Case Study: A 74-Year-Old Patient

The patient is a 74-year-old gentleman who presented to the ED with acute pain in the right quadriceps. After initial evaluation it was felt the patient was appropriate for observation. The patient refused to go and was threatening to sign out against medical advice or requesting to be discharged. Arrangements were made for the patient to be discharged to follow-up with the primary orthopedist. The patient then refused discharge and wanted admission. The patient was admitted inpatient and quickly converted to observation, which is the most appropriate modality for this patient. There is some question as to whether the patient had an occult fracture of the femur. The patient underwent an MRI which was completely negative for fracture