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. ...

Derm Dx: A cluster of moles on a man's back

Derm Dx: A cluster of moles on a man's back

A 35-year-old man has a family history of skin cancer and requests a full body examination. His wife is especially ...

Ortho Dx: New compression fractures in an elderly man

Ortho Dx: New compression fractures in an elderly man

A 79-year-old man presents with increasing thoracolumbar pain and difficulty straightening his back. He denies having radiating pain down the ...

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 ...

Derm Dx: A growth behind the ear

Derm Dx: A growth behind the ear

A 58-year-old man presents for evaluation of a growth behind his left ear. The lesion has been present for at ...

Ortho Dx: Arthritis of the knee

Ortho Dx: Arthritis of the knee

A 58-year-old woman presents with left knee pain of several months’ duration. She had a left knee arthroscopic lateral meniscectomy ...

Derm Dx: A rash on the cheek and forehead

Derm Dx: A rash on the cheek and forehead

The patient is a 43-year-old Hispanic man who complains of a rash affecting his right cheek and forehead. The eruption ...

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 ...

Ortho Dx: Back pain and loss of bladder control

Ortho Dx: Back pain and loss of bladder control

A 65-year-old woman presents to the emergency department with acute chronic back pain and lower extremity weakness. She has also ...

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 ...

Derm Dx: A rash on the arms and trunk of an elderly man

Derm Dx: A rash on the arms and trunk of an elderly man

The patient is an 86-year-old man with a 4-decade history of skin rashes. The rash was first noted on his ...

Ortho Dx: Swelling and pain in the knee

Ortho Dx: Swelling and pain in the knee

An 18-year-old male presents 1 week after sustaining a patella dislocation while playing football. He says that he fell awkwardly ...

Derm Dx: An asymptomatic rash on the lower extremities

Derm Dx: An asymptomatic rash on the lower extremities

A 27-year-old man presents with an asymptomatic rash of the lower extremities, which developed about 1 month prior. The rash ...

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 ...

Ortho Dx: Wrist pain and collapse of the lunate

Ortho Dx: Wrist pain and collapse of the lunate

A 21-year-old woman presents with a 2-year history of left wrist pain. She believes the pain started when she injured ...

Derm Dx: A papular rash on the scalp

Derm Dx: A papular rash on the scalp

A 31-year-old man presents to a homeless clinic complaining of a papular rash located on the occipital region of his ...

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, ...

Ortho Dx: Hip pain after a split-type fall

Ortho Dx: Hip pain after a split-type fall

A 35-year-old man presents to the office with right hip pain after a twist and split-type fall while working construction ...

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 ...

Ortho Dx: Chronic foot pain and deformity

Ortho Dx: Chronic foot pain and deformity

A 61-year-old man presents to the office with chronic left foot pain. He has pain over the medial ankle, especially ...

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.

Ortho Dx: What is the best treatment for these rib fractures?

Ortho Dx: What is the best treatment for these rib fractures?

A 29-year-old man sustains multiple left-sided rib fractures during a motor vehicle accident. You see the patient in surgical consultation ...

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 ...

Ortho Dx: Back pain aggravated by cold weather

Ortho Dx: Back pain aggravated by cold weather

A 66-year-old man presents with “years” of on and off lower back pain and stiffness. His stiffness is worse in ...

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 ...

Ortho Dx: Progressively worsening foot pain

Ortho Dx: Progressively worsening foot pain

Oral capsule FMT and colonoscopy delivery showed similar patient outcomes, low rate differences, and high success rates.

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 ...

Derm Dx: Pink plaques and crusting ulcerations

Derm Dx: Pink plaques and crusting ulcerations

A 53-year-old woman with a history of hypertension, alcohol abuse, and amphetamine dependence presents with painful wounds on the bilateral ...

Ortho Dx: Severe pelvic pain after childbirth

Ortho Dx: Severe pelvic pain after childbirth

A 19-year-old woman complains of severe pain in her pelvis after vaginal delivery of her first child. One day after ...

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 ...

Ortho Dx: What is the best treatment for this knee injury?

Ortho Dx: What is the best treatment for this knee injury?

A 22-year-old woman presents to the emergency department with left knee pain after a motor vehicle accident. Her left knee ...

Ortho Dx: Treatment for lower back and buttock pain

Ortho Dx: Treatment for lower back and buttock pain

A 27-year-old woman presents to the emergency department with increasing lower back and buttock pain for 3 weeks. She admits ...

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 ...

Ortho Dx: A 67-year-old woman with activity-related thigh pain

Ortho Dx: A 67-year-old woman with activity-related thigh pain

A 67-year-old woman presents with activity-related right thigh pain. The pain increases as she gets farther into her walks, and ...

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