Photo Quiz

A 49-year-old African American man was referred to rheumatology with a positive antinuclear antibodies (ANA) test result, constitutional symptoms, and lymphadenopathy.

A 46-year-old African American woman was admitted with a 3-month history of extensive macular, nonpruritic, erythematous rash on her upper chest wall.

A 17-year-old boy presented with a 3-day history of left upper quadrant abdominal pain; intermittent pain radiated to the right side. The patient complained of nonbilious vomiting and nausea and reported subjective fever. He also had a decreased appetite and up to 10 daily bouts of nonmucoid diarrhea.

A 10-year-old boy injured his left elbow during football practice. He subsequently had pain with normal range of motion of the elbow. He had minimal tenderness over his olecranon but no joint swelling, bruising, or palpable mass.

A slip on the grass sidelined a young football player 6 weeks after he sustained a complete tear of his medial collateral ligament. Learn how he added insult to the injury.

The woman who stands on this foot has bilateral hallux valgus deformities, but there are other problems with her feet which are causing pain.

A 45-year-old Hispanic male physician, a nonsmoker, presented with crippling, nonerosive, seropositive, symmetrical polyarticular arthritis that involved his wrists, hands, elbows, knees, and feet.

A 23-year-old woman who reported experiencing direct trauma to her right knee on a hard surface 3 months earlier was admitted to the arthroscopy unit with complaints of decreased range of motion (flexion, 90°; extension, 75°) and intractable pain.

A 52-year-old man with long-standing seropositive, erosive rheumatoid arthritis (RA) presented to our clinic with a mass on his left elbow (left). He had noticed it 2 years earlier—the mass had been painless, but it had gradually increased in size.

For 2 months, a 29-year-old man had pain and circular, soft swelling (7 x 7 cm in diameter) over the anterior left knee, superficial to the patellar ligament.

A 31-year-old Asian man presented for evaluation of left foot pain that began on the day before his clinic visit while he was practicing parkour (the physical discipline of training to overcome obstacles within one’s path by using only the human body and objects in the environment).

A 60-year-old woman with a history of osteoarthritis (OA) that involved both knees and the lumbosacral spine presented with worsening middle and upper back pain. She had no sensory complaints, but a history of obesity, depression, type 2 diabetes, hypertension, and dyslipidemia.

A 50 year-old physician experienced the abrupt onset of tenderness and swelling in the distal interphalangeal (DIP) joint of his right index finger, and later inhis left index finger and fifth digits of both hands. The symptoms made it difficult for him to type on the computer.

A 51-year-old woman presented to the clinic complaining of left heel pain. On physical exam there was tenderness and soft tissue swelling of the posterior aspect of the left heel.

A 25-year-old man was seen in the orthopedic clinic with a complaint of severe, exquisite pain at the ulnar aspect of the distal phalanx of his dominant right index finger. The pain had been present for 10 years, but he had not sought treatment.