Clinical Challenge

The patient is a 14-year-old who took a fall two hours prior to presenting to the urgent care clinic. The left ankle is swollen and unable to bear weight, but the patient is otherwise  healthy. 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.

The patient is a 52-year-old tourist who presents with a four-day day history of abdominal pain, constipation, not passing gas, and nausea. The patient was not comfortable but was hemodynamically stable. Temperature was normal, pulse was 94, BP was 195/99. The abdomen was markedly distended. WBC was 11. View the x-rays taken (Figure 1 and Figure 2) and consider what your diagnosis and next steps would be. Resolution of the case is described on the …

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. 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. <

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-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

The patient is a 2½-year-old female who presented after falling, unobserved, from an unknown height with tenderness and swelling around the elbow. Neurovascular exam was 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. Resulotion The correct diagnosis is a supracondylar fracture; note the loss of the normal angle at the distal humerus. The injury was managed …