Clinical Image Challenges

The patient is a 46-year-old female who presents with a painful, erythematous, indurated plaque on her lower leg. She reports that it developed over the past month. At first she attributed the pain to “a bump” of unknown origin, but as the area of red skin expanded she became concerned that she became concerned, as she reports a history of deep-vein thrombosis. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page …
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A 34-year-old female with no reported medical history presents to urgent care after a syncopal episode. She describes standing up rapidly to answer the phone, followed by a sensation of lightheadedness and nausea with subsequent collapse. On evaluation, her vital signs are normal, she appears well, and she is currently asymptomatic. View the ECG taken and consider what your diagnosis and next steps would be. (Case presented by Tom Fadial, MD, The University of Texas Health Science Center at Houston.) …
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The patient is a 13-year-old boy who presents with knee pain after an awkward fall while playing basketball on an asphalt court. He is unable to walk due to pain and has a swollen knee. View the x-rays taken and consider what your diagnosis and next steps would be …
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The patient is a 96-year-old man who is brought to your urgent care center by his daughter, with whom he lives. She reports that he has been feeling light-headed for “a few days.” The patient confirms this, adding that he has felt his heart “fluttering,” as well. He denies chest pain and shortness of breath, but acknowledges a history of coronary artery disease. View the ECG and consider what your diagnosis and next steps would be. (Case presented by Benjamin Cooper, MD, FACEP, McGovern Medical School Department of Emergency Medicine …
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The patients is a 13-year-old girl who presents to a pediatric urgent care clinic with 1 month of scaling and fissures on her lips which began after she started using a retinoid cream prescribed for acne. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page …
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