Atraumatic limp OSCE scenario
candidate brief
You are seeing Danny, a 8yo boy who started limping 3 days ago. He has presented with his mother. Take a history from his mother.
80% history taking
20% clinical reasoning
actor brief
You are the mother of Danny, who is 8 yo. 3 days ago he woke up and you noticed he was limping and complaining of pain in his thigh. Initially you thought he had hurt himself so have been giving him paracetamol and ibuprofen and this seemed to settle him down.
Term baby, no developmental concerns
PMH nil
NKDA
Today he had some pain in his belly and was crying in the morning, that worried you so you decided to bring him to hospital.
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examiner brief
- wash hands
- introduce self
- confirm patient identity and identity of caregiver
- offer analgesia
- checks that child is well
- checks for history of trauma
- checks for abdominal pain
- asks appropriate questions about abdo pain
- character +location of pain
- past medical history
- drug history and allergies
- red flags
- fever
- waking at night
- duration of limp
- explain need to examine child
- explain need for investigations
- XR - AP/frog-leg
- urine ?
- bloods
- explain most likely differentials
- answers questions
- thanks mother and patient
- global mark from examiner
- global mark from parent