Items tagged “emergency”

Gout is a crystal arthropathy due to deposition of monosodium urate crystals in and around the joints. Epidemiology Typically occurs in those above 40 years. There is a strong male predilection of 20:1, with this predilection more pronounced in younger and middle-aged adults. In the elderly, t...

Pulmonary embolism (PE) refers to embolic occlusion of the pulmonary arterial system. The majority of cases result from thrombotic occlusion, and therefore the condition is frequently termed pulmonary thromboembolism which is what this article mainly covers. Non-thrombotic pulmonary emboli sour...

Scaphoid fractures (i.e. fractures through the scaphoid bone) are common, in some instances can be difficult to diagnose, and can result in significant functional impairment. Epidemiology Scaphoid fractures account for 70-80% of all carpal bone fractures 1. Although they occur essentially at a...

Raccoon eyes sign (or panda eyes in the UK and Ireland) refers to periorbital ecchymosis with sparing of the tarsal plate 3 and is a physical examination finding indicative of a base of skull fracture of the anterior cranial fossa. However it is not pathognomonic for trauma, and there are sever...

The shoulder dislocation (more accurately termed a glenohumeral joint dislocation) involves separation of the humerus from the glenoid of the scapula at the glenohumeral joint. This article contains a general discussion on shoulder dislocation. For specific dislocation types please refer to the...

Pericarditis is defined as inflammation of the pericardium. It is normally found in association with cardiac, thoracic or wider systemic pathology and it is unusual to manifest on its own. Epidemiology Associations camptodactyly arthropathy coxa vara pericarditis syndrome Diagnosis The diag...

Elbow dislocation is the second most common large joint dislocation in adults and the most common in children.  Epidemiology Elbow dislocations are common and account for 10-25% of all elbow injuries in the adult population 1. They are the most common dislocation in children 4. Associations ...

Pneumopericardium represents gas (usually air) within the pericardium, thus surrounding the heart.  Pathology Etiology Underlying causes include: positive pressure ventilation thoracic surgery/pericardial fluid drainage penetrating trauma blunt trauma (rare) infectious pericarditis with ...

Cardiac tamponade is the result of an accumulation of fluid, pus, blood, gas, or benign or malignant neoplastic tissue within the pericardial cavity, which can occur either rapidly or gradually over time, but eventually, results in impaired cardiac output. This is to be distinguished from a per...

Pulled elbow (also known as nursemaid's elbow) is a subluxation of the radial head into the annular ligament, which usually spontaneously or easily reduces and rarely demonstrates abnormal radiographic features. If the clinical presentation is atypical, pulled elbow should be distinguished from ...

Gallbladder perforations are a serious complication of acute cholecystitis and represent an advanced stage of the disease. They tend to occur in an elderly and/or comorbid demographic and carry higher rates of morbidity and mortality. Clinical presentation Symptoms and clinical signs are varia...

A useful mnemonic which is used to read an emergency head CT scan is: Blood Can Be Very Bad Mnemonic Using a systematic approach will help to ensure that significant neuropathology will not be missed. B: blood look for epidural hematoma, subdural hematoma, intraparenchymal hemorrhage, intra...

Differentiating between acute and chronic infarction on a CT brain is an important skill for many health professionals particularly in the emergency setting: pathology acute: cytotoxic edema chronic: encephalomalacia; Wallerian degeneration hypoattenuation acute: more dense than CSF chroni...

An elbow joint effusion is a key finding to recognize on an elbow radiograph and should be used as a trigger to search for a fracture.  Finding an effusion  Recognizing an elbow joint effusion on lateral radiographs is an essential radiology skill. While the fluid itself is not discretely seen...

Retroperitoneal hemorrhage can be a source of significant yet occult blood loss. Terminology Some articles conflate and/or confuse retroperitoneal hemorrhage and Wunderlich syndrome 5. However Wunderlich syndrome refers primarily to bleeding around the kidney, not the retroperitoneum in genera...

Abdominal aortic aneurysm (AAA) rupture is a feared complication of abdominal aortic aneurysm and is a surgical emergency. It is part of the acute aortic syndrome spectrum. Epidemiology Abdominal aortic aneurysms are common and affect ~7.5% of patients aged over 65 years 6. Clinical presentat...

Hemoptysis (plural: hemoptyses) refers to coughing up of blood. Generally, it appears bright red in color as opposed to blood from the gastrointestinal tract which appears dark red. It is considered an alarming sign of a serious underlying etiology. Terminology A variety of clinical classifica...

Right heart strain (or more precisely right ventricular strain) is a term given to denote the presence of right ventricular dysfunction usually in the absence of an underlying cardiomyopathy. It can manifest as an acute right heart syndrome. Pathology Right heart strain can often occur as a re...