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.

Image of the Week: An extreme presentation

Image of the Week: An extreme presentation

A man presents with multiple erythematous plaques under his arm and on his chest.

Image of the Week: A rapid progression

Image of the Week: A rapid progression

A man with autism presents with new rapidly progressive nodular lesions on his trunk and limbs.

Image of the Week: A peripubertal anomaly

Image of the Week: A peripubertal anomaly

A teenager presents with a hairy plaque on his shoulder.

Image of the Week: Baby with a blue tongue

Image of the Week: Baby with a blue tongue

An 8-week-old, breast-fed infant presents with a blue tongue.

Image of the Week: Uncommon presentation or uncommon disease?

Image of the Week: Uncommon presentation or uncommon disease?

This unusual morphology formed when this patient was treated for a common wart with cantharidin.

Image of the Week: Mediterranean fever

Image of the Week: Mediterranean fever

This patient is from Syria and has familial Mediterranean fever, which primarily affects individuals of Mediterranean descent.

Image of the Week: Pedaling purpura

Image of the Week: Pedaling purpura

This patient returned from a 4-hour bike ride with a non-blanching purpuric rash on his lower legs that spared the ...

Image of the Week: Seeking asylum and a diagnosis

Image of the Week: Seeking asylum and a diagnosis

A 19-year-old Somali refugee presents with an 8-week history of non-pruritic verrucous growths on his face and ears.

Image of the Week: Something to write home about

Image of the Week: Something to write home about

A 9-year-old girl presented with painless brown macules on the sole of her right foot after spending the day playing ...

Image of the Week: A grueling walk to school

Image of the Week: A grueling walk to school

The crateriform pitting on the plantar surfaces of this patient’s feet is characteristic of pitted keratolysis,

Image of the Week: When a snake strikes twice

Image of the Week: When a snake strikes twice

A woman presents to the emergency room with bilateral snake bites.

Image of the Week: Green cerebrospinal fluid

Image of the Week: Green cerebrospinal fluid

This cerebrospinal fluid (CSF) is green due to a ventriculoperitoneal shunt infection with Pseudomonas aeruginosa.

Image of the Week: A fisherman presents with bruising

Image of the Week: A fisherman presents with bruising

This patient is suspected to have a ruptured popliteal cyst, or Baker cyst.

Image of the Week: An entire family presents with the same condition

Image of the Week: An entire family presents with the same condition

This patient has been diagnosed with a hereditary form of palmoplantar keratoderma, a condition characterized by an overproduction of keratin ...

Image of the Week: How would you manage this drug-induced reaction?

Image of the Week: How would you manage this drug-induced reaction?

A 55-year-old man is diagnosed with infective endocarditis 2 weeks after undergoing dental surgery.

Image of the Week: Citrus exposure and phytophotodermatitis

Image of the Week: Citrus exposure and phytophotodermatitis

This phototoxic reaction is caused by topical exposure to furocoumarin-containing plants, commonly limes, celery, and wild parsnip.

Image of the Week: An unusual rash after bathing in a stream

Image of the Week: An unusual rash after bathing in a stream

This patient developed these well-defined erythematous patches hours after bathing in a stream.

Image of the Week: When a spider bite is left untreated

Image of the Week: When a spider bite is left untreated

This ulcer likely resulted from envenomation by a brown recluse.

Image of the Week: Rebuilding a human eye

Image of the Week: Rebuilding a human eye

The Boston type 1 keratoprosthesis, an artificial cornea, is typically used when other treatments for corneal disease, such as transplants, ...

Image of the Week: Can you identify this atypical growth?

Image of the Week: Can you identify this atypical growth?

This lesion was caused by myxedema, a symptom of hypothyroidism.

Image of the Week: Is this vanishing bone disease?

Image of the Week: Is this vanishing bone disease?

This 23-year-old male was diagnosed with vanishing bone disease, a rare condition in which cancellous bone is replaced with new ...

