A 28-year-old woman presents to urgent care after an indoor rock-climbing event. She fell 10 feet from the wall without any safety gear to break the fall. She describes deep pain in her left foot, and she is limping. An exam reveals dorsal and plantar midfoot tenderness and bruising across the dorsal foot. A 3-view x-ray series is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the …
Read More36-Year-Old With Hair Loss
A 36-year-old man presents to urgent care with asymptomatic hair loss that developed on multiple sites of his scalp over the previous 2 months. The hair loss developed in round patches that expanded to involve most of the back of his scalp. His past medical history is notable for hyperthyroidism. View the image above and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.
Read MoreJuly/August 2015
Clinical Challenge: October, 2009
A 57-Year-Old Woman with Acute Pain After a Fall The aptient is a 57-year-old woman who presented to urgent care complaining of severe pain in her right foot, leg, hip, and elbow. She reported that she fell three to four hours prior to presentation while outside walking her dog; she was “tripped up” in the pet’s leash. She presented ambulatory, but was unable to bear any weight on her right leg. Past medical history …
Read MoreClinical Challenge: July/August, 2009
Clinical Challenge: January, 2008
Insights In Images: October, 2007
The patient pictured presented with two hours of intense pain and redness along the left side of her head and down her left arm. Though this could easily be mistaken for an infectious process, it was actually reflex sympathetic dystrophy (RSD), also referred to as complex regional pain syndrome (CRPS) type I. By any name, however, this is a rare and poorly understood neurological condition. It may manifest by way of sensory, focal autonomic, or …
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