Orthopedics

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Dorsally-Displaced Metacarpal Dislocation-Fracture

Richard Barnett, DO* and Richard Brodsky, MD*

DOI: https://doi.org/10.21980/J8ZW54Issue 3:3[mrp_rating_result]
A two-view radiograph of the right hand was obtained which revealed a dorsal dislocation of the distal fourth and fifth metacarpals (see red and blue outline, respectively) with a concomitant fracture of the distal fifth metacarpal (see yellow line) and avulsion fracture of the lateral aspect of the hamate (see green line). After reduction the fourth and fifth metacarpal dislocations are resolved; however, the distal fifth metacarpal fracture (yellow line) and avulsion fracture of the lateral aspect of the hamate (green line) are still visible.
OrthopedicsVisual EM
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Lisfranc Injury

Lisa Schwartz, BS*, Nelly Tan, MD^ and John Costumbrado, MD, MPH*

DOI: https://doi.org/10.21980/J8QD1MIssue 3:3[mrp_rating_result]
The frontal view of the right foot showed divergent dislocation of the second through fifth metatarsal bones (red outlines) consistent with Lisfranc injury. Though the Lisfranc ligament is not visualized by radiograph, the yellow markings represent the location of the Lisfranc ligament between the medial cuneiform (blue dot) and the base of the second metatarsal bone.  The first metatarsal and the medial cuneiform remain congruent. The lateral view shows dorsal dislocation of the midfoot (pink circle) consistent with instability. There is associated extensive midfoot soft tissue swelling.
OrthopedicsVisual EM
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Lateral Epicondyle Fracture

Valerie Lew, BS*, John Costumbrado, MD, MPH* and Curtis Knight, MD*

DOI: https://doi.org/10.21980/J8J05F Issue 3:2[mrp_rating_result]
Radiographs of the right elbow revealed an acute fracture through the lateral epicondyle with dislocation of the radial head inferiorly. Radiographs of the left elbow revealed a slightly angulated fracture through the lateral epicondyle.
OrthopedicsVisual EM
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Acromioclavicular joint separation

Devan Pandya, BS* and John Costumbrado, MD, MPH^

DOI: https://doi.org/10.21980/J8C91G Issue 3:2[mrp_rating_result]
History of present illness: A 30-year-old male was brought in by ambulance to the emergency department as a trauma activation after a motorcycle accident. The patient was the helmeted rider of a motorcycle traveling at an unknown speed when he lost control and was thrown off his vehicle. He denied loss of consciousness, nausea, or vomiting. The patient’s vital signs
OrthopedicsVisual EM
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Scaphoid Fracture

Esther Kim, BS* and Justin Yanuck, MD*

DOI: https://doi.org/10.21980/J80344Issue 3:2[mrp_rating_result]
The anteroposterior (AP) plain film of this patient demonstrates a full thickness fracture through the middle third of the scaphoid (red arrow), with some apparent displacement (yellow lines) and subtle angulation of the fracture fragments (blue line).
OrthopedicsVisual EM
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Acute comminuted intertrochanteric hip fracture

Samuel Kaplan, BS* and Jonathan Peña, MD*

DOI: https://doi.org/10.21980/J8QK9C Issue 3:2[mrp_rating_result]
History of present illness: A 69-year-old male presented to the emergency department (ED) with left hip pain after he was rear-ended on his bicycle by a vehicle traveling 10-15 miles per hour. He had normal vital signs. On exam, his left lower extremity was externally rotated and shortened with trochanteric point tenderness. His pelvis was stable. His lower extremity compartments
OrthopedicsVisual EM
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Rare Rapidly Growing Thumb Lesion in a 12-Year-Old Male

Alana J Arnold, MD, MBA*

DOI: https://doi.org/10.21980/J8B92J Issue 3:2[mrp_rating_result]
History of present illness: A 12-year-old male presented to the emergency department with right thumb pain and a mass for four months (see images). He denied fevers, chills, change in appetite, or fatigue. He noted that the lesion was growing and “bleeds easily if bumped.” He denied any trauma to the thumb, except “hitting it” months ago while in football
Hematology/OncologyOrthopedicsVisual EM
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Biceps Tendon Rupture

Daniel M Polvino, MD* and Grant Wei, MD*

DOI: https://doi.org/10.21980/J8RP8B Issue 3:1[mrp_rating_result]
Physical exam was significant for ecchymosis and mild swelling of the right bicep. When the right arm was flexed at the elbow, a prominent mass was visible and palpable over the right bicep. Right upper extremity strength was 4/5 with flexion at the elbow.
OrthopedicsVisual EM