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Four Cancers and a Rash: Henoch–Schönlein Purpura

A patient who had a history of 4 primary malignancies developed a rash that is usually seen among children. The 65-year-old man presented with a 2-day history of anasarca, painless skin lesions, and new arthralgias in both hands. He had a previous diagnosis of amyotrophic dermatomyositis, and although he had none of the typical skin […]

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Gynecomastia: Look Beyond the Obvious

A 29-year-old man was referred to our clinic with a 4-week history of a tender predominant left breast enlargement without nipple discharge. He had been practicing bodybuilding regularly for years, but denied taking anabolic androgenic steroids. His past medical history was unremarkable apart from surgical treatment of undescended testes in childhood. His sexual desire and […]

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Torus Mandibularis

A 34-year-old male patient presented with asymptomatic bony overgrowth in his mandibular arch. The overgrowth started 5 years back and gradually kept on increasing to its present size. On intraoral examination, the bony overgrowth was present bilaterally on the lingual surface of the mandible from canine to first molar region, measuring about 1.4 cm × 1 […]

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young female doctor examines x-ray

High-Value, Cost-Conscious Care: Iterative Systems-Based Interventions to Reduce Unnecessary Laboratory Testing

Inappropriate testing contributes to soaring healthcare costs within the United States, and teaching hospitals are vulnerable to providing care largely for academic development. Via its “Choosing Wisely” campaign, the American Board of Internal Medicine recommends avoiding repetitive testing for stable inpatients. We designed systems-based interventions to reduce laboratory orders for patients admitted to the wards […]

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Provoked Dizziness from Bow Hunter’s Syndrome

  A 62-year-old man was experiencing debilitating bouts of dizziness provoked by head rotation until ultimately finding relief with cervical spine fixation. He had a history of coronary artery disease, human immunodeficiency virus, tobacco use disorder, and generalized anxiety, and initially presented to a routine primary care visit with 3 weeks of episodic dizziness. During […]

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