Author | Stephen Schabel, MD

Articles

Upper Extremity Swelling in a Smoker

April 01, 2007

A 57-year-old woman presents with swelling of the hands that began several weeks earlier and is now worsening. She denies joint pain, and she has no history of trauma or significant vascular disease. She has had pneumonia several times; each episode was successfully treated with antibiotics. She has smoked 2 packs of cigarettes a day for the past 20 years

What Do These Images Reveal?

January 01, 2007

A 32-year-old man complains ofknee pain that resulted when he felland twisted his right knee skiing theday before. He suffered other minorcontusions from the fall, but none ofthese required medical attention. Heis otherwise in good health and hasno relevant medical history.

What Do These Images Reveal?

January 01, 2007

A 32-year-old man complains oflong-standing low back discomfortthat has worsened to frank pain overthe past month. He denies fever, trauma,and excessive physical activity. Hismedical history is noncontributory.

What Do These Images Reveal?

December 31, 2006

A 67-year-old man complainsof abdominal distention and bouts ofdiarrhea with intermittent constipation.These symptoms have beenpresent for weeks but recently havebecome more severe. The patienthas not seen blood in his stool. Hedenies fever, travel to a foreign country,and recent trauma. He has hypertension,which is well controlledwith calcium channel blockers.

Ischemia of the Liver Secondary to Portal Vein Thrombosis

December 31, 2006

A 59-year-old woman complainsof progressively worsening bloatingand right upper quadrant pain thatbegan 1 day earlier. She denies feverand trauma. Her medical history includescholecystectomy for cholelithiasisand several emergency departmentvisits for treatment of woundssustained in falls. She has a history ofalcohol abuse, for which she now receivescounseling. However, she admitsthat she occasionally has boutsof heavy drinking.

Photo Quiz

December 31, 2006

Right hip pain in a high schoolfootball playerA 15-year-old boy complains ofright hip pain that began the day before,when he felt a "pop" during footballpractice. His medical history issignificant only for several ligamentousinjuries in both ankles and fracturesof the right lateral malleolusand the left medial malleolus, whichhealed uneventfully. He denies anabolicsteroid use and alcohol use.

What Do These Images Reveal?

December 31, 2006

For the past month, a 19-year-old woman has had abdominalpain, diarrhea, intermittent fever, and occasionalvomiting. She now seeks medical attention because earlierin the day she noticed a large amount of blood in herstool. She denies trauma, travel to a foreign country, andillicit drug use. She drinks alcohol occasionally but hasnot done so for the past 3 months.

Abdominal Aortic Aneurysm and Dissection of the Left Internal Carotid Artery

December 31, 2006

A 75-year-old man with coronaryartery disease presents to the emergencydepartment with abdominalpain and light-headedness. The painbegan as a dull ache 4 days earlierand recently became considerablyworse. The patient denies recenttrauma, fever, nausea, vomiting, and diarrhea.

What Do These Images Reveal?

December 31, 2006

A 76-year-old woman complains of gradually worsening back pain thatbegan 6 weeks earlier, after she fell off a ladder rung 3 feet from the ground(she landed on her feet). She is otherwise in good health and denies fever andloss of sensation or control in the lower extremities.

What Do These Images Reveal?

December 31, 2006

A 75-year-old woman complains of chest pain that radiates to her back betweenher shoulder blades. The pain began the morning of her presentationand has progressed throughout the day. She denies recent trauma, shortnessof breath, and fever. She has hypertension, which is treated with a &#946-blocker.Three years earlier, she fractured her right femur in a motor vehicle accident;the fracture was treated by open reduction and internal fixation.