81-Year-Old Woman With Left Hip Pain

A 48-year-old Somali woman with hip pain.

Figure 1. Noncontrast computed tomography scan of the pelvis. The arrow points to a lytic lesion in the posterior mid-right ilium characteristic of a space-occupying hydatid cyst. Diagnosis: hydatid cyst bone disease. Cysts removed from the iliac bone cavity (figures 1 and 2) were consistent with hydatid cysts due to Echinococcus species. Microscopic examination confirmed the diagnostic feature...

An 81 Year Old with Back Pain

You see an 81-year-old man in the emergency department. He has been troubled by abdominal and back pain that has been worsening over the last two days. He has smoked 20 cigarettes a day for the last 60 years. On examination his heart rate is 110 beats per minute and his blood pressure is 130/80 mmhg. He is tender over the central abdomen and you feel a pulsatile mass above the umbilicus. You re...

49-year-old woman with chest pain.

Clinical Reasoning: A 47-year-old woman with left shoulder pain after a fall.

SECTION 1 A 47-year-old right-handed woman fell to the ground while dancing. She hit her head and neck. However, she did not lose consciousness and continued to dance. Three days later, she developed severe sharp and burning left shoulder pain radiating into her left arm. The pain was associated with weakness and numbness. She also noticed right facial numbness. On review of systems, she had no...

A 54-year-old woman with degenerative back pain.

Back pain is a common symptom: up to 70% of UK adults experience this symptom by the age of 60 and most have moderate to severe pain. Back pain accounted for 12% of consultations to traditional acupuncturists in 2001 and is one of the most common reasons for consultation with an acupuncturist. This case report concerns a 54-year-old woman with metastatic breast cancer and degenerative lower bac...