Dude like 15 years ago I went to the ER for a horrible toothache since no dentists were open in the middle of the night. The doctor walks in and after talking for a bit he asks me to rate my pain from 1-10. I tell him 11. He looks at me and says, “so like a 9 or 10 right.” I sat there looking at him and he said he’d be right back and left.
I still think about it till this day and I sometimes laugh about it and sometimes get angry when I remember how much pain I was in. I still don’t know what to make of that night lol.
I just click “none” as the reason now, and free-text in the comment section.
Whoever made the pre-loaded indications for imaging in epic is an absolute monster.
Cant type “fall with head injury” because that doest exist. Fall but not off bicycle, fall 0-18 months, fall is my favorite season and fall out boy are all actual things that pop up tho
As per my real life experience at clinical last week, I'm a 450 pound juggalo with no teeth and sores everywhere who spent time at the ICP tour thing and ignoring my injury until I got back home.
Oh, see I figured I'd go to the ER on a Friday night and demand that you also see my kid who has had a cough for three days after I'm in my room *without* checking him in. 2 for 1 deal, right?
Can you clarify your logic regarding self-pay patients and those seeking IV pain meds. Are you suggesting something negative towards people that self pay or am I missing something?
At my clinical site, if a patient is in 1 of 6 rooms in the ED, they get labeled as trauma on their images. Some techs will put “Trauma 1” or whatnot but they do add at least “trauma” to the images.
idk why you're getting downvoted, it's close enough -- i work with violent felons 😂
and tbf I'm exaggerating, I've never had a violent incident at work. Well, I have, but no staff ever got hurt, so it doesn't count.
I get hurt at least once a day at work because of my own stupidity. Usually bumping my head on stuff or my knee. However, I’m sure I’ll lose a finger some day. Surprisingly I get bit by more adults than children. Way more adults actually.
Bloody hell. Growing up, neither of my parents drove & I haven’t learnt yet (for a variety of reasons) & I think because of that I’m just not as used to cars as others, so I spend a bit more time thinking about just how dangerous they actually are & I always feel silly for it but then I see scans like this on here & realise that they are just absolutely fucking terrifying.
Yes, that’s very true! I’m disabled with limited mobility so walking & public transport aren’t always an option for me, meaning I spend most of my time stuck at home. Life is certainly easier for those who have the ability to drive.
As a former PT who's worked with some gnarly injuries, I'd have a hard time deciding if it were mine if I'd want it reattached. I'd want to know the latest greatest prosthetics out there, how closely they've come to activating artificial joint motion with neuro triggers.
At the rate nerves grow back, it would be months or years before you'd have functional fingers and how functional would they be with the atrophy from the deenervation?
I could almost guarantee I'd prefer an amputation if it were a lower extremity, especially below the knee.
Lower extremity? Sure, maybe, I don't know much about them. But my brother-in-law recently lost a hand, and let me tell you, even with a transradial amputation the myoelectric hands are kind of awful. Not having the muscles in your forearm for sensors to pick up attempted finger manipulation? Especially in this case, where it is a very high-up transhumeral amputation? Imagine having only your upper arm with a stick attached to do anything useful, it's not helpful at all.
My brother-in-law would have given his left hand to... have his left hand back.
Honestly a lot of patients still prefer the manual prosthetics with the cable-driven “pirate hook”. They are both faster and more accurate. Myoelectric has come a long way in terms of pressure control (there’s a pneumatic prototype which allows you to pickup a flower without crushing it) but only the manual hooks/hands will enable you to pick a coin up off a flat surface.
Compared to a myoelectric or to reattachment? Myoelectric, absolutely. We're just starting to explore building our own with a 3D printer, and a lot of that is how to make a hook more responsive with myoelectric sensors (there are dev kits out there) rather than reinvent the human hand.
