Crow's feet sign Superficial partial-thickness facial burns displaying the unburned crow's feet (魚尾紋) around the eyes. The presence of crow's feet sign correlates well with the absence of ocular injury. Sudden exposure to heat (e.g., hot water, steam, and flames) can activate the menace response. This reflex blinking occurs in response to the optical stimulus of a rapidly approaching object or perceived threat. This rapid eye closure results in the crow’s feet sign, represented by lateral lines of skin at the canthi that are spared from thermal damage. The presence of crow’s feet sign has been found to have a negative predictive value for an ocular injury and, in the context of forensic medicine, is indicative of consciousness at the time of injury. OnychomadesisOnychomadesis is a periodic idiopathic shedding of the nails beginning at the proximal end, possibly caused by the temporary arrest of the function of the nail matrix. One cause in children is hand foot and mouth disease. This generally resolves without complication. Another cause of onychomadesis in children is Kawasaki disease. Figure: Four Cases of Onychomadesis after Hand-Foot-Mouth Disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4252687/ Figure: Onychomadesis and Kawasaki disease
http://www.cmaj.ca/content/166/8/1069 Antithyroid drugs during pregnancy Propylthiouracil is the drug of choice during the first trimester of pregnancy because it causes less severe birth defects than methimazole. Because there have been rare cases of liver damage in people taking propylthiouracil, some clinicians will suggest switching to methimazole after the first trimester, while others may continue propylthiouracil. References: https://www.uptodate.com/contents/antithyroid-drugs-beyond-the-basics https://www.medscape.com/viewarticle/891627 Figure: http://www.footeducation.com/page/lateral-talar-process-fractures Lateral talar process fractures or snowboarder fractures are talus fractures that can mimic a lateral ankle sprain. It may be an isolated fracture or occur as a component of more complex ankle fractures. Mechanism of injury: The fracture occurs when the foot is dorsiflexed and inverted, as can happen with snowboarding (hence the term "snowboarder fracture"). A fracture should be suspected when there is soft tissue swelling inferior to the lateral malleolus. Figures: Case courtesy of Dr Roberto Schubert, Radiopaedia.org, rID: 15923 References:
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