check out the excellent video embedded below, made by Dr. Claire O'Brien, PGY-1 in the University of Cincinnati Dept. of Emergency Medicine Residency Training program, to find out!Read More