Here goes another attempt.

I am going to try to do this again. I have found it difficult to keep everything in life in check.... There hasn't been balance in my life for quite some time now. 

However, I have been urged by a friend to share some of the interesting cases I see at work...

60 something yo diabetic presents after fall 2 days ago. Pt reports a fall before going to the pmd for a regular checkup. Pt was told at that visit that it didn't look that bad however if the swelling continued the pt should probably go to the ER. Pt presents 2 days later. Radiographs below. 

In PA school they remind you about the importance of taking minimum two views PA and Lateral. This isn't a perfect example, however, you are unable to appreciate how severe the angulation is in the PA view. 

Amazingly the pt denied any pain, reporting ibuprofen has helped. I don't know about you but just looking at that image makes my bones hurt. Pt has long h/o diabetes and established paresthesias to lower exts, Which is the likely reason the pt has tolerated the injury so well. Ortho was consulted and pt was admitted for surgical fixation.