Brit J Hosp Med
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A referral from accident and emergency for a child with hip pain is a scenario commonly faced by orthopaedic juniors on call. The list of differentials is vast and can make assessment and diagnosis challenging, with severe consequences if diagnosis is delayed or missed. Three common causes of paediatric hip pain are septic arthritis, transient synovitis and osteomyelitis. ⋯ Differentiating between them can be challenging. A thorough history and examination, combined with appropriate investigations and imaging, is essential. Early diagnosis and prompt treatment are key to reducing irreversible secondary sequelae of joint destruction and long-term functional impairment.
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Burnout, mental health disorders and suicide are more common among doctors than the general population. Burnt-out doctors self-report increased rates of medical errors and the provision of suboptimal patient care. Surgeons in training are particularly at risk of burnout and are also less likely to seek professional support. ⋯ Schwartz rounds and mindfulness training have been shown to be effective, but only in those motivated to participate. A reduction in working hours has conflicting results, particularly among surgical trainees, which may be linked to the subsequent reduction in training opportunities, such as operative time and the ability to complete assessments. Early identification and targeted support of at-risk individuals is a potentially effective strategy that requires further research.