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Pediatric Management and Diagnostic Dilemma Tool
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Hot Seat #162: A Patient with Inadequate Imaging

HPI: 16-year-old male with no pertinent past medical history presents for medical clearance with police.  Earlier today he was in a physical altercation and was subsequently arrested.  During the altercation, he notes that he was punched multiple times in the face, and ultimately thrown to the ground. He currently reports pain in his jaw and […]

Hot Seat #157: 10 day old with elbow swelling

CC: 10 day old girl with elbow swelling HPI: 10 day old ex FT girl presenting with left elbow swelling and decreased movement of left arm. Parents report that in the middle of the night, they noticed she was not moving her left arm the same way she was her right. Waking every 1-3 hours […]

Hot Seat #166: Worsening Leg Pain

Author: Raj Sood, MD HPI: 17 year-old boy is presenting to the ED with 4 days of progressively worsening right lower extremity pain. Reports that the pain began in the back, and has since migrated the down the right side and includes the groin and leg (all on the right side). Pain is so bad […]

Hot Seat #165: Denouement

The case: 7 yo transferred from an OSH for r/o meningitis with hypotension Here is the case with answers to the questions. Discussion: n a patient with concern for sepsis vs meningitis vs appendicitis, most were in agreement that antibiotics, and pressers were indicated. The time at which pressors were indicated differed, some would recommend […]

Hot Seat #164: Denouement

Brief Case Review: 14yoM presenting to an academic center with 2 gunshot wounds to the back, with persistent pain despite escalating pain medication, found to have normal X-rays. Link to case with answers Discussion: A large part of the discussion focused on the apparent conflict between exam (seemingly superficial wounds) and normal x-rays and the […]

Hot Seat #165. 7 yo with vomiting

Harrison Hayward, MD HPI: 7-year-old male with an elevated BMI and otherwise healthy presents to an outside ED with 1 week of fever. He had COVID-19 one month ago, from which he fully recovered. Last week, he developed a fever and headache/abdominal pain. His PMD diagnosed him with a UTI and started cefdinir, which the […]

Hot Seat #164: Shot in the back

HPI: 14 year-old male arrives at the ED with a gunshot wound to the back. States he was hanging outside with friends when he heard shots and started to run. He heard multiple shots but felt one hit his mid back and fell down in pain. His friend immediately called 911. Denies any chest pain […]