Radiology - SYB II

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Radiology - SYB II

• Brad Moatz MS IV
• Penn State Hershey
• 2-28-08

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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)

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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 lt2 sec cap refill

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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

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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

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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

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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

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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

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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

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2 day f/u
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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

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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, lt2 sec cap refill

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