Ortho EM Pearls

Tolerate More Than Pain

It All Started With A FOOSH

A 17-year-old female presents with right elbow pain after a backwards fall with her arm extended behind her. On exam you note that she is holding her arm with approximately 45 degrees of flexion and is neurovascularly intact distally.

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May 20, 2026

It All Started With A FOOSH

May 13, 2026

Glenn Hurt His Shoulder

A 32 year old male presents to the ED after falling directly on his right shoulder while snowboarding. There is a bruise on the lateral aspect of the shoulder and he has pain with abduction and internal/external rotation.

May 06, 2026

Back Up The Shoulder

A 40-year-old male presents with left shoulder pain. He frequently dislocates his shoulder and attempted to reduce it again, but states it is still painful and “not working right.”

April 25, 2026

Dorsal Wrist

A 65-year-old male presents with left wrist pain. He has noted swelling to his left wrist for the past several days. You perform an ultrasound and notice an effusion. To assist with diagnosis, you opt to perform a wrist arthrocentesis.

April 15, 2026

Just Slipped Out

A 30-year-old male presents after motorcycle crash and FOOSH. He has pain and swelling on the volar surface of his right hand.

April 08, 2026

Pelvic Injury

A 45-year-old man presents to the Emergency Department with severe suprapubic pain after being thrown off of a forklift at work. On examination, there is significant pelvic tenderness to palpation, and blood at the urethral meatus.

March 28, 2026

Knee

A 55-year-old female presents after a fall at home. She is complaining of new shoulder pain and holding her arm in an abducted and externally rotated position. You grab your ultrasound for a quick, noninvasive (and sensitive!) evaluation.

February 25, 2026

Dancing Till You Drop

A 21 year old female presents to the emergency room after falling from dancing on a table and injuring her right ankle. She is in severe pain and unable to bear weight comfortably with swelling and tenderness along the lateral malleolus. X-rays are taken and shown above.

February 18, 2026

Stop Saltering That Harris

A 13-year-old male presents to the ED after being tackled while playing football and having sudden onset of pain in the knee. He noticed a deformity and was unable to ambulate after the injury.

February 11, 2026

Under Extended

A 45-year-old male presents as a polytrauma patient after a high speed MVC. He was unrestrained and airbags didn't deploy. After a full trauma evaluation, he complains of right knee pain and has developed bruising and an effusion in the right knee since arrival. He was unable to hold a straight leg raise when asked.

January 31, 2026

Shoulder

January 07, 2026

Chest Goes Crunch

A 45-year-old male presents to the ED with left-sided chest pain after falling off a 10-foot ladder.

December 31, 2025

Fracture Keeps Hurting

29-year-old presented to the emergency department with diffuse left lower-leg pain, swelling, and difficulty with mobility eight weeks after an inversion ankle and knee injury resulting in a known proximal fibular avulsion fracture. He reports wearing both an ankle brace and a knee immobilizer and has remained on protected weight bearing throughout this period with limited mobility.

December 27, 2025

Chest

A 62-year-old male presents with left shoulder/chest pain after falling and landing on the left shoulder. He has pain in the upper chest and describes a deformity.

December 10, 2025

One Wheelin' and Dealin'

A 45-year-old male presents to the ED complaining of left shoulder pain after falling off of his Onewheel. There is an obvious deformity noted to the left anterior/superior chest with decreased range of motion of the shoulder.

December 03, 2025

My Arm is Stuck Like This

A 70-year-old female presents with right shoulder pain and inability to adduct her arm after she fell on the sidewalk.

November 29, 2025

Wrist

A 47-year-old female notes radial wrist pain for a few weeks after caring for her newborn.

November 26, 2025

Don't Forget About the (Tibial) Spine

A 13-year-old patient presents to the Emergency Department after sustaining a twisting knee injury while playing soccer. There was a pop, and the patient was subsequently unable to bear weight secondary to pain and instability. In the hours following the injury the swelling and pain increased. On examination, there is a large knee effusion and a positive Lachman test.

November 19, 2025

El-bow Out of This One

A 65-year-old male presents with left elbow and forearm pain and deformity after falling on the soccer field when attempting a scissor kick. He fell onto his outstretched arm with his elbow flexed and supinated.

November 12, 2025

This Little Piggy Went to the Hospital

A 74-year-old female presents with right foot pain after tripping on a shoe. She reports discomfort on the lateral side of her foot with weightbearing.

Ortho EM Pearls

Ortho Pearls for the EM Professional

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We want to be the premier source of orthopaedic/sports medicine education as it relates to the Emergency Medicine professional.

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We are excited to begin this journey with you. There are TONS of excellent resources out there, but the purpose of our website is to provide you a consistent dose of high-yield image-based MSK cases so you can take something with you to your next shift in the Emergency Department!

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