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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 #172: A Case of a Broken Heart?

HPI: A 12-month-old girl with cerebral palsy, chronic lung disease, and G-tube dependence is brought in by ambulance for bradycardia. Her caregiver states that she had an episode of bradycardia on her home monitor with HR 50s. Her usual baseline is heart rate of 100 to 130s This lasted about 1 minute. During the episode, […]

Hot Seat #171 Denouement

The case: A 3 year old with neck swelling and concern for neck infection who will not tolerate a CT scan. Here’s how you answered the questions: Discussion and Denouement: This patient represents an unusual presentation for peritonsillar abscess in both his young age and his primary complaint being external neck swelling.  Although not all […]

Hot Seat #171: Toddler with neck swelling

Walt Palmer, MD, Children’s National Medical Center HPI: A 3-year-old previously healthy boy presents to the Emergency Dept for left-sided neck swelling.  Two weeks ago, he presented to another ED for neck swelling in the setting of URI symptoms, diagnosed with reactive lymphadenopathy, discharged home with supportive care instructions. Symptoms (including swelling) soon thereafter resolved.  […]

Hot Seat #170: 11yo with Left Abdominal Pain

Case by Chris Kovaleski, MD. Inova Children’s HPI: 8 year-old girl, otherwise healthy, presents with abdominal pain and emesis. The patient had abdominal pain starting three days ago, localized to her left side and associated with two episodes of non-bloody, non-bilious emesis. Otherwise denies fevers, diarrhea, urinary symptoms. She went to an outside urgent care […]

Hot Seat #169 Denouement

The case: a 4 yo with an embedded foreign body and mildly elevated inflammatory markers Here’s how you answered the questions: Discussion: This case raises many interesting questions regarding work up and management of a foreign body that has been in place for some time. In terms of the initial work up, the group was […]