Tag Archives: Physical exam
The patient's daughter provided us with these cell phone pictures (we obtained her written permission for publication); this first figure shows initial white plaques suggesting possible thrush.

Giant Cell Arteritis Presenting with a Tongue Lesion

An 83-year-old woman presented to our hospital with a 2-month history of progressive weight loss, weakness, and recent odynophagia. Her daughter first noticed her tongue with white plaques about 2 weeks prior to our admission (Figure 1). She was admitted to another hospital, treated for thrush, and discharged. Her tongue surface then developed a whitish […]

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Swelling on the upper lip (black arrow).

Strawberry Marks on Lip

A 32-year-old male patient presented with enlargement of his upper lip since childhood, which was compromising his facial aesthetics, as well as causing inability to close the mouth completely. History revealed the presence of a red spot on his lower lip when he was 2 months old, and it had increased considerably ever since. The […]

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Midclavicular and transaxial measurements of the liver.

How Strongly Do Physical Examination Estimates and Ultrasonographic Measurements of Liver Size Correlate? A Prospective Study

Liver size assessed by physical examination and ultrasound has long been used to gain useful clinical information. The size measurements obtained by these modalities have been difficult to compare as they are measured in 2 different axes (transaxial vs midclavicular). Our objective was to identify a measurement correlation between ultrasound and physical examination liver size […]

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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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Still frame of long-axis parasternal view on 2-dimensional color flow transthoracic echocardiogram showing severe aortic regurgitation. as depicted by arrow. The thick arrow at the bottom depicts the point of recording of the diastolic frame. AO = ascending aorta; LA = left atrium; LV = left ventricle.

‘Landolfi’s Sign’—Eyes Don’t See What the Mind Does Not Know!

To the Editor: A 60-year-old woman was admitted with progressively worsening dyspnea on exertion associated with intermittent lightheadedness and palpitations. On physical examination, a 3/6 diastolic decrescendo murmur was audible along the left sternal border. The murmur was most prominently heard in the left third intercostal space at end expiration with the patient in the […]

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Teaching Diagnostic Reasoning in the Digital Age: The Role of the Mentor

Each case has its lesson—a lesson that may be, but is not always, learnt, for clinical wisdom is not the equivalent of experience. A man who has seen 500 cases of pneumonia may not have the understanding of the disease which comes with an intelligent study of a score of cases, so different are knowledge […]

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