Clinical Reasoning: Leg weakness and stiffness at the emergency room

Leg weakness and decreased vision.

Progressive leg pain and weakness.

A 54-year-old man presented with progressive asymmetric leg pain and weakness. He had a history of invasive squamous cell carcinoma that was fully treated 2 years earlier. His leg symptoms progressed relentlessly during several months. Imaging studies demonstrated enhancement of the cauda equina and leptomeninges of the lower spinal cord. Initial cerebrospinal fluid examination showed an elevat...

Leg stiffness adjustment during hopping at different intensities and frequencies.

Understanding leg and joint stiffness adjustment during maximum hopping may provide important information for developing more effective training methods. It has been reported that ankle stiffness has major influence on stable spring-mass dynamics during submaximal hopping, and that knee stiffness is a major determinant for hopping performance during maximal hopping task. Furthermore, there are ...

Clinical reasoning: an unusual lung mass causing focal weakness.

Yasir El-Sherif, MD, PhD Harini Sarva, MD Helen Valsamis, MD SECTION 1 A 30-year-old right-handed man presented to the emergency room with right forearm numbness and elbow pain for 7 months. For the past 4 weeks he could not write or hold anything with his right hand. His primary care physician referred him to the hospital for further workup after noticing thenar atrophy in that hand. He also d...

Clinical Reasoning: A 48-year-old woman with generalized weakness.

Chafic Karam, MD Stephen N. Scelsa, MD SECTION 1 A 48-year-old woman was referred to the neuromuscular clinic because of progressive generalized weakness for 4 months. Her symptoms started after she had a thyroidectomy and radioactive iodine treatment for a thyroid papillary carcinoma. She had proximal arm weakness when washing her hair and had trouble climbing steps and getting out of her chai...