2026 I Humane Case Nur-6531 16-Year- Old Male Presenting With Hand Pain – iHuman Case Week #9 Walden University

He describes the pain as: • Quality: [Sharp, dull, throbbing, burning, etc.] • Severity: [Mild, moderate, severe; pain scale 1–10] • Location: [Specific location on the hand—e.g., dorsal, palmar, wrist, fingers] • Radiation: [Yes/No; specify direction if yes] • Timing: [Constant, intermittent, worsens with activity, etc.] • Aggravating Factors: [Movement, pressure, writing, etc.] • Relieving Factors: [Rest, ice, pain medications] • Associated Symptoms: [Swelling, bruising, numbness, tingling, decreased range of motion] Past Medical History (PMH): • No chronic illnesses reported • No history of musculoskeletal injuries or chronic joint issues Past Surgical History (PSH): • None Medications: • None reported Allergies: • No known drug allergies (NKDA) Family History (FH): • High school student • Active in sports (e.g., basketball) • Denies tobacco, alcohol, or drug use Review of Systems (ROS): • Musculoskeletal: Reports hand pain, possible swelling • Neurological: No numbness or tingling (or specify if present) • Skin: No open wounds or rash • General: Denies fever, chills, or weight loss Physical Examination General • Alert, oriented, and in no acute distress • Cooperative and well-nourished adolescent male Vital Signs (if available, plug in actual values) • Temperature: [e.g., 98.6°F] • Heart Rate: [e.g., 78 bpm] • Respiratory Rate: [e.g., 16 bpm] • Blood Pressure: [e.g., 112/70 mmHg] • Oxygen Saturation: [e.g., 98% on room air] Inspection of Hand • Special Tests (if applicable) • Snuffbox tenderness: Positive → suspicious for scaphoid fracture • Tinel’s/Phalen’s test: Negative (if ruling out carpal tunnel syndrome) Finkelstein’s test: [Positive/Negative] – evaluates De Quervain’s tenosynovitis Assessment Patient: 16-year-old right-handed male Chief Complaint: Right/left hand pain (based on your case specifics) Onset: Acute, following [insert mechanism — e.g., sports injury or fall] Summary of Findings: • Pain localized to [specific area, e.g., dorsum of hand or anatomical snuffbox] • Swelling and tenderness on palpation • Decreased grip strength and ROM due to pain • No signs of infection or systemic illness • Neurovascular status intact Differential Diagnoses (Ranked by Likelihood) 1. Scaphoid Fracture (most likely if snuffbox tenderness is present) o Mechanism often involves FOOSH (fall on outstretched hand) o Snuffbox tenderness is a classic finding o X-ray or MRI may be needed to confirm (early fractures may not be visible initially) 5. Growth Plate Injury (Salter-Harris fracture) o Consider in adolescents due to open physes o X-ray needed to assess Diagnostic Test Results Imaging • X-ray – Right/Left Hand & Wrist: o [ Normal / Abnormal] o Findings: [E.g., Nondisplaced fracture of the scaphoid / 5th metacarpal neck fracture / No visible fracture] [Signs of soft tissue swelling] [Growth plates open/intact (in pediatric/adolescent cases)]