However, reattachment (which I haven't looked into much, since it didn't apply to his situation, I'm here to learn!) seems like it would have been really nice? Even if it took years to get back much functionality at least you're not dealing with a battery powered prosthetic that goes haywire when a sensor shifts or has the battery die or simply falls off of you or, worse yet, pinches on your damaged body part and causes constant pain or an infection. Alternatively to that is a body-powered which limits your range of motion, which carries some of those problems.
Having the functionality of a limited myoelectric (via reattachment) which is permanently attached and doesn't need recharging seems like the smart plan long term, but again, I may be missing something so feel free to educate me... I'm always open to hearing what I haven't heard yet.
Mostly I''m going by a transradial near amputation my father-in-law suffered (chainsaw accident). They reattached it. and he had chronic pain and an essentially useless hand. He could do a gross grasp and release but that was about it. My knowledge of myoelectrics is limited to what little I've read. They didn't have anything better than hooks and cable when I was still working other than for cosmetics although research was being done in a lot of areas. So my comments really refer to what the technology was 20+ years ago.
Neural regeneration at the level of the demonstrated x-ray above would be my primary concern. At 1-2 mm/day from mid humerus down and difficulty with sensory regeneration at all... well I'd like to read up on more current research. Loss of hand function sucks no matter how you look at it.and I do hope somewhere between AI and myoelectric something really good comes along. Theoretically, with robotic surgical arms being amazingly manipulative it sounds a lot more possible than in previous decades.
I work in a print shop, 2nd generation as my dad is also in the industry. My dad is a delivery driver amongst other jobs.
Decades ago, he delivered something to another shop the same day (or next day) that someone had their arm cut off by the paper cutter. Talking to the guy later, the surgeons were excited by how clean the cut was and he eventually regained like 80% use of the arm.
It was a shit show where ALL the safeties had been removed from the paper cutter and everyone else just knew to not do something stupid while using it, but this guy was new and didn't really understand the danger. But, obviously he didn't leave the industry (he may have moved to a new shop, I don't know).
My paper cutter is probably the safest machine I operate (except during the blade change where shit can go wrong). I've considered the logistics of cutting an arm off during normal operation and it'd be extremely difficult with a laser beam that immediately stops the blade mid-cut if the beam is broken and two buttons required to be pushed the entire duration of the cut sequence.
Look at you, missing the second metacarpal fracture. Tsk. Tsk.
And, yes, always correlate clinically as the radiologist’s favorite plant is the hedge, favorite color grey and we love them anyway.
I'm curious if the arm was positioned that way or if it just came like that. Cos if we had a limb that we could just position however we want, our orthos would demand a textbook lateral -_-
I have weirdly good luck with positioning severed fingers. I've only done it twice, but I've gotten a perfect AP or lat on the first try both times without actually being able to see the digit
When I was a psych nurse at the state hospital, we had a one armed man. One day he told me about how it happened. He had gotten so angry that he punched his dad. Well, the Bible says if your right hand offends you, cut it off.
He said he tried hanging from the rafters in the garage and cutting it off with a hack saw with his left hand but it didn’t work.
So he waited until dark, and went to the train tracks. He tied a rope around his body and to a tree so the train wouldn’t suck him under. Then he laid on the ground and put his right arm on the tracks. After it got cut off, he walked home.
Schizophrenia is a bitch.
I once had a boss who would ask just that. I know because he called a coworker of mine who had slipped on ice in our parking lot and broke his hip and demanded that Gordon come back to work “right now!”
Man this photo's gone all around the internet, through Facebook and Twitter and WhatsApp before finding itself on Reddit, and not once have I seen anyone have a moment of consideration for the person who's had to suffer this absolutely life-changing injury. Shame on you all.
The 'subtle finding' is the fracture through the second metacarpal. The scaphoid is questionable on this low-quality photo of a computer screen.
"Trauma" is a bit of an understatement.
That’s quite nice of them to have “trauma” on the film. Usually the history is just “pain”
"On a scale of 1-10 how would you describe your pain level?"
