Medical Mystery Solved - A Deficient Diagnosis | NEJM

Ғылым және технология

This Double Take video from the New England Journal of Medicine presents the case
of a toddler with a limp. Based on a Clinical Problem-Solving article published
in the Journal, the video explores the differential diagnosis for a child refusing
to bear weight on his right leg and follows its evolution as new clinical findings
arise from the diagnostic evaluation.

For further reading, the following article, A Deficient Diagnosis (Hafez et al., in the April 7, 2016, issue) referenced in this video, is available
at www.nejm.org/doi/full/10.1056... .
The New England Journal of Medicine is the world’s leading general medical
journal. Continuously published for over 200 years, NEJM publishes
peer-reviewed research along with interactive clinical content for physicians,
educators, and the global medical community at NEJM.org.
#medicaleducation #clinicalmedicine #growthanddevelopment #pediatrics

Пікірлер: 16

  • @dr.anuptoshniwal
    @dr.anuptoshniwal7 ай бұрын

    I am for India. Fortunately or unfortunately 40-50 seconds in history i suspected scurvy.. It can be a tricky diagnosis.. There is so much pain due to bone changes, that sometimes kids present with pseudo-paralysis. A very good and needed video specially who work in high end hospitals. It is also common in Cancer patients

  • @ponsaravanan3749

    @ponsaravanan3749

    Ай бұрын

    Me too sir.. i am also from india.. i am also suspected initially as scurvy only...

  • @dariuslima
    @dariuslima7 ай бұрын

    The "picky eating" had me thinking what it could be...and i was surprised to see that it was scurvy. A thorough Anamnesis can go a long way, but understandable, since nowadays everything is fast...Amazing case! Thanks!

  • @srinivasaraghavan_devpaed
    @srinivasaraghavan_devpaed7 ай бұрын

    Scurvy must definitely be considered as a differential diagnosis of musculoskeletal symptoms in children with developmental needs. Especially if the child has picky eating, where child avoids fruits and vegetables

  • @as-sabahossain9099
    @as-sabahossain90992 ай бұрын

    Before going through all those invasive procedure, a simple nutritional assessment would have done it. I think more than the diagnosis, the important takeaway for video is to have in depth, detailed history to exclude all possible differentials. Very much grateful for this wonderful presentation 🙏🙏

  • @vishwakaran9020
    @vishwakaran90207 ай бұрын

    I love my teacher ...dr.Bhose ❤

  • @absurdum-the-artist
    @absurdum-the-artist6 ай бұрын

    To me the possibility of scurvy felt possible from the very beginning. I and many other people with ASD were far too close to being in the same position

  • @sim_aware
    @sim_aware7 ай бұрын

    Very interesting case. Thanks!

  • @chrislongdc
    @chrislongdc6 ай бұрын

    No offense but those were highly invasive procedures, and took way too long to come to that diagnosis. I don't see this as a win for medicine. Then again, a good reminder on what the child's diet consisted of was missed during the case history. A simple mistake.

  • @sviaxqu4072
    @sviaxqu40727 ай бұрын

    upload more cases

  • @anantasaikia2344
    @anantasaikia23446 ай бұрын

    Thank you for reminding , nutritional deficiencies are very common in new generation, maybe attributable to altered dietary habits .

  • @shirmila9911
    @shirmila99117 ай бұрын

    Very interesting case- thank you so much for highlighting the occurrence of Vit C deficiency even in resource rich settings. However, scurvy should have been in the differential from the beginning and an empiric trial of vitamin C would have spared this child from going through so many expensive and painful investigations. With the advent of iOmics and precision medicine , treatment for even common conditions is likely to get extremely expensive. Maybe case discussions in the future should also pause after H&P, and brainstorm possible treatment options if you had nothing further to go upon- ie. no further information from expensive investigations

  • @user-uv5ow9ps4c
    @user-uv5ow9ps4c5 ай бұрын

    🎯 Key Takeaways for quick navigation: 00:07 🚑 *Presentación del caso y síntomas iniciales* - Niño sano de dos años y medio con dificultad para cargar peso en la pierna derecha. - Radiografía muestra posible fractura de peroné, preocupación por causas infecciosas, malignas, inflamatorias o neuromusculares. - Desarrollo posterior de dolor en la pierna izquierda y síntomas gingivales, aumentando la preocupación por leucemia. 01:33 🏥 *Evaluación en el departamento de emergencias* - Agitación y dolor en ambas piernas, sospecha de trauma no accidental. - Pruebas muestran bajo nivel de hemoglobina, tamaño reducido de glóbulos rojos, y posible leucemia. - Consideración de anemia por deficiencia de hierro o envenenamiento por plomo. 02:57 🧠 *Evaluación neurológica y complicaciones* - Realización de resonancia magnética de cabeza y columna, descartando Guillain-Barré. - Desarrollo de erupción cutánea y traslado a otro hospital para evaluación adicional. - Exploración de posibles causas de parálisis en las extremidades inferiores, incluyendo la posibilidad de una picadura de garrapata. 04:23 🩹 *Exploración de otras posibles causas* - Estudios serológicos para condiciones reumatológicas y deficiencias nutricionales. - Resultados normales en pruebas de inflamación muscular y niveles de vitaminas. - Reevaluación de radiografías y CT scans revela bandas metafisarias lucentes en el fémur. 05:46 🍊 *Diagnóstico final y tratamiento* - Diagnóstico de escorbuto por deficiencia de vitamina C. - Inicio de suplementos de ácido ascórbico, mejoría en una semana. - Importancia de la historia dietética detallada para un diagnóstico preciso. Made with HARPA AI

  • @maohrtega
    @maohrtega6 ай бұрын

    What image and video editing applications did you use?

  • @ajitbirnale1971
    @ajitbirnale19714 ай бұрын

    American way of diagnosis 😂

  • @tarunaikrar3383
    @tarunaikrar33834 ай бұрын

    D/ Vit C Defiance

Келесі