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Otic quinolones (OQ) were associated with an increased risk of Achilles tendon rupture and all-type tendon rupture, but this was rare. Even with this risk, sometimes an OQ is still the right choice.
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Quinolone Ear Drops and Achilles Tendon Rupture. Clin Infect Dis. 2022 Sep 6;ciac709. doi: 10.1093/cid/ciac709. Online ahead of print.
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Empiric antibiotic therapy – without aspiration – is a reasonable approach for the management of suspected prepatellar septic bursitis in non-toxic patients with close outpatient follow up.
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Efficacy of empiric antibiotic therapy without aspiration for septic prepatellar bursitis in emergency department patients. Acad Emerg Med. 2022 Aug;29(8):1027-1032. doi: 10.1111/acem.14499. Epub 2022 Apr 25.
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Synovial fluid and peripheral blood neutrophil-to-lymphocyte ratios are promising novel diagnostic and prognostic biomarkers for septic arthritis.
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Synovial Fluid and Serum Neutrophil-to-Lymphocyte Ratio: Novel Biomarkers for the Diagnosis and Prognosis of Native Septic Arthritis in Adults. J Bone Joint Surg Am. 2022 Jun 20. doi: 10.2106/JBJS.21.01279. Online ahead of print.
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This article covers important pearls in the management of posterior hip dislocations along with 6 techniques all EM providers should know. Watch this hilarious YouTube video with all these techniques in under 2 minutes!
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Managing Posterior Hip Dislocations. Ann Emerg Med. 2022 Jun;79(6):554-559. doi: 10.1016/j.annemergmed.2022.01.027. Epub 2022 Mar 9.
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This article is a literature review that covers seven elbow reduction techniques and the key tenets of management. See the visuals for each — a picture is worth a thousand words.
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Many children discharged from the emergency department with minor traumatic cervical spine injury do not adhere to recommendations for cervical immobilization or outpatient follow-up, with no significant clinical consequences observed.
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The Fate of the Cervical Collar: An Observational Pilot Study Investigating Follow-up Care After Emergency Department Discharge in Children With Mild Traumatic Neck Injuries. Pediatr Emerg Care. 2022 May 25. doi: 10.1097/PEC.0000000000002755. Online ahead of print.
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Vapocoolant spray improved pain from digital blocks for repair of finger injuries.
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Evaluation of vapocoolant spray effect on pain reduction during digital nerve block: A randomized clinical trial. Am J Emerg Med. 2021 Dec;50:260-263. doi: 10.1016/j.ajem.2021.08.001. Epub 2021 Aug 6.
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Lumbar spinal stenosis affects more than 1 in 10 U.S. citizens and over 100 million patients worldwide. This painful condition is diagnosed clinically with confirmatory imaging. Firstline treatment is activity modification, analgesia, and physical therapy, and careful selection of surgical candidates should be done only if conservative management fails.
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Diagnosis and Management of Lumbar Spinal Stenosis: A Review. JAMA. 2022 May 3;327(17):1688-1699. doi: 10.1001/jama.2022.5921.
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Patients with Achilles’ tendon rupture undergoing surgical repair, either open or minimally-invasive, did not have better outcomes at 12 months compared to non-operative treatment. However, those managed nonoperatively had a higher rate of tendon rerupture.
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Nonoperative or Surgical Treatment of Acute Achilles’ Tendon Rupture. N Engl J Med. 2022 Apr 14;386(15):1409-1420. doi: 10.1056/NEJMoa2108447.
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This literature review helps emergency physicians systematically approach evaluation of traumatic arthrotomy (TA) while pointing out diagnostic pitfalls.
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High risk and low prevalence diseases: Traumatic arthrotomy. Am J Emerg Med. 2022 Jan 21;54:41-45. doi: 10.1016/j.ajem.2022.01.013. Online ahead of print.
