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NEJM—Images in Clinical Medicine

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https://www.readbyqxmd.com/read/28076713/fibromuscular-dysplasia-of-the-brachial-artery
#1
Mistyann-Blue Miller, Demetrio R Flores
A 68-year-old woman presented with exertional dyspnea and chest pain, symptoms that suggested unstable angina. She had undergone coronary-artery bypass grafting 5 years earlier. Vascular examination revealed palpable radial pulses on both sides of the body. The results of Allen’s test, conducted..
12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28076706/circinate-balanitis
#2
Ana Pulido-Perez, Ricardo Suarez-Fernandez
A 37-year-old man presented to the emergency department with a 7-day history of genital lesions. He also had weight loss (approximately 4 kg), fatigue, and back pain but no gastrointestinal symptoms. Two months before presentation, he had had dysuria and urethral discharge, both of which resolved..
January 12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28052229/gastric-cancer-in-chest-radiograph
#3
Jorge L Polo, Juan C Porres
A 90-year-old man presented with a 1-month history of progressive edema in both legs and several episodes of malaise and dizziness that were associated with hypoglycemia. On examination, a nontender epigastric mass was palpated. A plain radiograph of the chest showed a round, irregular opacity..
January 5, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28052220/acromioclavicular-joint-separation
#4
M Enes Kayaalp, Ali Seker
A 30-year-old man visited the emergency department after a fall that had resulted from a loss of balance while he was walking that day. The patient recalled that he had sustained the impact of the fall on his left shoulder. On examination, his vital signs were normal, but a palpable posterior..
January 5, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28029928/infected-urachal-cyst
#5
Nicholas Potisek, James Weihe
A 19-month-old girl with a history of myelomeningocele and Chiari malformation type II presented with abdominal pain. The initial abdominal examination was normal; however, within 24 hours, the umbilicus became protuberant and erythematous (Panel A). The white-cell count was elevated, with a large..
29, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/28029917/disseminated-cysticercosis
#6
Qiang Meng, Lingchun Liu
A 23-year-old woman presented with a 1-month history of headache, vomiting, recurrent episodes of syncope, weight gain, and leg pain. A physical examination revealed several subcutaneous nodules on the patient’s face and trunk. Exophthalmos, fundal hemorrhage, neck rigidity, and a hypertrophic..
December 29, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/28002703/uterine-rupture-with-protruded-legs-in-a-large-amniocele
#7
Pierre-Emmanuel Bouet, Charlyne Herondelle
A 33-year-old asymptomatic woman (gravida 6, para 5) presented at 22 weeks of gestation with a large herniation of the amniotic sac through the left uterine wall that was detected by routine ultrasonography. She had had five previous cesarean sections through a transverse incision of the lower..
December 22, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/28002702/acute-rheumatic-fever-with-erythema-marginatum
#8
Makoto Saito, Shuji Hatakeyama
A previously healthy 36-year-old man presented with a 1-month history of fever and pain in both shoulders and knees, which had been preceded by a sore throat 2 weeks before the onset of fever. Laboratory studies were notable for a white-cell count of 13,800 per cubic millimeter (85% neutrophils), a..
December 22, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27974038/african-trypanosomiasis
#9
Judy A Streit, Eiyu Matsumoto
A previously healthy 60-year-old woman presented with a 2-to-3-day history of fevers, chills, myalgias, headache, and two pruritic areas on her back. She had returned 3 days earlier from a 2-week trip to Botswana and Zimbabwe that had included canoeing and camping. She had received vaccines before..
December 15, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27974033/patellar-fracture-with-sleeve-avulsion
#10
Rachel A Lindor, James Homme
A 9-year-old girl presented with knee pain and inability to extend her leg after landing on her flexed right knee while jumping on a trampoline. Physical examination revealed superior displacement of the patella (Panel A), and a radiograph showed a fracture of the patella at the inferior pole..
