Image of the Week: Erythematous Rash and Muscle Weakness

Image of the Week: Erythematous Rash and Muscle Weakness

A 62-year-old woman presents with muscle weakness and an erythematous rash on her face, back, and neck.

Image of the Week: Deformities Found During a Newborn Examination

Image of the Week: Deformities Found During a Newborn Examination

An infant born full term presents with a broad chest with widely-spaced nipples, a webbed neck, and lymphedema of the ...

Image of the Week: Targetoid Lesion on the Index Finger

Image of the Week: Targetoid Lesion on the Index Finger

A 22-year-old man presents with a targetoid lesion on his index finger that appeared after working on a sheep ranch. ...

Image of the Week: Milky White Fluid Drained From the Chest

Image of the Week: Milky White Fluid Drained From the Chest

A 55-year-old woman presents with dyspnea, fatigue, and heaviness in the chest 3 days after a coronary artery bypass grafting. ...

Image of the Week: Ring-Shaped Lesions on the Hands

Image of the Week: Ring-Shaped Lesions on the Hands

A 69-year-old woman with a history of hypertension and irritable bowel syndrome presents with ring-shaped lesions on both of her ...

Image of the Week: Violaceous Livedoid Lesions on the Feet

Image of the Week: Violaceous Livedoid Lesions on the Feet

A 58-year-old woman presents with malaise, fatigue, and new violaceous livedoid lesions on her feet after undergoing cardiac catheterization.

Image of the Week: Fever and Swollen, Erythematous Nodules in the Fingers

Image of the Week: Fever and Swollen, Erythematous Nodules in the Fingers

A 70-year-old man with a history of hypertension presents with fever and painful nodules in the joints of his fingers. ...

Image of the Week: Seizures and Spontaneous Laughter in a Child

Image of the Week: Seizures and Spontaneous Laughter in a Child

A 4-year-old female patient is referred to a pediatric neurologist for evaluation of tonic-clonic seizures, as well as sudden bursts ...

Image of the Week: Painful Lesions on the Lower Limbs and Ears

Image of the Week: Painful Lesions on the Lower Limbs and Ears

A 45-year-old woman presents with painful lesions on her lower limbs and ears. The patient is a smoker and history ...

Image of the Week: Erythematous Rash and Fever

Image of the Week: Erythematous Rash and Fever

A 5-year-old boy presents with new-onset erythematous rash, fever that has persisted for 4 days, coughing, and sneezing.

Image of the Week: Severe Right Upper Quadrant Pain

Image of the Week: Severe Right Upper Quadrant Pain

A 24-year-old woman presents with severe right upper quadrant pain that worsens on inhalation. The pain has persisted for 3 ...

Image of the Week: Thin Film on the Cornea of an Elderly Woman

Image of the Week: Thin Film on the Cornea of an Elderly Woman

An 85-year-old female patient receiving treatment for COPD develops a thin white film on her cornea.

Image of the Week: Worsening Stress Urinary Incontinence in a 62-Year-Old Woman

Image of the Week: Worsening Stress Urinary Incontinence in a 62-Year-Old Woman

A 62-year-old woman presents to her gynecologist with worsening stress urinary incontinence. Magnetic resonance imaging of the pelvis was performed ...

Image of the Week: Poor Growth, Fatigue, and Irritability in a 3-Year-Old Boy

Image of the Week: Poor Growth, Fatigue, and Irritability in a 3-Year-Old Boy

A 3-year-old African American boy is brought to his pediatrician by his mother over concerns of poor growth, fatigue, and ...

Image of the Week: Neck Pain, Headache, and Dysdiadochokinesia

Image of the Week: Neck Pain, Headache, and Dysdiadochokinesia

A 28-year-old woman presents to the emergency department with an occipital headache and neck pain.

Image of the Week: Macroglossia and peripheral edema in a 65-year-old man

Image of the Week: Macroglossia and peripheral edema in a 65-year-old man

A 65-year-old man presents with complaints of increasing fatigue, dyspnea on exertion, and unintentional weight loss within the last 6 ...

Image of the Week: A purple urine bag

Image of the Week: A purple urine bag

An 80-year-old woman with a history of diabetes and chronic constipation presents to the emergency department with a urine bag ...

Image of the Week: Progressive headache, dizziness, and confusion in a 76-year-old man

Image of the Week: Progressive headache, dizziness, and confusion in a 76-year-old man

A 76-year-old man presents with a progressive headache, dizziness, and confusion after falling out of bed the previous night.

