Skip to content Skip to sidebar Skip to footer

Ottawa ankle rules. Does it really work?

A 16 yo guy is brought in ED by his mother after a scholar accident. While he was running, he crashed. My son has a sore ankle! Is it broken? Asks the mother seriously worried. The ankle his slightly tumefied, there isn’t bone tenderness at the posterior edge or tips of either malleolus,…

ByCiro Paolillo11 April 20140Comments

Abdomen

Plain X ray in suspected bowel obstruction. Is that all?

A 67 y/o woman arrives in the ED at 5pm because of diffused abdominal pain since 2 hours. She has nausea and she refers costipation from the day before. She has a history of hysterectomy 5 years before because of fibroma. Vital signs are normal, she presents pale and sufferer for pain, the abdomen…

ByIlenia Spallino11 November 20130Comments

Chest

Pleuritic pain and radio-occult lesion

A 33 y/o woman, comes to the ED because of a sudden emithorax pain localized on the left in basal region. The pain is described as stabbing, well localised, it worsen with inspirium …a pleuritic pain, no cough, no fever, not hemoptysis. She smokes, she does not take any medication. Chest x ray is normal.…

ByIlenia Spallino11 October 20120Comments

Chest Ultrasound

Can Ultrasound rule out a pneumothorax?

Y ou are allerted for a level 3 trauma from the mountain, a cyclist has fallen going down hill. You prepar the shock room with everything you may need, dress up, and wait. A 25 y/o cyclist arrives completely immobilized, you immidiately start to perform ABCDE as you learned in your recent ATLS course (you…

ByIlenia Spallino10 July 20120Comments

Chest

Thoracic trauma and chest X-Ray

Y ou are alerted for a level 3 trauma coming from the mountain, a cyclist has fallen going down hill. You prepare the shock room with everything you may need, dress up, and wait. A 25 y/o cyclist arrives completely immobilized, you immediately start to perform ABCDE as you learned in your recent ATLS course…

ByIlenia Spallino10 July 20120Comments

Chest

Chest X-Ray and aortic dissection

A 70 yo man come to the ED for restrosternal chest pain and shortness of breath during minimal activity in the last days. He is an ex smoker, with a history of hypertension. On physical examination the patient is not in distress, with a regular blood pressure and regular oximetry. ECG shows no evidence of…

ByCiro Paolillo28 June 20120Comments

Abdomen

Is CRP correlated to CT result in the evaluation of abdominal pain?

A 74 yo/man complained of diffuse abdominal pain. The pain was intermittent and accompained by vomiting. He has no history of abdominal pain or abdominal surgery. On examinations the patient presented non icteric, afebrile, not tachicardic. The abdomen was mildly distensed with midline tenderness. The US evidenced a normal aorta diameter. Abdominal…

ByCiro Paolillo10 May 20120Comments

Chest Ultrasound

Diagnosis of pneumonia. Is it the time for a combined imaging strategy?

A 80 yo man is brought from an assisted-living facility because of fever, productive cough, tachycardia and dyspnoea. He has a history of dementia and hypertension. He is cachectic, you hear ronchi on the left side. How should you approach this patient? In the Emergency department setting the pretest probability of pneumonia…

ByCiro Paolillo5 April 20120Comments