Matthew J. Letizia, DO

After a fall during a soccer match 2 weeks earlier, a 26-year-old woman had pain of the right midfoot, with moderate swelling. The pain was aggravated with a normal gait and alleviated with an antalgic gait, specifically with inversion of the right ankle such that most of the weight from heel-strike through toe-off transmitted forces from the lateral calcaneus through the fifth metatarsus to the fifth phalanx.

An obese 61-year-old man with a history of heroin abuse was brought to the hospital after he had fallen onto his buttocks on a sidewalk. He was able to stand initially, but weakness and numb-ness in his legs rendered him suddenly unable to walk or prevent himself from voiding. He denied abdominal or back pain. His medical history included asthma, chronic obstructive pulmonary disease, and hypertension.

Several hours after striking his closed fist against the side pillar of a passenger car, a 28-year-old man presented with acute pain and swelling of the left hand. The dorsum of the left hand appeared deformed and edematous; there were scattered abrasions but no lacerations, exposed bony fragments, ecchymosis, or active bleeding.

A 53-year-old woman with a history of hypertension presents to the emergency department with excessive vaginal bleeding (requiring 6 or 7 sanitary pads per day), light-headedness, and episodes of near-syncope of 1 month's duration.