2025/2026 NR 6512 i-Human Case Study:
16-Year-Old Male with Right Hand Pain |
Comprehensive SOAP Note Guide
aligned with Bates’ Guide to Physical
Examination 13th Edition by Lynn S.
Bickley, Peter G. Szilagyi, and Richard
M.
,## NR 6512 i-Human Case Study: 16-Year-Old Male with Right Hand Pain (2025/2026 Edition)
### Case Overview
| Feature | Details |
| :--- | :--- |
| **Patient** | 16-year-old male adolescent |
| **Chief Complaint** | "My right hand hurts" |
| **Setting** | Outpatient primary care clinic |
| **Typical Course** | NR 6512 / NURS 6531 (Week 9) |
| **Primary Learning Objectives** | Differentiating between traumatic and overuse causes of hand
pain; performing focused musculoskeletal exam; interpreting X-ray findings; developing age-appropriate
treatment plan |
---
### Subjective Data (History Collection)
#### History of Present Illness (HPI) – OLDCARTS Format
| Feature | Finding |
| :--- | :--- |
| **Onset** | 2-5 days ago (sudden/acute onset) |
| **Location** | Right hand – specific location varies by case version |
| **Duration** | Constant since onset |
| **Characteristics** | Sharp, throbbing, dull ache depending on activity |
, | **Aggravating** | Gripping, movement, use of hand |
| **Relieving** | Rest, OTC ibuprofen (minimal relief) |
| **Timing** | Worsening over first 48-72 hours |
| **Severity** | 6-8/10 (moderate to severe) |
#### Mechanism of Injury (Critical Differentiator – Two Case Versions)
| Case Version | Mechanism | Key Historical Finding |
| :--- | :--- | :--- |
| **Version A: Traumatic (Boxer's Fracture)** | Punched a wall during argument with friend 2 days ago
| Immediate pain and swelling over ulnar side of hand, particularly 4th/5th knuckles |
| **Version B: Overuse (De Quervain's Tenosynovitis)** | No specific injury; repetitive activities | "I
played video games all weekend, probably 10-12 hours total. I also text a lot" |
#### Associated Symptoms (Positive Findings)
- Swelling over affected area
- Bruising (traumatic version)
- Decreased grip strength
- Pain with movement or gripping
- Difficulty with fine motor tasks
#### Critical Denials (Rule-Out Findings)
| Denied Symptom | Clinical Significance |
| :--- | :--- |
16-Year-Old Male with Right Hand Pain |
Comprehensive SOAP Note Guide
aligned with Bates’ Guide to Physical
Examination 13th Edition by Lynn S.
Bickley, Peter G. Szilagyi, and Richard
M.
,## NR 6512 i-Human Case Study: 16-Year-Old Male with Right Hand Pain (2025/2026 Edition)
### Case Overview
| Feature | Details |
| :--- | :--- |
| **Patient** | 16-year-old male adolescent |
| **Chief Complaint** | "My right hand hurts" |
| **Setting** | Outpatient primary care clinic |
| **Typical Course** | NR 6512 / NURS 6531 (Week 9) |
| **Primary Learning Objectives** | Differentiating between traumatic and overuse causes of hand
pain; performing focused musculoskeletal exam; interpreting X-ray findings; developing age-appropriate
treatment plan |
---
### Subjective Data (History Collection)
#### History of Present Illness (HPI) – OLDCARTS Format
| Feature | Finding |
| :--- | :--- |
| **Onset** | 2-5 days ago (sudden/acute onset) |
| **Location** | Right hand – specific location varies by case version |
| **Duration** | Constant since onset |
| **Characteristics** | Sharp, throbbing, dull ache depending on activity |
, | **Aggravating** | Gripping, movement, use of hand |
| **Relieving** | Rest, OTC ibuprofen (minimal relief) |
| **Timing** | Worsening over first 48-72 hours |
| **Severity** | 6-8/10 (moderate to severe) |
#### Mechanism of Injury (Critical Differentiator – Two Case Versions)
| Case Version | Mechanism | Key Historical Finding |
| :--- | :--- | :--- |
| **Version A: Traumatic (Boxer's Fracture)** | Punched a wall during argument with friend 2 days ago
| Immediate pain and swelling over ulnar side of hand, particularly 4th/5th knuckles |
| **Version B: Overuse (De Quervain's Tenosynovitis)** | No specific injury; repetitive activities | "I
played video games all weekend, probably 10-12 hours total. I also text a lot" |
#### Associated Symptoms (Positive Findings)
- Swelling over affected area
- Bruising (traumatic version)
- Decreased grip strength
- Pain with movement or gripping
- Difficulty with fine motor tasks
#### Critical Denials (Rule-Out Findings)
| Denied Symptom | Clinical Significance |
| :--- | :--- |
