Extremities

Stanford Medicine 25 Blog

  • What Is The Specific Cause of This Patient’s Clubbing?

    The causes of clubbing are a favourite bedside question on rounds. They can be divided into: Pulmonary (commonest – think neoplasm until proven otherwise). Bronchial carcinoma Mesothelioma Bronchiectasis Cystic fibrosis Interstitial fibrosis...

  • What is Plummer-Vinson syndrome?

    A middle aged woman presents with difficulty swallowing. She has a history of menometrorrhagia for 10 years, secondary to uterine fibroids. She endorses fatigue and shortness of breath. What’s the cause of her dysphagia and why? Answer: Esophageal webs in the setting of iron deficiency anemia. This is seen in Plummer-Vinson syndrome. This syndrome usually has: dysphagia...

  • A patient asks you… what is this?

    The Stanford Medicine 25 website recently passed 500,000 total visits and 375,000 unique visits since our initial launch in February, 2012. We just wanted to thank everyone for all the support!…

  • This patient presents with chest pain. What’s the diagnosis?

    A majority of adults with Marfan’s syndrome have aortic dilation and if untreated can lead to aortic dissection.

  • Using Google Glass to Examine the Hand with Dr. Verghese

    Watch this video to get a first-person perspective of the Examination of the Hand with Abraham Verghese.

  • Terry's Nails - Nail Exam

    This finding is seen in people with low albumin such as in patients with liver failure and severe malnutrition. This finding is called Terry’s nails.

  • Remember this finding???

    Half and Half Nails are hallmarked by separate and almost even halfs with one half more pale than the other. This finding is usually seen in all (or almost all) nails when found. It is associated with chronic renal insufficiency.

  • Can you diagnose the cause of the patient’s lymphedema?

    Neurofibromatosis Type-1 (NF-1) can have a number of clinical exam findings. A hallmark of NF-1 are the tumors that can be anywhere (most commonly cutaneous). However, if deeper, they can lead to lymphatic obstruction as seen in our patient.

  • Stanford 25: Approach to Tremor

    In this video, we aim to provide you an overview of the approach your patient with tremor.

  • A patient presents with foot pain and these chronic findings?

    This is a patient with chronic tophaceous gout likely presenting with an acute gout attack of the foot. The enlarged and often inflamed fingers (dactylitis) can be mistaken for psoriatic arthritis and ankylosing spondylitis.

  • Tripe Palms

    A patient’s hands may reveal much about them. Fingers, nails and palms can all tell their own stories of habits, occupations or disease.

  • What’s the Cause of These Nail Findings?

    This patient has Beau’s lines. They are usually caused by severe stress to the body.

  • Do You Know How to Measure an Ankle Brachial Index?

    The ankle brachial index (ABI) is a common and useful exam in the outpatient setting to detect peripheral arterial disease. ABI’s should be measured in all people over the age of 50 if they are a diabetic or a smoker. It should also be checked in patients over the age of 60.

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