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Radiology cases presentation in egypt

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Interactive discussion session held at Emergency Medicine Update Course held at Cairo, Egypt. Presented by Dr Noureldin. www.emeregypt.org

Interactive discussion session held at Emergency Medicine Update Course held at Cairo, Egypt. Presented by Dr Noureldin. www.emeregypt.org

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Radiology cases presentation  in egypt Radiology cases presentation in egypt Presentation Transcript

  • ABDEL H NOURELDINPROGRAM DIRECTORCHAIRMAN SCIENTIFIC COMMITTEEEMIRATES SOCIETY OF EMERGENCY MEDICINETAWAM HOSPITAL EMERGENCY MEDICINE RESIDENCY PROGRAMEMERGENCY MEDICINE UPDATEJUNE - 12TH-2013Radiology casesIn Egypt
  • 20 y/o was involved ina fighthe was stabbed in theleft lower chest.
  • 7: the patient in the picture below presented to the ED with stabwound in the anterior abdominal wall. Which of the followingstatement is correct?A: Blind probing with fingers are accurateand safe during local woundexploration of the anterior abdominal wall.B: Blind probing Cotton tipped swabsare accurate and safe during localwound exploration of the anterior abdominal wall.C: Blind probing with instruments swabsare accurate and safe during local wound explorationof the anterior abdominal wall.D: Blind probing of chest injuries adds no potentialadditional information and may be hazardous. View slide
  • E-FAST IS NORMAL View slide
  • 33 Y/O WAS INVOLVED INA RTAHE WAS EJECTED OUT OFTHE CARBP =70, P=140
  • 33 Y/O WAS INVOLVED INA RTAHE WAS EJECTED OUT OFTHE CARBP =30, P=45
  • 33 Y/O WAS INVOLVED INA RTAHE WAS EJECTED OUT OFTHE CARBP =75 SYSTOLIC, P=65
  • E-FAST IS NORMAL
  • 17 y/o male who was involvedin RTA. Patient was ejectedout of the car and his BP is70/40, Pulse of 130, andpatient is cold and clammy.
  • Pelvic Fracture. In the setting of pelvicfracture, the clinical triage determinantis the presence or absence ofhemoperitoneum (Fig. 43-13). Although thesensitivity of FAST US inpatients withpelvic fractures is decreased, it stillserves as a tool to triage the patient tothe next intervention.116 In an unstablepatient, a positive FAST US is followed bya supraumbilical peritoneal aspirate. Ifthis reveals 10 mL or greater of blood,then the patient should expeditiously moveto laparotomy. If instead urine or otherfluid is aspirated, then the patient
  • Terry Thomas sign & signet ringsign
  • Perilunate dislocation stage II &III
  • 9: Patient complain of elbow pain after a fall and the x-ray isshown below. Which of the following statements is correct? patient ?A: Patient has positive anterior fat pad sign , positive posterior fatpad sign and positive anterior humeral line.B: : Patient has negative anterior fat pad sign , positive posteriorfat pad sign and positive anterior humeral line.C: : Patient has positive anterior fat pad sign , negative posteriorfat pad sign and positive anterior humeral line.D: : Patient has positive anterior fatpad sign , positive posterior fat pad signand negative anterior humeral line.E: : Patient has negative anterior fatpad sign , negative posterior fat pad signand negative anterior humeral line.
  • #9ARosen’s 7theditionpages # 547-
  • FAT PAD SIGN
  • ANTERIOR HUMERAL LINE
  • 7: Which of the following is the mostcommon type of Salter -Harris fracture ?A:B:C:D:
  • #7DRosen’s 7th editionpages 2245 - 2249
  • 8: Which of the following type of Salter -Harris fracture has the greater likelihoodof growth arrest ?A:B:C:D:
  • #8BRosen’s 7th editionpages 2245 - 2249
  • 9: which of the following is thegreenstick fracture?A:B:C:D:
  • #9DRosen’s 7th editionpages 2245 - 2249
  • 10: which of the following is the Torusfracture?A:B:C:D:
  • #10CRosen’s 7th editionpages 2245 - 2249
  • 23: Which of the following is the name of this injury seen on the x-ray below?A: TorusB: Green stickC: Plastic deformityD: Hutchinson’s fractureE: None of the above
  • #23CRosen’s 7theditionpage 543
  • PLASTICDEFORMITY
  • PLASTICDEFORMITY
  • # 10: 16 y/o fill down and complain of pain andswelling of the left wrist. X-ray is shownbelow. Choose the correct statement.A: Normal lateral view of thewristB: Fracture of the Lunate boneC: Fracture of the Hamate boneD: Fracture of theTriquetriumbone
  • #10DRosen’s 7theditionpage 531
  • 6: The patient of the x-ray below was brought to the EDbecause of pain and swelling of the wrist after a fall.Which of the following statement about the x-ray iscorrect?A: Patient has no fracture seen on the x-ray.B: Patient has positive clenched fist signC: Patient has positive carpal tunnel viewD: Patient has a positive pronator quadratus signE: None of the above
  • #6DRosen’s 7theditionpage 529
  • PRONATOR QUADRATUS FAT PAD SIGNENORMALPOSITIVE
  • 12: The child shown in the picture was brought to the ED because he isnot using his left arm and is holding his left wrist with right hand.Which of the following is the best method of treating this child?A: X-ray of the upper arm and forearm and if negative to seeorthopedic in AM.B: Flexion and supination of the elbowC: x-ray of the wrist if neg to see orthopedic surgeon in 2 to 3days.D: Hyperpronation
  • #12DRosen’s 7theditionpage # 549
  • 6: Which of the following age does theossification center of the trochleaappers?A: 3B: 5C: 7D: 9E: 11
  • #6CRosen’s 7theditionpage # 549
  • CRITOECRITOE (also known as CRITOL) helpsremember the order elbow ossificationcenters.C : capitellum : 1 yearR : radial head : 3 yearsI : internal (medial) epicondyle : 5 yearsT : trochlea : 7 yearsO : olecranon : 9 yearsE : external (lateral) epicondyle : 11 years
  • 15: patientcomplain oflocked right armand he is unable tomove it. Pleasechoose the correctdiagnosesA: Luxatio ErectaB: anterior subluxationC: anterior dislocationD: posterior dislocation
  • #15ARosen’s 6th editionpages 692-693
  • 13: Which of the following methods of reducingan anterior shoulder dislocation is associatedwith the highest incidence of complication and isno longer recommended?A: Leidelmeyer maneuver.B: Cooper and Milch maneuver.C: Hippocratic method and Kochermaneuver.D: Stimson technique.E: scapular manipulation technique
  • #13CRosen’s 6theditionpages 688-690
  • STIMSONTECHNIQUE
  • LIEDELMEYER MANEUVER
  • Milch maneuver
  • 16: The most likely cause of the injuryshown on the x-ray of this patient ischild abuse.A: TrueB: False
  • #16BRosen’s 7th editionpages 2255-2257
  • 11: 7 y/o male was brought to the ED because injury to the elbow.Patient complain of severe pain of the forearm and the pain increasewhen he passively moves his fingers. Which of the following is themost important step in managing this patient?A: Reduce the fracture to release the median nerveB: Measure the pressure in the compartmentsC: Splint the arm and discharge to see orthopedic in AMD: Reduce the fracture to releasethe brachial arteryE: reduce the fracture to releasethe radial nerve
  • #11BRosen’s 7th editionpages 2245 - 2249
  • VOLKMAN’S CONTRACTION
  • GARTLAND CLASSIFICATION
  • GARTLAND TYPE I
  • Gartland type II