Clinical Image Challenges

A 16-year-old female presents to urgent care with her mother after soccer practice at school. She says she felt a “pop” in her left hip, immediately followed by posterior hip pain. Walking makes it worse, but resting makes the pain better. 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 …
Read More

A 74-year-old woman presents to urgent care with epistaxis, controlled on arrival. She is also complaining of lightheadedness and fatigue that’s been going on for the past 2 weeks. 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 ECG Case presented by Adam M. Woods, MD, PGY3, Chief Resident, The University of Texas Health Science Center at Houston …
Read More

A 65-year-old woman presents to urgent care complaining of a growth that developed on her finger 2 months prior. She says it’s not painful or itchy and has not grown since she first noticed it. On examination, a solitary, smooth, pinkish papule with a tiny central crust is seen on her distal interphalangeal joint on her left index finger. The patient has a history of osteoarthritis. View the image below and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page …
Read More

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 …
Read More

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 …
Read More