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Reza

๐Ÿ‘ค Speaker
392 total appearances

Appearances Over Time

Podcast Appearances

The Clinical Problem Solvers
Episode 456 โ€“ RLR โ€“ A moving target

She feels fine.

The Clinical Problem Solvers
Episode 456 โ€“ RLR โ€“ A moving target

When she stands up is when it feels the stiffest and then it gets better with movement.

The Clinical Problem Solvers
Episode 456 โ€“ RLR โ€“ A moving target

So the only thing I can think of here is that it doesn't sound yet like this is an articular process, but if it were...

The Clinical Problem Solvers
Episode 456 โ€“ RLR โ€“ A moving target

it would be inflammatory in nature, given that it improves with movement.

The Clinical Problem Solvers
Episode 456 โ€“ RLR โ€“ A moving target

But the reason it's, and you have to realize too, with the hip, it's such a deep joint that even if you examine this patient, and remember audience, Zolvin is trying to navigate this through a telephone.

The Clinical Problem Solvers
Episode 456 โ€“ RLR โ€“ A moving target

Who even knows, like he might not even be looking at the patient's hip.

The Clinical Problem Solvers
Episode 456 โ€“ RLR โ€“ A moving target

We'll get more detailed, you know, in a short time.

The Clinical Problem Solvers
Episode 456 โ€“ RLR โ€“ A moving target

But the hip is a deep-seated joint.

The Clinical Problem Solvers
Episode 456 โ€“ RLR โ€“ A moving target

So even visibly, it might look fine.

The Clinical Problem Solvers
Episode 456 โ€“ RLR โ€“ A moving target

But when you move it, you know, and examine the patient,

The Clinical Problem Solvers
Episode 456 โ€“ RLR โ€“ A moving target

you might elicit discomfort, which points to a deeper structural problem.

The Clinical Problem Solvers
Episode 456 โ€“ RLR โ€“ A moving target

But the other thing I thought about sudden onset in a young guy is could this be testicular torsion?

The Clinical Problem Solvers
Episode 456 โ€“ RLR โ€“ A moving target

Could this patient have something happening that's outside of the hip area that's referring pain there?

The Clinical Problem Solvers
Episode 456 โ€“ RLR โ€“ A moving target

But I don't know how that would necessarily improve with movement.

The Clinical Problem Solvers
Episode 456 โ€“ RLR โ€“ A moving target

Robbie, anything else to layer on before we get more data?

The Clinical Problem Solvers
Episode 456 โ€“ RLR โ€“ A moving target

Yeah, I think, Zalman, this is really helpful because now we can say the patient's inflamed.

The Clinical Problem Solvers
Episode 456 โ€“ RLR โ€“ A moving target

And I think once this case completely, you know, you tell us what happens, maybe this hip pain and its acute onset is going to be related to the fever.

The Clinical Problem Solvers
Episode 456 โ€“ RLR โ€“ A moving target

At time point zero, all our attention would be to the joint and making sure the patient doesn't have a septic joint.

The Clinical Problem Solvers
Episode 456 โ€“ RLR โ€“ A moving target

But now that the pain has completely resolved, that is inconsistent with the possibility that you have an intra-articular infection.

The Clinical Problem Solvers
Episode 456 โ€“ RLR โ€“ A moving target

So now we have fever with no localizing symptoms.