Image of the Week: A man identifies music during a craniotomy

Image of the Week: A man identifies music during a craniotomy

This 37-year-old musician was diagnosed with right temporal lobe epilepsy.

Image of the Week: Dark red urine

Image of the Week: Dark red urine

A urine sample taken from this patient turned dark red when left in the sun, while the color of the ...

Image of the Week: Lippes Loop

Image of the Week: Lippes Loop

A 70-year-old patient presents to the hospital with back pain

Image of the Week: A yellow tongue

Image of the Week: A yellow tongue

One year after undergoing a gastric bypass, this patient presented with a yellow tongue.

Image of the Week: Congenital hydrocephalus

Image of the Week: Congenital hydrocephalus

This patient received a diagnosis of congenital hydrocephalus, a condition in which abnormally dilated ventricles cause cerebrospinal fluid to accumulate ...

Image of the Week: Rebuilding a human skull

Image of the Week: Rebuilding a human skull

This patient fell while riding a bicycle and sustained a Le Fort type II fracture.

Image of the Week: ECMO for a patient with swine flu

Image of the Week: ECMO for a patient with swine flu

This patient was diagnosed with the swine flu, which can cause acute respiratory distress.

Image of the Week: Angiogram reveals life-threatening diagnosis

Image of the Week: Angiogram reveals life-threatening diagnosis

A 48-year-old man with a previous history of occasional headache, blurry vision, and periods of brief blindness lost consciousness, fell, ...

Image of the Week: Zenker diverticulum

Image of the Week: Zenker diverticulum

This barium swallow demonstrates a Zenker diverticulum, a pouch that forms in the hypopharynx above the upper esophageal sphincter due ...

Image of the Week: IVC filters

Image of the Week: IVC filters

IVC filters isolate a pre-existing deep vein thrombosis preventing the development of a pulmonary embolism.

Image of the Week: An unusual case of small bowel obstruction

Image of the Week: An unusual case of small bowel obstruction

This 31-year-old man presented with features consistent with a small bowel obstruction.

Image of the Week: Drug-induced vasculitis

Image of the Week: Drug-induced vasculitis

This patient developed propylthiouracil-induced ANCA(antineutrophil cytoplasmic antibodies)-associated vasculitis (AAV), a condition associated with significant morbidity and mortality.

Image of the Week: Handwriting after a brain injury

Image of the Week: Handwriting after a brain injury

After a very bad car accident, this 74-year-old man sustained a traumatic brain injury followed by an extensive hemorrhagic stroke.

Image of the Week: Phlegmasia cerulea dolens

Image of the Week: Phlegmasia cerulea dolens

This patient, aged more than 90 years, with a history of atrial fibrillation presented with atypical measles syndrome and sudden ...

Image of the Week: 3D reconstruction of cocaine in a smuggler's abdomen

Image of the Week: 3D reconstruction of cocaine in a smuggler's abdomen

This image represents a 3D reconstruction of an abdominal computed tomography (CT) scan taken of a cocaine smuggler who presented ...

Image of the Week: What seasonal injury is demonstrated on this angiogram?

Image of the Week: What seasonal injury is demonstrated on this angiogram?

A 27-year-old man is found outdoors on a jogging path in the winter by a snow removal crew.

Image of the Week: Dark green urine after head injury

Image of the Week: Dark green urine after head injury

A 28-year-old man was producing green-colored urine after 2 days in the intensive care unit following a head injury sustained ...

Image of the Week: An unusual wound reconstruction

Image of the Week: An unusual wound reconstruction

This patient was working on his car when the fender fell, pinning his hand for 30 minutes and crushing it.

Image of the Week: An antiquated procedure

Image of the Week: An antiquated procedure

This x-ray was taken of an 87-year-old patient with a history of tuberculosis.

Image of the Week: Uremic frost

Image of the Week: Uremic frost

A 63-year-old man presented with obstructive uropathy.

Image of the Week: A life-threatening side effect

Image of the Week: A life-threatening side effect

This patient developed cobalt and chromium toxicity after a total hip replacement.

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