This week’s case highlights a patient with non-verbal autism presenting with difficulty walking. Most learners would start with x-rays but agree that if unremarkable, would likely progress to getting an ultrasound as well. Learners discussed the utility of getting labs prior to imaging results. Given the patient is autistic, there was discussion about holding on […]
Hot Seat #245: Can’t Talk, Can’t Walk
Case by Brittany Fitzpatrick MD, CNH PEM Fellow 6 yo F with non-verbal autism who presents with inability to bear weight x 4 days. She is here with her mother, who reports that she started having some difficulty with walking about a week ago and seemed not to want to bear weight on her left […]
Hot Seat #244 Denouement
This week’s case highlighted a child with lower extremity pain and weakness. Regarding initial imaging, the discussion focused on differentiating between pain and weakness. Weakness would prompt learners to lean more towards CT or MRI, which would provide more information and still include an evaluation of the bones and joint spaces. Urgent sedated MRI brain […]
Hot Seat #244: Gait Expectations
Case by Gabrielle Jasmin MD, CNH PEM Fellow 8-year-old male with history of eczema presents with RLE weakness. Mom reports that the child was recently seen in an outside hospital’s emergency department 2 weeks prior to presentation for cough and cold symptoms along with right leg calf and hip pain. At that time, he was […]
Hot Seat #243 Denouement
This week’s case highlighted a patient with fever and umbilical drainage who progressed into septic shock. The patient was started on ceftriaxone, vancomycin, and clindamycin for septic shock vs TSS. Started on NE in the ED for persistently widened pulse pressures. Transferred to the PICU, where she continued pressors until the next morning. Started on […]