Answer: VizD Radiograph Challenge Week of 7/30/2007
Congratulations to Michael - he is the first person to submit the correct answer to this week's VizD. Thank you to everybody who participated, there were many correct submissions but I can only pay one person a week!
To view Michael's answer, click here
Michael is the winner of $5.
Recap:
A 24-year-old woman presents to your ED complaining of knee pain. The patient as roller-skating, lost her balance, and fell directly onto her knee. After the fall, she was unable to ambulate and noted a swollen knee. The radiographs you ordered are shown below.
(click on image to enlarge)
Questions:
1. What is the diagnosis?
2. What is the most common type of this injury
3. What is the treatment of this injury?
1. Patella dislocation
2. Lateral
3. Reduction
For more information on patella dislocations, please visit the eMedicine article titled Patella Injuries and Dislocations
The next VizD will be posted on Monday August 13
VizD is a weekly contest of an interesting or pathognomonic image from emergency medicine. Its goal is to integrate learning into a fun and relaxed environment. All images are original and are posted with the consent of the patient. For more information please refer to the following link.
3 comments:
As a former RN who suffered subluxed patellas in both knees, first one due to on-the-job injury, and second d/t overuse injury, that is most certainly a dislocated patella...Lol. I don't know which is better, subluxed or dislocated. All I know is that I had 5 major knee surgeries in 3 years, and no longer have kneecaps. All this because I didn't want the stretcher to hit the wall as it swung around the corner, and my patient who had just had surgery to suffer minor pain.
Kiki,
My heart goes ut to you! You are correct indeed, this is a patella dislocation. The patella was relocated and the patient was discharged - sounds it was not as severe as in your case! Hope you are doing well.
Adam, thank you for your kindness. I have to admit, knowing that my knees aren't going to be any better and knowing that I'm going to have this pain for the rest of my life, is so much easier than dealing with hoping that each surgery would get me better, and I could go back to my old life. It was not to be, and I am dealing quite well with it, and have a wonderful pain management clinic that I go to. Of course, it only took me 9 years to get to them, and a bit of education on my part about chronic pain mgmt. Nope, we aren't drug addicts or drug seekers. We just want pain relief in order to live a better, more functional life.
The only other unfortunate thing, is that I wasn't done having all of my surgeries, before I developed signs of Cushing's Disease. Of course, it took me awhile(a few years) of having the symptoms before sorta figuring out what I had. Then, I went to a local endo, and he pretty much blew me off. Fast forward 6 years, still dealing with Cushing's symptoms, but finally found an awesome specialist 2/3 across the country from me to help me out, and to hopefully diagnose me soon, and get a cure. Of course, it's cyclic Cushing's, so it's much harder to diagnose than florid Cushing's. *sigh* I guess I got the bad genes in the family. ;-)
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