Monday, September 28, 2015

Hang Ten

A young otherwise-healthy man is learning to surf for the first time. After his first lesson, he begins to develop progressively worsening low back pain, followed by lower extremity paresthesias. On arrival to urgent care, he has normal vital signs, normal cardiopulmonary exam, no spinal deformity, and a neurologic exam significant for decreased sensation and strength in the lower extremities. Two hours later, he lost complete sensation and motor function of his legs as well as rectal tone. Labs and CSF are unremarkable. Lumbar spine films are unremarkable. CT of the lumbar spine showed no evidence of spondylolysis, spondylisthesis, fracture, or soft tissue abnormalities. Brain MRI is normal. A non-contrast spine MRI (T1w sagittal image) four weeks later shows this:

Challenge: What happened?

Monday, September 21, 2015

Axis of Awesome

Challenge: What does the echo show?

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Thursday, September 17, 2015


Challenge: What's being shown here?

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Monday, September 14, 2015

Everything but the Kitchen Sink

This is a poor child in a developing country. He gets recurrent infections because of a depressed immune system. He has impaired taste and smell as well as diarrhea. He has a bullous pustular rash. If untreated, he may develop night blindness, alopecia, and decreased spermatogenesis. The treatment, though, is fairly easy.

Challenge: What's he missing?

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Monday, September 7, 2015

Taking a Break

Hi everyone,

Thanks for following along Case of the Day. I'm going to take a break this week. I have my oral board exams coming up in a month so things are looking quite busy; I'll probably take a breather then as well. I feel a little like a hamster running on a wheel, always playing catch-up so hopefully this will give me a chance to get on top of things.


Thursday, September 3, 2015


This rash begins in the second or third trimester. The erythematous excoriated nodules or papules are seen on the extensor surfaces of limbs and the trunk. It should resolve in the immediate postpartum period. Labs are unrevealing.

Challenge: What is one of the many names for this disease?

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