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Fracture or a normal ossification center? This is a common question heard when viewing an xray of a pediatric elbow. How do you remember the timing of normal ossification centers?...
Michelle Lin, MD |
Is this coin in the esophagus or the trachea? The classic teaching for the Boards exam is: Esophageal coins appear in the coronal plane, as shown above. Tracheal coins appear in...
Michelle Lin, MD |
In the most recent EM Clinics of North America publication, Dr. Panebianco et al. discussed the evidence behind diagnostic tests for acute abdominal pain. There were some really great teaching...
Michelle Lin, MD |
In the setting of blunt trauma, it is easily to overlook a patient’s risk for blunt cerebrovascular injuries (BCVI). These are injuries to the carotid and vertebral arteries. Often they...
Michelle Lin, MD |
How great would it be if you could give patients concrete numbers when you are talking about cancer risk and CT? Well, Dr. Hans Rosenberg (Univ of Ottawa) has come...
Michelle Lin, MD |
The ideal clinical decision tool has a sensitivity and specificity of 100%. You need a high sensitivity to be sure that your negative result indeed predicts a true negative. That means...
Michelle Lin, MD |
Supine chest xrays have an extremely low sensitivity (12-24%) in detecting pneumothoraces. Because a pneumothorax layers anteriorly on an AP CXR film, the xray beam is perpendicular rather than...
Michelle Lin, MD |
Can you see the pneumothorax? Small pneumothoraces can be difficult to detect on chest xrays. Overlying ribs, other bony structures, and soft tissue can obscure subtle findings. For a patient...
Michelle Lin, MD |
Often times, I get called to triage to help decide whether a patient should be sent to Radiology for an initial x-ray after injuring their knee, ankle, and/or foot. After...
Michelle Lin, MD |
With increasing awareness of CT’s irradiation risk, I thought I would review a classic 2001 article from the New England Journal of Medicine. Head CT’s previously were commonly performed prior...
Michelle Lin, MD |
Ankle fractures are a common injury diagnosed in the Emergency Department. Being able to speak Ortho-ese (i.e. the language of orthopedists) is invaluable in consulting the orthopedist over the phone....
Michelle Lin, MD |
Find the fracture in this patient with blunt knee trauma. As a general rule, plain films are insensitive in ruling out orthopedic injuries. One particularly tricky area is the knee....
Michelle Lin, MD |
A man recently presents with knee pain after pivoting and torquing his knee while falling. He complains of concurrent mild ankle pain. He presents with this tib-fib xray. Realizing that a...
Michelle Lin, MD |
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