Challenge your diagnostic acumen: Study the following x-ray images, electrocardiograms, and photographs and consider what your diagnosis might be in each case. While the images presented here are authentic, the patient cases are hypothetical.
16-Year-Old With Rash After Septoplasty
A 16-year-old girl presents to urgent care with complaints of fever, chills, and a diffuse sunburn-like rash that developed over the past day. The patient underwent septoplasty 2 days prior for a deviated septum, and nasal packing was utilized to manage her postoperative bleeding. On examination in urgent care, she was febrile to 104°F (40°C), tachycardic, and hypotensive. Widespread erythematous blanching macules and patches were seen.  View the image below and consider what your diagnosis and next steps would be. Resolution of the case is described on the following …
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27-Year-Old with History of Asthma
A 27-year-old female with history of asthma presents to urgent care on a Friday morning with dyspnea for 1 day. She denies palpitations, syncope, or chest pain. An ECG is obtained. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. Figure 1. Initial ECGCase presented by Catherine Reynolds, MD, McGovern Medical School at UTHealth Houston …
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29-Year-Old With Pain After Foot Inversion
A 29-year-old man presents to urgent care on a Saturday with pain in his left foot after playing tennis. A series of x-rays is ordered. Review the images below and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page. Differential Diagnosis Midfoot sprain Avulsion fracture of the base of the 5th metatarsal Jones fracture (proximal 5th metatarsal fracture extending into the intermetatarsal joint) Os peroneum (ossicles in the peroneus longus) Diagnosis The correct diagnosis is an avulsion fracture of the …
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55-Year-Old With Wrist Pain
A 55-year-old woman presents to urgent care complaining of pain when she moves her right wrist. She reports the pain began suddenly when she woke up that morning without any known trauma. 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 …
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35-Year-Old With ESRD
A 35-year-old male with a history of end-stage-renal-disease (ESRD) presents to urgent care complaining of back pain. The patient missed his dialysis session today because of the pain. An ECG is obtained. View the ECG captured below 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, McGovern Medical School, The University of Texas Health Science Center at Houston, Department of Emergency Medicine …
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