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.

Derm Dx: Erythematous Rash on the Upper Back

Derm Dx: Erythematous Rash on the Upper Back

A 32-year-old man presents with an erythematous rash on his upper back that has been present for approximately 2 months. ...

Derm Dx: Asymptomatic Lesion Above the Left Eye

Derm Dx: Asymptomatic Lesion Above the Left Eye

A 36-year-old woman presents with a lesion above her left eye that has gradually increased in size over the past ...

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 ...

Ortho Dx: Persistent Left Knee Pain

Ortho Dx: Persistent Left Knee Pain

A 62-year-old woman presents with left knee pain that has been present for 2 years and worsens when she is ...

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. ...

Derm Dx: Rash on the Abdomen and Upper Arms

Derm Dx: Rash on the Abdomen and Upper Arms

A 75-year-old, obese woman presents with an asymptomatic rash affecting her abdomen and upper arms that has been present for ...

Ortho Dx: Leg Pain and Numbness

Ortho Dx: Leg Pain and Numbness

A 33-year-old man presents with pain and numbness in the lateral expect of his lower left leg that has persisted ...

Derm Dx: Itchy Lesion on the Chest

Derm Dx: Itchy Lesion on the Chest

A 66-year-old man presents with a growth on his chest that has been present for several months. The lesion does ...

Ortho Dx: Hip Fracture After a Fall

Ortho Dx: Hip Fracture After a Fall

An elderly woman presents to the emergency department with a periprosthetic fracture in her left hip after a fall at ...

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. ...

Derm Dx: A Bleeding Mole on the Forehead

Derm Dx: A Bleeding Mole on the Forehead

A 34-year-old woman presents with a bleeding mole situated on her upper forehead that has been present for approximately 3 ...

Ortho Dx: Persistent Leg Pain in a Dancer

Ortho Dx: Persistent Leg Pain in a Dancer

A 16-year-old girl presents with leg pain that has persisted for 2 months. The pain is aggravated during her dance ...

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 ...

Derm Dx: Rash on the Lower Abdomen and Groin

Derm Dx: Rash on the Lower Abdomen and Groin

A 56-year-old overweight woman presents with a rash affecting her lower abdomen and groin that has been present for 1 ...

Ortho Dx: Failed Hip Pinning

Ortho Dx: Failed Hip Pinning

An 82-year-old female patient presents with a nondisplaced femoral neck fracture 2 months after undergoing hip fracture repair.

Derm Dx: Growth on the Left Index Finger

Derm Dx: Growth on the Left Index Finger

A 58-year-old man presents with a mass on his index finger that only recently became bothersome after increasing in size ...

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.

Ortho Dx: Suspected Child Abuse

Ortho Dx: Suspected Child Abuse

A 6-month-old infant presents to the emergency department with left leg pain and contusions about the head and torso.

Derm Dx: Flesh-Colored Growth on the Cheek

Derm Dx: Flesh-Colored Growth on the Cheek

A 75-year-old man presents with a flesh-colored, asymptomatic growth on his right cheek that has persisted for 2 years.

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 ...

Derm Dx: Dark Spots on the Arms

Derm Dx: Dark Spots on the Arms

A 57-year-old woman presents with dark spots on her arms that have persisted for several months.

Derm Dx: Asymptomatic Genital Rash

Derm Dx: Asymptomatic Genital Rash

A 65-year-old man presents with an asymptomatic rash on his penis. He denies any recent sexual activity, commencement of new ...

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 ...

Derm Dx: Flesh-Colored Nodule in the Left Medial Canthus

Derm Dx: Flesh-Colored Nodule in the Left Medial Canthus

A 66-year-old woman presents with a flesh-colored nodule in the left medial canthus that had been previously removed but has ...

Derm Dx: Asymptomatic Lesion on the Forearm

Derm Dx: Asymptomatic Lesion on the Forearm

A 52-year-old man presents with a growing lesion on his right forearm that has developed following prolonged sun exposure.

Ortho Dx: Right Ankle Pain Following Sports Injury

Ortho Dx: Right Ankle Pain Following Sports Injury

A 12-year-old girl presents with right ankle pain after a fall on wet grass.

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.

Ortho Dx: Persistent Shoulder Pain

Ortho Dx: Persistent Shoulder Pain

A 56-year-old man presents with left shoulder pain that has persisted for several months.

Derm Dx: Rash on the Cheek and Scalp

Derm Dx: Rash on the Cheek and Scalp

A 24-year-old man presents to his clinician with acute-onset rash that developed on his left cheek and scalp.

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 ...

Ortho Dx: Radiating Neck and Upper Extremity Pain

Ortho Dx: Radiating Neck and Upper Extremity Pain

A 46-year-old man presents with pain radiating from his neck down into his right upper extremity, numbness in his right ...

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.

