RESUMO
Clavicle fractures are common; however, complications are unusual. Two such complications, subclavian artery pseudoaneurysm and brachial plexopathy, are rare events that can cause significant morbidity and mortality. We report the case of a 53-year-old man who presented with shoulder swelling and right arm weakness for 1 week. Three weeks before, he had fallen and fractured his right clavicle. On presentation to our emergency department, his examination revealed a brachial plexopathy and a large supraclavicular mass. An emergency bedside triplex sonogram was performed to characterize the mass and revealed a swirling pattern within a fluid collection anterior to the subclavian artery, suggestive of a pseudoaneurysm. After computed tomography-angiography, the patient was taken to the operating room, where he underwent hematoma washout and subclavian artery stent-graft placement. This case illustrates how bedside point-of-care sonography can rapidly assist in the initial assessment of subclavian artery injury.
Assuntos
Falso Aneurisma/diagnóstico por imagem , Neuropatias do Plexo Braquial/etiologia , Clavícula/lesões , Sistemas Automatizados de Assistência Junto ao Leito , Artéria Subclávia/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Neuropatias do Plexo Braquial/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Stents , Artéria Subclávia/cirurgia , UltrassonografiaRESUMO
A rare case is presented of intercondylar dislocation of the patella with vertical axis rotation. The injury was the result of blunt trauma directed to the lateral border of the patella. The patient presented with the knee locked in full extension and with a vertical ridge-shaped deformity caused by the medial border of the patella facing anteriorly. Reduction was accomplished under intravenous conscious sedation by manipulation.
Assuntos
Futebol Americano/lesões , Luxações Articulares/diagnóstico por imagem , Patela/lesões , Ferimentos não Penetrantes/complicações , Adulto , Sedação Consciente , Tratamento de Emergência , Humanos , Luxações Articulares/etiologia , Luxações Articulares/terapia , Masculino , Manipulação Ortopédica , Radiografia , RotaçãoRESUMO
Emergency physicians occasionally encounter dislocations of the distal radioulnar joint when these are associated with fractures of the forearm, such as the Galeazzi fracture. Isolated dislocations of the distal radioulnar joint without fracture are rare and are described in terms of the position of the ulna in relation to the radiocarpal joint. Radiographs may be difficult to interpret if a true lateral view is not obtained. This injury may be easily missed in the emergency department because of its infrequent occurrence, its relatively benign appearance, and difficulty in interpretation of radiographs.
Assuntos
Luxações Articulares/diagnóstico por imagem , Ulna/lesões , Traumatismos do Punho/diagnóstico por imagem , Adulto , Feminino , Humanos , Luxações Articulares/terapia , Radiografia , Traumatismos do Punho/terapiaRESUMO
A 25-year-old man presented to the emergency department with an acute onset of frontal sinus pain during descent on a commercial airliner. There was no history of recent upper respiratory infection, sinus infection, or chronic allergic rhinitis. Sinus radiographs demonstrated a left frontal sinus submucosal hematoma. Symptoms improved within 24 hours with systemic and topical decongestants/vasoconstrictors and a nonsteroidal antiinflammatory agent. He was asymptomatic at 1 week postinjury.
