radiology - syb ii brad moatz ms iv penn state – hershey 2-28-08
TRANSCRIPT
Case #1
• Ms. D• Cc: R wrist pain • HPI: 28 y.o. s/p fall from roof. RHD. Pt seen in
ED in FL was offered surgery but declined. Pt was instructed to seek medical tx within 3 days. Did not receive any tx while in FL.
• PMH: unremarkable• SH: no tobacco, no EtOH• All: NKDA• PSH: ACL surgery (2000)
Case #1
• PE – numbeness and paresthesia in median n. distribution.
• Full sensation in radial and ulnar nn.
• Pt unable to flex/extend wrist
• Pt able to move fingers but decreased ROM secondary to pain
• Marked swelling appreciated
• 2+ radial pulse with <2 sec cap refill
Case #2
• Ms. B• Cc: L hip pain• HPI: 89 y.o. female with h/o fall in bathroom.
Presents with L hip pain. No LOC. • PMH: Dementia, angina, HTN, colon polyps
removed in 1990• SH: no EtOH, no cigs• Meds: Paxil, Nemenda• All: NKDA
Case #2
• PE – No overlying ecchymosis,
• Prominence over L ant & lat thigh
• LLE shortened, ER
• SP/DP/S/S/T SILT
• EHL/TA/G/S 5/5, limited ROM with HF and ext. as well as knee flexion/ext
• 2+ DP/PT pulse
Case #3
• Mr. B• Cc: R foot pain • HPI: 18 y.o. male. Chasing dog around house
and kicked couch. C/o R 5th toe pain• PMH: unremarkable• Meds: None• SH: no cigs, no EtOH• All: NKDA• PSH: None
Case #3
• PE – R 5th toe markedly swollen
• No overlying ecchymosis
• Toe is laterally deviated
• Pt able to flex toe slightly
• S/S/SP/DP/T SILT
• DP/PT 2+ pulse
Case #4
• Mr. M• Cc: R arm pain • HPI: 8 y.o. male. Pt was jumping on trampoline
and landed on R arm. No LOC. RHD• PMH: L forearm fx 4 years ago• Meds: None• All: NKDA• PSH: None
Case # 4
• PE – Pt able to move all 5 fingers but decreased ROM secondary to pain
• SILT r/u/m distribution
• 2+ radial pulse
• No overlying ecchymosis
• Prominence over R posterior forearm with marked swelling
Case #5
• Mr. J• Cc: R arm pain• HPI: 56 y.o. male with h/o HCC. Fell while attempting to
sit on stool. Fell onto R arm and L side. No LOC• PMH: HCC, s/p liver transplant 1994 secondary to Hep
C, HTN• All: NKDA• SH: no cigs, no EtOH• Meds: Avastin, Zarafinib, Rapirimine, Pepcid, Lyrica,
Ursodiol, Lexapro, Lasix, Fosamax, Dexamethasone
Case #5
• PE – No obvious overlying skin changes
• Decreased ROM at R shoulder and R elbow secondary to pain
• R and L wrist fused previously (MVA)
• No sensory deficits, C5 – T1 SILT
• 2+ radial pulse, <2 sec cap refill