Clinical Image Challenges

A 51-year-old man presents to urgent care complaining of night sweats and a productive cough with visible blood for the past 2 weeks. He says he’s been feeling rather tired lately. A chest x-ray is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page. Figure 1. The X-ray …
Read More

A 17-year-old male presents to urgent care with syncope. He has a family history of sudden cardiac death. He is well appearing and with normal vital signs. An ECG is obtained. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. Figure 1. Initial ECG Case presented by Benjamin Cooper, MD, MEd, FACEP, McGovern Medical School at the University of Texas Health Science Center at Houston …
Read More

A 55-year-old woman presents to urgent care with complaints of arthralgia and a pustular rash on her hands. She has a past medical history of Crohn disease and has taken infliximab as treatment for the past year. The patient has no recent history of travel or infections and no history of any skin conditions. On dermatological examination, multiple pustules, some becoming confluent to form “lakes of pus,” were seen on the palms and fingers. Bacterial and fungal cultures were negative. View the image and consider what your diagnosis and next …
Read More

A 28-year-old woman presents to urgent care after an indoor rock-climbing event. She fell 10 feet from the wall without any safety gear to break the fall. She describes deep pain in her left foot, and she is limping. An exam reveals dorsal and plantar midfoot tenderness and bruising across the dorsal foot. A 3-view x-ray series is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page. Figure 1. The X-ray …
Read More

A 65-year-old female with a history of hypertension presents with chest pain and dyspnea for 1 day. She denies fever, cough, nausea, vomiting, or abdominal pain. Upon arrival to urgent care, her respiratory rate was 28 breaths per minute, blood pressure 179/102, and oxygen saturation 92% on room air. An ECG is obtained. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. Figure 1: Initial ECG Case presented by Catherine Reynolds, MD, McGovern Medical …
Read More