Browse Clinical Cases

A 3-year-old boy presented with abdominal pain and vomiting. He had associated chills without fever, nonbloody and nonbilious emesis, constipation, reduced urinary output, and a decreased activity level.

A 75-year-old man with chronic obstructive pulmonary disease underwent lung-volume–reduction surgery. Postoperatively, severe subcutaneous emphysema developed.

A 32-year-old man with daily nitrous oxide inhalant use presented with an inability to walk. MRI of the whole spine revealed hyperintensities in the posterior spinal cord on T2-weighted images.

A 13-year-old girl with blurry vision, painful eye movements, and weakness and paresthesias in her left leg was found to have a relative afferent pupillary defect in her left eye (shown in a video).

A 61-year-old woman with primary biliary cholangitis and Raynaud’s phenomenon was referred to the rheumatology clinic. Tongue telangiectasias, puffy fingers, and nailfold capillary hemorrhage were present.

A 48-year-old woman was evaluated for abdominal pain. CT showed numerous liver lesions and lung cysts and nodules; liver biopsy revealed an eosinophilic inflammatory infiltrate. A diagnosis was made.

An 86-year-old woman presented with acute pain on the right side of her abdomen. Computed tomography revealed a distended gallbladder outside the gallbladder fossa and swirling of the cystic artery and duct.

A 25-year-old woman was evaluated for worsening headaches, photophobia, nausea, vomiting, and blurred vision. MRI revealed hydrocephalus and leptomeningeal enhancement. CSF analysis revealed neutrophilic pleocytosis.

A 74-year-old woman with psoriatic arthritis presented with swelling of the fifth finger. On examination, there were nontender, subcutaneous nodules in the hypothenar region and over the fifth finger.

A 51-year-old man with chronic myeloid leukemia who was receiving treatment with nilotinib presented for follow-up with a report that his hair had turned from gray to its original brown color.

A 71-year-old man with a history of iritis presented with nodules on the nose. Computed tomography of the chest revealed hilar and mediastinal lymphadenopathy and parenchymal fibrosis.

This interactive feature describes a 50-year-old woman who presents to the ED with progressive neurologic symptoms and is admitted to the neurology service. Test your diagnostic and therapeutic skills at NEJM.org.

A 68-year-old woman living in Japan presented with a 5-day history of rash and fevers. She had been bitten by a tick 1 week earlier. Examination revealed a petechial rash and eschar on the ankle.

A 47-year-old woman presented with shortness of breath. Chest CT showed a filling defect in the left atrium, and a mobile left atrial mass was seen on transthoracic echocardiography (shown in a video).

A 63-year-old woman presented with dyspnea and cough. She had been in her usual state of health until 2 days earlier, when myalgias and dyspnea with ambulation developed, followed by a cough productive of green sputum.

A 49-year-old man with a family history of diabetes was evaluated because of hypoglycemia. Two hours earlier, he had been found on the floor, obtunded and making nonpurposeful movements. A diagnostic test was performed.

A 59-year-old woman with a history of smoking tobacco presented with a 5-month history of darkening of the skin on her palms. Velvety thickening on the palms and fingers was observed on physical examination.

A 23-year-old man presented with double vision and eyelid drooping on the right side that worsened at the end of the day. The neurologic examination showed ptosis on the right side and “curtain sign” (as seen in a video).

A 26-year-old woman presented with sore throat, pain while swallowing, shortness of breath, and fever. Marked swelling of the posterior oropharynx was observed on physical examination, and CT of the neck was performed.