Clinical Image Challenges

A 47-year-old man presents to urgent care after trying out a new cardio boxing class at the local recreation center. He indicates that his right hand has been hurting ever since he hit a punching bag this morning, and the pain has been getting worse. X-rays are ordered, both anterior posterior (AP) and oblique views. Review the images and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page …
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A 52-year-old male presents to urgent care complaining of palpitations. An ECG is obtained. 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 ECGCase 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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A 64-year-old man presents to urgent care with a lesion on his face for the last 2 months. On examination, a shiny, eroded, blue-black nodule was seen on his right cheek. He is a postal worker.  Histopathology examination showed aggregates of melanin and melanocytes within sheets of basaloid keratinocytes with peripheral palisading and surrounding clefts within a fibromyxoid stroma containing melanophages. View the image above and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page …
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A 29-year-old man presents to urgent care complaining of chronic right hip pain with movement and exercise. He’s an avid mountain climber and used to play sports in college. Review the images and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page …
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A 70-year-old male with a history of atrial fibrillation presents to urgent care for 1 week of fatigue and edema of the lower extremities and face. An ECG is obtained. 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. Case presented by Joe Stockhausen, MD Figure 1: Initial ECG …
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