SAEM Clinical Image Series: Bumps and Balls

Kaposi sarcoma

A 31 year old African-American male, with a history of HIV, non-compliant with medications, presents with 3 months of painful “balls and bumps” on his left thigh. He was evaluated at another hospital prior to this visit and was discharged with 7 days of TMP-SMX. He denies any fever, chills, weight loss, night sweats, or anorexia.

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SAEM Clinical Image Series: Seeing Stars

Seeing Stars asteroid hyalosis

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Chief complaint: Left eye pain, redness, and foreign body sensation

History of Present Illness: 39 year old man presents after metal grinding without protective eyewear three days prior.

He had felt something strike his left eye. He developed “burning” pain, tearing, and redness. Pain worsens with extraocular movements. He notes that vision in his right eye has always been worse than the left. Denies any other visual complaints.

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By |2019-09-27T21:17:56-07:00Sep 30, 2019|Ophthalmology, SAEM Clinical Images|

SAEM Clinical Image Series: A Page Turner

Gray Turner's sign

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Chief complaint: Abdominal pain

History of Present Illness: A 36-year-old male with a history of alcohol abuse, hypertension, hyperlipidemia, and myocardial infarction with a subsequent stent on ticagrelor and aspirin presents with abdominal pain.

He reports 3 days of epigastric and periumbilical pain and multiple episodes of non-bloody, non-bilious emesis. He denies fever, diarrhea, blood in his stool, and urinary symptoms. He endorses bruising to his bilateral flanks and multiple falls recently while drinking.

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By |2019-09-23T09:58:06-07:00Sep 23, 2019|SAEM Clinical Images, Trauma|

SAEM Clinical Image Series: Hip Pain

hip pain anterior inferior iliac spine fracture

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Chief complaint: Left hip pain

History of Present Illness: A healthy right leg-dominant 13-year-old male athlete presents with left hip pain after kicking a soccer ball.

He states that he kicked the ball awkwardly and experienced hip pain immediately afterwards. He did not feel a pop or cracking sensation but could not stand after the kick and fell to the ground. He can ambulate but only with significant pain.

He now has 8/10 sharp, non-radiating left hip pain that is worse with movement, weight-bearing and palpation.

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SAEM Clinical Image Series: Foreign Body Ingestion

foreign body ingestion

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Chief complaint: Foreign Body Ingestion

History of Present Illness:

A 4-year-old male presents to the Pediatric ED for evaluation of swallowed foreign body.

The mother reports the patient was at his grandmother’s house playing near a cabinet when they witnessed him put a small unknown object in his mouth and swallow. Family denies vomiting, difficulty breathing, change in behavior, abdominal pain, or any additional symptoms at this time.

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SAEM Clinical Image Series: Young Woman with a Headache

Headache

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Chief complaint: Headaches for 1 year

History of Present Illness: A 31-year-old woman with no significant past history presents with a dull headache.

She notes the headache is generalized, has been almost daily for a year and is worsened by bending over. She denies nausea, vomiting, photophobia, trauma, seizures, focal weakness, numbness, or vision change. Acetaminophen and ibuprofen provide only mild, short-acting relief. She takes oral birth control and her periods have been normal.

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