Derm Dx: Dermatitis on the Torso of a Baseball Player

Derm Dx: Dermatitis on the Torso of a Baseball Player

A 21-year-old baseball player presents for evaluation of multiple erythematous papules and occasional pustules on his chest and back.

Ortho Dx: Lower Back Pain in a 16-Year-Old Male Athlete

Ortho Dx: Lower Back Pain in a 16-Year-Old Male Athlete

A 16-year-old male football player presents to his clinician with 2 months of lower back pain that worsens upon playing. ...

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 ...

Ortho Dx: Open Fracture of the Hand

Ortho Dx: Open Fracture of the Hand

A 28-year-old man sustained a distal fifth metacarpal fracture of the right hand after striking a wall.

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 ...

Derm Dx: Flesh-Colored Papule With Pigmented Speckles

Derm Dx: Flesh-Colored Papule With Pigmented Speckles

A 70-year-old woman presents for evaluation of an asymptomatic growth on her right wrist.

Ortho Dx: Right Hip Pain Following a Fall on Ice

Ortho Dx: Right Hip Pain Following a Fall on Ice

A 42-year-old man complains of a 2-month history of moderate right hip pain following a fall on ice.

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.

Derm Dx: Coarse Hairs on the Lower Extremity

Derm Dx: Coarse Hairs on the Lower Extremity

A 30-year-old Hispanic man requests laser removal of cosmetically bothersome coarse hairs on his lower extremity.

Ortho Dx: Chronic Lower Back Pain and an Incidental Abdominal Aortic Aneurysm

Ortho Dx: Chronic Lower Back Pain and an Incidental Abdominal Aortic Aneurysm

A 78-year-old man presents with chronic lower back pain; lateral radiographs demonstrate an incidental abdominal aortic aneurysm.

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 ...

Derm Dx: Pigmented Area in the Nail of the Hallux

Derm Dx: Pigmented Area in the Nail of the Hallux

A 42-year-old avid tennis player is referred by his primary care provider for evaluation of a pigmented area on his ...

Ortho Dx: Syndesmotic Injury Following Football Game

Ortho Dx: Syndesmotic Injury Following Football Game

A 23-year-old man complains of left ankle pain after falling awkwardly during a football game.

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 ...

Ortho Dx: Severe Lower Back Pain in an Elderly Woman

Ortho Dx: Severe Lower Back Pain in an Elderly Woman

A 75-year-old woman complains of lower back pain after falling out of bed the previous morning, which resulted in extreme ...

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.

Derm Dx: A growth on the scalp in an elderly man

Derm Dx: A growth on the scalp in an elderly man

A 91-year-old man is referred by his barber for assessment of a growth on his scalp. Although he had ...

Ortho Dx: A Persistent Finger Infection in a 61-Year-Old Female

Ortho Dx: A Persistent Finger Infection in a 61-Year-Old Female

A 61 year-old female presents with a persistent right finger infection. The infection started as a painful small wound at ...

Derm Dx: A moderately itchy rash on the neck and cheek

Derm Dx: A moderately itchy rash on the neck and cheek

A 56-year-old Hispanic man presents with a moderately itchy rash affecting his neck and lower cheek. Despite treatment with various ...

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.

Ortho Dx: Leg pain after a fall in an elderly woman

Ortho Dx: Leg pain after a fall in an elderly woman

A 91-year-old obese woman presents to the emergency department by ambulance with right leg pain after a fall at home. ...

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 ...

Derm Dx: Abrupt onset of hair loss

Derm Dx: Abrupt onset of hair loss

A 63-year-old Hispanic woman presents with an abrupt onset of hair loss, first noted 6 weeks ago. Examination reveals diffuse ...

Ortho Dx: Which medication is likely causing this bone fragility?

Ortho Dx: Which medication is likely causing this bone fragility?

A 42-year-old woman presents with a new T12 compression fracture. The fracture occurred from a standing height fall as she ...

Derm Dx: A growth on the armpit

Derm Dx: A growth on the armpit

The patient is a 42-year-old man requesting removal of a growth located on his right armpit. He is moderately obese ...

Derm Dx: A rapidly spreading rash and fever

Derm Dx: A rapidly spreading rash and fever

A 44-year-old Hispanic man presents for evaluation of a rash of 2 days’ duration. Lesions originated on his face and ...

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, ...

Ortho Dx: Chronic hip pain after a soccer injury

Ortho Dx: Chronic hip pain after a soccer injury

A 33-year-old man presents with chronic right hip pain from an injury 10 months ago. He was playing soccer when ...

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 ...

Derm Dx: A sudden, blistering rash

Derm Dx: A sudden, blistering rash

A 47-year-old man presents for evaluation of a rash. The rash developed 24 hours after perioperative administration of vancomycin following ...

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 ...

Ortho Dx: Knee pain after falling down the stairs

Ortho Dx: Knee pain after falling down the stairs

A 45-year-old woman presents to the emergency department with right knee pain and deformity after falling down the stairs. A ...

