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The Approach to the Foot X-ray
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.
Approach to Reading MRI of the Spine
It's another back pain type of day in Minor Care. 3 hours into your shift and you've seen 6 patient's with back pain. You quickly evaluate them asking them about red flag symptoms, searching for signs of neurologic injury on your physical exam. As you talk to Jane, your next patient, you get worried she doesn't have simple musculo-ligamentous back pain. Jane has a history of IVDU and states her last use was 3 months ago. She cites some subjective fever and chills over the past several days along with aching low back pain which has been getting steadily worse. On exam, you find she is febrile with a temperature of 101.4, tachycardic to 110, with a normal blood pressure. She has midline upper lumbar and lower thoracic spinal tenderness to palpation.
Right Upper Quadrant Ultrasound
You are talking to your new patient, John. He's a pleasant 30 year old man who, by your estimation appears to be a victim of HGS... Holiday Gluttony Syndrome. John presented to you in the ED with abdominal pain, nausea, and vomiting. He goes on to tell you all this started after he chowed his way through a few too many Buckeyes. You see every Christmas, his mom sends him a far too large tin of Buckeye candies, which John had eagerly eaten and eaten and eaten, until the belly pain hit.