A 6-week-old boy is brought for routine examination at his pediatrician’s office. The patient was born at 39 weeks to a 26-year-old G1P1 mother by normal vaginal delivery. External cephalic version was performed successfully at 37 weeks for breech presentation. Pregnancy was complicated by gestational diabetes that was well-controlled with insulin. The patient’s maternal grandmother has early onset osteoporosis. On physical examination, the left hip dislocates posteriorly with adduction and depression of a flexed femur. An ultrasound is obtained that reveals left acetabular dysplasia and a dislocated left femur. Which of the following is the next best step in management?
APavlik harness
BClosed reduction and spica casting
CObservation
DPhysiotherapy
EOpen reduction and femoral osteotomy
A 65-year-old man presents to the emergency department with a complaint of intense pain in his right foot for the past month, along with fever and chills. He denies any traumatic injury to his foot in recent memory. He has a medical history of poorly-controlled type II diabetes and is a former smoker with extensive peripheral vascular disease. On physical exam, the area of his right foot around the hallux is swollen, erythematous, tender to light palpation, and reveals exposed bone. Labs are notable for elevated C-reactive protein and erythrocyte sedimentation rate. The physician obtains a biopsy for culture. What is the most likely causative organism for this patient’s condition?
APasteurella multocida
BMycobacterium tuberculosis
CStaphylococcus aureus
DPseudomonas aeruginosa
ENeisseria gonorrhoeae
A 69-year-old woman presents with pain in her hip and groin. She states that the pain is present in the morning, and by the end of the day it is nearly unbearable. Her past medical history is notable for a treated episode of acute renal failure, diabetes mellitus, obesity, and hypertension. Her current medications include losartan, metformin, insulin, and ibuprofen. The patient recently started taking high doses of vitamin D as she believes that it could help her symptoms. She also states that she recently fell off the treadmill while exercising at the gym. On physical exam you note an obese woman. There is pain, decreased range of motion, and crepitus on physical exam of her right hip. The patient points to the areas that cause her pain stating that it is mostly over the groin. The patient's skin turgor reveals tenting. Radiography is ordered. Which of the following is most likely to be found on radiography?
ALoss of joint space and osteophytes
BPosterior displacement of the femoral head
CHyperdense foci in the ureters
DFemoral neck fracture
ENormal radiography
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