Image of the Week: Persistent cough and sputum in a 75-year-old woman

Image of the Week: Persistent cough and sputum in a 75-year-old woman

A 75-year-old woman presents with a 2-year history of a persistent cough and fatigue as well as occasional purulent sputum.

Image of the Week: Subacute shortness of breath and fatigue in a 70-year-old man

Image of the Week: Subacute shortness of breath and fatigue in a 70-year-old man

A 70-year-old man is brought to the emergency department with subacute shortness of breath and fatigue, and his daughter suspects ...

Image of the Week: Headache and a rash on the trunk and extremities

Image of the Week: Headache and a rash on the trunk and extremities

A 32-year-old woman presents with a headache and a rash on her trunk and extremities. Examination reveals generalized nontender lymphadenopathy, ...

Image of the Week: Severe abdominal pain and a swollen knee in a young female

Image of the Week: Severe abdominal pain and a swollen knee in a young female

A 19-year-old female exchange student presents to the emergency department with severe abdominal pain and a swollen right knee. She ...

Image of the Week: A raised erythematous lesion on a pregnant woman's chest

Image of the Week: A raised erythematous lesion on a pregnant woman's chest

A 28-year-old woman presents with a one-week history of a slightly raised erythematous lesion on her chest. She has been ...

Image of the Week: Dyspnea and sharp abdominal pain radiating to the back

Image of the Week: Dyspnea and sharp abdominal pain radiating to the back

A 66-year-old man with a history of hypertension presents to the emergency department with dyspnea and sharp abdominal pain radiating ...

Image of the Week: A thin white film on the cornea after COPD diagnosis

Image of the Week: A thin white film on the cornea after COPD diagnosis

After an 85-year-old woman is admitted to the hospital with COPD, she is treated with bronchodilators, oral glucocorticoids, antibiotics, and ...

Image of the Week: Headache, retro-orbital pain, and diplopia

Image of the Week: Headache, retro-orbital pain, and diplopia

A 25-year-old man presents to the emergency department with headache, retro-orbital pain, and diplopia when gazing to the right. He ...

Image of the Week: Fatigue, jaundice, and subtle dark corneal rings

Image of the Week: Fatigue, jaundice, and subtle dark corneal rings

A 19-year-old female with a family history that suggests Wilson disease presents with fatigue, jaundice, and subtle dark corneal rings.

Image of the Week: Recurring abdominal and flank pain in a 37-year-old woman

Image of the Week: Recurring abdominal and flank pain in a 37-year-old woman

A 37-year-old woman with a family history of kidney problems presents to her clinician with recurring abdominal and flank pain. ...

Image of the Week: Dyspnea, cough, and facial swelling in a smoker

Image of the Week: Dyspnea, cough, and facial swelling in a smoker

A 70-year-old smoker presents with a 4-week history of dyspnea, cough, and facial swelling that is exacerbated by bending forward, ...

Image of the Week: Ataxia gait, vision loss, and diarrhea in a 14-year old boy

Image of the Week: Ataxia gait, vision loss, and diarrhea in a 14-year old boy

A 14-year-old boy is brought to the pediatrician by his mother over concerns of difficulty walking and worsening clumsiness. He ...

Image of the Week: When should ART be initiated in adults with HIV?

Image of the Week: When should ART be initiated in adults with HIV?

A 60-year-old man who is HIV-positive presents with fever, dyspnea, and inflammatory lesions on the skin. A biopsy reveals a ...

Image of the Week: Blue-black discoloration on the neck and face

Image of the Week: Blue-black discoloration on the neck and face

A 58-year-old man with a history of rosacea presents with blue-black discoloration on his neck and face that worsens after ...

Image of the Week: Irregular menses, impaired vision, and galactorrhea

Image of the Week: Irregular menses, impaired vision, and galactorrhea

A 21-year-old woman presents with a 6-month history of irregular menses, decreased libido, impaired vision, and galactorrhea and undergoes an ...

Image of the Week: Tense vesicles and bullae on the neck, lower abdomen, and extremities

Image of the Week: Tense vesicles and bullae on the neck, lower abdomen, and extremities

A 4-year-old boy with known G6PD deficiency presents with numerous tense vesicles and bullae on his neck, lower abdomen, and ...

Image of the Week: Acute chest pain and dyspnea

Image of the Week: Acute chest pain and dyspnea

A 67-year-old woman presents to the emergency room with acute chest pain and dyspnea after the death of her husband. ...

Image of the Week: Salmon-pink, scaly papules

Image of the Week: Salmon-pink, scaly papules

An 8-year-old boy is brought to the pediatrician by his mother due to concerns of numerous small, salmon-pink, scaly papules ...

