A 65-year-old female with a history of diabetes, hypertension, obesity, chronic lymphedema and venous insufficiency presents to the ED with redness to her right leg noted 2 days ago but worsening since yesterday. She has had pruritus and swelling to the site accompanied by a painful burning sensation and a couple “painful knots” on her right inguinal region. She denies any prior history of deep vein thrombosis (DVT, IV drug use, or any history of vascular surgeries to the lower extremities. She has also had malaise for a few days and says that the redness has markedly increased since yesterday. On examination of the right lower extremity there is a large area of intense erythema with sharply demarcated borders that appears raised with some swelling and mild tenderness to palpation. What is the most likely diagnosis?

The emDOCs cast covers hemophilia this week. What should you consider when it comes to evaluating and managing these patients?

Journal Feed brings you the DEVICE RCT with VL versus DL, doxycycline in kids, and DOACs versus warfarin for atrial fibrillation in CKD.

Walid Malki returns with Visual Wednesdays. This week he covers neurocritical care.

This post looks at subarachnoid hemorrhage, including evaluation and management.

A 3-year-old male presents to the ED with one week of daily fevers >102°F associated with four days of rash on the trunk. His parents have been managing his fevers with acetaminophen and ibuprofen, but became worried today when they noticed redness and swelling of the tongue in addition to swelling in the hands and feet. Vital signs demonstrate a rectal temperature 39.5°C, BP 92/60, HR 130, RR 35, and SpO2 of 98%. Physical exam demonstrates an ill appearing child with bilateral conjunctival injection; erythematous tongue with dry, fissured lips; right sided cervical lymphadenopathy; an erythematous maculopapular rash on the chest, abdomen, and back; and nonpitting edema of the hands and feet. What is the most likely diagnosis?

Medical Malpractice Insights takes us back to the history, exam, and listening to our team members.

How should you evaluate the patient with a hand injury in the ED? This post provides what you need to know.