Derm Dx: A lesion on the cheek from shaving

Derm Dx: A lesion on the cheek from shaving

An 84-year-old man requests removal of a lesion on his cheek due to chronic irritation from shaving. The growth has ...

Ortho Dx: Toe pain in a runner

Ortho Dx: Toe pain in a runner

A 35-year-old man complains of right great toe pain for several months. He is very active and enjoys running.

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 ...

Derm Dx: Pain at the base of a fingernail

Derm Dx: Pain at the base of a fingernail

The patient is a 52-year-old woman who complains of pain at the base of a fingernail. The condition was first ...

Derm Dx: An itchy rash on the hands

Derm Dx: An itchy rash on the hands

The patient is a 62-year-old Hispanic woman seeking treatment for an itchy rash affecting both hands. The dermatitis is of ...

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 ...

Ortho Dx: Neck fracture and loss of bone mineral density

Ortho Dx: Neck fracture and loss of bone mineral density

A 27-year-old woman presents for follow-up of a nondisplaced right talar neck fracture. She was treated with a nonweight-bearing boot ...

Derm Dx: Xerosis with a fish scale pattern

Derm Dx: Xerosis with a fish scale pattern

A 60-year-old man requests consultation for severely dry skin. Examination reveals marked xerosis with a fish scale pattern of both ...

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 ...

Ortho Dx: Knee pain over the lateral patellofemoral facet joint

Ortho Dx: Knee pain over the lateral patellofemoral facet joint

A 42-year-old woman presents with a few months of right knee pain. The pain is worse when going up and ...

Derm Dx: A large lesion on the thumb

Derm Dx: A large lesion on the thumb

A 74-year-old woman presents for treatment of a bothersome lesion on her thumb. A flesh-colored, semitranslucent nodule is noted between ...

Ortho Dx: Thumb pain and swelling after a tumbling injury

Ortho Dx: Thumb pain and swelling after a tumbling injury

A 13-year-old girl presents with left thumb pain after a tumbling injury during gymnastics. On examination, she has moderate swelling ...

Derm Dx: A large mass on the scalp

Derm Dx: A large mass on the scalp

A 40-year-old African American man presents for evaluation of a mass affecting his posterior scalp, which has enlarged in size ...

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.

Ortho Dx: Radiating right arm pain

Ortho Dx: Radiating right arm pain

A 34-year-old man presents with right-sided arm pain for 6 months, which radiates down his arm and is associated with ...

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, ...

Ortho Dx: Shoulder pain radiating into the biceps

Ortho Dx: Shoulder pain radiating into the biceps

A 42-year-old woman presents with left shoulder pain radiating into the biceps for the past 2 months.

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 ...

Derm Dx: A dome-shaped growth on the upper thigh

Derm Dx: A dome-shaped growth on the upper thigh

The patient is a 57-year-old man requesting removal of a growth on his left upper thigh. The lesion has been ...

Ortho Dx: Posterior hip dislocation after an accident

Ortho Dx: Posterior hip dislocation after an accident

A 34-year-old man presents to the emergency department after a motor vehicle accident with severe left hip pain and a ...

Derm Dx: A sudden, blotchy rash on the cheeks

Derm Dx: A sudden, blotchy rash on the cheeks

The patient is an 18-month-old child who presents for evaluation of a rash affecting both cheeks. The onset was sudden ...

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 ...

Ortho Dx: Treatment for a greater tuberosity fracture

Ortho Dx: Treatment for a greater tuberosity fracture

A 43-year-old woman presents with left shoulder pain after a fall 2 days ago. She was ice skating and fell ...

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 ...

Derm Dx: Elastic skin and scattered scars

Derm Dx: Elastic skin and scattered scars

A 10-year-old boy presents for evaluation of scattered scars on his ankles and back, which are slightly atrophic and violaceous. ...

Ortho Dx: Medication-induced tendinopathy

Ortho Dx: Medication-induced tendinopathy

A 45-year-old woman presents with a history of left heel pain for several months. She has a medical history of ...

Derm Dx: Dark areas on a teenager's trunk

Derm Dx: Dark areas on a teenager's trunk

A 14-year-old moderately obese Hispanic female is concerned about dark areas on her trunk, which are asymptomatic but unsightly.

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 ...

Ortho Dx: Right lower extremity pain

Ortho Dx: Right lower extremity pain

A 25-year-old man presents to the emergency department after a fall while rock climbing. He is unable to bear weight ...

Derm Dx: A growth behind the ear with straw-colored fluid

Derm Dx: A growth behind the ear with straw-colored fluid

A 25-year-old woman presents for evaluation of a growth behind her right ear. The lesion was first noted several weeks ...

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 ...

Ortho Dx: A painful ring finger

Ortho Dx: A painful ring finger

A 72-year-old man presents with pain and stiffness in his right hand. The pain is worse in his fingers, especially ...

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. ...

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