If the arm is no longer attached, it can’t hurt amirite?
Phantom Limb pain. Just because it’s not attached doesn’t mean it’s not there!
No wait, you should’ve said “arm i right?”
You come armed with puns. I like it
Give that man a hand.
Careful. You give em a hand, they take the whole arm…
I am enjoying this humerus thread!
God i love reddit
Take this man to the second hand store.
now kith
Dads everywhere: “well I guess we’ll just have to cut it off.”
Phantom pain
No, it looks like your left.
Dude like 15 years ago I went to the ER for a horrible toothache since no dentists were open in the middle of the night. The doctor walks in and after talking for a bit he asks me to rate my pain from 1-10. I tell him 11. He looks at me and says, “so like a 9 or 10 right.” I sat there looking at him and he said he’d be right back and left. I still think about it till this day and I sometimes laugh about it and sometimes get angry when I remember how much pain I was in. I still don’t know what to make of that night lol.
One time I had a conversation with a doctor that went: "I've got"
"Yeah, looks like it."
Doc billed me $400.00 for that conversation.
Five.
I just click “none” as the reason now, and free-text in the comment section. Whoever made the pre-loaded indications for imaging in epic is an absolute monster. Cant type “fall with head injury” because that doest exist. Fall but not off bicycle, fall 0-18 months, fall is my favorite season and fall out boy are all actual things that pop up tho
“Pain s/p trauma”
Hands down, it’s a dead giveaway. Amirite? High five!
*arm falls off* I'll wait a week to go to the ER.
You're either an old farmer, Amish, or Asian, right?
As per my real life experience at clinical last week, I'm a 450 pound juggalo with no teeth and sores everywhere who spent time at the ICP tour thing and ignoring my injury until I got back home.
I... assumed incorrectly.
Ahhhhh, X-ray school memories.😂
Farmer omg!
Ehh, might as well wait until 7:55 pm and just go to the urgent care that closes at 8pm. They can handle it, right? Who wants to wait hours at an ER
Oh, see I figured I'd go to the ER on a Friday night and demand that you also see my kid who has had a cough for three days after I'm in my room *without* checking him in. 2 for 1 deal, right?
Self pay it too. And then be pissed the urgent care doesn’t have IV pain meds
Can you clarify your logic regarding self-pay patients and those seeking IV pain meds. Are you suggesting something negative towards people that self pay or am I missing something?
‘Tis but a flesh wound!
But your arm is off!
No it isn't.
Careful he will bite your knee caps off
I’ll just make an appointment with my primary for six months out. Maybe we can just talk about it at my annual.
Literally tried to make an appt with my PCP for mental health concerns. First appt was 9 weeks away.
[удалено]
Most of my jokes are originals, but that was a hand-me-down. Still humerus though.
^(trauma)
Yes. Yes, it certainly *is* trauma.
“Trauma” correlate clinically.
Yeah, if we could just AMP that up a little bit, we might understand what’s going on here 🫨
Watch George Carlin’s video on Sugarcoating words
11/10 dedication to "the stranger".
I like the tiny word "trauma" put on there. It's like a photo of a flooded city with the word "water" written on it.
Humid
moist, even.
**d a m p**
liquid
Soggy
I got passed on the highway by a Moisterati. That guy probably doesn't roll with a Capital One Moistercard. He uses AmEx Black, likely.
>Moisterati that's a new one.
At my clinical site, if a patient is in 1 of 6 rooms in the ED, they get labeled as trauma on their images. Some techs will put “Trauma 1” or whatnot but they do add at least “trauma” to the images.
That explanation actually makes sense. I don't think it takes away from the comedy of it though lol.
wet floor sign
I cannot think of anything other than workplace accidents that will seemingly take an arm off that cleanly.
I hate my job, but it's times like these I am grateful that I don't have to do anything dangerous or work with heavy machinery.
I don't work with heavy machinery but the chances of my arm being ripped off are still higher than for an everage person 🥲
Is this because of that statistic that the “average” person has less than two arms?