Image of the Week: Erectile dysfunction and bilateral buttock pain

Image of the Week: Erectile dysfunction and bilateral buttock pain

A 56-year-old man presents with a 3-month history of erectile dysfunction and bilateral buttock pain on exertion, but not at ...

Image of the Week: A pruritic, erythematous lesion on the foot

Image of the Week: A pruritic, erythematous lesion on the foot

A 40-year-old male presents to his family physician with a pruritic, erythematous lesion on his foot after returning from vacation ...

Image of the Week: Fever, heart murmur, and Janeway lesions

Image of the Week: Fever, heart murmur, and Janeway lesions

A 55-year-old woman presents with a low-grade fever, a new heart murmur, and Janeway lesions one week following a dental ...

Image of the Week: Painful urination, a swollen knee, and eye pain

Image of the Week: Painful urination, a swollen knee, and eye pain

A 31-year-old woman presents to the emergency department with a 2-day history of pain on urination and right eye pain, ...

Image of the Week: This condition mimics Parkinson's disease

Image of the Week: This condition mimics Parkinson's disease

A 69-year-old man presents with parkinsonian symptoms. A midsagittal MRI of the brain demonstrates a hummingbird sign consistent with prominent ...

Image of the Week: What's causing this recurrent abdominal pain?

Image of the Week: What's causing this recurrent abdominal pain?

An otherwise healthy 15-year-old male presents with a 6-month history of progressive bloating, recurrent abdominal pain, bloody diarrhea, and tenesmus.

Image of the Week: Recurrent pleural effusions and yellow nails

Image of the Week: Recurrent pleural effusions and yellow nails

A 58-year-old man presents with worsening dyspnea and lower extremity edema. Examination reveals bilateral pitting edema of his legs and ...

Image of the Week: Failure to thrive in a newborn—what's the cause?

Image of the Week: Failure to thrive in a newborn—what's the cause?

A 26-day-old term male infant is brought to the emergency department by his mother because she was concerned about his ...

Image of the Week: Can you identify these cutaneous findings?

Image of the Week: Can you identify these cutaneous findings?

An otherwise healthy 50-year-old man presents with a rash that he has had for several years. The skin eruption becomes ...

Image of the Week: What is causing this patient's resistant hypertension?

Image of the Week: What is causing this patient's resistant hypertension?

A 54-year-old man presents with fatigue, lethargy, and frequent headaches. He has a 1-year history of hypertension that has been ...

Image of the Week: Injuries after a physical altercation

Image of the Week: Injuries after a physical altercation

Three days following a physical altercation, a 21-year-old man presents with nausea and ecchymoses behind the mastoid processes, also called ...

Image of the Week: Wrinkling of the palms after water exposure

Image of the Week: Wrinkling of the palms after water exposure

A 16-year-old female presents with a 1-year history of skin changes to both palms. They are transient in nature, appearing ...

Image of the Week: What is causing this patient's headaches?

Image of the Week: What is causing this patient's headaches?

A 50-year-old woman presents to the emergency department with a 2-week history of headaches. The pain is widespread and throbbing ...

Image of the Week: Why is this newborn hypotonic?

Image of the Week: Why is this newborn hypotonic?

A full-term infant male is born to a healthy 32-year-old woman. The newborn examination reveals generalized hypotonia and a distended ...

Image of the Week: Painful lesions in the armpits

Image of the Week: Painful lesions in the armpits

A 27-year-old man presents with painful lesions in both armpits. He has experienced several worsening episodes similar to this one ...

Image of the Week: Do you recognize this chest abnormality?

Image of the Week: Do you recognize this chest abnormality?

A 30-year-old man presents for a routine physical. He reports being in good health, but he has some cosmetic concerns ...

Image of the Week: What disorder is a risk factor for this presentation?

Image of the Week: What disorder is a risk factor for this presentation?

A 71-year-old man presents to the emergency department with severe abdominal pain. A palpable tender mass can be felt in ...

Image of the Week: What is the threshold for surgical intervention?

Image of the Week: What is the threshold for surgical intervention?

A 55-year-old woman with a history of hypertension presents for a routine pre-employment checkup. She is a smoker with a ...

Image of the Week: What audible finding is consistent with this presentation?

Image of the Week: What audible finding is consistent with this presentation?

A 40-year-old man presents to the emergency department with sharp chest pain and palpitations. He says the pain is worse ...

Image of the Week: What is causing this patient's aphthous ulcers and abdominal tenderness?

Image of the Week: What is causing this patient's aphthous ulcers and abdominal tenderness?

A 23-year-old woman presents with a recurrence of severe, crampy abdominal pain and a prolonged history of diarrhea. Her chart ...

