Clinical Image Challenges

The patient is a 34-year-old male who presents with bilateral ocular pain and burning. He is noted to have excessive tearing and continuous eye rubbing. He comments that his eyes itch persistently and that both eyes feel as if there is something in them. Scaly plaques and crust are visible along the top and bottom eyelid. View the picture 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 38-year-old female with no past medical history presents to an urgent care with right upper quadrant abdominal pain and chest tightness, worsening for 1 week. She reports that her chest tightness is associated with shortness of breath, and is worse when walking and lying on her side. She denies fever, cough, dysuria, headache, or weakness. View the ECG and consider what your diagnosis and next steps would be. (Case presented by Catherine Reynolds, MD, McGovern Medical School Department of Emergency Medicine.) …
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The patient is a 24-year-old male who reports to urgent care with right ankle pain after falling from a ladder while cleaning out the gutters at his parents’ home. He reports that he was only a few rungs up but that he landed “awkwardly” and immediately felt a sharp pain on the front of the ankle. He is unable to bear weight but denies any numbness or tingling. View the x-ray taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the …
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History:  A 67-year-old female presents to urgent care complaining of one episode of syncope earlier in the day. No seizure-like activity was noted by the family and she returned to baseline within a minute. She has a past medical history of end-stage renal disease on scheduled hemodialysis, hypertension, diabetes, coronary artery disease, and chronic nausea. Medications include aspirin, insulin, amlodipine, hydralazine, ondansetron, metoclopramide, and amiodarone.               View the ECG taken and consider what your diagnosis and next steps would be. (Case presented by Jonathan Giordano, DO, MS, MEd, The University …
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The patient is a 36-year-old man who presents with wrist pain after “hitting it on something.” Further history reveals that he punched a wall in a fit of anger and felt sharp pain immediately. He has no past medical history and takes no medications. View the images 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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