Non-Steroidal Anti-Inflammatory Drugs for Low-Back Pain (Review) Key point: NSAIDS are more effective than placebo, are all similar in efficacy, and do have significant side effects. COX- 2 seems to have fewer side effects; however, the recent data on CV side effects is a concern. Citation: Roelofs PDDM, Deyo RA, Koes BW, et al. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD000396. DOI: 10.1002/14651858.CD000396.pub3. The authors searched the MEDLINE and EMBASE databases …
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30-year-old male in severe discomfort after "twisting" ankle
The patient is a healthy 30-year-old male who presents with pain shortly after “twisting” his ankle while playing soccer. Pain is severe enough to prevent him from putting weight on the ankle. There are no other remarkable findings from exam or patient history. View the image taken and consider what your diagnosis would be.
Read MoreClinical Challenge 2: February 2008
The patient is a 3 ½-year-old girl who fell from a bicycle, receiving a blow to the elbow a short time before presentation. She had marked swelling and local tenderness over the elbow. The only other remarkable finding was a pulse of 132. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreClinical Challenge: February, 2008
The patient is a 9-year-old girl who fell and received a blow to her right chest. A few hours later, she presented to urgent care complaining of pain on deep breathing. On exam, you find a pulse of 103, and SAT of 96. She is not in respiratory distress; her chest exam was clear and she has an abrasion over her right chest. She is generally healthy, is on no medica- tions, and has no …
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55-year-old man with knee pain after fall
The patient is a 55-year-old man who presented complaining of pain after experiencing a fall on the street and a blow to the knee. View the x-ray taken and consider your diagnosis and next steps.
Read MoreClinical Challenge 2: December 2007
The patient is a 10-year-old boy who received a blow to the forearm when he fell at home. He presented with local swelling and tenderness on exam, complaining of severe pain in his wrist. View the x-rays taken (Figure 1 and Figure 2) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreA 14-year-old who took a fall two hours prior to presenting to the urgent care clinic
The patient is a 14-year-old who took a fall two hours prior to presenting to the urgent care clinic. The left ankle is swollen and unable to bear weight, but the patient is otherwise healthy. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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Management of Distal Radial Fractures
Urgent message: Distal radial fractures in children can often be treated by non-orthopedists without the need for full casting in an urgent care center that can perform simple splinting, thus sparing hospital referral. Deena R. Zimmerman, MD, MPH, IBCLC, Scott Fields, MD, and Nahum Kovalski, BSc, MDCM Introduction Wrist fracture is a com-mon injury in children. Many of these fractures are buckle or torus fractures. Traditionally, treatment for buckle fractures has been short-arm casting for …
Read MoreClinical Challenge: August, 2007
The patient is a 9-year-old boy who received a blow to the shoulder from a height of approximately 6 ½ feet. He has limited elevation of the arm due to pain. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. <
Read MoreClinical Challenge 2: July 2007
The patient is an 18-year-old male who jumped or fell from a “short height” but landed hard on his heel. He is able to ambulate, but cannot put any pressure on his heel. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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