Category Archives: Image Challenge

Image Challenge of the Week!

A 63-year old woman with no significant past medical history presents with 3-months of short-term memory difficulty, trouble concentrating, and emotional lability. She also has been noted by family to have intermittent bilateral jerking of her arms upon being startled. CMP, CBC, TSH, CRP, ESR, and B12 were all negative. RPR, ANA HIV, paraneoplastic antibody panel, urine drug screen, and serum HSV PCR were negative. Lumbar puncture was performed and lab results are pending. Brain MRI is shown below:

Cortical Ribboning.PNG
Intern Emerg Med. 2016 Mar;11(2):281-3.

What is the name of the above MRI finding and likely diagnosis? Scroll down for the answer.

Continue reading Image Challenge of the Week!

Image Challenge of the Week!

A 36-year old HIV-positive man with AIDS presents with multiple red nodules distributed throughout his trunk and back.

Bacillary Angiomatosis
Medicine (Baltimore). 2016 Jul; 95(28): e4155.

Biopsy demonstrated vascular proliferation withint the dermis and numerous bacilli with Warthin-Starry staining. HHV-8 staining was negative. What is the likely diagnosis? Scroll down for answer.

Continue reading Image Challenge of the Week!

Image Challenge of the Week!

You are rounding in the medical intensive care unit and begin to examine your patient who is intubated and sedated for refractory status epilepticus. The overnight nurse turns your attention to the patient’s Foley bag. Upon evaluation, you note the following:

propofol urine.PNG
J Clin Diagn Res. 2015 Nov; 9(11): OD03–OD04.

What is the likely cause of this finding? Scroll down for answer.

Continue reading Image Challenge of the Week!

Image Challenge of the Week!

A 21-year old white woman presents to your clinic complaining of oral lesions. She describes them as multifocal, irregular patches with slightly raised, white borders. The lesions are typically non-painful but cause her a great deal of anxiety and embarrassment. They have occasionally been associated with a burning sensation. The lesions change location (they have appeared in all locations including the dorsum and lateral borders of the tongue), pattern, and size on her tongue in periods of minutes to hours. There are periods of flares when these lesions occur with periods of remission that can last days to months. When the lesions recede, there is no scar formation.

geographic tongue
Arch Oral Biol. 2017 Jan;73:259-268.

What is the diagnosis? Scroll down for answer. Continue reading Image Challenge of the Week!

Image Challenge of the Week!

A patient with AIDS presents with acute dyspnea. An ultrasound probe is placed on his lateral chest wall producing the following image:

https://lifeinthefastlane.com/ultrasound

What is the name of the above finding and the associated diagnosis? What is likely the underlying cause of the above diagnosis?

Scroll down for the answer.

Continue reading Image Challenge of the Week!

Image Challenge of the Week!

A 22-year old man presented with progressive headache, painless unilateral vision loss, fever, and axillary lymphadenopathy. CT head and lumbar puncture were negative. RPR and Lyme titers were negative. Fundoscopic examination revealed the following:

stellate neuroretinitis
Curr Opin Ophthalmol. 1999 Jun;10(3):209-16.

What is this finding and the likely etiology in the context of the patient’s symptoms?

Scroll down for the answer.  Continue reading Image Challenge of the Week!