A 15-year-old adolescent girl fell under a decelerating train at a suburban railway station, which resulted in head and left-sided truncal injuries. The primary survey revealed that she was alert with repetitively questioning. She had a systolic blood pressure of 95 mm Hg, a pulse rate of 105 beats/min, and an oxygen saturation level of 96% on ambient air. She had a large contusion to the left…

A 12-year-old healthy boy was evaluated for a growth under his right great toenail (Figure 1). The lesion was initially diagnosed as a subungual verruca and treated for 4 months with topical salicylic acid and cryotherapy. No improvement was observed, and the growth continued to enlarge and became increasingly painful. Radiographs of the right foot demonstrated an osseous protuberance at the…

A 6-year-old previously healthy child presented to the pediatric emergency department with a 5-day history of fever and cough. Point-of-care ultrasonography of the chest was performed by the pediatric emergency physician. The image in Figure 1 was obtained from the left anterior chest.

A 15-year-old girl presented to the emergency department (ED) with progressive right lower quadrant abdominal pain for 2 days shortly after menarche. She had no vomiting or diarrhea. On examination, she was afebrile, with marked right lower quadrant abdominal tenderness without peritoneal signs. Blood test results were negative. Abdominal ultrasonography revealed a cystic mass over the right…

A 13-year-old girl presented to the emergency department (ED) with a 3-week history of a “weeping wound” on her right medial thigh. Three months before, she fell off a horse and obtained a saddle injury to her right medial thigh, with extensive bruising and swelling. She initially presented to an outside ED, where radiographs were negative for fracture and venous ultrasonography was negative for…

A 12-year-old girl presented with a sudden- and nontraumatic-onset, painless, left-sided neck mass. She had had no previous surgery. Examination demonstrated a smooth and fluctuant mass palpable in the left supraclavicular region. Ultrasonographic scan showed a unilocular cyst measuring approximately 7 cm in diameter (Figure 1). Magnetic resonance imaging (MRI) confirmed a well-circumscribed…

A 7-year-old girl presented to the emergency department with headache. The headache was described as occipital and worsening during the past 2 weeks. The headache woke her from sleep several times. On the day of presentation, she had 2 episodes of emesis. There was no history of fever or trauma. Physical examination revealed normal vital signs and a nonfocal neurologic examination result. Brain…

An 8-year-old boy with a history of one episode of hematemesis presented to the emergency department. His pulse rate was 109 beats/min and blood pressure was 112/74 mm Hg. The findings from his physical examination were normal. Blood work showed a hemoglobin level of 61 g/L (reference range, 120 to 160 g/L). Bedside abdominal ultrasound showed a hypoechoic 33 × 22 × 33 mm mass in the stomach with…