Tag Archives: pain
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 […]

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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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Axial computed tomography of the abdomen/pelvis following intravenous contrast showing no evidence of paraspinal muscle pathology but an incidental finding of left greater than right quadratus lumborum muscle asymmetry.

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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Prominent superficial veins over the right upper arm and shoulder, reflective of Urschel's sign.

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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A computed tomography scan with contrast revealed no pulmonary emboli, multiple small pulmonary nodules, a hyperinflated right lung crossing the midline, and patchy opacity of the left lower lung, consistent with atelectasis. A = anterior; P = posterior.

Dueling Lungs: The Progression of Swyer-James Syndrome

Severe pulmonary hypertension led us to recommend surgery in the face of progressive Swyer-James syndrome. Presentation A 50-year-old African American woman presented to the Emergency Department with worsening pain over her left flank, chest, and back. The pain had been getting worse, especially in the morning, over the previous couple days and was described as […]

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(A) This is what the patient's foot looked like during the index admission. The thickened skin denotes retention hyperkeratosis, which is a result of lymphedema. (B) Roughly 2 months after initiation of therapy with Unna boot compression, the patient reported marked improvement in pain and swelling. Hyperkeratosis remained.

Sole-Searing Pain: Classic Kaposi’s Sarcoma

To read this article in its entirety please visit our website. – This article originally appeared in the November 2017 issue of The American Journal of Medicine.

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