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.
22-Year-Old With Growing, Painful Lump on Back of Knee
A 22-year-old male presents to urgent care complaining of a painful lump on the back of his left knee that developed roughly 3 years prior. It has gradually grown in size and discomfort since then. The lump has been growing more quickly and becoming more painful over the last month, to the point where it is difficult to play sports and exercise. Physical examination reveals normal vital signs and full range of motion and strength of the knee. A large, hard, bony, and immobile mass is visible and palpable in …
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43-Year-Old Male With Large Bump on Elbow
A 43-year-old man presents to urgent care reporting a soft lump that developed on his arm 3 months prior. He denies pain, itching, or systemic symptoms and feels well otherwise. Examination reveals normal vital signs and a 5 cm soft, mobile, nontender subcutaneous nodule on the proximal dorsal forearm. Range of motion for the elbow and wrist is normal. No erythema or induration is noted; circulation, strength, and sensation are intact distally. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case …
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29-Year-Old With Muscle Weakness
A 29-year-old male presents to urgent care with generalized muscle weakness. His oxygenation is normal on room air, and his blood pressure is 117/72 mm Hg. He denies chest pain, palpitations, or shortness of breath. 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 ECGCase presented by Catherine Reynolds, MD, McGovern Medical School at UTHealth Houston …
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68-Year-Old Female With Swollen, Painful Hand
A 68-year-old woman presents to urgent care with her husband after tripping on a rug at home the previous day and falling onto her left hand. She has experienced persistent pain and swelling in the hand since the fall. Ibuprofen provided modest pain relief. Physical examination reveals normal vital signs with focal edema and tenderness over the dorsal surface of the 4th and 5th metacarpals. Decreased range of motion and knuckle contour at the 5th metacarpophalangeal (MCP) joint are noted, and ecchymosis is seen to the palmar surface on the …
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52-Year-Old Female With Extremely Itchy Dark-Ringed Bumps on Skin of Back
A 52-year-old woman visits the urgent care clinic for itchy bumps that have been present on her back for the past 3 months. The lesions are very itchy, and it is difficult for the patient to stop scratching. She has not tried any treatments for her symptoms since onset. On dermatological examination, pink scaly papules with dark exterior rims are seen on her back, some of which appear excoriated. Laboratory results for complete blood count, comprehensive metabolic panel, and thyroid function tests are all within normal limits. View the image …
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