SimKit

Septic knee bedside pearl:
If they’re walking and can flex past 90° on their own comfortably, a septic joint is less likely. Not a guarantee — but a strong clue when paired with the rest of the exam, vitals, and risk factors.
Full episode: https://youtu.be/CpT1tsXMbd4
Resources: https://linktr.ee/simkit
Educational only — not medical advice.
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Atraumatic knee pain exam flow you can run fast, every time:
• Milk for effusion
• Compare quad symmetry/atrophy
• Straight leg raise = extensor mechanism intact (quad/patellar tendon)
• Patellar glide (medial/lateral) for pain/instability
• Lachman = ACL check (endpoint matters)
• Palpate medial/lateral joint lines + MCL tenderness
Pearl: in middle-aged patients who ramp up activity (hello pickleball), a Grade 1 MCL strain can overlap with degenerative meniscus symptoms—so localization matters.
Full episode: https://youtu.be/CpT1tsXMbd4
Link in bio / resources: https://linktr.ee/simkit
Educational only — not medical advice.
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Hot, swollen knee + limited ROM? If septic arthritis is on the table, tap it and send the right studies:
✅ Cell count + diff
✅ Crystal analysis
✅ Gram stain + culture
Pearl: WBC > 50,000 (and especially neutrophils > 90%) + a concerning exam = high concern for septic arthritis in a native joint. Culture helps guide targeted antibiotics.
Full episode: https://youtu.be/CpT1tsXMbd4
Resources: https://linktr.ee/simkit
Educational only — not medical advice.
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Big swollen knee? Aspiration can help right now.
If you can pull off 60–80cc, patients often feel immediate relief. Ortho pearl: after the tap, they often do nothing else—no routine “cocktail” back into the joint. If injections are considered later, it’s usually a separate decision (often discussing viscosupplementation or PRP depending on the case).
Full episode: https://youtu.be/CpT1tsXMbd4
Resources: https://linktr.ee/simkit
Educational only — not medical advice.

Should you tap a knee effusion? Start with pre-test probability.
If the patient has no risk factors, the knee isn’t hot/erythematous, and they can range comfortably, a diagnostic aspiration may not help—and every procedure carries risk (including introducing infection).
Teaching pearl: aspirate when you truly suspect septic arthritis and there’s enough fluid to analyze.
Full episode: https://youtu.be/CpT1tsXMbd4
Resources: https://linktr.ee/simkit
Educational only not medical advice.

“Just do what I do” is risky — especially in high-acuity or complex procedures. It’s like telling someone: “I’m Michael Jordan… just dunk like me.”
Links: https://linktr.ee/simkit
Full episode: https://youtu.be/O84OjpqFSic?si=IwGxcbfhkPtbKFv_
Educational only — not medical advice.

Teaching procedures isn’t just for “medical educators.” If you onboard new attendings, teach residents/med students, coach APPs, or train colleagues — this matters. When we don’t prepare, we default to “watch me… just do what I do.” That only works when conditions are perfect. Frameworks help make it safer and more reliable.
Links: https://linktr.ee/simkit
Full episode: https://youtu.be/O84OjpqFSic?si=IwGxcbfhkPtbKFv_
Educational only — not medical advice.

At 5 min, both groups were ~7/10 pain. After that, PENG improved pain more at 15/30/60 min. SPID: 63% vs 38%.

Responder rates: ≥33% drop = 28/32 vs 19/32 | ≥50% drop = 24/32 vs 7/32 (PENG vs FIB).

Links: https://linktr.ee/simkit

Full episode: https://youtu.be/Z1Nfm956TNo?si=hfrHj_-IIW1ghUlu

Educational only — not medical advice.

Jason Hine’s bottom line: regional anesthesia should be standard for elderly hip fracture patients. Longtime fascia iliaca user, but he’s shifted toward PENG — and with this study, it may be his preferred approach. Caveats: body habitus, above–inguinal ligament approach, and consider anticoagulation risk. If both are options, he’s reaching for PENG.

Links: https://linktr.ee/simkit

Full episode: https://youtu.be/Z1Nfm956TNo?si=hfrHj_-IIW1ghUlu

Educational only — not medical advice.

Figure 2 is wild: at 5 minutes, both groups were ~7/10 pain. Then PENG dropped pain more than fascia iliaca at 15/30/60 min. SPID favored PENG too: 63% vs 38%.
Links: https://linktr.ee/simkit
Full episode: https://youtu.be/Z1Nfm956TNo?si=hfrHj_-IIW1ghUlu
Educational only — not medical advice.

Study details: 0.375% levobupivacaine + 4 mg dexamethasone for both blocks. Volume differed — PENG 20 mL vs Fascia Iliaca 30 mL. Pain checks were done at 5 / 15 / 30 / 60 minutes post-block.
Links: https://linktr.ee/simkit
Full episode: https://youtu.be/Z1Nfm956TNo?si=hfrHj_-IIW1ghUlu
Educational only — not medical advice.