No abstract

We present an algorithm-based approach to soldiers presenting with post-traumatic wrist pain. The algorithm was fashioned with the aim of reducing complications and poor outcomes associated with delayed diagnosis of scaphoid fractures, affecting soldier health and unit readiness. A prospective study of the algorithm is underway.

A 63-year-old female patient with a recent left posterior cerebral artery infarction and pyelonephritis presented with persistent fevers despite adequate intravenous antibiotic therapy. Whole-body gallium-67 scintigraphy was performed to evaluate for occult infection. Tracer accumulated bilaterally in the kidneys consistent with the previously diagnosed pyelonephritis. Relatively intense uptake was also noted in the area of a known occipitoparietal infarct. Incidentally noted was an abnormal focus of increased tracer uptake in the retroareolar region of the right breast. Subsequent guided core biopsy of the right breast mass demonstrated a previously undiagnosed invasive ductal carcinoma.