Ep 176 Orthopedic X-rays Master Class – Pitfalls in Obtaining and Interpreting MSK X-rays

Emergency Medicine Cases

Dr. Anton Helman

Education, Health & Fitness, Courses, Medicine, Science

4.7 • 602 Ratings

🗓️ 8 November 2022

⏱️ 49 minutes

🔗️ Recording | iTunes | RSS

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Summary

Do not let a negative X-ray rule the day! Like almost all medical tests X-rays are far from perfect and should be ordered and interpreted only in the context of a thorough history and physical exam. In this 2nd part of our 2-part series on orthopedic x-rays with Dr. Arun Sayal and Dr. Yatin Chadha we discuss the pitfalls of obtaining and interpreting orthopedic X-rays, when orthopedic X-ray decision tools lead us astray, how understanding the concept of central ray helps dictate how we should order X-rays and interpret them, how the ring structure concept of the forearm and lower leg can remind us where to look for a second injury, when we need 3 views vs 2 views, when extra views like the clenched fist view and weight bearing views are indicated, why we should always look at the lateral view first, the limitations of ultrasound and CT in long bone and joint injuries and more... Please support EM Cases by giving a donation: https://emergencymedicinecases.com/donation/

Transcript

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0:00.0	Welcome to the Emergency Medicine Cases podcast.
0:05.0	I'm your host, Dr. Anton Hellman, bringing you Canada's brightest minds in emergency medicine from EMC studios in Toronto.
0:13.9	EM cases is part of SREMI, Schwartz-Risman Emergency Medicine Institute, the nonprofit organization dedicated to improving EM care through research
0:21.1	and education.
0:22.7	The opinions expressed on this podcast are intended for information and education purposes only
0:24.7	and should not be used to diagnose treat or prevent any medical condition, nor should they
0:26.6	be used as a substitute for medical advice from qualified practicing physician.
0:30.9	EMKases Summit tickets just went on sale at EMKases Summit.com.
0:36.4	Space is limited for the virtual simulation sessions and for the morning symposiums on rural
0:40.9	EM, global EM, and wellness.
0:43.1	So to help ensure that we continue to provide the EM cases podcast for free, as well as the
0:48.5	entire learning system, the videos, the email blast, etc.
0:52.1	Consider please getting a ticket for the summit. It has full
0:55.9	CME accreditation in both the U.S. and Canada, so you can catch up on any CME obligation you
1:01.1	might have or bank tons of CME credits for the future. Again, visit emcasesummit.com for all the
1:07.9	details. On part one of our two-part podcast on when x-rays lie, we went in detail
1:16.2	into Dr. C.L's scared of mnemonic for the differential diagnosis of MSK injuries. In this part
1:23.6	two, we're going to first dive into how to order x-rays and how to interpret x-rays
1:29.8	properly. And then there's going to be a whole bunch of other good pearls in there after we do
1:34.4	that. Now, we're going to be talking about how to improve our x-ray interpretation skills,
1:38.2	but before we get into how we read x-rays, I'd like to talk about how to order them properly. So first, Dr. Cial, I want to
1:46.2	talk about the rules that we have for when to order x-rays. There's the very famous Ottawa ankle
	...

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