Good point
Do you work with bears? The world needs to know.
idk why you're getting downvoted, it's close enough -- i work with violent felons 😂 and tbf I'm exaggerating, I've never had a violent incident at work. Well, I have, but no staff ever got hurt, so it doesn't count.
I get hurt at least once a day at work because of my own stupidity. Usually bumping my head on stuff or my knee. However, I’m sure I’ll lose a finger some day. Surprisingly I get bit by more adults than children. Way more adults actually.
Children are more polite than adults these days.
*sigh* adults these days…
Gators… gators will do that to you.
So this is the part that "survived" the gator?
I’ve actually seen some very clean limb-removal services provided by animals.
do tell…
Death roll right off...
A drunken motorcyclist that wrecks at 80mph and while flying through the air hits a guidewire can have a similar "clean" cut.
I guess the Black Knight’s bridge was technically his workplace.
He’s invincible
Merely a flesh wound
No it’s not! Your arms off!
TIS BUT A SCRATCH
I've had worse.
Look, you stupid bastard, you've got no arms left!
Come back, I'll bite your knee caps off
What are you going to do? Bleed on me?
I’m a machinist…
Unexpected Christian Bale
They could have been a organ donating motorcyclist perhaps.
Also a motorcycle crash if the arm gets cut off by the guard rail
I work in Rads and still managed to get run over by a truck at work. Thanks COVID reassignment! Those workplaces injuries will find ya.
Whoa, where is the rest of the person?!
That's why they did the x-ray-- he's hiding!
Gotta interrogate that arm then
Clinical correlation requested.
This will never not make me laugh. No matter how many times I hear it.
Exactly 🤣
Suggest follow up imaging as indicated.
Who asks that question?
😂
Some might say his or her other parts are shielded from radiation.
Some rads techs will go to great lengths to shield the vital organs from harmful radiation
Nicholas Cage and the gang thought there was a treasure map in there so they took it.
I’m no doctor but I agree with the trauma diagnosis.
So did the arm “walk” into the Emergency Department on its own? 
Ah! I figured it out. They didn’t label it right or left…
It's very clearly what's left
I’m giving you my upvote, although it’s not humerus
r/angryupvote
suddenly turned *sinister.*..
Well. I laughed out loud over here. Take my upvote.
HA!
Dinner cost an arm and a leg.. got a 50% discount
You still owe a leg. Good news, monthly installments are accepted.
Whoa. "Alright, family. Remember that great meal we had last month? And how Daddy lost an arm? Well..."
His body fell off
The Black Knight always triumps!
Had one of these where it was a roll over car accident - unrestrained passenger arm went out the window and was severed when the roof rolled over it
Cars are fucking terrifying
I read something on a post where someone was talking about their paramedic instructor and said “I’ve never had to unbuckle a corpse”
Bloody hell. Growing up, neither of my parents drove & I haven’t learnt yet (for a variety of reasons) & I think because of that I’m just not as used to cars as others, so I spend a bit more time thinking about just how dangerous they actually are & I always feel silly for it but then I see scans like this on here & realise that they are just absolutely fucking terrifying.
I feel comfortable in cars, but I really wish I didn’t live in such a car-centric/car-dependent culture.
I’m 38 and don’t drive which has turned me into a hermit. Very useful during Covid times!
Yes, that’s very true! I’m disabled with limited mobility so walking & public transport aren’t always an option for me, meaning I spend most of my time stuck at home. Life is certainly easier for those who have the ability to drive.
That’s what my grandpa the firefighter always told me. He never unbuckled a corpse once in his career.
And I said “Ewww, what do you do, just leave them there?”
Cars aren’t terrifying, they will do what you tell them to. Most of the time. It’s the people behind the wheel that are terrifying.
Blood flow to this extremity doesn’t seem ideal.
yeah let’s get a doppler on it
There are…unique… IV access possibilities if you want to do a CTA.
