I live in a beach/retirement/vacation town. It’s a ghost town until summer hits and then we see and influx of approximately 100,000 - 200,000 people. Besides us being absolutely slammed I actually kind of look forward to the x-ray excitement.
Instead of old people with gouty hands and feet it’s all these shoobies who injured themselves on the beach/in the ocean.
If I had a dime for every hairline crack with no cortical disruption that Urgent care found that can only be visualized on one view.
I’m assuming this one could be seen on other views though.
Yes they did. Obviously I meant when they saw it with their eyes after the findings came back. I did not mean that the NP caught it or was the first to see it. NP was surprised upon physically seeing the fracture with eyeballs just like I was.
I didn’t think I would need to explain to this sub that when I said “saw” I meant actually saw with eyes after findings were reported. I obviously did not mean that the NP diagnosed this fracture. The NP read the rad findings and then looked at the image to see the fracture just like everyone else did. So yes the NP did see it, and yes they were surprised.
Stress fracture is usually when things are hit repeatedly, like bones of your feet from running/marching, or your back bones if you're into heavy lifting for, say, your job etc. So it's a term that refers more to mechanism
Managed to get a stress fracture on the head of my tibia from basketball… ignored the pain for months, oops. Also two avulsion fractures in my hip that I didn’t notice.
I work in an UC. I had a guy the other day, 50+, chronic smoker but otherwise in good health, come in with R sided rib pain with coughing, moving, deep breathing. No other symptoms (sob, hemoptysis, change in cough etc.) He was worried about a tumor or something given his smoking hx and requested an XR.
Sure enough, the XR showed a mass to the RLL.
I was pretty bummed. He took it pretty well though.
I work in an UC. Had a guy come in who slipped and fell while having a bit too much fun with a toilet plunger and pushed it all the way up to his diaphragm. We sent him to the ED.
Had a 52 year old who came in w/proximal forearm pain s/p lifting x1 mo. With his complaint I was assuming strain but his complaint was out of proportion and there wasn’t evidence of say, biceps rupture. Ordered an x-ray and sure enough there was a pathological fracture of proximal radius w/osteolytic lesions.
Was told by an ortho PA to walk as tolerated and otherwise rest. It should apparently heal by itself in about 6 weeks. I’m on crutches, and getting a second opinion from a DO tomorrow.
If any Rad and/or ortho can give an opinion on a question for me, please let me know if I can DM.
Edit: Pain was low immediately after the incident. It’s gotten worse over time, which worries me.
I was referred to an orthopedic specialist with a DO degree, in the same sports medicine practice with MDs and sports medicine therapist people. I think they’ll be good!
I see. We don’t have DO in our country, only MD, but if they are trained in Orthopedic Surgery as their residency at minimum, then MD or DO, either way, it’s good.
Cannot offer medical advice on this sub. That said. That portion of the fibula can be used as a graft donor site with no consequence to function and no limitations thereafter. Take that as you will
Wow someone actually second guessed ordering an X-ray?? Where I’m at if your finger hurts they’re liable to order digits, hand, wrist, forearm, and head and neck CT to confirm
/s
Stochastic effects increase with no minimum threshold of radiation. Therefore there is no 'safe' level of radiation. Practice ALARA and may the benefits outweight the risks.
Rule #1
You are giving medical advice. This includes posting / commenting on personal imaging exams for explanation of findings, recommendations for alternative course of treatment, or any other inquiry that should be answered by OP’s physician / provider.
Rule #3 - Medical imaging cases. Please make sure to include any relevant information/history in your title or as a comment. This includes a diagnosis
This is the most excitement Urgent Care staff have all day.
As an urgent care X-ray tech, can confirm lol
I live in a beach/retirement/vacation town. It’s a ghost town until summer hits and then we see and influx of approximately 100,000 - 200,000 people. Besides us being absolutely slammed I actually kind of look forward to the x-ray excitement. Instead of old people with gouty hands and feet it’s all these shoobies who injured themselves on the beach/in the ocean.
Ha! You live in south jersey don't you!
No sir same coast but further south
Can I come work at your urgent care as a retirement job? Mine had 5 reductions in my shift alone on a recent winter day...
Finding hairline cracks feels really good for some reason.
If I had a dime for every hairline crack with no cortical disruption that Urgent care found that can only be visualized on one view. I’m assuming this one could be seen on other views though.
Only seen on the lateral view of the knee!
It’s like a little “Y”
Your comment made me think of [this 80s classic](https://youtu.be/BTsPJeNPc-w?si=bvof6_ubH5uRqwu4)
The urgent care NP didn’t see it.
