Does this young adult patient need a hip radiograph?

Does this adult patient have septic arthritis?

CONTEXT In patients who present with an acutely painful and swollen joint, prompt identification and treatment of septic arthritis can substantially reduce morbidity and mortality. OBJECTIVE To review the accuracy and precision of the clinical evaluation for the diagnosis of nongonococcal bacterial arthritis. DATA SOURCES Structured PubMed and EMBASE searches (1966 through January 2007), li...

Does This Adult Patient Have Acute Meningitis?

Does this adult patient have a blunt intra-abdominal injury?

CONTEXT Blunt abdominal trauma often presents a substantial diagnostic challenge. Well-informed clinical examination can identify patients who require further diagnostic evaluation for intra-abdominal injuries after blunt abdominal trauma. OBJECTIVE To systematically assess the precision and accuracy of symptoms, signs, laboratory tests, and bedside imaging studies to identify intra-abdominal...

Does this coughing adolescent or adult patient have pertussis?

CONTEXT Pertussis is often overlooked as a cause of chronic cough, especially in adolescents and adults. Several symptoms are classically thought to be suggestive of pertussis, but the diagnostic value of each of them is uncertain. OBJECTIVE To systematically review the evidence regarding the diagnostic value of 3 classically described symptoms of pertussis: paroxysmal cough, posttussive emes...

Does this adult patient with suspected bacteremia require blood cultures?

CONTEXT Clinicians order blood cultures liberally among patients in whom bacteremia is suspected, though a small proportion of blood cultures yield true-positive results. Ordering blood cultures inappropriately may be both wasteful and harmful. OBJECTIVE To review the accuracy of easily obtained clinical and laboratory findings to inform the decision to obtain blood cultures in suspected bact...