Ortho EM Pearls

Tolerate More Than Pain

Pull to Start

A 59-year-old male with a history of DVT on Eliquis presents to the emergency room with severe shoulder pain. The patient had been pushing his car when he fell onto his outstretched arms. His son subsequently pulled on his right arm to attempt to “relocate” it. During this, the patient experienced sudden worsening pain with his right arm becoming stuck above his head with the onset of numbness and tingling in his right arm.

Slide Background

Your Premier Source for Emergency orthopedic and Sports medicine Education

Weekly Orthopedic Cases

Monthly Ultrasound Cases

Splinting Guides

Monthly Ultrasound Cases

Next Slide

Block

Wild Ortho Wednesdays

New Orthopedic Casese Every Friday

Preview revealed Monday on Instragram/X (Twitter)

Monthly Ultrasound Cases

Monthly four-part series--one part each Saturday

X-Ray

MRI

Ultrasound

CT Scan

Slide 2

2023 Awards

Authors of the Year

Kaylar Darris/Liana Meffert | Katie Dolbec

Editor of the Year

Click here to view all cases!

Recent Cases

All

Weekly Cases

SOS

Splinting Series

Procedures

April 23, 2025

Pull to Start

April 16, 2025

Oh Snap

A 14-year-old male presents for left medial elbow pain after pitching during a baseball game the night before when he felt a snap in his left elbow during a pitch. He continued to feel a sharp pain with every subsequent pitch in the medial elbow. He has point tenderness on the medial aspect of his left elbow and pain with elbow extension but full ROM. He has tried OTC anti-inflammatory medications and icing at home with mild relief.

April 09, 2025

Shoulder Check: A common skier's shoulder injury

A 38-year-old female presents to the ski clinic for left shoulder pain after a fall while skiing. Her ski caught an edge causing her to fall directly onto her left shoulder. She now has significant pain in the left shoulder that increases with attempt at forward flexion and adduction at the shoulder. She denies any other associated symptoms.

Shoulder Check: A common skier's shoulder injury

April 02, 2025

The Floating Elbow

A 30-year-old male with no pertinent medical history presented as a trauma after a motorcycle crash where he was traveling approximately 70 mph. The patient was cut off by another vehicle, and flew off his bike going airborne unknown feet, landing onto his outstretched hands. He is primarily complaining of left arm pain.

March 26, 2025

Dropping the Ball

A 20-year-old college basketball player presents to the Emergency Department after a syncopal event at practice. He was found pulseless by the athletic trainer, who initiated chest compressions, and achieved ROSC after delivering 1 shock via AED.

March 19, 2025

A Sudden Turn of the Ankle

A 77-year-old presents to the ED for evaluation of right ankle pain, which occurred approximately 1 hour prior to arrival after making a sharp right turn with his foot planted in the restroom. He had sudden onset pain. He reports normal sensation over the right foot and is neurovascularly intact. An obvious open deformity is noted to the right ankle.

March 12, 2025

Pedal to the Metal

A 32-year-old female presents to the emergency department with right ankle pain after a high-speed motor vehicle accident. On exam, she is noted to have ecchymosis and swelling over the dorsal foot, and pain with ankle dorsiflexion and plantarflexion.

February 26, 2025

Hold On Tight!

A 34-year-old female presents after a waterslide accident. She was traveling down a water slide with her fourth and fifth digits of her right hand in the handle of the inner tube when the inner tube was ripped out from under her at the bottom of the slide. She instantly noted pain and swelling in the middle of her hand. She complains that she can not make a fist.

February 23, 2025

Superior Knee

A 55-year-old male presents with right knee pain after a ski accident. She has swelling of her knee and difficulty bearing weight. You obtain an ultrasound image given the difficult exam.

February 19, 2025

Acute Shoulder Pain After a Fall

An 80 year-old female tripped over her cat at home. This caused her to fall, hitting her right shoulder on the counter on the way to the floor. She is complaining of right shoulder pain and denies hitting her head or LOC. X-rays obtained in the Emergency Department are shown below.

February 12, 2025

Can’t Climb a Tree

A 35-year-old male with past medical history of Crohn’s disease presents to the ED for insidious lower back pain worse with prolonged exertion, climbing stairs, and morning stiffness. He reports some relief with movement and NSAIDs, but the pain has progressively worsened over the past few months.

February 05, 2025

Achilles Heel - Kager’s Fat Pad

A 25-year-old male with no medical history presents with left foot pain after a soccer injury yesterday. He states he was running when he felt a sudden “pop” to the posterior aspect of the left ankle and thought someone had kicked him. He is complaining of mild pain localized to the posterior ankle though has been ambulating with pain.

January 29, 2025

Calf-inated

A 45-year-old male presents with pain in the posterior right calf after falling forward while skiing. He now has pain with ambulation. He has pain with passive dorsiflexion of the ankle, pain with resisted plantar flexion, but preserved plantar flexion with squeeze of calf muscles.

January 27, 2025

Regional Anesthesia Interscalene Block

A 27-year-old male presents with left shoulder pain after falling down a flight of stairs and trying to grab onto a railing to catch himself. He has an obvious deformity to his left shoulder, and is holding his arm in abduction and internal rotation.

January 22, 2025

Too much send

An 18-year-old male presents with left ankle pain after overshooting the landing of a large jump while snowboarding.

January 15, 2025

I declare a thumb war

A 39-year-old female presents to the emergency department with right thumb pain after falling in a skiing accident. On exam, there is mild swelling, tenderness on the ulnar aspect of the 1st MCP joint. Additionally, there is laxity with valgus stressing of the 1st MCP joint.

January 08, 2025

The Heel Deal

A 57-year-old male with a history of alcohol induced cirrhosis presents to the ED w/ 10 days of reported L foot pain after fall from 6 foot ladder, landing directly onto his left foot. Since his injury, he has noticed increasing redness and swelling to the posterior aspect of the foot beginning approximately 4 days after the fall. He has been using a walker that he borrowed from his friend to assist in ambulation. He denies any knee pain or back pain.

December 28, 2024

Regional Anesthesia Upper Extremity

A 24-year-old male presents after a high-energy ATV rollover. He presents with a gross deformity to his forearm.

December 25, 2024

Foosh there it is

A 72-year-old woman presents to the emergency department with right wrist pain and swelling. She states that she was crossing the street when she fell and attempted to brace herself with her right hand.

December 18, 2024

Red Hot Wrist

The patient is a 74-year-old male with a PMH of diabetes, and hypersensitivity pneumonitis on chronic prednisone who presented with fevers and right wrist pain. He had a cortisone injection in his right wrist 4 days prior. The patient reports pain, swelling, and erythema of the right wrist. Pain is worse with movement. He denies trauma to the wrist. His distal neurovasculature is intact. He is febrile to 38.5C, tachycardic (HR:130), tachypnic (RR: 25), and hypoxic requiring oxygen (85% room air).

Ortho EM Pearls

Ortho Pearls for the EM Professional

Vision Statement

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

About Us

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!

Mission Statement

We want to provide free, concise, high-quality, and peer-reviewed orthopaedic/ sports medicine content to the Emergency Medicine professional.

All content on the Ortho EM Pearls website is purely educational and should not be construed as medical advice. The content and all associated information on this website is not intended to diagnose, treat, cure, or prevent any disease. Please seek care from a medical professional and if you are having a medical emergency, please call 911.

Ortho EM Pearls is a 501(c)(3) nonprofit organization.