Does Prepatellar Bursitis Need Aspiration?
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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.
Source
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.
A Simple New Biomarker for Septic Arthritis
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Synovial fluid and peripheral blood neutrophil-to-lymphocyte ratios are promising novel diagnostic and prognostic biomarkers for septic arthritis.
Source
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.
How to Do 6 Hip Reduction Techniques – New Video!
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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!
Source
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.
How to Perform Seven Elbow Dislocation Reduction Techniques
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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.
A Real Pain in the Neck – C-Collar Adherence in Children After PED Discharge
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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.
Source
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.
Does Vapocoolant Spray Work When Used Before Digital Block?
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Vapocoolant spray improved pain from digital blocks for repair of finger injuries.
Source
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.
How to Manage Spinal Stenosis | Spoon-Feed Version
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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.
Source
Diagnosis and Management of Lumbar Spinal Stenosis: A Review. JAMA. 2022 May 3;327(17):1688-1699. doi: 10.1001/jama.2022.5921.
The Achilles’ Heals…Without Surgery? Non-op vs Operative Management RCT
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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.
Source
Nonoperative or Surgical Treatment of Acute Achilles' Tendon Rupture. N Engl J Med. 2022 Apr 14;386(15):1409-1420. doi: 10.1056/NEJMoa2108447.
Traumatic Arthrotomy – Should I Load That Joint?
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This literature review helps emergency physicians systematically approach evaluation of traumatic arthrotomy (TA) while pointing out diagnostic pitfalls.
Source
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.