Cases

Sudden-Onset Severe Abdominal Pain, Lightheadedness, and Nausea An 85-year-old man is brought to the ED with severe, radiating abdominal pain that began 2 hours ago. The patient has nausea and felt light-headed at the onset of the pain. What is the diagnosis?
Clinical Case, May 2012
Progressive Weakness and Numbness With a Long History of Back Pain A 44-year-old man is evaluated for a 6-month history of progressive bilateral lower extremity numbness and weakness and a 4-year history of back pain. What is the diagnosis?
Clinical Case, May 2012
Severe Weakness and Speech Disturbance A 67-year-old woman is brought to the ED for severe right-sided weakness and difficulty speaking that was observed by her husband on awakening this morning. What is the diagnosis?
Clinical Case, May 2012
Severe Headache, Nausea, and Diplopia in a Teenage Girl A teenager presents with a headache, nausea, vomiting, and diplopia. She feels dizzy and cannot walk. She has a history of severe episodic headaches during the past 2 weeks. What is the diagnosis?
Clinical Case, May 2012
Acute-Onset Severe Penile Pain, Swelling, and Bruising A 35-year-old man presents to the ED with acute-onset penile pain and swelling that started during sexual intercourse. His partner recalls hearing a cracking sound. What is the diagnosis?
Clinical Case, May 2012
Slurred Speech and Dysphagia Leading to Spastic Quadriplegia Following Treatment An elderly man presents with 5 days of epigastric pain and vomiting. He is treated for hyponatremia; he responds well, but his condition deteriorates in the days following. What is the diagnosis?
Clinical Case, November 2011
Mysterious Bruising, Weakness, Back Pain, and Gum Bleeds A 42-year-old woman presents with bleeding gums and reports progressive weakness and occasional unexplained bruising. She also has a 1-year history of backache. What is the diagnosis?
Clinical Case, October 2011
Painful, Persistent Swelling Restricting Range of Motion in a Child A 10-year-old boy presents with recurrent episodes of painful swelling associated with restricted movement and areas of residual, painless, persistent, nontender bony swelling. What is the diagnosis?
Clinical Case, October 2011
Acute Progressive Pain, Swelling, and Restricted Motion in a Teenager's Knee A 16-year-old boy is presented for acute-onset knee pain and swelling that began 1 week ago after a soccer match. He had a patellar dislocation 2 months ago, with full recovery. What is the diagnosis?
Clinical Case, September 2011
Insidious Abdominal Symptoms With Urinary Disturbances A 75-year-old man presents with a 6-week history of lower abdominal pain and distention, bilateral lower-extremity swelling, and weight loss. He has been anuric for 3 days. What is the diagnosis?
Clinical Case, September 2011
Ominous Symptoms in an Elderly Cancer Survivor An elderly woman with a history of breast cancer complains of weakness and lack of appetite. She is being evaluated for iron-deficiency anemia and heme-positive stool. What is the diagnosis?
Clinical Case, September 2011
An Unexpected Cause of Severe Knee Pain in an 8-Year-Old An 8-year-old boy presents with a 1-day history of right knee pain. On presentation, he cannot bear weight on his right leg and there is associated swelling and fever of 103°F. What is the diagnosis?
Clinical Case, August 2011
Chronic Recurrent Symptoms Suggesting an Insidious Etiology A 17-year-old girl presents with a history of oral fungal infections, diarrhea, recurrent abdominal pain, vomiting, dizziness, darkening of the skin and oral cavity, and fever. What is the diagnosis?
Clinical Case, July 2011
Mysterious Progressive Chest Pain, Dyspnea, and Syncope An obese 53-year-old woman presents with a 1-week history of chest pain and dyspnea with associated weakness, dizziness, and syncope. Today, she had chest pain in the morning. What is the diagnosis?
Clinical Case, July 2011
Mysterious Recurrent Abdominal Pain With Nausea and Vomiting A 68-year-old woman presents with a 4-month history of episodic epigastric pain with associated nausea and vomiting. She previously had a splenic marginal zone lymphoma. What is the diagnosis?
Clinical Case, June 2011
A Child With Breathing Difficulties and Nasal Discharge A 5-year-old presents with an 8-month history of progressive malodorous nasal discharge. She has experienced sleep disturbances and remarkable snoring. What is the diagnosis?
Clinical Case, June 2011
An Abdominal Mass With Related Premenstrual Pain A woman presents with a 2-year history of an abdominal wall mass that has recently enlarged in size, with associated soreness and pain, and a 3-year history of menstrual issues. What is the diagnosis?
Clinical Case, June 2011
Abdominal Pain, Progressive Dyspnea, and Palpitations in a 30-Year-Old Woman A 30-year-old woman presents with a 2-month history of progressive dyspnea. Her history includes diffuse abdominal pain, leg swelling, and cyanosis with amputation of a toe. What is the diagnosis?
Clinical Case, May 2011
Acute Shortness of Breath Following a Subtotal Colectomy A 59-year-old man undergoes an elective subtotal colectomy. On postoperative day 4 he develops sudden-onset dyspnea. A chest x-ray reveals bibasilar subsegmental atelectasis. What is the diagnosis?
Clinical Case, May 2011
An 8-Month History of Vague Systemic Symptoms A 43-year-old man presents with abdominal pain, severe intermittent headaches, subjective fever, chills, weakness, reduced appetite, and a 30-lb weight loss over the last few months. What is the diagnosis?
Clinical Case, April 2011

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