2020 ◽  
pp. 263-270
Author(s):  
Pat Croskerry

In this case, a woman in her late 30s was brought to the emergency department (ED) following a motor vehicle collision. She was a passenger in a car that was T-boned on the passenger side. Her principal complaint was neck pain. After plain radiographs showed no bony injury, she was discharged with cervical strain. She presented again to the same ED on three further occasions before her correct diagnosis was made. Aspects of implicit bias are highlighted in her care.


2002 ◽  
Vol 180 (5) ◽  
pp. 441-448 ◽  
Author(s):  
Richard Mayou ◽  
Bridget Bryant

BackgroundThe psychiatric outcome of whiplash neck injury is controversial.AimsTo describe outcomes and predictors as compared with other types of road accident injury.MethodConsecutive emergency department attenders (n=1148; whiplash 278) assessed by self-report at baseline, 3 months, 1 year and 3 years.ResultsModerate to severe pain was reported by 27% of whiplash sufferers at I year and by 30% at 3 years. Psychiatric consequences were common and persistent. Whiplash victims and those with bony injury were more likely to seek compensation. Accident and early post-accident psychosocial variables predicted the pain at 1 year. Claiming compensation at 3 months predicted the pain at 1 year for those with whiplash or bony injury.ConclusionsThere is no special psychiatry of whiplash neck injury. Psychological variables and consequences are important following whiplash in a similar manner to other types of injury.


Author(s):  
Sanad Younes ◽  
Ahmad Saad ◽  
Zeyad Buahlaika

The distal radioulnar joint is one of the inherently unstable joint in the body, its injury is commonly missed and the patient may present later with pain and restricted movement because of joint instability.  The distal radioulnar joint instability could be dorsal , volar , or bidirectional, and it could be caused by soft tissue injury or bony injury and malunion. It is fundamentall to recognize the type of injury and the cause of instability to be able to provide the proper form of treatment to get the best results.


Author(s):  
Arvind Kumar ◽  
Mozammil Pheroz ◽  
Rajesh K. Chopra ◽  
Benthungo Tungoe ◽  
Narendra Kumar ◽  
...  

<p class="abstract"><strong>Background:</strong> At present the risk assessment for osteoporosis using low bone mineral density (BMD) is based on data obtained from elderly females, largely ≥ 65 years of age. The risk factors for low peak bone mass or accelerated bone loss that occurs during perimenopausal phase is ignored in this risk assessment. Osteoporosis is found to occur at a relatively younger age in the Indian population. Although lower BMD values have an established identity as a major risk factor for fractures in postmenopausal women, we endeavour to evaluate relationship between bone mineral density and fragility fracture in perimenopausal women.</p><p class="abstract"><strong>Methods:</strong> 65 Patients were recruited for the study. After X-ray of involved part, patients were divided into cases (with fracture, n=33) and control (no bony injury, n=32). All patients underwent dual energy X-ray absorptiometry (DEXA) scan. Results of DEXA scans were evaluated in both the groups. BMD was expressed in g/cm<sup>2</sup>.<strong></strong></p><p class="abstract"><strong>Results:</strong> 33 patients (50.77%) were diagnosed as fracture, 32(49.23%) had no bony injury. Threshold bone mineral density (BMD) for fragility fracture found out asfor L1, cut off ≤0.767. For L2, cut off ≤0.829. For L3, cut off ≤0.811. L4, cut off ≤0.798. For L1-L4, cut off ≤0.845. For left femur total hip, cut off ≤0.918. For left forearm-total, cut off ≤0.411. For right femur total hip-cut off ≤0.795. For right forearm-total, cut-off≤0.382.</p><p class="abstract"><strong>Conclusions:</strong> Perimenopausal women having BMD below threshold for involved site are at risk of fragility fracture and should be given prophylactic treatment to improve bone mineral density.</p>


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