There is no significant difference between the soft tissue shadows when comparing patients with and without cervical spine fractures on lateral radiographs. Both commonly used measures of soft tissue shadows in clinical practice are insensitive in identifying patients with significant osseous injuries. They, therefore, do not offer any further value in interpreting traumatic cervical spine radiographs. The management of patients with cervical spine trauma in the absence of obvious osseous injury on standard radiographs should warrant a computed tomography (CT) scan if clinically indicated.
We present a rare case of endocarditis in a 33-year-old woman with a splenectomy. The patient presented with meningeal symptoms and was diagnosed with endocarditis on the medical admissions unit using a portable echocardiography machine. Bordetella holmesii was cultured from the blood on admission and the patient underwent subsequent aortic valve replacement. We discuss the importance of echo skills within the specialty of acute medicine and the benefits of swift senior review at the front door. We emphasise the guidelines on antibiotic prophylaxis for the post-splenectomy patient as well as discuss the pathogen B holmesii and its growing association of septicaemia in asplenic individuals.
Highlights
Extra articular osteochondromatosis is rare and scarcely reported around the ankle joint.
Due to the subtle clinical and radiological presentation of SC they often lead to a diagnostic challenge.
Higher degree of suspicion enables early diagnosis, thereby preventing both morbidity and inadequate treatment.
Although MRI plays a key role in deciding the extent of the surgery, confirmation can be made only with histopathology.
Long term follow up is mandatory considering both the risk of local recurrence and rare malignant transformation.
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