Case Presentation: An 89-year-old man with coronary artery disease, hypertension, and osteoarthritis presented with acute-onset severe posterior neck pain, with no viral prodrome. The patient reported experiencing generalized weakness and associated headache, but denied any fevers, chills, cough, myalgia, joint pain, ulcers or rashes. Additionally, he did not report any photophobia, phonophobia, changes in vision, [...]

Background: The prevalence of gout has risen in recent decades despite advancements in therapeutic options due to several reasons, including lack of adherence to treatment guidelines by physicians and patients’ poor perception and adherence to therapy. We aim to assess the beliefs and knowledge of gout management in Internal Medicine residents, to investigate the gaps, [...]

Case Presentation: 42 year old male with history of alcoholism and chronic tophaceous gout on allopurinol, presented with acute left elbow pain and swelling. Exam showed synovitis of left wrist and elbow, distal interphalangeal joint (DIJ) and right knee and tophi  on left DIJ.  Arthrocentesis of left elbow revealed purulent fluid with leukocytosis (5000,000/mm3) and [...]

Case Presentation:   A 76-year-old female was admitted from an outside hospital for concern for osteomyelitis of her cervical spine.  She had previously had a week of neck pain with limited range of motion due to pain.  She was treated for E. coli sepsis following positive blood and urine cultures, but her neck pain persisted.  Upon transfer, [...]

Case Presentation: A 60-year old gentleman with past medical history of liver transplant 5 years ago presented to the hospital with acute onset of right-sided knee pain. For his immunosuppressive regimen, he took 2 mg/day of tacrolimus. However, the patient reported noncompliance with his outpatient follow-up. His social history was negative for excessive alcohol use [...]

Case Presentation: 60-year-old African American male with history of polyarticular tophaceous gout, chronic back pain related to DDD, HTN, CKD stage III, HIV on HAART, COPD presented with worsening back pain of 1-week duration associated with progressive lower extremity weakness and inability to walk. Low back pain was noted as sharp, stabbing in nature radiating [...]

Case Presentation: A 65-year-old man with a past medical history of gout and chronic pancreatitis complicated by pseudocyst presented with bilateral lower leg swelling, erythema, and pain for few weeks. The rash was also associated with bilateral lower extremity nodules that would spontaneously open and discharge white material. He was seen and treated in the [...]

Case Presentation: A 51 year old male with history of obesity, spinal stenosis, and gout presented with 1 week of worsening low back pain with bilateral radiculopathy. He had no bladder or bowel incontinence, or other neurologic compromise. He was afebrile, with normal vital signs. Lab data was significant for WBC 25 x 10^9/L, hemoglobin [...]

Case Presentation: A 73 year-old woman with a history of recurrent pancreatitis, severe osteoarthritis presented to the ED with acute pancreatitis. On hospital day 3 she noted right shoulder pain, similar to her chronic arthritis but worse in intensity. Her examination did not reveal any abnormalities; she had severely limited ROM of motion due to [...]

Case Presentation: A 95-year-old man with hypertension, benign prostatic hyperplasia, irritable bowel syndrome, and a recent herpes zoster ophthalmicus infection presented to the emergency department (ED) with fevers. The patient had been well until 3 days prior, when he developed a temperature of 103°F followed by severe pain in the neck radiating to both shoulders. [...]