Pediatric Appendicitis: CT or Ultrasound?

Appendicitis is the most common pediatric surgical emergency accounting for 5% of urgent pediatric outpatient visits for abdominal pain. Computed tomography (CT) and ultrasonography (US) are two imaging modalities used in the diagnostic evaluation of acute pediatric appendicitis. Both have decreased the incidence of negative appendectomy results. It is well known that CT has greater diagnostic accuracy than US for diagnosing acute appendicitis, but there is concern over long-term cancer risk, with routine use of CT in children.

What modality should be used for pediatric patients who are suspected of appendicitis?

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By Salim Rezaie, MD|2019-09-10T13:38:32-07:00May 8, 2013|Pediatrics, Radiology|

Patwari Academy video: Early goal directed therapy

Do you know the protocol for early goal directed therapy (EGDT)? It’s all about IV fluids. Get the scoop here in this 12 minute video.

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By Michelle Lin, MD|2019-01-28T21:59:54-08:00May 5, 2013|Infectious Disease, Patwari Videos|

Limping is a common reason for parents to bring their children to emergency departments. It is known that 77% of acute, atraumatic limp is dealt with in the ED, and 20% do not even complain of pain.¹ Our job as physicians is to complete appropriate assessments to not miss any serious pathology. Specifically, differentiating between transient synovitis (TS) and septic arthritis (SA) of the hip can be difficult and frustrating for everyone. What is your approach?

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By Salim Rezaie, MD|2019-09-10T13:38:27-07:00May 1, 2013|Orthopedic, Pediatrics, Radiology|

The Case: A 8-day-old, uncircumcised male is brought to the ED with fever, irritability, and decreased urination.

The Problem: Getting a clean catch urine in a timely, non-invasive manner

The Solution?

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By Salim Rezaie, MD|2016-11-11T18:38:43-08:00Apr 30, 2013|Genitourinary, Pediatrics, Tricks of the Trade|

The SCRAP Rule: Indications for chest CT in blunt trauma

CT_Scanner_01.jpg2d5efea2-a1b7-4c15-848e-4d6c5567eecfLarger At my institution, trauma patients frequently receive the “Pan Scan,” to rule out acute injury. Recently, Payrastre et al published the SCRAP Rule article in CJEM 2012 ¹ looking to derive and internally validate a clinical decision rule that would identify blunt trauma patients at very low risk for major thoracic injury with 100% sensitivity, thereby eliminating need for a chest CT. Currently, the decision on whether to perform a chest CT is made mostly by clinical judgment.

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By Salim Rezaie, MD|2019-09-10T13:38:17-07:00Apr 25, 2013|Radiology, Trauma|

“Done Fell Out”, or DFO, is a common saying in the South to describe syncope. Although the saying is funny the diagnosis is not. Syncope accounts for about 3–5% of ED visits and 1–6% of hospital admissions. In patients >65, syncope is the 6th most common cause of hospitalization.

How do you approach the management of patients with syncope?

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By Salim Rezaie, MD|2019-09-10T13:38:10-07:00Apr 18, 2013|Cardiovascular|