altA 47-year-old male presents to your emergency room following a motor vehicle accident. The second year resident gathers in the history that he was a restrained front-seat passenger in a car that was traveling approximately 45 mph when the car was rear-ended. Airbags were deployed and the remainder of the passengers in his car were unharmed.

altA 49-year-old, right-hand- dominant male presents to the emergency department with right shoulder pain. The patient was playing volleyball and immediately after spiking the ball felt severe pain to the right shoulder. He was unable to lower the arm, and states that he feels numb over the arm and fingers.

altDistal radial fractures are among the most common fractures in childhood, and are a frequent presenting complaint in the emergency department. Traditionally, ED management of displaced distal radial fractures in children has included closed reduction and splinting of displaced fractures, usually under sedation.

altAn 89-year-old female presented to the emergency department with a three to four day history of gradually worsening, sharp right lower quadrant abdominal pain without radiation. On the day prior to the emergency room visit, a hard, tender mass developed in the area of discomfort. The patient usually had regular bowel movements; however she had not had a bowel movement for the past three days.

altA 40-year-old Hispanic female presented to our Emergency Department complaining of upper abdominal pain, nausea and vomiting for 1 day. She denies fever; last bowel movement was the previous day. She has no history of prior abdominal surgeries and past medical history was unremarkable. Vital signs were normal except for tachycardia at 112 bpm.

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