Tag Archives: diagnostic testing
(A) Focused radial endoscopic ultrasound (EUS) at the level of the papilla, illustrating a formal double duct sign with the pancreatic duct (PD) measuring 5 mm and the common bile duct (CBD) measuring 10 mm with stone material in the distal (arrow) and papillary CBD segments (asterisk). (B) Duodenoscopic visualization of the papilla during endoscopic retrograde cholangiography (ERC) confirming papillary stone impaction underlying acute biliary pancreatitis.

“Endoscopic Ultrasound First Policy” in Acute Pancreatitis of Presumed Biliary Origin

A 61-year-old patient without significant alcohol history presented with epigastric pain of 2 days’ duration, most recently aggravating and radiating into the back. Laboratory analysis indicated acute pancreatitis (ie, serum lipase 1839 U/L; procalcitonin 11.1 ng/mL) as well as moderately elevated liver function tests (ie, bilirubin 1.6 mg/dL). Abdominal ultrasound demonstrated gallbladder stones with normal […]

Read more
Contrast-enhanced abdominal computed tomography scan. (A) Diffuse bowel wall thickening of 13 mm showing the “target sign” (arrows). (B) Engorgement of mesenteric vessels or ‘‘comb sign’’ (arrow head) and bladder wall thickening (asterisk).

Recurrent Abdominal Pain in Systemic Lupus Erythematosus: Concurrent Lupus Enteritis and Lupus Cystitis

A 44-year-old woman was admitted to the hospital in March 2017 with a 5-day history of abdominal pain, vomiting, diarrhea, dysuria, and urinary frequency. She was afebrile, normotensive, and in sinus tachycardia. Her abdomen was distended and diffusely tender. Bowel sounds were hyperactive. No abdominal guarding or rebound pain in response to deep palpation was […]

Read more
Chest radiograph demonstrating 2 bilateral cavitating pulmonary infiltrates (A) and chest radiograph 9 months later demonstrating complete resolution of the infiltrates after immunosuppressive therapy (B).

Granulomatosis with Polyangiitis Presenting as Hypophysitis

A 20-year-old healthy woman presented to a local hospital with 3 months of headaches and fatigue and 3 weeks of intermittent fevers to 40°C. Physical examination was normal. White blood cell count was 6.1 × 109/L, hemoglobin 10 g/dL, sodium 153 mmol/L, and creatinine 0.80 mg/dL. Magnetic resonance imaging demonstrated a 2.1 × 1.8 × 0.9-cm cystic sellar lesion. Hormone testing […]

Read more
Doppler assessment by transesophageal echocardiogram of severe mitral stenosis.

Diagnostic and Management Dilemma: Massive Hemoptysis from Severe Mitral Stenosis

Severe hemoptysis in a critically ill patient must prompt rapid development of a broad differential. We present an unusual case that presented a diagnostic and management dilemma. A 55-year-old man presented to the Emergency Department with dyspnea and hemoptysis. He was hemodynamically unstable, requiring intubation and pressor support. Assessment On examination, he was afebrile and […]

Read more
PET/CT images showing increased 18F-fluorodeoxyglucose uptake that was consistent with a diagnosis of polymyalgia rheumatica. (A) Shoulders (blue arrows) and peritrochanteric bursae at hip joints (green arrows). (B) Greater trochanter (red arrows) and ischial tuberosities (yellow arrows).

Polymyalgia Rheumatica with Normal Inflammatory Markers

A 70-year-old man presented with pain in his shoulders, low back, and thighs for 1 year. He had difficulties when changing clothes, taking a bath, and getting out of bed because all these body movements aggravated the pain. He also experienced morning stiffness for 1 hour. Although his weight decreased by 5 kg because of loss […]

Read more
Selected cuts from magnetic resonance imaging of the spine.

Atypical Cause of Functional Decline in Parkinson’s Disease

A 74-year-old Chinese man with past medical history of Parkinson’s disease presented with rapid functional decline over 2 months. From being able to ambulate independently, he had become bedridden and was dependent in activities of daily living. On admission, he was also noted to be coughing on eating and had visual hallucinations for 2 weeks […]

Read more
UA-42320404-1