82-year-old man slips and takes a blow to his shoulder

The 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 and consider what your diagnosis and next steps would be.

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7-year-old boy with persistent fever and cough

7-year-old boy with persistent fever and cough

The patient is a 7-year-old boy who presents to urgent care at midnight with a four-day history of fever and cough. Two days prior, a throat culture administered elsewhere showed nothing suspicious. The parents brought him to urgent care tonight because of subsequent increasing chest pain. On exam, you find the child is not in respiratory distress, but has decreased air entry on the left side of his chest. His temperature is 101.3 degrees F, …

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82-year-old man injured from falling to his back

82-year-old man injured from falling to his back

The patient is an 82-year-old man who presents after having fallen backwards and landing on his back. He did not lose consciousness; nor did he vomit. The patient enters the clinic using a walker, which he reports using on a regular basis. Examination reveals an abrasion over his forehead and over the anterior right tibia. The neurological exam shows no acute changes. The patient is specifically tender over the shoulder, but there is no spiny …

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9-year-old girl has painful breathing after falling on chest

9-year-old girl has painful breathing after falling on chest

The patient is a 9-year-old girl who presents after experiencing a fall and a blow to her right chest. She complains of pain on deep breathing. On exam, you find a pulse of 103, and SAT of 96. She is not in respiratory distress; her chest exam is clear. She has an abrasion over her right chest. The patient is generally healthy, is on no medications, and has no significant past medical history. View the …

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