The Case Files: Diagnosing with Ultrasound

Vitello, Sarah DO; McGerald, Genevieve DO; Teng, David MD   An 11-year-old boy was brought into the ED by wheelchair complaining of left hip pain after slipping and falling on the floor at home just prior to arrival. He was not able to get up. The patient also reported that he had fallen two weeks earlier while running, and had had ongoing left hip discomfort since then. He denied any other injuries or complaints, and had no significant past medical history. He de-nied prior surgeries, allergies, and medications. His temperature was 98.4°F, pulse 103 bpm, blood pressure 128/71 mm Hg, respiratory rate of 20 breaths per minute with O2 saturation of 99% on room air. He reported his pain as 10/10. This overweight boy was lying uncomfortably on the stretcher, moaning in pain. His pupils were equally round and reactive to light. He had a normal pharynx with no erythema or tonsil-lar hypertrophy; his neck was supple and nontender without lymphadenopathy. His heart rate was regular with no murmurs, rubs, or gallops, and his lungs were clear to auscultation with no wheezes, rhonchi, or rales. His abdomen was soft with normal bowel sounds, nondistended and nontender. He was lying with his left leg externally rotated, and he had left hip tenderness and limited range of motion due to pain. He was unable to bear weight but had good distal pulses, capillary refill <2 seconds, and no clubbing, cyanosis, or edema. He was awake, alert, and oriented, his deep tendon reflexes were intact, ...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research