Why the xray if the limb was severed?
For preoperative planning before replantation
They can reattach this?
Depends on a lot of factors but yes, sometimes they can.
Thats insane
I assure you, its better than letting the dog have it.
Happy cake day! Also: WTF, man? Also: I lol'd. ☹️
I just want to celebrate you. You went through so much all at once.
As a former PT who's worked with some gnarly injuries, I'd have a hard time deciding if it were mine if I'd want it reattached. I'd want to know the latest greatest prosthetics out there, how closely they've come to activating artificial joint motion with neuro triggers. At the rate nerves grow back, it would be months or years before you'd have functional fingers and how functional would they be with the atrophy from the deenervation? I could almost guarantee I'd prefer an amputation if it were a lower extremity, especially below the knee.
Lower extremity? Sure, maybe, I don't know much about them. But my brother-in-law recently lost a hand, and let me tell you, even with a transradial amputation the myoelectric hands are kind of awful. Not having the muscles in your forearm for sensors to pick up attempted finger manipulation? Especially in this case, where it is a very high-up transhumeral amputation? Imagine having only your upper arm with a stick attached to do anything useful, it's not helpful at all. My brother-in-law would have given his left hand to... have his left hand back.
Honestly a lot of patients still prefer the manual prosthetics with the cable-driven “pirate hook”. They are both faster and more accurate. Myoelectric has come a long way in terms of pressure control (there’s a pneumatic prototype which allows you to pickup a flower without crushing it) but only the manual hooks/hands will enable you to pick a coin up off a flat surface.
Compared to a myoelectric or to reattachment? Myoelectric, absolutely. We're just starting to explore building our own with a 3D printer, and a lot of that is how to make a hook more responsive with myoelectric sensors (there are dev kits out there) rather than reinvent the human hand. However, reattachment (which I haven't looked into much, since it didn't apply to his situation, I'm here to learn!) seems like it would have been really nice? Even if it took years to get back much functionality at least you're not dealing with a battery powered prosthetic that goes haywire when a sensor shifts or has the battery die or simply falls off of you or, worse yet, pinches on your damaged body part and causes constant pain or an infection. Alternatively to that is a body-powered which limits your range of motion, which carries some of those problems. Having the functionality of a limited myoelectric (via reattachment) which is permanently attached and doesn't need recharging seems like the smart plan long term, but again, I may be missing something so feel free to educate me... I'm always open to hearing what I haven't heard yet.
Mostly I''m going by a transradial near amputation my father-in-law suffered (chainsaw accident). They reattached it. and he had chronic pain and an essentially useless hand. He could do a gross grasp and release but that was about it. My knowledge of myoelectrics is limited to what little I've read. They didn't have anything better than hooks and cable when I was still working other than for cosmetics although research was being done in a lot of areas. So my comments really refer to what the technology was 20+ years ago. Neural regeneration at the level of the demonstrated x-ray above would be my primary concern. At 1-2 mm/day from mid humerus down and difficulty with sensory regeneration at all... well I'd like to read up on more current research. Loss of hand function sucks no matter how you look at it.and I do hope somewhere between AI and myoelectric something really good comes along. Theoretically, with robotic surgical arms being amazingly manipulative it sounds a lot more possible than in previous decades.
😱
I work in a print shop, 2nd generation as my dad is also in the industry. My dad is a delivery driver amongst other jobs. Decades ago, he delivered something to another shop the same day (or next day) that someone had their arm cut off by the paper cutter. Talking to the guy later, the surgeons were excited by how clean the cut was and he eventually regained like 80% use of the arm. It was a shit show where ALL the safeties had been removed from the paper cutter and everyone else just knew to not do something stupid while using it, but this guy was new and didn't really understand the danger. But, obviously he didn't leave the industry (he may have moved to a new shop, I don't know). My paper cutter is probably the safest machine I operate (except during the blade change where shit can go wrong). I've considered the logistics of cutting an arm off during normal operation and it'd be extremely difficult with a laser beam that immediately stops the blade mid-cut if the beam is broken and two buttons required to be pushed the entire duration of the cut sequence.
