Welcome to The Pearl Log — where post-shift wisdom surfaces, one shiny clinical take at a time. Some pearls are fresh, some are rough, all are found under pressure.
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Deep Dive: ED Hip Fracture Management
A practical review of ED management of hip fractures, including high-yield bedside pearls, occult fractures, peripheral nerve blocks, and communicating with orthopedics. It also takes a closer look at the evidence behind preoperative Buck's traction and what current guidelines recommend.
Leg Pain Pontification
Osteoarthritis is a clinical diagnosis driven by multifactorial structural and central pain mechanisms, where symptom severity often poorly correlates with imaging, and management remains stepwise with a focus on nonpharmacologic therapy and, if needed, topical NSAIDs. For suspected DVT, a structured approach using Wells criteria and age-adjusted D-dimer safely reduces unnecessary imaging, with recent prospective data supporting its reliability in low- to moderate-risk patients.
Knee Pain and Monkeypox
Throw out those knee immobilizers for traumatic knee pain.
Don’t miss monkeypox when it walks into your ER!
Varicoceles and Jones Fractures
A quick pair of pearls today: first, a rundown on why varicoceles show up on the left and what makes a right-sided one worth a second look in the ED. Then, a rapid comparison of Jones versus pseudo-Jones fractures.