Background: Chronic pain is a healthcare problem that significantly affects the physical and mental health of patients and impact their quality of life. It can complicate many disorders and represents a common symptom of rheumatologic diseases. Patients with Scleroderma report pulmonary and gastrointestinal symptoms as the limiting factor on their daily functioning, however pain remains [...]

Background: It is often challenging to assess pain in patients on chronic opioids either in acute care setting or in outpatient centers. Pain assessment in this group is more challenging especially if they are hospitalized with acute or acute on chronic pain. Opioid uses associated with increased pain perception and increased self-report of pain. Further, [...]

Case Presentation: Patient is a 53 year old African American male with past medical history of hypertension who presented with syncope. He had this episode a total of 3 times, most recently 1 month prior and initial episode 1 year prior. He had resolution of symptoms both times and diagnostic workup did not reveal any [...]

Case Presentation: A 70 year-old female with hypertension and diabetes presented to the hospital with a one-day history of non-positional, left-sided chest pain associated with shortness of breath and subjective fevers. Physical exam and vitals were unremarkable. Work up included three negative troponins, EKG in normal sinus rhythm (Figure 1), and D-Dimer of 1100 ng/mL. [...]

Case Presentation: A 40-year-old male presented to the emergency department with complaints of back pain for 3 weeks. He described the pain as aching and circumferential involving the sternum, right ribs, shoulders, and back. His previous medical history was unremarkable and he never had any prior imaging studies. Plain radiographs of the spine did not [...]

Case Presentation: A previously healthy 42 year-old man was admitted with acute abdominal pain. He described onset of periumbilical pain on the morning of admission, resolving after an episode of non-bloody, non-bilious emesis. Later that day, he developed a severe, sharp, constant and non-radiating left lower quadrant pain associated with emesis. He denied fevers, chills, [...]

Case Presentation: 62-year-old male presenting to the hospital for left sided abdominal pain. His past medical history is significant for chronic obstructive pulmonary disease (COPD) requiring six liters of oxygen via nasal cannula daily, hypertension and hyperlipidemia. He states that he had a cough attack and then proceeded to have sudden onset of severe left [...]

Case Presentation: A 55 year old male with metastatic lung cancer presented to the emergency department with right arm pain, weakness and right hand numbness. Patient had brain metastasis previously treated surgically and with radiotherapy. His last treatment with radiation was to the left cerebellum, 3 months prior. Patient was started on pembrolizumab and vorinostat [...]

Case Presentation: A 64-year-old woman with a history of heart failure (HF) and end stage renal disease on dialysis presented with three days of abdominal pain. She was lethargic, hypothermic to 34.5 C, with jugular venous pulsations (JVP) to the earlobe, a systolic murmur at the left sternal border, and right upper quadrant tenderness. Laboratory [...]

Case Presentation: A 56 year-old woman with past medical history of gastritis and past surgical history of appendectomy and C-section presented with a six-month history of intermittent abdominal discomfort, non-bloody diarrhea, nausea and bloating that was significantly worsening during the week prior to admission. In a span of six months, the patient was noted to [...]