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Homeless adults are far more likely to have chronic health problems and also to experience more complications as a result of their social circumstances. Participants in a US study were randomised to usual care (discharge to an overnight shelter with no further input) or interventional care (transitional then stable housing accompanied by ongoing care management). Intervention resulted in significant reductions in hospital visits and admissions. It would appear that not only does charity begin at home, so does better health (JAMA 2009;301:1771–8).


Although many low energy mechanisms involve sprains and other soft tissue injuries to the ankle, minor fractures are not uncommon and not uncommonly initially missed. US researchers developed a template approach to try to improve interpretation of ankle x rays. They report that their approach increased detection rates of subtle avulsion fractures, chip fractures and osteochondral fractures of the ankle and foot in adults. The template had eleven “target sites” in total. If successful, this approach may prove to be invaluable aid for less experienced members of staff (Emerg Radiol 2009; …

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