The Clinical Problem Solvers Episode 356 – RLR – All About the Exam
Oct 1, 2024
Explore the challenges of managing clinical documentation with an innovative AI medical scribe, Freed. Dive into the complexities of diagnosing diplopia, where critical assessments reveal underlying neurological issues. Witness a gripping case of a serious foot infection that sheds light on effective treatment strategies. Learn about Charcot arthropathy and its intricate diagnostic challenges, plus the crucial connection between nerve health and bone integrity in foot conditions. Engage with lighthearted discussions that make clinical analysis both educational and fun!
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Episode notes
Simple Diplopia Cover Test
- Test monocular vs binocular diplopia by covering each eye to distinguish refractive/retinal causes from misalignment.
- If vision normalizes with one eye covered, focus workup on ocular alignment and extraocular muscle/nerve causes.
When Cover Test Fails, Look Beyond Muscles
- Diplopia that persists when either eye is covered suggests a problem inside the visual pathway or the eye itself, not extraocular muscle misalignment.
- Consider retinal, optic nerve, chiasm, cortical lesions or psychogenic causes when cover-testing fails.
Image Early For Red, Swollen Foot
- For a red, swollen foot after trauma, get imaging early to assess for fracture or deep infection.
- Prefer advanced imaging (CT or MRI) when concerned for deep involvement or bone pathology despite normal pulses.