Clinical Image Challenges

A 42-year-old man presents to urgent care on a Sunday afternoon. He explains that he was playing a game of pick-up football in his neighborhood and suffered a rough kick to the face from another player. His nose is swollen, and he’s clearly in pain. An x-ray is ordered to capture a lateral view of the nasal bones. Review the image 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 56-year-old female with no past medical history presents to urgent care with 2 episodes of chest pain that woke her up this morning. She had 2 additional episodes while walking and while bathing earlier in the day. The episodes lasted about 10 minutes each, and she is currently free from chest pain. The pain is pressure-like and left-sided, radiating to her back. An ECG is obtained. 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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A 3-week-old girl presents to urgent care with widespread scaly skin. On physical examination, her vital signs are normal. She is noted to have ectropion and large, thick, plate-like scales covering most of her body. The patient had a personal history of prematurity and collodion membrane at birth. There is no family history of dermatological or genetic disorders. View the image below and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page. The X-ray …
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A 13-year-old boy presents to urgent care after “rolling” his left foot. He explains that he tripped on a cement curb while riding his skateboard. He has foot and ankle pain that is worse with weight. An x-ray is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page. Figure 1. The X-ray …
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A 33-year-old female presents to urgent care with pleuritic chest pain that is gradual in onset over the preceding several days and worse when lying flat. She denies fever, cough, and shortness of breath. She is well appearing with normal vital signs. An ECG is obtained. View the ECG 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, MEd, FACEP, McGovern Medical School at the University of Texas Health …
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