Presentation A patient with an isolated rib fracture or a minor costochondral separation usually has recently fallen, injuring the side of the chest; been struck by a blunt object; coughed violently; or leaned over a rigid edge. The initial chest…
Presentation The patient may have been sprayed with tear gas (e.g., Mace) during a riot being dispersed by the police or may have accidentally sprayed oneself. The patient might complain of burning of the eyes, nose, mouth, and skin, as…
Presentation The patient was trapped in an enclosed space with toxic gases or fumes (e.g., produced by a fire, a leak, evaporation of a solvent, a chemical reaction, or fermentation of silage) and comes to the emergency department or acute…
Presentation Patients, typically younger than age 40, present with a day or more of steady aching with intermittent stabbing chest pain. The pain may follow an episode of minor trauma, a period of frequent coughing, or unusual physical activity or…
Presentation The patient’s symptoms generally begin with 1 to 5 days of fever, malaise, and myalgias that are often indistinguishable from other acute upper respiratory tract infections (URIs). With acute bronchitis, the acute phase is followed by a second phase…
Presentation The patient presents with a foreign-body sensation or a fullness or lump in the throat, possibly associated with a slightly muffled voice and gagging. Often patients have seen their swollen uvula after looking in a mirror. On examination of…
Presentation Patients present with the inability to close the jaw, usually after yawning, laughing, taking a large bite of food, suffering a traumatic jaw injury, or having a dystonic drug reaction. Such patients have difficulty enunciating clearly. Although they usually…
Presentation Patients usually complain of poorly localized facial pain or headache that does not appear to conform to a strict anatomic distribution. The pain is generally dull and unilateral, centered in the temple above and behind the eye, and in…
Presentation Although most common in men of age 30 to 60 years, patients of any demographic may develop salivary duct stones. Most salivary stones occur in the Wharton duct from the submandibular gland. The patient typically presents after rapid swelling…
Presentation Patients present with inflammation and soreness of the skin and contiguous labial mucous membranes at the angles of the mouth ( Fig. 56.1 ). On examination, there is erythema, fissuring, and maceration of the oral commissures. In severe cases,…