Clinical Image Challenges

Case The patient is an 80-year-old man with history of hypertension and high cholesterol who presents with rhinorrhea and cough. On further history, he admits to 2 months of intermittent dizziness, not worsening.  He denies any chest pain/discomfort, SOB, or sweating. No neuro symptoms. On exam, you find:  General: A&O, NAD Lungs: Clear bilaterally Cardiovascular: Regular rhythm, without m,r,g Abdomen: Soft and nontender Ext: No edema or asymmetry, pulses are 2+ and equal in all extremities, no pain with palpation …
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Case The patients is a 48-year-old woman who presents with a single lesion on her cheek/face. As a healthcare worker herself, she says she is concerned that the excoriation might get infected. She denies knowing anything about the possible cause, but insists on receiving treatment. Notably, she is a frequent visitor to your urgent care center in spite of the fact that she is in excellent physical health. However, she has been diagnosed with borderline personality disorder. View the image and consider what your diagnosis and next steps would be …
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Case The patient is a 2-year-old girl who is brought to your urgent care center by her parents several hours after jumping on a trampoline with her friend, but that she “seemed fine” when the mother picked her up to come home. View the images 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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A 27-year-old woman who has been training for a marathon presents to the urgent care center with epigastric pain. She states the pain is worse after she consumes tomato sauce or orange juice, and wonders if she may have reflux. She denies shortness of breath, exertional component, pleuritic pain, leg swelling, use of hormonal therapy, or sweating. No right upper quadrant pain. Improves with antacids. No FH or heart disease or other risk factors. Upon exam, you find: General: A&O, NAD, conversational and interactive. Normal body habitus Lungs: Clear bilaterally …
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Case The patient is a 45-year-old male construction worker who felt pain immediately after stepping down from a truck into a pothole. View the images taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page. Figure 1 …
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