Welcome to the Emergency Medicine Cases podcast.

I'm your host, Dr. Anton Hellman, bringing you Canada's brightest minds in emergency medicine from EMC studios in Toronto.

EM cases is part of SREMI, Schwartz-Risman Emergency Medicine Institute, the nonprofit organization dedicated to improving EM care through research

and education. The opinions expressed on this podcast are intended for information and education

purposes only and should not be used to diagnose treat or prevent any medical condition,

nor should they be used as a substitute for medical advice from qualified practicing physician.

Back when Aaron CL, one of our special guests on this podcast, started working in the ED

about 30 years ago, the algorithm for patients with limb injuries was

pretty simple. Do an x-ray where it hurts. If the x-ray shows a fracture or dislocation,

make sure it's in good enough position and immobilize it, follow up in the orthopedic clinic.

And if the x-ray does not show a fracture, call it a soft tissue injury and prescribe rice,

the old restricted activity, ice, compression,

and elevation, and suggests they follow up with their primary care physician, maybe some

physiotherapy thrown in. But it just ain't that simple. And thanks in part to Dr. C.L's

masterful teaching on orthopedic injuries to the worldwide EM community over the last couple of

decades,

we've become much more sophisticated in our thinking around how to approach orthopedic injuries.

In this podcast, we're not going to talk about the obvious trimaleolar fracture dislocation

or the glaring Terry Thomas sign of scaffold lunate dislocation or the shattered proximal humerus.

What we are going to talk about are the limitations of x-rays, how to become master x-ray readers,

when ultrasound or CT may or may not help, and how to think about orthopedic injuries a bit

differently than we have in the past. And to help us along with Dr. Seale,

...