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Tag Ortho

Question: Joint

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 12 year old boy with pain in his lower back and right buttock for 2 weeks. He is an active soccer… Continue Reading →

Question: Back Pain

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Question: Syndromes

You are seeing a 6 year old girl who comes in for right leg pain after a ground level fall at the park. She is currently being worked up by her pediatrician for precocious puberty, including vaginal spotting and breast… Continue Reading →

Amazing Apps

Harbor-UCLA Emergency Medicine Residency grad and all around great educator Tom Fadial has made some highly useful apps that you absolutely need. The latest, Fractures, is a comprehensive library of fracture types along with radiograph images, pearls, a guide to… Continue Reading →

Question: Sports

(Click the link to comment and to vote – voting not working through email, sorry!) A father brings in his 11-year-old son for medial elbow pain. The boy is the star player (and often the starting pitcher) on his little… Continue Reading →

Question: leg pain

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 17-year-old boy with one day of right calf pain and swelling. The day before onset of his symptoms, he was helping… Continue Reading →

Question: Back Pain

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 3 year old child with 3 weeks of gradually progressing low back pain, now impacting her ability or willingness to walk…. Continue Reading →

Question: Ortho

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 16 year old basketball player who presents with pain and swelling over his dorsal PIP joint, and inability to extend at… Continue Reading →

Question: Ortho

(Click the link to comment and to vote – voting not working through email, sorry!) A 20 month old boy is brought in by his mother for refusal to bear weight on the right leg. She was at work all… Continue Reading →

Question: Ortho

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 17 year old boy who fell while skateboarding and sustained an axial loading force to his right thumb. He is exquisitely… Continue Reading →

Question: Nursemaid’s

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Question: Trauma

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing an adolescent who slammed her finger in a door and has a subungual hematoma. 

Buckle Fractures

(Click the link to comment and to vote – voting not working through email, sorry!) Note: controversies are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also… Continue Reading →

Question: Ortho

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a child who fell on an outstretched hand and sustained a radius fracture. 

Question: Neuro

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Question: Ortho

(Click the link to comment and to vote – voting not working through email, sorry!) A teen who plays on the high school varsity basketball team comes in after jamming her finger during a game. She has a distal phalanx… Continue Reading →

Question: Musculoskeletal

(Click the link to comment and to vote – voting not working through email, sorry!) An 11yo girl presents with 2 weeks of right knee pain and limp after falling off a bicycle. She has had no fever, rash, other… Continue Reading →

Traumatic arthrotomy

(Click the link to comment and to vote – voting not working through email, sorry!) Note: conundrums are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also… Continue Reading →

Hand exam: nerves

PEM Infographics (linked here) has many helpful infographics. One of my all-time favorites is how to use rock-paper-scissors-OK sign to test children’s peripheral nerves in the upper extremity / hand exam

Question: Ortho

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Stimson shoulder reduction

Busy ED and don’t have time for procedural sedation or prolonged anterior shoulder dislocation reduction techniques? Set ’em up in the Stimson technique position and forget ’em – check back in 20-30 minutes. AliEM posted this great tip for using… Continue Reading →

Question: Ortho

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 17 year old who was playing basketball for his high school team this evening when he felt a sudden pop and… Continue Reading →

Question: Trauma

(Click the link to comment and to vote – voting not working through email, sorry!) An 11 year old left-hand dominant boy is brought in after accidentally sustaining an injury from a paint injection gun while helping his father on… Continue Reading →

Question: Nursemaid’s

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Question: Ortho

(Click the link to comment and to vote – voting not working through email, sorry!) You are seeing a 10 year old boy active in club soccer who comes in complaining of intermittent posterior heel pain, particularly after soccer games…. Continue Reading →

Question: Elbow Trauma

(Click the link to comment and to vote – voting not working through email, sorry!) Which of the following elbow radiography findings can be normal in a 2 year old that fell on an outstretched arm and has decreased use… Continue Reading →

Question: Onychocryptosis

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Question: Dislocation

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Question: Ortho

(Click the link to comment and to vote – voting not working through email, sorry!) A 16 year old football player is brought in with severe right knee pain after being hit from the front. He states that he thought… Continue Reading →

Question: Abd & hip pain

(Click the link to comment and to vote – voting not working through email, sorry!) 14yo boy presents with LLQ abdominal pain and left hip pain for 5 days. He has not had any fever. He is an active baseball… Continue Reading →

Question: Extremity

(Click the link to comment and to vote – voting not working through email, sorry!) A 9 month old baby is brought in with this problem, first noted a few hours prior. By James Heilman, MD [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)… Continue Reading →

Hip pain in kids

(Click the link to comment and to vote – voting not working through email, sorry!) Note: conundrums are not meant to have a “right” answer – they are to see how most people are practicing. Would love your comments also… Continue Reading →

Question: NAT

(Click the link to comment and to vote – voting not working through email, sorry!) An 18 month old child has sustained an arm fracture. Per the parent, the 4 year old sibling was carrying the child and tripped.

Question: Ortho

(Click the link to comment and to vote – voting not working through email, sorry!) A 5 year old was bitten by the family cat superficially on his right index finger, 3 days ago. He presents now with redness, warmth,… Continue Reading →

Question: Limp

(Click the link to comment and to vote – voting not working through email, sorry!) Put these causes of pediatric limp in order of what age they typically present, from youngest to oldest: Legg-Calve-Perthes disease Developmental dysplasia of the hip… Continue Reading →

Question: ID

A 12yo girl presents to the ED in December with fever for 4 days, malaise, and pain in the right thigh gradually leading to her having difficulty walking. There is no history of trauma, although she did play a lot… Continue Reading →

Question: MSK

NEW! Vote your answer and see what others voted for. Correct answer will be in Comments in a few days. A 14yo female soccer player comes to the ED complaining of bilateral knee pain x 1 month, right greater than… Continue Reading →

Question: Fractures

Of the following fractures, which is most concerning for non-accidental trauma? A. 18 month old brought in for refusing to walk, no history of any trauma or fall.  (source medscape) B. 18 month old brought in for refusing to walk, history… Continue Reading →

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