Challenge your diagnostic acumen: Study the following x-ray images, electrocardiograms, and photographs and consider what your diagnosis might be in each case. While the images presented here are authentic, the patient cases are hypothetical.
12-Year-Old Boy With Left Groin and Buttock Pain
A 12-year-old male presents to urgent care with his mother for left groin and buttock pain since acute onset while running in a track meet earlier today. He reports that he felt a pop while running a sprint race and was subsequently unable to finish the race or bear weight on his left leg due to pain. He has no other past medical history and takes no medications. Physical exam reveals that he is afebrile with normal vital signs besides an elevated heart rate at 108 bpm. He is visibly …
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39-Year-Old Male With Itchy Rash to Chest
A 39-year-old male presents to the local urgent care reporting an intensely itchy rash for the past 3 weeks that is getting gradually worse. The patient has a history of HIV infection, denies any recent travel or trauma, and is not taking any medications. Physical exam shows he is afebrile with normal vital signs. He has diffuse papular lesions to the trunk and arms ranging from pink to dark brown in color, some with notable excoriation. Laboratory examination shows mild leukocytosis and eosinophilia with a CD4 count of 210 cells/mm3 …
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42-Year-Old With Altered Mental Status
Figure 1. Initial EGC Case presented by Benjamin Cooper, MD, McGovern Medical School, The University of Texas Health Science Center at Houston, Department of Emergency Medicine. The family of a 42-year-old male brings the patient to urgent care for altered mental status believing that they had arrived at an emergency department. His family found him on the floor at home with a non-functioning heater on a very cold day. He is bradycardic and ill-appearing. An ECG is obtained …
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26-Year-Old Female With Cough, Shortness of Breath, and Fatigue
A 26-year-old female presents to urgent care with a persistent productive cough for 1 week. Over the past 3 days, she reports progressive shortness of breath and fatigue. She has a history of recurrent pneumonia. Vital signs show the patient is afebrile with normal blood pressure, heart rate, respiratory rate, and oxygen saturation. Physical examination revealed clear lung sounds with diminished air movement in the bilateral bases. Jugular venous distension (JVD) at 4 cm above the sternal angle and trace bilateral lower extremity edema to the ankles are noted. Cardiac …
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67-Year-Old Man With Dark Patch on Ankle
A 67-year-old man visits urgent care for a lesion on his right ankle that was first noticed 25 years ago. He reports that it has progressively grown larger over the past 6 months. The lesion is painless but is intermittently mildly pruritic. The patient denies any recent injury or past medical history besides chronic venous insufficiency. On dermatologic examination, a discrete dark brown plaque is noted posterior to the lateral malleolus with numerous surrounding spider veins, and deeper varicose veins are seen. A biopsy is taken, showing a proliferation of …
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