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Picture Quiz

Picture Quiz

While peripheral lesions account for a significant proportion of cases presenting with isolated motor hand weakness (Box 1), this case illustrates the importance of recognizing infarction of the hand

A 76 year-old right-handed man presented acutely with a sudden onset of weakness affecting his right hand only. This happened while working in the garden.

On detailed history taking, he denied any previous

Case Outcome

The patient was initially commenced on intravenous antibiotics, aspirin, clopidogrel and low molecular weight heparin (LMWH) for a putative diagnosis of community acquired pneumonia complicated

58 year old policeman presented with a 4 week history of cough, haemoptysis, exertional dyspnoea, ear discomfort and sore throat. He was previously healthy and taking no regular medications. He was

Outcome

His syphilis serology was positive
– Initial IgG ELISA test positive
– TPHA positive
– IgM positive and RPR (128) positive confirm recent infection

All other screening tests (including viral

Case History

A 19 year old male with no previous medical history presented to hospital with an eight day history of jaundice and general malaise. He was homosexual with a history of unprotected sex

A fifty-one-year-old man with history of treated hypertension and seronegative rheumatoid arthritis presented to hospital with a three day history of a rash affecting the whole body and general malaise.

An 86 year old woman with a background of hypertension and arthritis presented to our medical assessment unit with 3 weeks history of mild dyspnoea and central chest discomfort. She did not have any

Answer The MRI scan reveals a shallow anterior epidural abscess at C5 / C6 level without cord compression. The recent history of diarrhea is suggestive of salmonella enteritidis.