Practice Management
The patient is a 16-year-old girl who received a blow to the right hip when she fell in her bathroom at home. She is able to ambulate, albeit with great pain and guarding of her right leg. Her vital signs are stable. View the x-ray taken and consider what your diagnosis and next steps would be.
Read MoreAssumptions About Uninsured Patients in U.S. EDs: More Fiction Than Fact Key point: Commonly held beliefs were either debunked or found to be equally true for insured patients. Citation: Newton MF, Keims CC, Cunningham R, et al. Uninsured adults presenting to U.S. emergency departments: Assumptions vs, data. JAMA. 2008; 30: 1914-1924. Recent physician testimony before Congress asserts that uninsured and underinsured patients unnecessarily drain emergency department medical resources. To evaluate the evidence for this and …
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The patient is a 10-year-old boy who experienced a direct blow to the elbow approximately six hours prior to presentation.He had incomplete range of motion with minimal local swelling and considerable pain. View the image and consider what your next steps would be.
Read MoreThe patient is a 55-year-old female who experienced a blow to the back when she fell while riding a bus. She complains of pain in her neck, shoulder, and back. On examination, you find that her vitals are stable and she has no significant past medical history. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. (Hint: this …
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The patient is a 10-month-old child who presents with the parents, upon referral by the pediatrician, with a history of three days of pain but no history of trauma. The child refuses to stand, presumably due to pain, and resists crawling. View the x-ray taken and consider what your diagnosis and next steps would be.
Read MoreThe patient is a 23-year-old male who presents with a complaint of pain in the heel area after slipping down four steps. He is limping but able to bear weight. On exam, you note local tenderness and swelling over the area of the Achilles tendon. Other findings are unremarkable. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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The patient is an 18-year-old male who jumped or fell from a \”short height\” but landed hard on his heel. He is able to ambulate, but cannot put any pressure on his heel. Examination and history reveal nothing remarkable. View the x-ray taken and consider what your diagnosis or next steps would be.
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The patient is a 9-year-old boy who received a blow to the shoulder from a height of approximately 6 ½ feet. He has limited elevation of the arm due to pain. Examination and history reveal no additional factors. View the x-ray taken and consider what your diagnosis or next steps would be.
Read MoreThe patient is an 82-year- old man who slipped on the street, experiencing a blow to his right shoulder. He has significant local swelling in the injured shoulder specifically, over the acromioclavicular joint as well as significantly limited range of motion. His distal pulses are normal. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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The patient is a 15-year-old boy who presents with pain in the wrist 40 minutes after stopping a soccer ball with his hand. There is no snuffbox tenderness. View the x-rays taken and consider what your diagnosis and next steps would be.
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