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Premium-Inhalte aus der Serie "Clinical Practice: Clinical Images"

Erst brennende Schmerzen, dann Schwäche und Muskelabbau

A 79-year-old man presented to clinic 2 months after acute onset of right shoulder pain and weakness. His symptoms began with 1 week of burning pain, followed by inability to lift his right arm above his head. He denied antecedent trauma. 

Was wächst denn da auf dem Tattoo?

A 33-year-old previously healthy man presented with an asymptomatic rash on his tattoo. Physical examination revealed brown and black papules confined to the ink of his tattoos. Chest x-ray showed hilar lymphadenopathy. Biopsy of a papule on his tattoo demonstrated non-caseating granulomas consistent with a diagnosis of sarcoidosis.

Seltener Fall: Woher stammt der Pleuraerguss?

A 71-year-old male presented with two weeks of nausea, vomiting, abdominal pain, and difficulty urinating. He denied shortness of breath or chest pain. Laboratory tests were notable for a potassium of 7 mmol/l, BUN 176 mg/dl, and creatinine 17.6 mg/dl. 

Schwarze haarige Zunge

A healthy 32-year-old woman presented with 2 weeks of black discoloration of the tongue. She denied new medications and tobacco use, but had started using mouthwash containing hydrogen peroxide 1 month earlier. 

Plagende Plaques an der Ferse

A 59-year-old man with rheumatoid arthritis on long-term methotrexate presented with 6 months of multiple painful lesions on his heels that impaired his gait. He denied any trauma to his foot or new medications. 

Sweet-Syndrom: So schnell kann's gehen

A 69-year-old man with ulcerative colitis presented with fever, fatigue, and rash. The patient reported onset of symptoms within 5 days of starting azathioprine. Physical examination revealed a painful rash of erythematous plaques with pustules on bilateral elbows and neck.

Fieber, Splenomegalie und Panzytopenie

A 26-year-old man with acquired immunodeficiency syndrome (AIDS) taking no medications presented with fever and anorexia. Examination showed a febrile cachectic man with splenomegaly. Laboratory analysis revealed pancytopenia and CD4 count 2/μL. 

Diesem Pilz war die Haut nicht genug

An 89-year-old patient with a past medical history of diet-controlled diabetes mellitus presented with a 4-month history of fevers and skin lesions that persisted despite two courses of oral antibiotics. He reported exposure to outdoor-dwelling cats.