Emergency Medicine Cases EM Quick Hits 68 Osteomyelitis, Tourniquet Technique, Pediatric Distal Radius Buckle Fractures, DSI RCT, AMS in ESRD & Dialysis, EM Leadership Spotlight #3
Oct 7, 2025
Guest
Dr. Lisa Thurgur
Guest
Victoria Myers
Guest
Brit Long, MD
Guest
Justin Morgenstern
Guest
Andrew Tagg
Guest
Isaac Bogoch
Dr. Isaac Bogoch, an infectious diseases expert, discusses recognizing and managing osteomyelitis, emphasizing key risk factors and the importance of imaging. Dr. Andrew Tagg shares insights on treating pediatric distal radius buckle fractures, highlighting findings from the FORCE trial. Dr. Justin Morgenstern analyzes Delayed Sequence Intubation, advocating its cautious adoption based on new evidence. Additionally, Dr. Brit Long explores altered mental status in ESRD patients, while Dr. Lisa Thurgur reflects on leadership challenges in medical education.
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Why Osteomyelitis Matters
- Osteomyelitis causes major morbidity including amputation, disfigurement, and loss of mobility.
- Early recognition and basic steps make diagnosis and treatment manageable in the ED.
When To Suspect Osteomyelitis
- Suspect osteomyelitis for ulcers present >2 weeks or ulcers directly over bone.
- Use a short therapeutic antibiotic trial to distinguish cellulitis from deeper infection when appropriate.
Use Probe-To-Bone As A Clue
- Use the probe-to-bone test to raise pretest probability but don't rely on it alone.
- Proceed to imaging because probing has inter-observer variability and can't definitively rule in/out bone infection.