Case presentation A 14-year-old male is brought to the Emergency Department after being involved in a motor vehicle crash. The patient was a restrained front seat passenger in a vehicle that was struck by another car while stopped at a red light. The patient did not lose consciousness and has no complaint of head pain, neck pain, back pain, or abdominal pain. He states he feels…
Case presentation A 12-year-old male presents to the emergency department with left ankle pain. Two hours ago, he was jumping on a trampoline when he “landed wrong, twisting” the ankle. He cannot remember in which direction the ankle twisted but he states he developed swelling to the ankle and had difficulty ambulating due to pain. He denies neck pain, back pain, numbness, and weakness, and there…
Case presentation A 7-year-old male is brought in for evaluation. A few hours prior to presentation, he was jumping up and down on a couch when he jumped off, landing on his right leg. He states he heard a “pop” and then began to experience pain and difficulty with ambulation secondary to the pain. There is no reported loss of consciousness; he denies neck pain, back…
Case presentation A 14-year-old female is brought to the Emergency Department following a basketball game. She pivoted to take a shot and felt a tearing sensation, followed by a pop, then fell to the ground. She presents with an obvious right knee deformity. Her vital signs are normal for her age, and on examination, her knee is held in flexion at 30 degrees with a laterally…
Case presentation A 9-year-old female presents with 5 weeks of progressively worsening left knee pain. There has been no known trauma and the family denies fever, rash, knee swelling or erythema, weakness, numbness, or incontinence. She is able to ambulate but, due to her pain, has been excused from physical education classes at school. She has seen numerous physicians, and multiple plain radiographs of the left…
Case presentation A 2-year-old male presents with acute right leg pain after falling while jumping on a trampoline. Apparently, he fell off the trampoline onto the ground and landed on his left leg. The distance was estimated at 3 ft (approximately 1 m) and the incident was witnessed by his parents and two older siblings. There is no reported loss of consciousness. The child is unable…
Case 1 presentation A 14-year-old male presents with a complaint of acute right hip pain. The patient is an avid soccer player and was kicking a ball “pretty hard.” Immediately upon full extension of the right leg, he felt a “pop.” Thereafter, he began to experience pain that was radiating to the right upper thigh. He was unable to continue the game. He denies other injury…
Case presentation A 12-year-old male presents with a left fifth phalanx injury (his “pinky” finger). He was jumping on a trampoline and somehow injured the digit; he believes he landed on the digit. Since then, he has had pain and swelling. His examination reveals a patient complaining of digit pain. There is swelling and tenderness of the left fifth digit at the proximal interphalangeal (PIP) joint…
Case presentation A 15-year-old male presents with left hand pain after becoming angry and punching a wall. He did this several hours ago and his only complaint is medial hand pain; he denies digit, wrist, forearm, or elbow pain. He denies numbness or weakness. This is the second time he has sustained this injury. However, he was not seen the first time because he and his…
Case presentation A 16-year-old female presents to the emergency department with complaints of right wrist and hand pain following a fall on an outstretched hand during sports practice after school. Vital signs are age appropriate and her physical examination is significant for tenderness in the anatomic snuffbox and the radial portion of the wrist. Grip strength and range of motion in the wrist are both reduced…
Case presentation An 11-year-old male presents with left wrist pain and swelling 3 days after he fell while playing soccer. Apparently, in the course of the game, he fell on his outstretched left arm. After the injury, he continued to play but later in the day he noted pain and swelling to the left wrist. He denies neck, shoulder, elbow, upper arm, hand, or digit pain.…
Case presentation A 4-year-old male presents with right forearm pain after falling while in a “bouncy house.” Apparently, the child was in the house with several other children and had a witnessed fall onto the arm. The parents noted that he had swelling to his right elbow. There is no other reported injury, and Emergency Medical Services applied a temporary splint and gave the child intranasal…
Case presentation A 4-year-old child presents after falling on an outstretched hand while running at school. He complains of pain to the right forearm and is splinted by the school nurse and given pain medicine by paramedics. There is no open abrasion or puncture to the skin. His vital signs are all age appropriate. There does not appear to be any injury to the head, neck,…
Case presentation A 12-year-old male presents after a direct fall onto his right arm and shoulder while playing soccer. He is comfortable and prefers to hold the arm close to his body and is supporting the injured arm with his opposite hand. There is an obvious bulge at the midshaft of the clavicle with no abrasion or breaks in the skin seen. There is no tenting…
Case presentation A 6-year-old boy presents with right upper arm and shoulder pain after falling off a horse while riding at a brisk trot. There is no reported loss of consciousness and he denies neck pain, abdominal pain, back pain, or elbow pain. His vital signs are age appropriate and there is no obvious injury other than mild edema and tenderness of his proximal right humerus.…
Case presentation A 17-year-old male presents with right shoulder pain after falling while playing soccer. The patient tripped while running and landed on his shoulder. He was able to continue playing the game but now complains of vague right shoulder pain. When asked to localize the pain, he points to his back, at the inferior portion of the scapula. He has no neck pain, other back…
Case presentation A 4-year-old male presents with right elbow pain and swelling. He was playing on his school’s monkey bars when he fell, landing on his right arm and elbow. He fell approximately 3 feet. There was no reported loss of consciousness and the child immediately cried. He complained of elbow pain and was brought directly for evaluation. The child is afebrile and has age-appropriate vital…
Case presentation A 5-year-old male is brought for right elbow pain and swelling after falling while playing on the monkey bars at school. The fall was witnessed by several teachers and friends, who reported no loss of consciousness or other injuries. He complains of right elbow pain but denies neck or back pain. His physical examination is remarkable for impressive right elbow swelling and pain. He…
Case presentation A 15-year-old male presents to the emergency department with right wrist pain. The patient reports that he fell on his outstretched right hand while skateboarding. Physical examination is significant for mild swelling with tenderness to palpation over the distal right forearm. He has 2+ radial pulses with full range of motion and intact sensation in the radial, ulnar, and median distributions. Capillary refill in…
Case presentation A 3-month-old male presents with what the parents describe as fussiness since yesterday. The child has had nasal congestion over the past few days so they took him to an emergency department 1 day ago, where he had a respiratory syncytial virus test that was negative and a chest x-ray that was reported to be unremarkable, per the parents. The parents noted that, after…