Presentation Following minimal trauma or repetitive motion, a nonarticular synovial sac or bursa protecting a tendon or prominent bone becomes swollen and possibly painful, inflamed, and fluctuant. It may be nontender or tender. The elbow, hip, knee, and shoulder are…
Presentation The patient seeks help for painful swelling of the hand over the distal fifth metacarpal (MC) after punching an object or another person with a closed fist. It occurs commonly during fistfights or from punching a hard object, such…
Presentation After jamming the tip of a partially or fully extended finger (resulting in hyperflexion of the proximal interphalangeal [PIP] joint) or with direct trauma over the joint, the patient develops a painful, swollen PIP joint. These injuries are seen…
Presentation A toddler who is between 1 and 4 years of age presents with upper extremity pain and reluctance to use that extremity following a sudden jerk on the arm. Circumstances surrounding the injury may be obvious (such as a…
Presentation Most patients with ankle sprains describe an inversion injury; eversion injuries are less common. Inversion injuries constitute 85% of ankle sprains. Patients may report having stepped off a curb or into a hole. Sports-related injuries often occur after jumping…
Presentation After a direct blow to or a fall onto the lateral shoulder with the arm adducted, the patient complains of shoulder pain increased by motion of the arm ( Fig. 95.1A ). An indirect mechanism of injury commonly involves…
Presentation A patient presents for evaluation of vaginal discharge, possibly with itching and/or irritation of the labia and vagina. Odor, dysuria, vague low abdominal discomfort, or dyspareunia may be present. Abdominal examination is benign, but examination of the introitus may…
Presentation A worried menstruating female presents with greater-than-usual bleeding, which is either off of her usual schedule (metrorrhagia), lasts longer than a typical period, or is heavier than usual (menorrhagia), perhaps with crampy pains and passage of clots. Bleeding is…
Presentation A female patient presents for evaluation after sexual contact. There was no barrier to prevent sexually transmitted infections (STIs) or pregnancy, or the barrier method being used was suspected to have failed (e.g., a condom broke or contraceptive pills…
Presentation A sexually active female, possibly with a new sex partner or multiple sex partners, presents with lower abdominal pain beginning with or soon after her last menstrual period. There may be associated vaginal discharge, malodor, dysuria, dyspareunia, menorrhagia, or…