radER Vol 1.1

Case 1.1

A 55-year-old woman presents to your ED after tripping on the sidewalk curb.  She complains of pain to her lower extremity.  You obtain the following radiograph.

Questions:
1. What is the diagnosis based from the radiograph?

2. What radiographic view is this?

3. What is the Emergency Department treatment?

Please click on the “comments” link or post your answer in the “reply box”. You will not see your answer post until next week when all of the submitted answers will be posted. Good luck!

radER is a weekly contest consisting of a radiograph selected from various areas of emergency medicine that are central to the education of medical students and residents in training.

9 Responses

  1. 1) Patellar dislocation
    2) SUnrise
    3) closed reduction and immobilization

  2. 1. patellar dislocatoin
    2. sunrise view
    3. reduce the patella

  3. 1. Acute Lateral Dislocation of the Patella
    2. Sunrise View
    3. Pain Control Meds, Plain Films, If No Evidence of Osteochondral Fracture then Manual Closed Reduction under Procedural Sedation. Compression Bandage, Knee Immobilizer, Crutches/Education, Pain Meds Rx (I favor NSAIDs over Vicodin here), Instructions for Relative Rest/Wt Bearing as Tolerated, Ice, Elevation, Close Ortho F/U.

  4. 1. Patella dislocation
    2. Sunrise view (axial patellar) of the knee/patella
    3. Reducation, knee brace or splint/long leg cast, orthopedics follow up, and eventual physical therapy.

  5. DX: Patellar dislocation.
    I have no idea what view this is supposed to be…maybe a “sunrise view” that is just distorted secondary to the dislocation.
    TX: Immediate reduction…flex at hip, fully extend at knee with medial pressure on patella and BAM!! back in like new.

  6. 1) Patella dislocation
    2) Sunrise
    3) Closed reduction

  7. 1. Patellar Dislocation
    2. Sunrise View
    3. Closed reduction followed by knee immobilization in full extension. Ice, elevation, NWB, and analgesia. Orthopedic follow-up within 2 weeks.

  8. 1) Dislocated patella
    2) Skyline or sunrise view of patella
    3) Need to reduce by flexing hip, hyperextending the knee and move patella into place

  9. Patellar dislocation
    Sunrise view
    Reduction, knee immobilizer, crutches, pain control, ortho f/u

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