A 45-year-old man with a history of hypertension and type 2 diabetes mellitus presented to the emergency department with acute onset of pain in his right calf while watching television. The patient also reported an episode of chest pain 4 days before admission. Physical examination was notable for a cold, pale, pulseless right leg. ECG showed sinus tachycardia at 117 beats/min, with anterior…

An 11-month-old boy presented with fever and rapidly spreading, itching skin rash for 2 days. On his arrival at our clinic, we found erythematous papules and blisters (5 to 10 mm) throughout his upper and lower extremities, with relative sparing of the trunk and face (Figures 1 and 2).

[Ann Emerg Med. 2009;54:e16-e17.]

A 46-year-old man presented to the emergency department with abdominal swelling for 2 weeks. He had a history of hepatitis C that he treated with milk thistle for 20 years. He denied significant alcohol intake. His vital signs were normal and his examination revealed a distended abdomen that was tympanic to percussion with mild tenderness. Paracentesis was performed and milky white fluid was…

A 37-year-old woman from Haiti presented to the emergency department after a syncopal episode. The patient experienced a stressful event, after which she developed palpitations and shortness of breath followed by loss of consciousness. On examination, a grade 2 of 6 diastolic murmur was auscultated. ECG showed normal sinus rhythm, and chest radiograph was interpreted as mild cardiomegaly….

A 10-year-old boy presented to the emergency department after “jamming” his right thumb while catching a football. He noted pain at the base of the nail. Examination revealed a bloody nail base, a torn cuticle with a 5-degree flexion deformity, and an enlarged lunula (Figure 1). Radiographs of the thumb were obtained (Figure 2).

An 84-year-old woman with osteoporosis treated with bisphosphonates for 6 years presented to the emergency department for evaluation of 1 week of nontraumatic right thigh pain when bearing weight. Her physical examination was notable for tenderness over the lateral proximal right thigh in the absence of skin changes, deformity, or impaired hip range of motion. Femur radiography revealed a lateral…

An 87-year-old man presented to the emergency department with shortness of breath without chest pain, palpitations, or diaphoresis. He had a history of atrial fibrillation with a previous left atrial thrombus. On examination, he was afebrile, with an irregular pulse rate of 86 beats/min and a blood pressure of 103/66 mm Hg. The jugular venous pressure was elevated and the jugular vein was…

A 55-year-old man presented to the emergency department (ED) with a 2-day history of severe, sharp pain on the right side of the throat. He also reported being unable to swallow because of the pain. He denied fever, chills, dyspnea, recent dental work, or oral trauma. Vital signs were unremarkable and he was not immunosuppressed. Physical examination revealed significant swelling and tenderness…