HPI: 5-year-old female with a non-verbal autism presents to the ED due to progressive refusal to bear weight over the past month. Patient was initially seen three weeks ago by her pediatrician for LLE pain. At that visit the CBC, CK, ESR, and CRP were all normal. She was incidentally found to have Vitamin […]
Author: Brian Lee
Brian is currently a Pediatric Emergency Medicine fellow at Children's National. Prior to starting his fellowship, he completed his Internal Medicine/Pediatrics residency at Brown University and then worked both as a pediatric hospitalist and a pediatrician in a community emergency department. He is very interested in medical education.
Hot Seat #178: To do or not to do…?
HPI: AS is a 12yoF ex-25 weeker, with history of hypoxic ischemic encephalopathy, currently with trach and g-tube dependence presenting with fevers and increased tracheal secretions. At baseline she is on trach collar during the day and BiPAP at night. She was last well 3 days ago when she developed nasal congestion and daily fevers […]
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 #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 #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 […]