About Harriet Lane Handbook: Pediatric Insights from The Johns Hopkins Hospital
The Harriet Lane Handbook, published by Elsevier, has been trusted for over 70 years as the #1 source of pediatric point-of-care clinical information. Now, listen to residents and faculty at The Johns Hopkins Hospital discuss case studies and healthcare disparities based on topics from this bestselling book.
Episode 20: Pediatric Musculoskeletal (MSK) Injuries and Exam
A child won't bear weight after a tumble on the playground. Sprain, strain, or fracture? In this episode, join Dr. Eva Seligman, a pediatric emergency medicine and sports medicine specialist at Johns Hopkins Hospital, with host, Dr. Luisa Costa to unpack the evaluation of pediatric ankle and knee injuries. They explore why open growth plates change the game in kids, whether the Ottawa ankle rules really hold up in young patients, and which exam maneuvers separate a stable joint from an unstable one. Dr. Seligman breaks down when imaging is truly warranted, how to decide between sports medicine and orthopedic referral, and what families need to hear about return-to-play timelines. Whether you'refacing a swollen knee in the ED or a worried parent in clinic, this conversation offers a practical framework you'll reach for again and again. Tune in for the pearls every trainee needs before the next limping patient walks in.
Why the Ottawa ankle rules don't behave quite the sameway in kids — and how that should shift your threshold for ordering an X-ray.
The single biomechanical concept (hint: it involves growth plates) that explains almost every injury pattern unique to pediatric patients.
A rapid rundown of the exam maneuvers for kneeinstability — and the one pitfall that can make them unreliable in kids.
How to tell when a "simple sprain" is something more, and when to loop in sports medicine versus orthopedics.
The return-to-play framework Dr. Seligman uses tocounsel families — simpler than you'd think, but easy to get wrong.
Get more must-know information in The Harriet Lane Handbook, 24th edition, available now.
10 Aug 2026
Episode 19: Signs of Abuse
A three-month-old arrives in the ED with irritability,decreased feeding, and a story that doesn't quite add up: he "rolled off the bed." Is this an accident, or something more? In this episode, Dr. Brian Schultz, Dr. Mitchell Goldstein, Dr. Gabrielle Pollack, and Dr. Samantha Waslewski from Johns Hopkins Hospital walk through a real-world case to teach clinicians how to spot the subtle, often non-specific signs of physical child abuse — before it's too late. They cover red flags in history and exam, the sentinel injuries doctors miss, how implicit bias shapes who gets scrutinized, and exactly which imaging and labs to order. Whether you're in the ED or a pediatrician's office, this conversation will change how carefully you listen to every history you take. A must-listen for any provider who cares for children.
The story doesn't match the injury — why a "three-month-old rolled off the bed" should immediately raise red flags, and how to spot developmental inconsistencies in any history.
The 2/3 statistic that changes everything — most kids with abusive head trauma have no other physicalfindings. Learn why a normal exam doesn't mean you're in the clear.
Sentinel injuries you might be missing — subtle signs like a torn frenulum or subconjunctival hemorrhagethat can be the only clue before a fatal injury occurs.
Bias is invisible until it isn't — how implicit assumptions about "who abuses children" cause providers to miss cases in higher socioeconomic, two-parent households.
CT vs. MRI — practical, concrete guidance on imaging choices, skeletal surveys, and how to start aworkup even without a trauma center's resources.
13 Jul 2026
Episode 18: Episode Primary and Secondary Trauma
When a critically injured child arrives in the emergency department, every second counts — and every decision matters. In this episode of the Harriet Lane Handbook Audio Companion, pediatric residents Dr. Sarah-Thérèse Curtis Welling and Dr. Peyton Russell sit down with Dr. Keith Kleinman, a pediatric emergency medicine physician and researcher at Johns Hopkins, to break down what it really takes to assess and stabilize a child in trauma. From the moment EMS calls ahead to the last step of the secondary survey, Dr. Kleinman walks through the ABCDE framework, the unique physiologic challenges of treating pediatric patients,and the leadership skills that keep a trauma bay from descending into chaos. Whether you're a trainee stepping into the trauma bay for the first time or a seasoned provider looking to sharpen your approach, this episode deliverspractical, expert guidance on one of medicine's highest-stakes scenarios.
Master the ABCDE primary survey framework andknow exactly when to intervene at each step
Learn why children are not small adults — andhow their physiology can fool even experienced providers
Understand the early warning signs of shockin kids before blood pressure tells you it's too late
Get a step-by-step guide to pediatricintubation, including how to handle a difficult or failed airway
Discover how to communicate with nonverbaland developmentally delayed patients during high-stakes trauma
Hear expert advice on leading a trauma teamwith calm, clarity, and control when the pressure is on
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