Case Presentation: A 23-year-old man presents with progressively debilitating headaches since a fall 1 year ago. Headaches were worsening, exacerbated by exercise and lying flat, and localized to the occipital region. He had been taking finasteride and topical minoxidil for 3 years to treat chronic alopecia. After 3-6 months of use, two cystic, nontender, mobile [...]

Case Presentation: A 23-year-old male with no past medical history presented with neck pain and bilateral arm paresthesia of four-week duration. The patient was prescribed ibuprofen, and an MRI cervical spine was ordered. The MRI showed multilevel degenerative disc disease, and the patient was referred to physical medicine and rehabilitation. In the weeks prior to [...]

Case Presentation: A 37-year-old previously healthy woman developed nausea, non-bloody vomiting and abdominal cramping a few hours after eating a beef chili followed by two episodes of self-limiting “chocolate” colored diarrhea. She presented three days later with persistent nausea, increasing fatigue and lethargy. Vital signs included a heart rate of 99/minute, blood pressure of 117/74 [...]

Case Presentation: A 34 year old female presented to the emergency department with several days of rapidly progressive skin and tongue lesions. Over the preceding months, she was evaluated by outpatient otolaryngology for recurrent otalgia and sinusitis, receiving antibiotics and prednisone without improvement. She underwent electromyography with neurology and was diagnosed with peripheral neuropathy of [...]

Case Presentation: The case represents a 74-year-old female who presented to the emergency room with constitution of symptoms including headache, fatigue, Upper extremity/Neck pain and worsening of “skin rash”. For the past 10 years, the patient had suffered from Compulsive Skin picking disorder, necessitating multiple visits to PCP and Dermatologist with recurrent courses of antibiotics [...]

Case Presentation: A 48-year-old male with a past medical history of deep vein thrombosis (DVT) and pulmonary embolism (PE) presented with one day of severe chest pain, dizziness, and brief loss of consciousness resulting in a head injury. EKG showed T wave inversions in inferior leads and elevated troponin to 625 within a few hours. [...]

Case Presentation: A 66 yo man with a past medical history of CAD, b/l knee osteoarthritis, CKD, CVA, T2DM, HTN, and HLD presented to the ED complaining of back pain and left knee pain. In the ED, patient was responsive and fully alert. Labs were significant for hyperkalemia of 6.0, anemia of 9.1. He was [...]

Case Presentation: A 33-year-old male with alcohol use disorder presented with progressive bilateral proximal arm weakness and muscle twitching for months. MRI of his brain and cervical spine were unremarkable. Electromyography (EMG) demonstrated mild diffuse fasciculations and changes consistent with denervation, which were attributed to alcohol-related polyneuropathy. The patient planned to abstain from alcohol and [...]

Case Presentation: Vertebral arterial dissections (VAD) while commonly associated with strokes in younger patients (below age of 45) can occur at any age. They are typically seen in patients with head or neck trauma having underlying vascular risk factors including hypertension, hyperlipidemia, tobacco use, and connective tissue disorders. Growing interest in physical fitness has resulted [...]

Case Presentation: A 65-year-old male presented to his primary care clinic with a one-week history of right-sided facial pain radiating around his jaw with a negative dental workup. Patient had progressive neck pain and CT scan found an ill-defined soft tissue in the superior mediastinum encasing the proximal left common carotid artery, concerning for lymphoproliferative [...]