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NEJM—Images in Clinical Medicine

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https://www.readbyqxmd.com/read/29141173/falciform-ligament-sign
#1
Po-Chen Chou, Yu-Jang Su
An 87-year-old woman with a history of hypertension and peptic ulcer disease presented to the emergency department with a 3-day history of abdominal distention, pain in the epigastrium, and watery diarrhea. She had hypotension (blood pressure of 78/49 mm Hg), and diffuse abdominal tenderness with..
November 16, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29141167/-popeye-sign
#2
Naoki Yoshida, Yoshihiko Tsuchida
A 79-year-old man presented to the orthopedic clinic with a large bulge on his left upper arm. The bulge had developed 2 days before presentation, when he was lifting an object and felt a sudden sharp pain in his left shoulder. A physical examination revealed an obvious deformity in the anterior..
November 16, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29117495/compartment-syndrome
#3
Aileen F Egan, Kevin C Cahill
A 26-year-old man presented to the emergency department with a painful, swollen left hand (Panel A). He had been lying on the ground for more than 13 hours after using illicit drugs. The physical examination revealed edema in the left hand and forearm. Active and passive motion of the hand was..
November 9, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29117488/gold-thread-acupuncture-for-rheumatoid-arthritis
#4
Young-Bin Joo, Kyung-Su Park
A 58-year-old woman presented to the rheumatology clinic with long-standing joint pain and deformities of both hands and feet. Her joint symptoms had begun when she was approximately 18 years of age, after which she had received treatment with ibuprofen and gold thread acupuncture (the insertion of..
November 9, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29091571/pigmented-macule-a-skin-manifestation-of-invasive-breast-cancer
#5
Takashi Oide, Tsuyoshi Mitsuishi
A 62-year-old woman presented to the breast-surgery clinic with stiffness of the left nipple. Palpation of the left breast, mammography, and ultrasonography revealed no abnormalities. However, a pigmented macule that measured 5 mm in the greatest dimension was noted on the left areola (Panel A,..
November 2, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29091566/hiv-infection-manifesting-as-proximal-white-onychomycosis
#6
Elisabeth Gómez-Moyano, Vicente Crespo-Erchiga
A 48-year-old-man presented to the dermatology clinic with a whitish discoloration and hyperkeratosis of the first toenail that had extended from the proximal to the distal nail during the past month (Panel A). The patient reported no history of trauma to the nail. He had no fever, weight loss,..
November 2, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29069554/congenital-diaphragmatic-hernia
#7
Jared Klein, Megan Sirota
A female infant was delivered by planned cesarean section at 36 weeks of gestation because of a prenatal diagnosis of congenital diaphragmatic hernia. The neonate was intubated immediately after delivery. A nasogastric tube was inserted and suction begun to decompress the bowels to allow for better..
October 26, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29069553/button-magnets-in-the-nasal-cavity
#8
Kadir C Kazikdas, Mehmet A Dirik
An 11-year-old boy was brought to the emergency department 6 hours after he had inserted button magnets in both sides of his nose. He had been unable to remove the magnets and presented with epistaxis and severe pain. Examination of the nasal cavity showed mucus and crusted blood. Radiography of..
October 26, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29045210/decompression-sickness
#9
Qing Sun, Guangkai Gao
A 42-year-old man presented to the emergency department with palpitations, arthralgias, and vomiting 2 hours after scuba diving to a depth of 26 m. The physical examination revealed diffuse violaceous skin mottling over his trunk and arms (Panel A). Laboratory values were notable for mild..
October 19, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29045209/takotsubo-cardiomyopathy
#10
Abhishek Maiti, Abhijeet Dhoble
A 61-year-old woman with hypertension and hypothyroidism presented to the emergency department with acute onset of severe chest pain. She reported multiple recent stressors, including the death of her dog. An electrocardiogram showed ST-segment elevation in the anterolateral leads. Emergency..
