When I have a pediatric patient with acute abdominal pain and need to assess rebound tenderness, I do not apply pressure to the painful area. Instead, I finish my exam, then have the patient jump off the exam table or get down and jump in place and see if it causes splinting due to the pain elicited. That way, I am not the “bad guy” causing pain to my patient, but I still get the information that I need.—DEB WOLF, PA-C, Syracuse, N.Y. (213-4)

These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it here.

Continue Reading