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Orthopaedic Emergencies Case 2

Cyberschool Creators: Kevin Baumlin, MD & Michael Bessette, MD
Module Author: Edward Mintz, MD
Web Authors: Carol Lewis & Marcy Wang


Situation


You are working on a sunny Sunday in November. A 20-year old male patient accompanied by his friends, is brought to your attention. The patient was playing football in the park and reports that he collided with another player, striking his shoulder and sustaining a very painful blow. He can not raise his arm and is in severe pain. He is supporting his injured side with the other hand and will not let anyone touch his shoulder. With difficulty, you are able to remove his clothing, exposing a clearly deformed shoulder.

1.

What are your initial steps in evaluating the patient? Should you try to "pop" his shoulder back into place?

   

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2.

What X-rays should you request?

   

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3.

The patient's X-rays are shown. How should this be managed?

   

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4.

What are other imaging modalities that one can emply to evaluate a shoulder and when should they be used?

   

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