X-ray to Physical Exam: Knee
From April 2021, Go Away GonorrheaMatt and Mike sit down with Dr. Arun Sayal to discuss the evaluation of acute knee injuries in the urgent care. All knee injuries should be evaluated for knee stability and fractures to determine the need for prompt orthopedic consultation. Although commonly applied, knee immobilizers are not …
18min 21Matthew DeLaney, MD, Mike Weinstock, MD, and Arun Sayal, MD
X-ray to Physical Exam: Shoulder
From January 2021, The Game ChangerDoctor’s Arun, Matt, and Mike sit down to discuss how to approach shoulder x-rays and what to look out for with specific injuries. They review common injuries including shoulder dislocations, rotator cuff tears, and fractures.
24min 13Arun Sayal, MD, Mike Weinstock, MD, and Matthew DeLaney, MD
Hurts So Good
From November 2020, Hurts So GoodMatt and Mike sit down to discuss the ins and outs of pain management in the treatment of musculoskeletal pain. Topical NSAIDS are a great first line agent for most patients, and clinicians should consider side effect profiles when prescribing acetaminophen or ibuprofen for pain management.
17min 16Matthew DeLaney, MD and Mike Weinstock, MD
Legal Lessons: Hip pain with 7 Bounceback Visits
From July 2020, UFBs: Unidentified Foreign BodiesThere are no clinical findings which definitively diagnose or ‘rule out’ a DVT. When this diagnosis is suspected, a doppler study should be done. If missed, a pulmonary embolism may occur. •
20min 2Mike Weinstock, MD and Matthew DeLaney, MD
Excellence in the Physical Exam : Shoulder Pain
From May 2020, I Got The Gout!The shoulder exam begins with inspection for bruising or an empty sulcus which may indicate a dislocation. Next is range of motion to evaluation for rotator cuff tears, impingement, and adhesive capsulitis. Then a neurovascular exam to check sensation in the distribution of the axillary nerve and …
9min 52Andre Bonnet, DO and Mike Weinstock, MD
Gout!
From May 2020, I Got The Gout!NSAIDs, corticosteroids, and colchicine can all be used to treat acute gout. While these agents have similar efficacy, they have vastly different side effect profiles. •
21min 39Mizuho Morrison, DO and Matthew DeLaney, MD
Patella Injuries
From May 2020, I Got The Gout!Andy, Drew, and Miz discuss common presentations of patella fractures and review appropriate stabilization, treatment and follow-up recommendations. •
12min 24Andy Little, DO, Drew Kalnow, DO, and Mizuho Morrison, DO
PE basics - Joint Pain
From January 2020, Mainlining MadnessComparison of the physical exam findings between 3 types of arthritis.
9min 43Ben Trotter, DO and Mike Weinstock, MD
Knee X-rays
From December 2019, Medication MishapsArun runs through a thoughtful approach to the knee exam that includes the Mnemonic “SLR-CDEF” as a reminder of what diagnosis we should think about with every knee injury. The mnemonic stands for Septic knee, Locked knee, Referred pain, Compartment syndrome, Dislocation (spontaneously reduced …
15min 42Neda Frayha, MD, Matthieu DeClerck, MD, and Arun Sayal, MD
Common Sprains
From October 2019, SVT?! REVERT Me!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
Elderly Hip Pain
From October 2019, SVT?! REVERT Me!There are over 250,000 hip fractures per year in the US. Plain radiographs are 90% sensitive for hip fracture.. The most sensitive test for hip fracture is a MRI scan.
12min 9Mike Weinstock, MD and Matthieu DeClerck, MD
Rotator Cuff Injuries
From September 2019, Off The Cuff“Doc, my shoulder hurts.” We hear this all the time. But how often do we have a thoughtful, stepwise approach to diagnosing and managing rotator cuff disease? Dr. Matt Baird, an EM and Sports Medicine specialist, gives our own Matt DeLaney the lowdown on rotator cuff injuries and how we can …
21min 58Matt Baird, MD, Matthew DeLaney, MD, and Rick Pescatore, DO
What Would I Do Next? | Whiplash Injuries
From September 2019, Off The CuffWe see patients who present after a MVA all the time. Knowing how to identify high risk neck injuries is critical. More often than not, patients after a good H&P need no workup and more education and reassurance. Jenny and Miz discuss how to properly evaluate whiplash injuries.
21min 19Mizuho Morrison, DO and Jenny Beck-Esmay, MD
Approach To Pediatric Back Pain
From September 2019, Off The CuffBack pain in kids is most commonly musculoskeletal but the differential diagnosis includes a few “can’t miss” diagnoses. When evaluating children with back pain, having a standardized approach that includes looking for the “red flags” in both the history and physical is important and helps the …
22min 23Ilene Claudius , MD, Andrea Marmor, MD, and Mizuho Morrison, DO
Listener Feedback & Questions
From March 2019, Bun (Not) In The OvenPatients with compressive lesions in the lumbosacral spine below the level of the conus medullaris may present with signs and symptoms of cauda equina syndrome. Symptoms are due to compression of multiple nerve roots of the cauda equina and may include pain radiating into one or both legs …
15min 17Mike Weinstock, MD and Matthieu DeClerck, MD
Pediatric Ortho | 10 Can’t Miss Fractures
From March 2019, Bun (Not) In The OvenToddlers fracture, pediatric fractures, nonaccidental trauma, • Summary: Mike and Matt interview Dr.Ilene Claudius, pediatric and adult emergency physician to review common pediatric fractures. Deciphering between non-accidental trauma and other common pediatric fractures is key!
23min 45Ilene Claudius , MD and Matthieu DeClerck, MD
Excellence in the Physical Exam Series | The Scaphoid Bone
From January 2019, Can't We All Just Get Along?Up to 10% of initial radiographs fail to detect a fracture, so initial treatment should be directed by clinical suspicion • 1/4 patients who present with scaphoid tenderness and initially negative x-rays will be subsequently diagnosed with a scaphoid fracture • MRI has a sensitivity of 88% (95 …
7min 15Mike Weinstock, MD
Acromioclavicular (AC) Joint & Sternoclavicular (SC) Joint Injuries
From December 2018, Head, Shoulders, Knees and ToesRick, Miz, and Delaney discuss how we can do a better job of looking for injuries to the SC and AC joints that require unique consideration, treatment, or intervention.
19min 1Mizuho Morrison, DO, Matthew DeLaney, MD, and Rick Pescatore, DO
Excellence in the Physical Exam Series | Anterior Cruciate Ligament Injuries
From December 2018, Head, Shoulders, Knees and ToesA relatively new physical exam maneuver called the Lever test (also known as Lelli's test) looks promising as a potential new gold standard for ACL tears. The fist of one hand is placed under the patient's proximal calf, while the other hand grabs the patients's distal thigh just above the knee. A …
7min 34Mike Weinstock, MD and Mike Pallaci, DO
Approach to Ankle Fractures
From November 2018, Breaking Bad - Insulin Pumps and MandiblesFractures in the UC setting are very common. Most are straight forward but there a many pitfalls and complications that can be avoided by doing a thorough exam. The steps to this exam include the following: • Step 1: Don’t get distracted by the injury and miss other possible injuries • Step 2 …
16min 49Matthieu DeClerck, MD and Mike Weinstock, MD
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