A 48-Year-Old Female with Pruritic Lesions

Case A 48-year-old woman presents with several red lesions that are extremely pruritic. They are scattered haphazardly on the back of her leg. A few of the lesions are still smooth nodules, but others are now excoriations; she just can’t stop scratching them no matter how hard she tries. She estimates they appeared nearly a month ago. She reports a history of atopic dermatitis, but “this doesn’t feel like the same thing.” View the photo …

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A 38-Year-Old Woman with Shoulder Pain

A 38-Year-Old Woman with Shoulder Pain

Case A 38-year-old female patient presents with acute shoulder pain following a fall on an outstretched arm during a spring skiing vacation. There is a normal appearance to the shoulder, but significant pain even with minimal attempts at range of motion. The clavicle and elbow are nontender. Neurovascular status is intact. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the …

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A 62-Year-Old Woman with Dizziness and Palpitations

A 62-Year-Old Woman with Dizziness and Palpitations

Case The patient is a 62-year-old woman who presents to the urgent care center after 1 hour of intermittent dizziness and feeling of palpitations. She has no chest pain, fever, vomiting, or diarrhea. Further history reveals that she has a history of anxiety, which is manifested by intermittent feeling of heart “palpitations.” Her primary care doctor is treating her with a selective serotonin reuptake inhibitor (SSRI) for anxiety. Upon exam, you find: General: Alert and …

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Clavicular Pain in a 23-Year-Old

Case A 23-year-old man presents to an urgent care with pain at the distal end of his left clavicle that began the previous day after he fell onto his left shoulder while mountain biking. His pain is constant and sharp and worse when moving his left arm and shoulder. He does not have fever, vomiting, chest pain, shortness of breath, or abdominal pain, and he has no head injury, no head or neck pain, and …

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Heel and Ankle Pain in an Adult After a Jump from a Second-Floor Window

Heel and Ankle Pain in an Adult After a Jump from a Second-Floor Window

A 38-year-old man presents to an urgent care center and reports pain in his right heel and ankle that he describes as severe enough that he cannot walk on the foot. He says that the pain began the previous evening when he landed on the group after jumping out of a second-floor window on a dare. He has some minimal paresthesia, but he has no fever, vomiting, head trauma, head or neck pain, or chest …

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Hip Pain in an Adult After a Fall

Hip Pain in an Adult After a Fall

A 67-year-old woman presents to an urgent care center after 12 hours of pain in her right hip that began after she slipped in her kitchen and fell onto that hip. She reports that the pain is constant and worsens with walking. She has not experienced numbness in the hip, and she reports no other injuries. She has not sustained any head trauma, and she has no head or neck pain. View the image taken …

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Shoulder Pain in a 62-Year-Old After a Fall

A 62-year-old man presents with right shoulder pain that began the previous evening after he fell in his garage. The pain is worse with movement through the range of motion. He has no pain in the elbow and says that he has no head pain or head injury. His social history reveals that he is a smoker and drinks alcohol. View the image taken (Figure 1) and consider what your diagnosis would be.

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Shoulder Injury During Football Game

An 11-year-old boy presents with pain over the right clavicle that developed the previous day while he was playing football and another player fell on him. He has pain with range of motion of the right shoulder as well as with movement of the torso. He has no shortness of breath, chest pain, dizziness, or numbness of the arm. View the image taken (Figure 1) and consider what your diagnosis would be.

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