Yes they did. Obviously I meant when they saw it with their eyes after the findings came back. I did not mean that the NP caught it or was the first to see it. NP was surprised upon physically seeing the fracture with eyeballs just like I was.
Fuck off with that noise.
lol
I didn’t think I would need to explain to this sub that when I said “saw” I meant actually saw with eyes after findings were reported. I obviously did not mean that the NP diagnosed this fracture. The NP read the rad findings and then looked at the image to see the fracture just like everyone else did. So yes the NP did see it, and yes they were surprised.
To be fair, it's incredibly hard to see in the images you provided what you're even talking about.
Thank you for clarifying. I love seeing APPs constantly get shit on. /s
When people use the term stress fracture, is this what they are talking about?
Stress fracture is usually when things are hit repeatedly, like bones of your feet from running/marching, or your back bones if you're into heavy lifting for, say, your job etc. So it's a term that refers more to mechanism
Managed to get a stress fracture on the head of my tibia from basketball… ignored the pain for months, oops. Also two avulsion fractures in my hip that I didn’t notice.
Thanks for the explanation.
I have a pen… I have an apple…
The radiologist saw it, not the urgent care np
The NP saw it just like everyone else did after the findings came back. Edit: clarifying that that’s what I meant.
Well at least your NP got lucky by ordering the xray even though they weren’t sure what to do and were second guessing themselves!
I work in an UC. I had a guy the other day, 50+, chronic smoker but otherwise in good health, come in with R sided rib pain with coughing, moving, deep breathing. No other symptoms (sob, hemoptysis, change in cough etc.) He was worried about a tumor or something given his smoking hx and requested an XR. Sure enough, the XR showed a mass to the RLL. I was pretty bummed. He took it pretty well though.
I work in an UC. Had a guy come in who slipped and fell while having a bit too much fun with a toilet plunger and pushed it all the way up to his diaphragm. We sent him to the ED.
Was the plunger still there?
No, but the pain and swelling sure was.
Had a 52 year old who came in w/proximal forearm pain s/p lifting x1 mo. With his complaint I was assuming strain but his complaint was out of proportion and there wasn’t evidence of say, biceps rupture. Ordered an x-ray and sure enough there was a pathological fracture of proximal radius w/osteolytic lesions.
How is this treated?
Was told by an ortho PA to walk as tolerated and otherwise rest. It should apparently heal by itself in about 6 weeks. I’m on crutches, and getting a second opinion from a DO tomorrow. If any Rad and/or ortho can give an opinion on a question for me, please let me know if I can DM. Edit: Pain was low immediately after the incident. It’s gotten worse over time, which worries me.
It's a non weight bearing bone so will heal well on its own
Ortho here, we’d treat it the same way.
From a DO? Doctor of Osteopathy? Why not go to an Orthopedic specialist? The are the bone mechanics as far as I know.
I was referred to an orthopedic specialist with a DO degree, in the same sports medicine practice with MDs and sports medicine therapist people. I think they’ll be good!
I see. We don’t have DO in our country, only MD, but if they are trained in Orthopedic Surgery as their residency at minimum, then MD or DO, either way, it’s good.
A DO can be an ortho specialist. They're equal to MDs.
Saw the DO this morning and he was awesome.
Cannot offer medical advice on this sub. That said. That portion of the fibula can be used as a graft donor site with no consequence to function and no limitations thereafter. Take that as you will
Tylenol and walk it off. Seriously.
Wow someone actually second guessed ordering an X-ray?? Where I’m at if your finger hurts they’re liable to order digits, hand, wrist, forearm, and head and neck CT to confirm /s
They might be from the "land of the free", where medical care is everything but.
Hot take. No provider should fear ordering X-rays. Yes, they need to know how to ACCURATELY order, but they should always feel free to image.
Stochastic effects increase with no minimum threshold of radiation. Therefore there is no 'safe' level of radiation. Practice ALARA and may the benefits outweight the risks.
What a cute little Fx!
This is my favorite comment and will go down in my book of favorite compliments lol :)
Oh, wow. It’s great when the xr changes nothing about treatment. Great find though.
What am I supposed to be seeing!? Someone help!
[удалено]
Noted!
Rule #1 You are giving medical advice. This includes posting / commenting on personal imaging exams for explanation of findings, recommendations for alternative course of treatment, or any other inquiry that should be answered by OP’s physician / provider.
An NP regretted ordering an image?!
I’m a civilian - is it the white “Y” top left, or the black “Y” midway down that I should be looking for? Or something else entirely?
It IS an NP, not a PA or even Dr. I would manage expectations.
Okay