A page comes in from downstairs—another admission. A 41-year-old postal worker in bed 22, presented with severe back pain and needs pain control and a physical therapy evaluation. Three weeks ago, he was lifting a box when he felt a sharp pain in the middle of his lower back. The pain has not decreased, despite his taking naproxen around the clock. I look at the vital signs: temperature, 99°; pulse, 92 bpm; pressure, 140/90 mm Hg; respirations and oxygen saturation, normal. Nothing stands out as I click through the laboratory results.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Sargsyan Z. The “Hemolyzed” Physical Examination—Situational Challenges to Accurate Bedside Diagnosis. JAMA Intern Med. 2019;179(4):465–466. doi:10.1001/jamainternmed.2018.8753
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: