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A Case of Addison’s Disease Nearly Mistaken for Anorexia Nervosa

A 22-year-old woman presented to her primary care physician because of an unintentional weight loss of 30 pounds (Figure A) associated with nausea, vomiting, anorexia, and generalized abdominal pain. She also described symptoms of anxiety and low mood that coincided with the breakdown of a relationship. Although she did not report body image distortion or fear […]

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doctor in uniform using futuristic looking digital screens and keyboard

Sherlock Holmes and the Case of the Vanishing Examination

We live in a world steeped in technology where we all spend increasing amounts of time on our cell phones and computers and less time observing the world around us. These changes have also affected how we practice medicine. Many physicians today spend more time reviewing imaging studies and laboratory tests and less time taking […]

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Adult-Onset Still’s Disease: A Classic Presentation of a Rare Illness

Adult-onset Still’s disease is a rare inflammatory disorder of unclear etiology. Here, we highlight a classic presentation of this disorder. Case Description A 30-year-old woman presented with a 1-month history of daily fevers, myalgias, 7.5-kg unintentional weight loss, and a 2-week history of diffuse skin rash. Her medical history was notable for Hashimoto’s thyroiditis, and […]

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Magnetic resonance imaging brain scan with contrast. (A) Axial view showing (arrow) transverse and sigmoid sinus venous thrombosis. (B) Axial view showing (arrow) left ophthalmic vein thrombosis. (C) Sagittal view showing (arrow) left ophthalmic vein thrombosis. (D) Axial view showing (arrow) focal perichiasmatic enhancement of the left optic nerve.

Lesson Learned Through a Case of Pneumococcal Meningitis: Sometimes Doing Less Is More Harmful

Pneumococcal meningitis is commonly associated with intracranial complications. We present a case of pneumococcal meningitis leading to partial loss of vision in the left eye secondary to vascular complications. A 62-year-old African American female with a past medical history of breast cancer and hypothyroidism presented with complaints of altered mental status, neck pain, headache, and […]

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Photograph of the patient's face shows bilateral periorbital ecchymosis (raccoon eye appearance).

Raccoon Eye Appearance: Amyloidosis

To the Editor: An 82-year-old woman presented to our outpatient clinic with a 6-month history of recurrent internal bleeding near the eyes. The patient had a history of type 2 diabetes mellitus, but had no significant medical history including traumatic injuries. Physical examination revealed bilateral periorbital ecchymosis and large tongue (Figure). Serum protein electrophoresis revealed […]

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(A) Ultrasound imaging of the patient's right shoulder, shown here in this panoramic view, revealed multiple, round, mass-type lesions with homogenous echoes (arrows) and irregularly scattered hyperechoic plaques with acoustic shadows. (B) Ultrasound-guided aspiration was performed using the direct in-plane technique. The arrowheads indicate the needle.

Big Gain, No Pain: Tumoral Calcinosis

A patient’s odd physical presentation was the result of what could be termed a mineral deposit. The 40-year-old man reported that his right shoulder had been swelling progressively for more than 6 months. His medical history was significant for chronic kidney failure, and he had been undergoing hemodialysis for the previous 10 years. He had […]

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