Image of the Week: Do you recognize this neurodegenerative disorder?

Image of the Week: Do you recognize this neurodegenerative disorder?

A 71-year-old male returns for his annual health exam with concerns over progressive memory deterioration. He is pleasant and cooperative ...

Image of the Week: How would you manage this slow-growing neck mass?

Image of the Week: How would you manage this slow-growing neck mass?

A 4-year-old boy presents with an 8-month history of a slow-growing submandibular mass. Further history reveals that he has felt ...

Image of the Week: What is causing this child's lethargy and foul-smelling vomiting?

Image of the Week: What is causing this child's lethargy and foul-smelling vomiting?

A 7-year-old girl presents with subacute lethargy, abdominal pain and distension, and foul-smelling vomiting in the context of a lifelong ...

Image of the Week: A suspected overdose of acetaminophen

Image of the Week: A suspected overdose of acetaminophen

A 75-year-old woman is brought to the emergency department after ingesting an unknown amount of acetaminophen. After an initial assessment, ...

Image of the Week: Abdominal pain, a rash, and knee pain

Image of the Week: Abdominal pain, a rash, and knee pain

A 3-year-old female presents to her pediatrician with a 1-week history of abdominal pain and a rash following recovery from ...

Image of the Week: Abnormal gynecologic findings

Image of the Week: Abnormal gynecologic findings

A 22-year-old G0P0 female presents for follow-up after a first-time cervical screening test. On her cervical cytology slide, a cluster ...

Image of the Week: Why does this patient's back pain remit with exercise?

Image of the Week: Why does this patient's back pain remit with exercise?

The patient’s symptoms are typically worse first thing in the morning, but they seem to remit later in the day ...

Image of the Week: How would you manage this sheep rancher's lesion?

Image of the Week: How would you manage this sheep rancher's lesion?

A 22-year-old male presents with a 1-week history of a lesion on his index finger after working at his uncle’s ...

Image of the Week: What is the cause of this pustular rash?

Image of the Week: What is the cause of this pustular rash?

An 80-year-old female with a history of arthritis and high blood pressure presents with lesions and erythema on her palms ...

Image of the Week: What's causing this elderly woman's weight loss?

Image of the Week: What's causing this elderly woman's weight loss?

A 65-year-old woman presents to a clinician for the first time in 25 years with a history of weight loss ...

Image of the Week: What's causing this greasy underarm rash?

Image of the Week: What's causing this greasy underarm rash?

A 17-year-old male presents with a recurrent pruritic rash on his back, shoulders, hands, and axillae. He says the rash ...

Image of the Week: Free-floating mass found in stab victim

Image of the Week: Free-floating mass found in stab victim

This firm unattached mass was found on exploratory laparotomy of a 57-year-old man who had been stabbed multiple times.

Image of the Week: A rare reaction to a popular Asian food

Image of the Week: A rare reaction to a popular Asian food

After going to an Asian food festival a few days earlier, a 50-year-old man presents with this pruritic, whiplash-striped, erythematous ...

Image of the Week: Do you recognize the clinical triad in this emergency case?

Image of the Week: Do you recognize the clinical triad in this emergency case?

A 35-year-old woman presents to the emergency department with lower abdominal pain and vaginal spotting. Her last menstrual period was ...

Image of the Week: Could a pacemaker be causing this patient's hiccups?

Image of the Week: Could a pacemaker be causing this patient's hiccups?

Hiccups result in a patient whose pacemaker leads are found to be retracted and coiled around the device.

Image of the Week: The classic findings of a rare condition

Image of the Week: The classic findings of a rare condition

A 36-year-old woman presents with severe headache, palpitations, diaphoresis, and pruritic, pigmented lesions on her back. An abdominal CT scan ...

Image of the Week: Why would this man's urine turn red after a house fire?

Image of the Week: Why would this man's urine turn red after a house fire?

A man is rescued from a house fire, resuscitated on scene, and brought to the emergency department, where his urine ...

Image of the Week: A dead cat, a sick child, and an unusual rash

Image of the Week: A dead cat, a sick child, and an unusual rash

An 11-year-old boy and his family develop these annular scaling plaques after their cat eats a mouse and dies the ...

Image of the Week: What condition is contributing to this rare disorder?

Image of the Week: What condition is contributing to this rare disorder?

A 56-year-old man with a history of cirrhosis presents with new pigmented papules on his fingers and toes and progressive ...

Image of the Week: What's causing this distinctive mucosal pattern?

Image of the Week: What's causing this distinctive mucosal pattern?

