5-2015 ortho power point part 8 - x-ray review #1.ppt

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Acute Orthopedics & Basic Musculoskeletal Imaging PART 8 Clinical Medicine III PAST 543 Summer 2015 X-RAY REVIEW #1 Linda Metzger, BS, MPA, PA-C 1

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Acute Orthopedics &Basic Musculoskeletal ImagingPART 8Clinical Medicine IIIPAST 5!Summer "#$5%&RA' R()I(* +$Linda Metzger, BS, MPA, PA-C12HAND3418 y/o mae!"at i# t"e diagno#i#$Ho% do yo& de#'ri(e %"at yo& #ee$)21 y/o mae, *&n'"ed a tree+Hematoma (o', -#ee .ideo/01ed&'tion %"ie 'a#t #et0Patient #ig"ed 2 #aid t"at it 3et (etter45S'a*"oid 673 di33erent *eo*e8!18S9:+ y/o 1HD 3emae 3e o33 mon,ey (ar#1;+ y/o 1HD mae 3e o33 mon,ey (ar#11+ y/o *o#t-red&'tion1213 y/o (oy, 3e, "&rt L %ri#t1313 y/o (oy, one year ater14H8S9 Patient i# a 1)-year-od rig"t-"and-dominant mae0 Patient %a# at t"e (ea'" and %a# ing "i# #,in (oard0 He 3e and in?&red "i# e3t %ri#t0 Patient i# "ere %it" (ot" *arent#0 9"e *atient "a# a t%in #i#ter0 PH=S8CAL @AAM8NA98 PatientB# e3t %ri#t doe# not "a.e any o(.io de3ormity, (r&i#ing or #%eing0 Patient i# ne&ro.a#'&ary inta't0 He "a# no tenderne## to "i# e(o%0 Patient i# e7tremey a**re"en#i.e and ?&m*y %"en 8 get near "im0 Patient did not "ande t"e red&'tion .ery %e and got dizzy0 A3ter a(o&t ) min&te#, "e 3et %e eno&g" to #it &* and t"e dizzine## e.ent&ay re#o.ed0 PatientB# 3at"er #tayed %it" "im t"ro&g"o&t t"e *ro'e##0 A-1A=> Le3t di#ta radia and di#ta &na 3ra't&re#, meta*"y#ea0 9"e radi "a# a**ro7imatey a 24 degree dor#a ang&ation0 ASS@SSM@N9> Le3t di#ta radi and di#ta &na 3ra't&re#0 PLAN> 10 8 "ad a engt"y di#'#ion %it" (ot" *arent# a(o&t "i# in?&ry and 'on#er.ati.e treatment .er#mani*&ation0 Bot" *arent# agreed to 'o#ed red&'tion %it" mani*&ation, (&t re3ed t"e "ematoma (o',0 20 PatientB# *arent# &nder#tand t"at e.en %it" t"e #&''e##3& red&'tion today t"at t"e red&'tion 'an (e o#t,ne'e##itating anot"er red&'tion or *o##i(e red&'tion &nder a genera ane#t"e#ia0 30 Patient %a# "&ng in 3inger tra*# %it" 8 *o&nd# 3or ) min&te#0 A3ter t"i# %a# remo.ed, t"e 'o#ed red&'tionand mani*&ation %a# *er3ormed0 9"e *atient *a'ed into e3t ong-arm 'a#t %it" %ri#t 3e7ion and #ig"t &nar de.iation0 Po#tred&'tion 7-ray #"o%ed im*ro.ement o3 aignment0 40 Patient "a# 9yeno No0 3 at "ome 3or *ain 'ontro0 9"e *atient %i 3oo% &* in 1 %ee, 3or 7-ray, 2 .ie%#, e3t%ri#t in 'a#t0 1)1) y/o mae C day one1+1) y/o mae C *o#t red&'tion 2 'a#ting0S%ore at me, tried to ,i', me, 'ried 2 amo#t *a##ed o&t06amiy 'an'eed tri* to Ha%aii0151) y/o mae C one mont" ater181) y/o mae C t%o mont"# ater1:@LB