A 16-year-old girl presents after being in a car accident where a car drove into the back of the car that her mother was driving. This happened on a motorway slip road the previous day. Having initially thought there were no injuries, she has woken up with pain and stiffness in her neck and a sore right wrist. She thinks she may have knocked it on the dashboard. She attends the general practitioner.
Mental state examination On examination, she has no evidence of any fractures, no neurological symptoms or signs on history or examination. You diagnose whiplash and recommend simple analgesia, a neck collar and arrange physiotherapy. On examination, you notice multiple new and old transverse scars on her forearms hidden underneath a long sleeve jumper. On further discussion, the girl explains that she has been cutting herself on a regular basis to relieve stress for about 18 months. Some of…
