Lymphedema and Its Mimics

Lymphedema and Its Mimics

Lymphedema is a progressive pathologic condition of the lymphatic system where interstitial accumulation of protein-rich fluid leads to subsequent inflammation, adipose tissue hypertrophy, and fibrosis [1]. The direct effect of this development and its long-term complications can lead to disfigurement, decreased mobility, and significant morbidity. While the management of lymphedema typically requires long-term therapeutic interventions outside of the role of the Emergency Department, a thorough understanding of this condition and its mimics will help Emergency Physicians appropriately evaluate and manage the broad presentation of “swelling”.

Read More

Grand Rounds Recap 2.2.22

Grand Rounds Recap 2.2.22

In this week’s Grand Rounds, Dr. Laurence led us through an incredible and education Morbidity and Mortality Conference, Drs. Gillespie and Continenza worked through a dramatic case combining vision changes and rash, Dr. Wright reminded us to not forget the esophagus in our patients with chest pain and Dr. Connelly gave a fantastic overview of EMS provider education and systems structure in her R4 Capstone. Finally, our incredible visiting professor, Dr. Megan Rybarcyzk gave us insight into building an emergency medicine education program in the midst of a pandemic and provides tips and tricks for those seeking a career in global health.

Read More

Don't Kill the Beans: The Specter of Contrast-Induced Nephropathy

Don't Kill the Beans: The Specter of Contrast-Induced Nephropathy

Working in the Emergency Department, we often encounter patients with either pre-existing renal disease or an acute compromise of their renal function who also have a disease process necessitating a contrasted radiology study.  So what do we do with that patient with a creatinine of 1.8 who has a possible vascular dissection/traumatic injury/infection? What is the risk of contrast to that patient?  Should you compromise your diagnostic evaluation to avoid a harm to the patient's renal function?  Dr. Nick Ludmer, Dr Michael Miller, and Dr. Amanda Polsinelli recap 3 articles recently published looking into contrast induced nephropathy.  Take a listen to the podcast and read the blog post to get yourself acquainted with the current state of the literature.

Read More