Daily Em Pearl, 5/6/12

A middle aged male p/w L-great toe pain for 3days, unresponsive to acetaminophen and ibuprofen. He denies fever or other complicating sx. On exam, the medial aspect of the L-great toe is erythematous w/TTP. No areas of fluctuance are appreciated. You need to remove this ingrown toenail. What’s your plan?Read more

Daily Em Pearl, 5/5/12

A young lady presents to your ED a few hours after a fist fight, c/o L-eye pain. She does not wear contacts and has tried ice and ibuprofen for the pain but noticed her eye was very red, so she came in for help. You do a complete eye exam, including visual acuity and aRead more

Daily Em Pearl 4/29/12

A middle aged woman p/w R-shoulder pain after falling on her outstretched arm. You order a plain film to eval for fracture or dislocation. What do you see? R-shoulder plain film  Read more

Daily Em Pearl, 4/27/12

A middle-aged lady presents to the ED but won’t tell the triage nurse what’s wrong. “I need to see a doctor, is all.” Turns out she has a rectal foreign body. On xray it appears to be an apple. On digital exam you can just feel the bottom of the apple with the distal tipRead more

Daily Em Pearl, 4/22/12

Abscess: After incision and drainage, do you pack or not? What does the literature say?Read more

Daily Em Pearl, 4/18/12

Early in the morning, a young man p/w R-great toe pain after having his foot stepped on while dancing last night (a few hours ago). On exam, you appreciate full ROM and strength but your patient is pretty uncomfortable. He took paracetamol and ibuprofen at home with minimal relief. There are no signs of infectionRead more