October 19, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29020597/lingual-papillomas
#11
Dulce M Barrios, Jeffrey R LaDuca
A 59-year-old man with a history of melanoma (3 years ago) presented to the dermatology clinic for routine surveillance. He had macrocephaly (head circumference in the >97th percentile), as well as multiple trichilemmomas (benign flesh-colored papules) on the face and chest and acral keratosis..
October 12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29020580/calcium-oxalate-crystals-in-ethylene-glycol-toxicity
#12
Mohamad Hanouneh, Teresa K Chen
An 80-year-old man with a remote history of alcohol-use disorder presented to the emergency department with altered mental status after a fall at home. He was somnolent and unable to provide any further history. Serum studies revealed a creatinine level of 2.4 mg per deciliter (212 μmol per liter;..
October 12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28976865/-acrobatic-lice
#13
Adan Fuentes-Suárez, Tita N González-Márquez
A 65-year-old man presented to the dermatology clinic with a 6-week history of severe itching in the inguinal area. Examination did not reveal any cutaneous lesions, and the symptoms were subsequently investigated by means of dermoscopy. Dermoscopy revealed a nit firmly attached to the pubic hair,..
October 5, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28976854/acute-esophageal-necrosis
#14
Takahiro Matsuo, Naoki Ishii
A 63-year-old woman with type 2 diabetes presented to the emergency department with a 2-day history of hematemesis and black stool. Esophagogastroduodenoscopy (EGD) revealed a black esophagus with ulcerated longitudinal necrosis in the lower esophagus (Panel A), findings that were consistent with..
October 5, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28953434/pulmonary-foreign-body-granulomatosis
#15
Dustin A Staloch, J Stephen Hedley
A 31-year-old woman who was receiving long-term total parenteral nutrition after having undergone Roux-en-Y gastric bypass that was complicated by small-bowel resection presented to the pulmonology clinic with exertional dyspnea that had progressed over the course of 1 year. She had normal oxygen..
September 28, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28953433/eagle-s-syndrome
#16
Firat Elmas, Bikash L Shrestha
A 35-year-old man presented to the ear, nose, and throat clinic with sharp neck pain and a sensation of having a foreign body in the throat, symptoms that had developed during the past year. At times the pain extended to his right ear. He had no pain or difficulty on swallowing. On physical..
September 28, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28930513/intraocular-infection-with-a-trematode
#17
Pablo J Guzman-Salas, Juan C Serna-Ojeda
A 17-year-old boy from a rural town in Mexico presented to the hospital with a 3-week history of decreased visual acuity and pain in the right eye. He could see only hand motions. Intraocular pressure in the right eye was elevated at 30 mm Hg (reference range, 10 to 21 mm Hg). Slit-lamp examination..
September 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28930502/squamous-cell-carcinoma-of-the-mouth
#18
Tanay V Chaubal, Renjeet A Bapat
A 54-year-old woman presented to a dental clinic with a 1-year history of oral swelling and a sore mouth. She had regularly chewed loose-leaf tobacco, which she had placed on the floor of her mouth between the jaw and tongue, up to five times each day for more than 10 years. Intraoral examination..
September 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28902597/iridodonesis
#19
Dhaval Desai, A Jamil Tajik
A 65-year-old woman presented to a clinic to be evaluated for Marfan’s syndrome after her identical twin received a diagnosis of the disorder. Physical examination revealed iridodonesis, or "dancing" of the iris, which was elicited by rapid movement of the eye (see video). A 3/6 holodiastolic..
September 14, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28902582/marfan-s-syndrome-with-ectopia-lentis
#20
Jayanth Sridhar, Jonathan S Chang
A 41-year-old man presented with progressive loss of vision in both eyes that was worse in the right eye than in the left. There was no history of trauma. His uncorrected visual acuity was 6/200 in the right eye and 20/100 in the left eye. Slit-lamp examination revealed ectopia lentis in both eyes,..
September 14, 2017: New England Journal of Medicine
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