A 55-year-old man who is a smoker and a heavy drinker presents with a new cough and flulike symptoms. Gram stain shows no organisms; silver stain of sputum shows gram-negative rods. What is the diagnosis?
A middle-aged man presents with acute-onset monoarticular joint pain and bilateral Bell's palsy. What is the likely diagnosis, and how did he get it? Treatment?
Lyme disease, Ixodes tick, doxycycline.
A patient develops endocarditis three weeks after receiving a prosthetic heart valve. What organism is suspected?
S. aureus or S. epidermidis.
Back pain that is exacerbated by standing and walking and relieved with sitting and hyperflexion of the hips.
Joints in the hand affected in rheumatoid arthritis.
MCP and PIP joints; DIP joints are spared.
Joint pain and stiffness that worsen over the course of the day and are relieved by rest.
Genetic disorder associated with multiple fractures and commonly mistaken for child abuse.
Hip and back pain along with stiffness that improves with activity over the course of the day and worsens at rest. Diagnostic test?
Suspect ankylosing spondylitis. Check HLA-B27.
Arthritis, conjunctivitis, and urethritis in young men. Associated organisms?
Reactive (Reiter's) arthritis. Associated with Campylobacter, Shigella, Salmonella, Chlamydia, and Ureaplasma.
A 55-year-old man has sudden, excruciating first MTP joint pain after a night of drinking red wine. Diagnosis, workup, and chronic treatment?
Gout. Needle-shaped, negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid.
Rhomboid-shaped, positively birefringent crystals on joint fluid aspirate.
An elderly woman presents with pain and stiffness of the shoulders and hips; she cannot lift her arms above her head. Labs show anemia and ↑ ESR.
An active 13-year-old boy has anterior knee pain. Diagnosis?
Bone is fractured in a fall on an outstretched hand.
Distal radius (Colles' fracture).
Complication of scaphoid fracture.
Signs suggesting radial nerve damage with humeral fracture.
Wrist drop, loss of thumb abduction.
A young child presents with proximal muscle weakness, waddling gait, and pronounced calf muscles.
Duchenne muscular dystrophy.
A first-born female who was born in breech position is found to have asymmetric skin folds on her newborn exam. Diagnosis? Treatment?
Developmental dysplasia of the hip. If severe, consider a Pavlik harness to maintain abduction.
An 11-year-old obese African-American boy presents with sudden onset of limp. Diagnosis? Workup?
Slipped capital femoral epiphysis. AP and frog-leg lateral view.
The most common 1° malignant tumor of bone.
Unilateral, severe periorbital headache with tearing and conjunctival erythema.