December 15, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27959689/tongue-fasciculations-in-organophosphate-poisoning
#11
Bharath A Chhabria, Ashish Bhalla
A 15-year-old boy who lived with his family on a farm presented to the emergency department with a 1-day history of vomiting, diarrhea, and altered sensorium. On initial assessment, he was drowsy and had tachypnea and hypotension. Auscultation of the lungs revealed diffuse crepitations. His pupils..
December 8, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27959674/tinea-imbricata
#12
Carrick Burns, Johannah Valentine
An 18-year-old Fijian woman presented with a 3-year history of a concentric, scaly rash on her shoulders; the rash was also present on her trunk, arms, and legs (not shown). The rash was pruritic and progressively spread to involve approximately 70% of the body-surface area. Her brother had similar..
December 8, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27959752/skin-mottling
#13
Damien Contou, Nicolas de Prost
A 68-year-old woman was admitted to the intensive care unit with respiratory failure and hypotension. Her blood pressure was 70/50 mm Hg, and her heart rate was 125 beats per minute. Physical examination revealed skin mottling on the legs (Panel A). Laboratory values were notable for an..
December 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27959751/neurogenic-megacolon-in-spinal-cord-injury
#14
Rukma R Govindu, Michelle Kelley
A 44-year-old man with a 20-year history of quadriplegia from a gunshot wound to the neck presented to the emergency department with symptoms of a urinary tract infection. His medical history included chronic megacolon and neurogenic bladder, and he had been admitted to the hospital many times for..
December 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27959734/dizziness-and-vertigo-during-mri
#15
Bryan Ward, David Zee
A healthy 33-year-old man who was participating in a research study underwent magnetic resonance imaging (MRI) in a 7-tesla MRI scanner. On entering the scanner, he had a spinning sensation for approximately 2 minutes that persisted whether his eyes were open or closed. Nystagmus was recorded with..
November 24, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27959726/large-hiatal-hernia
#16
Carolina C Sousa, Joana Duarte
An 81-year-old woman with cerebrovascular disease presented to the emergency department with a 1-week history of vomiting. Findings on abdominal examination were notable for normal bowel sounds and the absence of tenderness, rebound, or guarding. A chest radiograph showed a large air–liquid shadow..
November 24, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27959611/heterotopic-pregnancy
#17
Simone Goettler, Rosanna Zanetti-Dällenbach
A 34-year-old woman with a history of appendectomy presented to the emergency department after 45 minutes of acute abdominal pain. Her last menstrual period was 9 weeks before presentation, and a normally conceived intrauterine pregnancy (8 weeks of gestation) had been diagnosed by her gynecologist..
November 17, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27959596/tabes-dorsalis-and-argyll-robertson-pupils
#18
Chinar Osman, Tristan W Clark
A 47-year-old man with a history of human immunodeficiency virus (HIV) infection presented with an 8-month history of severe paroxysmal shooting pains in his legs, progressive difficulty in walking, tinnitus, and urinary incontinence. He had a fully suppressed HIV viral load and a CD4+ count of 400..
November 17, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27959649/hemothorax-after-thoracentesis
#19
Ittikorn Spanuchart, Scott Gallacher
A 65-year-old woman with atherosclerotic cardiovascular disease and renal failure was hospitalized for acute respiratory failure and bilateral pleural effusions associated with pneumonia (Panel A). To rule out the presence of empyema, a diagnostic, ultrasonography-guided thoracentesis was performed..
November 10, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27959645/diagnosing-myasthenia-gravis-with-an-ice-pack
#20
Wendy W Liu, Adam Chen
A 68-year-old man presented with unilateral ptosis and no other symptoms. The neurologic examination revealed ptosis of the left eye after a sustained upward gaze (Panel A). The movements of the extraocular muscles were normal. Myasthenia gravis was suspected, and the ice-pack test was performed..
November 10, 2016: New England Journal of Medicine
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