White lace-like striations of the buccal mucosa are noted on a woman with a three-month history of mouth pain, sensitivity ...

Image of the Week: Can you recognize the infrequent signs of this deadly disease?

Image of the Week: Can you recognize the infrequent signs of this deadly disease?

A 14-year-old male with a genetic disorder presents with worsening drowsiness, palpitations, shortness of breath, and difficulty swallowing. An X-ray ...

Image of the Week: What comorbidity would cause this discolored bone?

Image of the Week: What comorbidity would cause this discolored bone?

A surgeon notices discolored bone during foot surgery on a man with progressive foot pain. What condition could have led ...

Image of the Week: Which pulmonary function test findings would you expect?

Image of the Week: Which pulmonary function test findings would you expect?

The chest X-ray of a 60-year-old woman with a five-year history of progressive cough, dyspnea, and wheezing shows widely spaced ...

Image of the Week: A drinking binge leads to a surgical emergency

Image of the Week: A drinking binge leads to a surgical emergency

A 58-year-old man with a history of alcoholism presents to the emergency room after a 4-day drinking binge. A diagnosis ...

Image of the Week: Which arteriovenous malformation is linked with migraines?

Image of the Week: Which arteriovenous malformation is linked with migraines?

A man presents with severe epistaxis, frequent migraines, and multiple cutaneous and oral mucosal telangiectasia. His diagnosis commonly manifests as ...

Image of the Week: What's the cause of these lesions and vision loss?

Image of the Week: What's the cause of these lesions and vision loss?

A 29-year-old woman presents with new-onset blurred vision and a history of oral aphthous ulcers and painful genital lesions.

Image of the Week: Which neurotransmitter is the cause of these symptoms?

Image of the Week: Which neurotransmitter is the cause of these symptoms?

A woman presents with an 8-month history of colicky abdominal pain, diarrhea, and cutaneous flushing, which are the result of ...

Image of the Week: Hunting for deer and a diagnosis

Image of the Week: Hunting for deer and a diagnosis

An 18-year-old male begins having episodes of pruritus and erythematous plaques upon field-dressing a deer.

Image of the Week: Which malignancy is the greatest risk for this patient?

Image of the Week: Which malignancy is the greatest risk for this patient?

A 60-year-old woman presents with a new nonpruritic rash and muscle weakness. Her condition is associated with an increased risk ...

Image of the Week: A striking skin abnormality since birth

Image of the Week: A striking skin abnormality since birth

A 15-year-old boy presents with rough, corrugated plaques on his hands, wrist, feet, and ankles that has worsened over the ...

Image of the Week: Which drug might prevent this condition?

Image of the Week: Which drug might prevent this condition?

Following a myocardial infarction and coronary stent implantation, a 63-year-old man has an increased white blood cell count, an enlarged ...

Image of the Week: An abnormal growth and an incidental finding

Image of the Week: An abnormal growth and an incidental finding

An elderly patient presents with a mass on his tongue and multiple deep grooves dorsally and laterally.

Image of the Week: When a tight wedding ring suggests a rare diagnosis

Image of the Week: When a tight wedding ring suggests a rare diagnosis

A man’s complaint of a tight wedding ring leads to the diagnosis of an adenoma that can only be debulked, ...

Image of the Week: How 3D printing is being used to treat cancer

Image of the Week: How 3D printing is being used to treat cancer

Diagnosed with Ewing sarcoma and facing a total femur amputation, one man’s surgeon uses 3D printing to preserve his ability ...

Image of the Week: A heavy metal emergency

Image of the Week: A heavy metal emergency

Blue discoloration is seen on the gum line of this patient who reports spending the last 5 months renovating his ...

Image of the Week: Cutaneous cobblestone lesions

Image of the Week: Cutaneous cobblestone lesions

A procedure to treat burns applied 30 years ago resulted in these non-tender, punched-out lesions.

Image of the Week: A clinical clue appears at the bedside

Image of the Week: A clinical clue appears at the bedside

Following pituitary surgery, a blood-tinged stain appears on this patient’s pillowcase.

Image of the Week: Why is this pianist losing dexterity?

Image of the Week: Why is this pianist losing dexterity?

A 77-year-old pianist presents with a loss of dexterity and limited extension of the fingers of his dominant hand.

Image of the Week: A striking ocular abnormality

Image of the Week: A striking ocular abnormality

After ashes from this patient’s cigarette flew into his eyes, he presented with this striking abnormality.

Image of the Week: A dramatic cutaneous presentation

Image of the Week: A dramatic cutaneous presentation

This patient presents with large, nodular, erythematous lesions on only one leg.

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