Clinical

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.    

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.

The patient is a 6-year-old boy who cried out in pain after jumping off the fourth step of the stairs in his house yesterday, landing hard on his feet. His mother reports that he has been limping ever since. She applied ice at home, hoping the pain would resolve overnight. It did not. On exam, you note the pain is located at the base of the first/second metatarsal. View the images taken and consider what …

The patient is a 70-year-old male who presents to urgent care with numbness, pain, and difficulty opening his hands. His son, who drove his father to the appointment, notes that the skin also looks “bunched up in places.” The physician also observes what look like raised scars. The thumb and index finger seem unaffected. Upon questioning, the patient says he started noticing smooth nodules “a couple years ago.” He attributed that to his many years …