Tag Archives: Physical exam

An Uncommon Cause of Low Back Pain

A 21-year-old active duty Air Force male without past medical history presented to our Emergency Department with low back pain. The patient had been performing general resistance strength training, including specific exercises focusing on the low back region, for about 2 months. A few hours after a workout session, he developed acute pain to the […]

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Urschel’s Sign in Paget Schroetter Syndrome

A 32-year-old man, employed as a deckhand, was referred for right upper extremity swelling and pain of 3 months’ duration. Physical examination revealed swelling of the right upper extremity and prominent superficial veins over the right upper arm and shoulder (Urschel’s sign; Figure). Blood work including thrombophilia screen was unremarkable. Right upper extremity venous duplex ultrasonography […]

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Sometimes the Eyes Say More Than the Mouth

A 48-year-old man with a history of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS)-associated cryptococcal meningitis was referred to our hospital with blurred vision in his left eye for several months. He was diagnosed with bilateral chronic posterior uveitis (Figure). After ruling out secondary uveitis, such as sarcoidosis, Behçet disease, Vogt-Koyanagi-Harada disease, […]

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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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Steroid-Refractory Autoimmune Hemolytic Anemia with Massive Splenomegaly

To the Editor: A 63-year-old woman was admitted in January 2012 with a 1-month history of general fatigue and jaundice. Physical examination revealed a pale conjunctiva, icteric sclera, and splenomegaly with no evidence of systemic lymphadenopathy. Laboratory findings revealed normocytic anemia (49 g/L) with increased reticulocyte count, decreased haptoglobin level, normal white cell count without […]

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