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Geographic Tongue

A 45-year-old female patient presented to our clinic with a painless, erythematous lesion on her tongue. Medical history was negative, with absence of any allergies or habits. The patient recalled that she had a similar lesion on her tongue 6 months earlier, which resolved spontaneously. Clinical examination of the dorsal surface of the tongue revealed […]

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Diagnosing Bilateral Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is a clinical condition characterized by pain and numbness involving the feet, and it occasionally spares the heels. It is often caused by physical compression by ganglion or posttraumatic change in the tunnel.1, 2 Cases of idiopathic bilateral tarsal tunnel syndrome have been reported, but not as many as expected, thereby rendering the entity […]

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Not so Obvious: Acute Herpes Esophagitis

  The gross examination immediately suggested infection with Candida species, but biopsy results pointed to a different culprit. A 29-year-old woman sought care in the emergency department after experiencing sharp epigastric pain over 2 days. She was initially seen at an urgent care center and empirically treated for gastritis with omeprazole. However, her pain progressively worsened and […]

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More than a Mite Contagious: Crusted Scabies

Although an extensive skin infestation might be expected to cause serious discomfort, this is not always the case. A holiday visit sparked concern among family members when they saw that their relative, a 53-year-old woman who lived alone, was unable to perform routine daily activities. They brought her to the hospital to be evaluated for […]

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The Master Clinician’s Approach to Diagnostic Reasoning

“The value of experience is not seeing much, but in seeing wisely.” William Osler, MD “There are only three things that are important in medicine: diagnosis, diagnosis, diagnosis.” Charles Bryan, MD   Just as age, of itself, does not make a person wise, experience in medicine without clinical insight does not improve diagnostic skills. Clinical […]

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