Diabetic foot infections
1) Diabetic foot cellulitis - it comes from ulcers, if there is/was no ulcer, it's likely not cellulitis.
2) Limb-threatening diabetic foot infections - cellulitis extending >2cm from ulcer, probes to bone
3) Charcot foot - occurs in stages, no systemic symptoms, labs will likely be normal. 45% mortality in 4 years.
Orthopedic pearls/orthopedic lab
1) Shoulder dislocations - anterior dislocations are the most common, and most of those are subcoracoid dislocations. Least common dislocation is an inferior dislocation - aka luxatio erecta - the arm will be locked in abduction.
2) Nursemaid's elbow - reduce by supinating the child's forearm with the elbow flexed and apply pressure over the radial head. You should hear a 'click' as the annular ligament is liberated from the joint.
1) Withdrawal seizures - you should not need a lot of benzodiazepines to control alcohol withdrawal seizures. If the patient requires escalating doses of benzodiazepines to control seizures, consider additional seizure etiologies.
2) CIWA score - it is not diagnostic of alcohol withdrawal, just a severity score. Diagnose withdrawal based on signs and symptoms in the right context. The patient must be able to participate in questioning as 4 out of the 6 categories necessitate answers from the patient.
Dissociated ramblings - attachment from ASA (short read, funny)
1) Achilles ultrasound - sensitivities and specificities vary from paper to paper, however, you can use it to diagnose Achilles' tendon rupture. One difficulty with tendon ultrasound is a sonographic artifact called anisotropy. This occurs when the probe is not perpendicular to your higher-than-average refractive structure (ex: tendon) and will cause the structure to appear hypoechoic.
2) Local anesthetic toxicity (LAST) - the more lipophilic, the more potent the local anesthetic (the uncharged drug must penetrate nerve membrane as well as bind to a hydrophobic site on the sodium channel). If systemic toxicity occurs, you can consider giving lipid emulsion as a reversal agent. Lipid rescue is a big area of research in toxicology.