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.

Fused sacroiliac joints

38-Year-Old With Pelvic Pain After a Fall

A 38-year-old man present to urgent care complaining of pain around his entire pelvis after a fall on a slippery floor at home. Imaging is obtained. Review the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page. Figure 1. Acknowledgment: Images and case provided by Experity Teleradiology (www.experityhealth.com/teleradiology) …
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Talon Noir

21-Year-Old With Heel Lesion

A 21-year-old man presents to urgent care concerned about a painless blackish lesion that had developed on his left heel. On examination, a stippled, deeply violaceous, blackish patch with overlying scale was seen on his plantar heel. He had no history of dermatological disease but mentioned he played in a basketball tournament last week. View the image above and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page. Figure 1 …
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61-Year Old With Light-Headedness

A 61-year-old male presents to urgent care complaining of light-headedness. The patient has a medical history of hypertension and recently started metoprolol. 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 Benjamin Cooper, MD, McGovern Medical School, The University of Texas Health Science Center at Houston, Department of Emergency Medicine …
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ACL tear

42-Year-Old Soccer Player With Knee Injury

A 42-year-old man presents to urgent care with knee pain. He says the pain started when he was playing soccer, just as he kicked a ball toward the goal. Ultimately, he had to leave the game because of the pain. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page …
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Erythema ab igne

38-Year-Old With Rash After Heating Pad Use

A 38-year-old woman presented to urgent care for rash that had developed on her trunk 2 months prior. On examination, extensive hyperpigmented, reticulated patches were seen on her back. She had no recent history of sunburn, extensive sun exposure, or history of dermatological conditions. Additional history revealed the use of a heating pad for the preceding 3 months to help manage her chronic back pain. She often rested on the electric heating pad for several hours and sometimes fell asleep with the heating pad on.   View the image above and …
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