SAEM Clinical Images Series: Modern Pirate
The patient is a 72-year-old male with multiple medical problems who presents to the Emergency Department complaining of dyspnea on exertion. The patient also complains of bruising that has developed on his right leg. He states that he previously had a similar episode for which she was admitted to the hospital and had warfarin discontinued due to thrombocytopenia. He also reports that he has been unable to eat or drink much lately due to gum swelling and tenderness, and states that when he begins chewing he feels as [+]
SAEM Clinical Images Series: A Mucous Membrane Mystery
The patient is a healthy 14-year-old male without past medical history who presents to the Emergency Department with oral lesions, eye swelling, intermittent fevers, and pain with urination. Over the past 10 days he has been seen by his PCP and at an outside ED for a cough, sore throat, fevers, and oral pain. Three days ago he was seen by his PCP, had a positive rapid strep test, and was started on amoxicillin. His oral lesions and lip swelling have been progressively worsening over [+]
SAEM Clinical Images Series: An Unusual Appearing Umbilicus
The patient is a 70-year-old female with a remote history of breast cancer who presents to the Emergency Department with family due to frequent falls and disorientation. Her family reports that she previously walked independently. However, over the last several months, she has had worsening weakness and has become wheelchair-bound. Nonetheless, she frequently attempts to walk and loses her balance, leading her to falling. She is brought in today due to another fall along with worsening confusion over the [+]
SAEM Clinical Images Series: Bilateral Leg Swelling with a Uterine Twist
The patient is a 40-year-old female who presents to the Emergency Department with bilateral leg swelling. Her symptoms started six days prior and have progressively worsened. Her symptoms are associated with shortness of breath with no chest pain. The patient has taken an over-the-counter diuretic, which has helped with her symptoms. She also reports intermittent vaginal bleeding for the past two months, with a LMP that was two months prior. She is not currently on contraceptives, and does endorse unprotected intercourse over this time. The patient denies headache, blurry vision, nausea [+]
SAEM Clinical Images Series: A Curious Case of Abdominal Pain
The patient is a 22-year-old G0P0 female who presents to the Emergency Department with two days of left lower quadrant abdominal pain. The patient rates her pain as 10/10 in intensity, sharp in character, and states the pain radiates to her lower back. She notes similar intermittent pain over the past few months, but the pain became persistent over the past two days and has worsened. She also reports decreased appetite with nausea and vomiting. Her pain is exacerbated by movement. She began her menstrual period three [+]
SAEM Clinical Images Series: Quirky Quincke’s
The patient is a 38-year-old male with no past medical history who presents to the Emergency Department with chief complaint of “swollen uvula” that started 4 hours ago. The patient reports that he woke up this morning with pain in his throat and associated shortness of breath secondary to swelling. States he looked in his mouth in the mirror and saw that his uvula was swollen, prompting his visit to the ED. He states that he took Benadryl and Tylenol at onset of symptoms with no relief. The patient denies fever, [+]
EM Match Advice 50: Making Your Rank List | Program Directors Share Their Best Advice
With interview season behind you, it's time for one of the most important decisions of your medical career: creating your rank list. In this episode of ALiEM Match Advice, host Dr. Sara Krzyzaniak (Stanford EM Program Director) sits down with Dr. Elaine Rabin (Mount Sinai Hospital, Elmhurst Program) and Dr. Miriam Kulkarni (St. John's Riverside Hospital) to discuss what really matters when ranking programs—and what doesn't. Key Dates to Remember February 2, 2026: Rank list entry opens on NRMP March 4, 2026: Rank list certification deadline (same for programs and applicants) March 16, 2026: Match status notification March 20, [+]
Education Theory Made Practical: All 8 Volumes Free
After eight years, 240 faculty members, and countless Slack conversations across time zones, the ALiEM Faculty Incubator has come to a close. And with it, we're celebrating the completion of something I'm incredibly proud to share: the Education Theory Made Practical book series—8 volumes, 77 educational theories and frameworks, now freely available to educators worldwide [download at ALiEM Library]. We became victims of our own success. The mentors and community members we nurtured? They're now department chairs, deans, and program directors. The people we brought into our sandbox are now making the big decisions and shaping the future of [+]
SAEM Clinical Images Series: Pain, Paralysis, and Rash
The patient is an 81-year-old female with a history of asthma and hypertension who presents to the Emergency Department with right-sided abdominal swelling for five days. Five days ago, the right side of her abdomen appeared to protrude more than the left. This protrusion then increased over the next 2-3 days. The patient was diagnosed with shingles to the right lower abdomen earlier that month, but her rash has now nearly resolved. She continues to have “electric” pain in the region of the prior shingles infection. She denies any fevers, abdominal [+]
ACMT Toxicology Visual Pearl – Hidden Danger
This abdominal radiograph indicates what type of activity? Body packing Body pushing Body stuffing Parachuting [Image from Wikimedia Commons] [+]
Mary E. Heslin, MD
Atrium Health Carolinas Medical Center