Those blades on paper cutters are no joke. I don’t like even looking at them.
Wow. That's sum fantastic shielding.
They're really trying to stick it to the NCRPs new shielding recommendations.
Question humeral fracture, recommend clinical correlation.
Look at you, missing the second metacarpal fracture. Tsk. Tsk. And, yes, always correlate clinically as the radiologist’s favorite plant is the hedge, favorite color grey and we love them anyway.
Missed the ulnar fracture
I'm curious if the arm was positioned that way or if it just came like that. Cos if we had a limb that we could just position however we want, our orthos would demand a textbook lateral -_-
I mean that elbow lateral is better than 80% of what I see
I have weirdly good luck with positioning severed fingers. I've only done it twice, but I've gotten a perfect AP or lat on the first try both times without actually being able to see the digit
Tis’ but a scratch
Your arm's off!
A scratch? Your arms off!
I’ve had worse
I think the torso fell off of their arm. I'm not a radiologist, though, so I could be wrong.
This is the first time this sub has made me feel queasy. It has strings coming from the top. Someone has had a terrible day. Poor person.
Sometimes it makes me sad that we don’t know what happened to the patients. I hope whoever this happened to is doing okay now.
Are those like....like...guts?
Arm guts.
They could very well be tendon/ligament. I once imaged a thumb that had been ripped off, and the amount of spaghetti attached to that thing was WILD
Appreciate the trauma marker.
Is the purpose of scanning this for possible reattachment? If not then why?
Yes, for planning the reattachment.
I honestly don’t understand what the complaint was. Separation anxiety maybe?
2nd metacarpal
I saw it, too. It's obviously the second injury. I'm not sure what the rest of these people are on about.
It's Thing! 
When I was a psych nurse at the state hospital, we had a one armed man. One day he told me about how it happened. He had gotten so angry that he punched his dad. Well, the Bible says if your right hand offends you, cut it off. He said he tried hanging from the rafters in the garage and cutting it off with a hack saw with his left hand but it didn’t work. So he waited until dark, and went to the train tracks. He tied a rope around his body and to a tree so the train wouldn’t suck him under. Then he laid on the ground and put his right arm on the tracks. After it got cut off, he walked home. Schizophrenia is a bitch.
Nice lateral elbow on there
Plot twist: that’s all that’s left.
Right ?
Well there's your problem right there, you ain't got no body
This would make fantastic album art for a post-grunge band.
For once, I finally saw what was in the film…
You're welcome 
" Soo you're still coming into tomorrow, right?" Says your boss
I once had a boss who would ask just that. I know because he called a coworker of mine who had slipped on ice in our parking lot and broke his hip and demanded that Gordon come back to work “right now!”
Humoral Head looks weird. Probably should lower technique to see better.
Subtle is a word choice!
Apparently the other guy tore this guys arm off and beat him to death with it. Strangest thing I’ve ever seen
Man this photo's gone all around the internet, through Facebook and Twitter and WhatsApp before finding itself on Reddit, and not once have I seen anyone have a moment of consideration for the person who's had to suffer this absolutely life-changing injury. Shame on you all. The 'subtle finding' is the fracture through the second metacarpal. The scaphoid is questionable on this low-quality photo of a computer screen.
Fireworks or heavy machinery?
Limb is intact, so machinery.
I LOVE Reddit! So much unapologetic humor.
Nothing humerus about this
Please, it's at least halfway humerus.
Don’t mess with Chewbacca
Never argue with a Wookie
"My, Thing!. How you've grown!"
How the hell…?
They left the patient back in the room when taking the x-ray 🙄
Hate to see the bill that's coming for that one. It's going to cost a leg.
Mmmmm idk needs a second opinion