Background: Joint physician-nurse rounding is an important best practice that facilitates communication and patient participation in their care while improving outcomes and satisfaction. Interdisciplinary bedside rounding has been shown to reduce mortality, lengths of stay, medication errors, and readmissions while improving staff engagement, teamwork, and patient experience (1, 2, 3). In 2018, our hospital added [...]

Background: Septic arthritis (SA) of native joints has an incidence rate of 4-12 per 100,000 person-years. In 2012, there were 36, 539 hospitalizations for SA in US non-VA hospitals and costed the US healthcare system $2.85 billion. Such data has not been reported for US VA-healthcare System. SA has a mortality of 4-13%. Among survivors [...]

Background: Alternative payment models have been proposed for lower extremity joint replacement surgeries to deliver well-coordinated and high quality care. It is speculated that while these payment models may lead to more cost effective care, institutions may “cherry pick” less costly and less complex patients to minimize financial risks. In this study, we aim to [...]

Background: Total joint arthroplasties (TJA) are the most frequently performed orthopedic surgeries in the USA. Given the aging US population, the number of TJA surgeries is expected to grow by 559% by 2060. Additionally, the average medical comorbidity for patients undergoing TJA surgery is increasing, a trend that is expected to continue. Given both the [...]

Case Presentation: A 68-year-old male with osteoarthritis, status post bilateral knee replacement in 2014, presented with two weeks of flu-like symptoms, generalized weakness, and shortness of breath. Upon admission, the patient was noted to have a tender, swollen right knee with laboratories revealing neutrophilia with bandemia. Computed tomography (CT) of the joint revealed punctate gas [...]

Case Presentation: A 68-year-old female presented to the emergency department with altered mental status. A few weeks prior to presentation, she was found to have a viral influenza infection which was managed supportively. Approximately one week prior to presentation, she had started developing a productive cough associated with body aches and fatigue, and eventually developed [...]

Case Presentation: A 42 year-old woman with history significant for systemic lupus erythematous (SLE) for 20 years complicated by pleurisy and thrombocytopenia on belimumab presented with a 10-day history of migratory polyarthritis. Her pain started in her left wrist, traveled to her right wrist one day later and then to her right shoulder after two [...]

Case Presentation: A 55-year-old woman with a history of rheumatoid arthritis presented for generalized weakness, dysuria, nausea, and dizziness of 1 week duration. She developed progressive weakness with associated decreased exercise tolerance, nausea, and diarrhea. Her oral intake decreased. There was no inciting event and did not note any recent close contacts with similar symptoms.Her [...]

Case Presentation: A 27-year-old woman with a past medical history of recurrent bilateral shoulder dislocations presented with three months of progressive constipation, early satiety, nausea, vomiting, and an 18 kg unintentional weight loss. Prior to this admission, she had seen orthopedic surgery due to her recurrent, spontaneous bilateral shoulder dislocations and was noted to have [...]

Case Presentation: Case 1: A 3-year-old female with no significant past medical history presented with a 5-week history of recurrent fevers as well as bilateral lower extremity pain with difficulty to ambulate. Imaging of the femur revealed focal lucencies in the proximal femoral shaft. The leading diagnosis at admission was malignancy given the length of [...]