Anyone seen this high of RF, antiCCP? pt with intermittent | Figure 1

Anyone seen this high of RF, antiCCP? pt with intermittent bilat foot pain. Specifically 3rd 4th MTP regions. Slight erythema and edema. Non-tender. Denies other joint complaints. No PMH. Seen podiatry multiple times without diagnosis. Came to PCP (me) for further opinion. Pt sent to rheumatology.

Similar cases

Pt is a 48F who presents due to spontaneous pneumothorax. Tx was chest tube insertion followed by blebectomy and partial pleurectomy. However, the most interesting thing about this case is the presence of an Azygous lobe of the lung. This anatomical variant occurs when the posterior cardinal vein (developmental precursor to the AV) fails to migrate superiorally during development, creating a pleural septum, and a separate lobe. The vein can be seen inferiomedial to a bleb in the right lung on image number 1. The septum can be seen extending superiorly over the vein toward the lung apex.

75F brought by EMS to ED presented with severe AMS (mostly unresponsive), bradycardia, temp: 89.1F, otherwise normal VS. Family reported: mental changes over the past week and pt said her shoes weren't fitting on her feet. Repeat ABG indicates BiPAP did not improve patient's condition. Family later reported that pt told sister she did not need to take her thyroid medicine. Thyroid tests lead to the ED MD's dx of Myxedema-coma with no IV T3 in the area, due to the severity of her condition, family asked for comfort care.

pt 56 yom, former "sun lover" as he put it. Developed over last yr (since last dr appt), we have a debate among the med students, should we biopsy or not?

pediculated lesion on torso, second largest I've seen.

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?