When X-Rays LieFrom July 2020, The Certainty of Uncertainty
Medical tests can lie. X-rays are simply a test. The purpose of any test is to affect our pre-test probability - it is not to make a diagnosis. Any test result (positive or negative) must be placed in the clinical context it is being used. We should have an expectation of any test before we order …11min 7Arun Sayal, MD and Neda Frayha, MD
TIDBSI: Knee InjectionsFrom June 2020, Cause of Death?
An elderly patient with knee pain limps into your clinic asking for a “cortisone shot”. Do you reach for the needle? Paul Simmons and Justin McCarthy dive in to the real evidence behind intra-articular knee injections in this TIDBSI segment. •15min 43Paul Simmons, MD and Justin McCarthy, MD
Common SprainsFrom February 2020, Don't Go Breaking My Heart
Management of sprains can be divided into the acute and functional phase. In the acute phase early range of motion exercises and techniques to manage pain and swelling are key aspects of treatment. In the functional phase the focus shifts more to emphasize strength, stability, and a return to …18min 27Matt Baird, MD, Neda Frayha, MD, and Matthew DeLaney, MD, FACEP, FAAEM
Common Peds FracturesFrom June 2019, Does My Liver Look Fat?
Andi and Miz sit down with PEM doc Ilene Claudius to sort out high yield and “can’t miss” pediatric foot and ankle injuries. •23min 45Matthew DeLaney, MD, FACEP, FAAEM, Ilene Claudius, MD, and Mike Weinstock, MD
BursitisFrom April 2019, A Maelstrom of Mail!
In acute superficial bursitis, aspiration can be both therapeutic and diagnostic. In this segment, Brandon Grove takes us on a tour of olecranon and pre-patellar bursitis, and how to approach aspiration and treatment.8min 18Brandon Grove, MD
Paper Chase #1 | Calcium and Vitamin D Supplements Don’t Always HelpFrom April 2018, Will You Be My Facebook Friend?
In this meta-analysis of randomized clinical trials, the use of calcium, vitamin D, or both was not associated with a lower risk of fractures. We should stop prescribing or recommending them for this purpose.5min 50Andrew Buelt, DO and Joe Weatherly, DO
Orthopedic Injuries in Non-Accidental Trauma (NAT)From March 2018, What’s Your (Code) Status?
Non-accidental trauma should be considered in cases where the nature of the fracture is inconsistent with the mechanism described by the provider, which can include severity of the injury, location, or mechanism is inconsistent with child’s development stage.23min 6Solomon Behar, MD and Jason Woods, MD
Paper Chase 3 - Do Steroid Injections Make You Weak in the Knees?From September 2017, You Can Do It!!
This study found that triamcinolone knee injections were inferior to saline injections as measured by the WOMAC scale every three months over a two year period. Triamcinolone was also associated with a statistically significant decrease in amount of knee cartilage.6min 12Andrew Buelt, DO and Joe Weatherly, DO
Paper Chase 4 - Joint Replacement and Patient AgeFrom May 2017, My Gut Biome Told Me So
The vast majority of knee and hip replacements are still functional 20 yrs post implantation. Given this, perhaps joint replacement surgeries could be considered in younger patients than is typical. •5min 29Andrew Buelt, DO and Joe Weatherly, DO
Vertebral Compression FracturesFrom March 2017, The Benzos & Fungus Among Us
Vertebral compression fractures are the most common osteoporotic fractures. They can be caused by low force activities, such as coughing, straining at stool, or as in this case, trying to open a frozen front door. Plain films are the diagnostic modality of choice, although CT and MRI may also be …23min 29Adrien Selim, MD and Joe Weatherly, DO
Osteoporosis, Part 1From January 2017, Bones Lose Their Autonomy
Who should care about osteoporosis? Everybody. It affects 1 in 3 women and 1 in 5 men. Dr. Heidi James and Dr. Sylvie Ouellette discuss the evaluation and treatment of patients at risk for, and who have, osteoporosis. •17min 55Heidi James, MD and Sylvie Ouellette, MD
Osteoporosis, Part 2From January 2017, Bones Lose Their Autonomy
Who should care about osteoporosis? Everybody. It affects 1 in 3 women and 1 in 5 men. Dr. Heidi James and Dr. Sylvie Ouellette discuss the evaluation and treatment of patients at risk for, and who have, osteoporosis.24min 4Heidi James, MD and Sylvie Ouellette, MD
Hip PainFrom November 2016, Aspirin Loses Its Tenure
Patients present with hip pain and how you approach a patient should be methodical. Matt and Sarah discuss a step by step approach to hip pain, including how to evaluate intra-articular and extra-axial causes of hip pain and how to evaluate for referred pain as well. •15min 31Mizuho Morrison, DO
Things I Do But Should I: Sacral DimplesFrom September 2016, Best Weight, Best Exercise!
Review an approach to the neonate with a sacral dimple.6min 44Vanessa Cardy, MD and Adrien Selim, MD
Paper Chase 4: Avoid Surgical Repair of Degenerative Meniscal TearsFrom June 2016, C Diff Shows No Mercy!
Resection of a torn meniscus has no added benefit over sham surgery to relieve knee catching or occasional locking •5min 4Andrew Buelt, DO and Joe Weatherly, DO
Paper Chase 3: Vitamin D Supplement Yields No Benefit in Knee OsteoarthritisFrom June 2016, C Diff Shows No Mercy!
In patients with low serum vitamin D levels and knee pain, vitamin D supplementation did not result in significant differences in change in tibial cartilage volume or knee pain. •6min 57Andrew Buelt, DO and Joe Weatherly, DO
Introduction: Dupytren's DiseaseFrom May 2016, The Sexology of Radicular Back Pain
Dupuytren's’ contracture can cause significant disability, but 10% will resolve spontaneously. •11min 36Rob Orman, MD and Heidi James, MD
Paper Chase 1: Knee OsteoarthritisFrom February 2016, The Allergy That Isn't and the B-12 That Is
In patients with knee osteoarthritis, unilateral total knee replacement followed by nonsurgical treatment resulted in greater pain relief and functional improvement after 12 months than did nonsurgical treatment alone. •6min 4Andrew Buelt, DO and Joe Weatherly, DO
The Painful Pediatric ElbowFrom April 2015, The Iron Cranberry
Review common presentations of the painful elbow in the pediatric population.26min 3Mizuho Morrison, DO, Solomon Behar, MD, and Yu-Tsun (Yo) Cheng, MD