WDIDN Ankle Pain/Maisonneuve
From September 2020, Get Your Game OnEven without a history of pain at the proximal fibula, a Maisonneuve fracture may be present. Specifically palpate the proximal fibula with each ankle pain/strain patient. Beware of patients who are anticoagulated as there may be rapid swelling which can compress the neurovasculature requiring …
14min 43Mike Weinstock, MD and Jenny Beck-Esmay, MD
What Would I Do Next? - Neck Pain after an MVC
From December 2019, Medication MishapsBoth NEXUS and the Canadian C-Spine rule are evidence based tools that can be used to evaluate patients with potential cervical spine injuries.
16min 16Charles Khoury, MD, Mike Weinstock, MD, and Matthew DeLaney, MD
When X-Rays Lie
From November 2019, Who's The Black Sheep?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, Neda Frayha, MD, and Matthieu DeClerck, MD
Ankle and Foot Pain
From April 2019, April Showers, Syncope & SprainsCertain pediatric foot and ankle injuries can be missed on either physical exam or x-ray. It is important to have a high clinical suspicion for such injuries and use a systematic approach to physical examination and review of x-rays.
24min 37Ilene Claudius, MD, Andrea Marmor, MD, and Mizuho Morrison, DO
What Would I Do Next? | The Painful Pediatric Elbow
From January 2019, Can't We All Just Get Along?The UC:RAP team discusses management of the painful pediatric elbow and distinguishing between supracondylar fractures from nursemaid’s elbow. Rick reviews both reduction techniques for nursemaid’s and which is more efficacious.
18min 14Rick Pescatore, DO and Mike Pallaci, DO
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
Not To Miss Foot Injuries
From April 2018, Hacking Up A LungRick, Mike, and Miz join with Martha Roberts to discuss common and can’t miss diagnoses of the foot. From heel-to-toe, the team reviews important foundational concepts including the Ottawa Foot Rules, and focuses further on specific and high-risk bony injuries.
18min 41Martha Roberts, NP, Rick Pescatore, DO, Mike Weinstock, MD, and Mizuho Morrison, DO
Orthopedic Injuries in Non-Accidental Trauma (NAT)
From March 2018, Fibrillate into the Future!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
Excellence in the Physical Exam Series | Elbow Exam
From December 2017, Lucy In The Sky With DiamondsExamination of the elbow begins with inspection, neurovascular assessment, range of motion and palpation. Consider diagnoses such as Tennis elbow, Rupture of the biceps tendon, Golfers elbow, Septic arthritis, and Radial head fracture.
8min 19Tracy Tran, DO and Mike Weinstock, MD
Gamekeepers Thumb
From August 2017, Game of ImpostersA typical mechanism of strain or tear of the ulnar collateral ligament (UCL) of the thumb is by a hyperextension and abduction of the thumb. With severe hyperextension, the UCL can be torn or may avulse bone at the point of approximation at the proximal aspect of the phalanx. Mike and Miz discuss …
11min 37Mizuho Morrison, DO and Mike Weinstock, MD
Paper Chase 1 | Ibuprofen is OK for Kids With Broken Bones
From July 2017, Franks and BeansNate and Brett review recent literature to keep clinicians up to date on latest data.
3min 24Nate Finnerty, MD and Brett Ebeling, MD
What Would I Do Next? 18yo Male with Hand Laceration, Part 1
From June 2017, A Disposition Conundrum?!Review high risk hand lacerations. Practical approaches to discussing high risk wounds with patients.
14min 33Mike Weinstock, MD and Greg Henry, MD
Knee Immobilizer
From June 2017, A Disposition Conundrum?!Review indications and contraindications for use of a knee immobilizer.
10min 48David Ebenezer, MD and Paul Jhun, MD
What Would I Do Next? 18yo Male with Hand Laceration, Part 2
From June 2017, A Disposition Conundrum?!Review high risk hand lacerations. Practical approaches to discussing high risk wounds with patients.
15min 58Greg Henry, MD and Mike Weinstock, MD
Knee Pain, Part 2
From May 2017, Pain in the Neck!Provide a review/approach to acute knee pain in patients presenting to urgent care, including key history, physical exam, and diagnostic findings to assist in the appropriate diagnosis and treatment of specific etiologies of knee pain. •
16min 1Mizuho Morrison, DO and Matthieu DeClerck, MD
Knee Pain, Part 1
From May 2017, Pain in the Neck!Undifferentiated knee pain in the UC is common. The most common injuries are soft tissue rather than osseous. Matt and Miz discuss the keys and clinical decision rules for workup They review the initial acute management of undifferentiated soft tissue injuries consists of RIICE, pain control …
23min 48Mizuho Morrison, DO and Matthieu DeClerck, MD
Cervical Spine Imaging
From May 2017, Pain in the Neck!Mike and Miz discuss the evaluation of the cervical spine, when imaging is indicated. They review both NEXUS and Canadian C Spine rules and application in the UC. •
13min 52Mizuho Morrison, DO and Mike Weinstock, MD
Nightstick Fracture
From April 2017, Defend Yourself - Nightstick FracturesMiz & Mike discuss a case of a 38 year old woman who has a nightstick fracture from falling onto a counter. They discuss the importance of asking about mechanism of injury (chance to intervene with alcohol); Considering abuse if history doesn’t correlate with exam knowing that classic nightstick …
11min 9Mizuho Morrison, DO and Mike Weinstock, MD
Clavicle Fractures
From March 2017, You Broke It Where??Initial evaluation and management of clavicle fractures is pretty straight forward. Mike and Miz give an overview of workup, treatment in the UC as well as red flags of when to refer a patient for emergent evaluation. •
15min 1Mike Weinstock, MD and Mizuho Morrison, DO
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