Musculoskeletal

Rapid Review

• Background
  • Involves puncture of elbow joint and aspiration of synovial fluid for therapeutic or diagnostic purposes. 
• Indications
  • Suspicion for septic arthritis or inflammatory causes such as gout, pseudogout, or rheumatologic disorders. May also be used to relieve pain and improve mobility. 
• Contraindications
  • No absolute contraindications. Relative contraindications include overlying skin infection, joint prosthesis, bacteremia, or anticoagulant use. Do not inject steroids into joint if infection is suspected.
• Complications
  • Infection (rare), hemarthrosis, allergic reaction to anesthetic.

Rapid Review

• Background
  • Involves puncture of knee joint and aspiration of synovial fluid for therapeutic or diagnostic purposes. 
• Indications
  • Suspicion for septic arthritis or inflammatory causes such as gout, pseudogout, or rheumatologic disorders. May also be used to relieve pain and improve mobility. 
• Contraindications
  • No absolute contraindications. Relative contraindications include overlying skin infection, joint prosthesis, bacteremia, or anticoagulant use. Do not inject steroids into joint if infection is suspected.
• Complications
  • Damage to cartilage if place improperly, infection (rare), small hemarthrosis

Rapid Review

Rapid Review

• Background
  • Procedure used to assess for compartment syndrome. 
• Indications
  • Pain or paresthesia following fractures, crush injury, snake bites, burns, prolonged tourniquet, or infection.
• Contraindications
  • No absolute contraindications. Avoid sites with overlying infection.
• Complications
  • Pain, low risk of infection

Rapid Review

Rapid Review

Rapid Reviews

Rapid Review

Rapid Review

• Background
  • Reduction of patellar dislocation; common in athletes and adolescent women. Dislocation may be lateral (most common), horizontal, vertical, or intercondylar
• Indications
  • Lateral/medial dislocations, especially if associated with vascular compromise.
• Contraindications
  • Presence of proximal tibia or distal femur fracture.
• Complications
  • Osteochondral fractures (rare)

Rapid Review

• Background
  • Reduction of anterior (most common), posterior, or inferior (rare) shoulder dislocation.
• Indications
  • Uncomplicated, low force shoulder dislocations
• Contraindications
  • Associated fractures of humeral neck or subclavicular/intrathoracic dislocations. Avoid multiple attempts in those with suspected nerve injuries or other common fractures (Hill-sachs deformity, bankart fracture, 
• Complications
  • Rare, but include fractures, neurovascular injuries, or rotator cuff injuries (rare)

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