Clinical Image Challenges

The patient is a 55-year-old woman who presents with what she calls minor pain in her left hip. She denies any trauma, and insists the pain “isn’t that bad.” She’s only seeking care as a precautionary measure in advance of a family camping trip. View the image taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page …
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The patient is a 72-year-old woman who complains of multiple skin lesions on her lower legs. She says she first noticed them several months ago, appearing in a net-like pattern, then becoming painful ulcerations, and finally leaving atrophic scars. She is concerned because she had already had several bouts 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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The patient is a 54-year-old female woman who presents to urgent care with a 3-day history of nonproductive cough with associated rhinorrhea. She does endorse some chest pain after coughing episodes, which resolve with NSAIDs. She otherwise denies nausea, vomiting, diaphoresis, or exertional symptoms. Personal medical history is remarkable for hypertension. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page …
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The patient is a 42-year-old man who presents with a symmetrical rash of palpable purpura on his legs. He also complains of a fever and arthralgia, but denies any headache or neck pain. He also discloses current infection with the hepatitis C virus. 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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The patient is a 58-year-old female who reports having an episode of syncope earlier in the day. She denies chest pain, difficulty breathing, or recent illness. She has a history of hypertension, diabetes, coronary artery disease. View the ECG and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page …
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