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A Diagnosis at Hand: Pulmonary Arterial Hypertension

A classic physical examination finding pointed to underlying disease in a 43-year-old Hispanic woman. On presenting to the Emergency Department, she reported progressive shortness of breath, fatigue, and chest pressure. One month earlier, she could exercise without limitation. However, in the ensuing interval, she developed increasing dyspnea and constant, nonexertional, left-sided chest pressure. A review […]

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Systemic Inflammation Gone Awry: PASH Syndrome and Temporomandibular Joint Ankylosis

The development of new symptoms in a patient with hidradenitis suppurativa led to the recognition of a systemic autoinflammatory condition. A long battle with hidradenitis suppurativa and acne became even more difficult for a 24-year-old man who developed increasing pain and malodorous drainage from the chronic subcutaneous nodules on his axillae, groin, and buttocks, as […]

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Back Pain After Sudden Onset of Abdominal Pain in Crohn’s Disease Patient

In November 2014, a 33-year-old man presented to the Chiba University Hospital with a sudden onset of right lower abdominal pain spreading to the right lower back, developing 10 hours after gross bleeding. He had been receiving anti-tumor necrosis factor therapy for 10 years for mild to moderate Crohn’s disease with no fever. On examination, […]

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Misdirected by a Mass: Syphilis

The presence of an intraabdominal mass suggested malignancy rather than an increasingly common sexually transmitted infection. A 20-year-old man presented with fever and severe epigastric pain. Three weeks earlier, he sought treatment for a sore throat at an urgent care center. At that time, rapid strep testing was negative, and his symptoms subsequently resolved. One […]

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Crowd-Sourcing Syncope Diagnosis: Mobile Smartphone ECG Apps

A 76-year-old gentleman with a history of hypertension, on low-dose lisinopril, had a witnessed syncopal episode. He fainted from a standing position with no prodrome. He was unresponsive for 15 seconds without epileptiform activity or loss of sphincter control. He quickly regained consciousness with mild disorientation, without additional symptoms or focal deficits. A cardiologist at […]

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