Radiology - SYB II

Brad Moatz MS IV

Penn State – Hershey

2-28-08

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

2 day f/u

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