A 20-year-old male patient arrives at the emergency department following a fall from his skateboard, where he landed on his outstretched right hand. On examination, the patient reports experiencing considerable pain and tenderness between the extensor pollicis longus and extensor pollicis brevis tendons of his right hand. An X-ray is conducted, but no abnormalities are detected.
What is the best initial approach to managing this injury?
A 67-year-old man visits his GP complaining of pain, swelling, and bruising in his left shoulder. The symptoms began two days ago when he was attempting to retrieve a heavy box from a high shelf. He reports hearing a popping sound followed by intense pain. The patient is a smoker and has undergone multiple corticosteroid treatments for COPD exacerbations in the past year. During the examination, a bulge is visible in the middle of his upper arm, and he experiences weakness in his shoulder and elbow, with particular difficulty in supination. What is the diagnosis for this patient?
A 75-year-old male presents to his primary care physician and is screened for osteoporosis using the QFracture risk assessment tool. The tool indicates that his risk of experiencing a fragility fracture is over 10%, leading to a referral for a DEXA scan. The results of the scan show a T-score of -2.9.
What abnormalities might be observed in this patient’s blood work?
A 50-year-old woman comes to see her GP for a follow-up on her Dupuytren’s contracture. She has been experiencing more difficulty lately with her job, which involves a lot of typing. Despite taking Naproxen, she has not found much relief. During the examination, the GP observes that the metacarpophalangeal joints on her right hand’s little finger and ring finger are bent forward by 30 degrees, and she is unable to place her hand flat on the table. What should be the GP’s next appropriate step in managing her condition?
An 85-year-old female presents to the emergency department with complaints of pain in the left hemithorax after a fall at home. The patient has a history of chronic obstructive pulmonary disease and osteoarthritis. Upon examination, there is visible bruising and tenderness upon palpation over the left hemithorax. A chest x-ray confirms a complete disruption of the bony contour of the left 6th rib, without disruption of the pleura or lung parenchyma. What is the most appropriate management for this injury?
A 70-year-old man is currently in intensive care after experiencing a fall at home resulting in an open fracture of his right tibia/fibula and simple fractures in ribs 3-6. What steps can be taken to prevent the development of a chest infection in this patient?
A 75-year-old male comes to the emergency department following a fall at home. During the examination, it is observed that his left leg is externally-rotated and shortened. An X-ray confirms the presence of an intertrochanteric femoral fracture. This patient is typically mobile and able to perform all activities of daily living independently. What is the most suitable surgical approach for this patient?
A 82-year-old female is brought to the emergency department following a fall at her nursing home. She has a medical history of osteoporosis, dementia, and is considered clinically frail. During examination, her left leg is found to be shortened and her hip externally rotated. An X-ray reveals a displaced intracapsular fracture. What is the most suitable course of action for this patient?
A 28-year-old man presents to his GP with complaints of joint pain and swelling, feeling generally unwell. He recently returned from a hiking trip in Thailand, and one day after his return, he experienced severe watery diarrhoea and abdominal cramps that lasted for a week.
Upon examination, the patient appears fatigued and unwell. He has large effusions of the left knee and right ankle, along with tender plantar fascia bilaterally. Additionally, he has tender metatarsophalangeal joints on both feet and a papular rash on the soles of his feet. Despite taking regular paracetamol and ibuprofen for the past week, he has experienced minimal improvement in symptoms.
What is the most appropriate next step in managing this patient, given the most likely diagnosis?
A 70-year-old man is brought to the emergency department after a fall. He fell from standing height and is experiencing pain in his right leg. A pelvic X-Ray shows a right intertrochanteric femoral fracture. There are no fractures present on the left. He has a history of osteoporosis and osteoarthritis but generally considers himself to be active and enjoys playing golf.
What is the most suitable course of action for management?