Medical Mystery Solved - The Road Less Traveled | NEJM

This Double Take video from the New England Journal of Medicine presents the
real-life case of a woman with progressive chest pain after a trip to Puerto
Rico, where she spent time exploring local national parks and caves. Viewers
are guided through the differential diagnosis of the patient’s presentation and
how it evolves with the diagnostic evaluation, culminating in the patient’s final
diagnosis and clinical course.

For further reading, the following Interactive Medical Case, referenced in the
video, is available at www.nejm.org/doi/full/10.1056... : The Road Less Traveled (Romano et al., in the
September 21, 2017, issue of the Journal).
The New England Journal of Medicine is the world’s leading general medical
journal. Continuously published for over 200 years, NEJM publishes
peer-reviewed research along with interactive clinical content for physicians,
educators, and the global medical community at NEJM.org.
#medicaleducation #clinicalmedicine #nejm #doubletake #interactivemedicalcase #diagnosticevaluation #emergencymedicine #differentialdiagnosis

[@mattcool97]

As soon as they mentioned she was in a cave I knew that was going to be the key to the diagnosis 😄

[@BUY_YOUTUB_VIEWS_481]

The cinematography is outstanding. Each shot feels purposeful, contributing to the overall emotional impact of the video.

[@kemarbarrett2832]

The visuals were amazing and loved the morning report style approach 👏🏽

[@thomasli2561]

Thank you very much for the video. In my opinion, with the presence of acute pleuritic chest pain with tachycardia, even in the absence of elevated D-dimer, a CT pulmonary angiogram is essential for diagnosis if resource is available. Without the CT, the subtle lung shadow and lymphadenopathy cannot be detected.

[@narek335]

Just wonderful! We need more of these!

[@alirezazakaie1106]

Perfect

[@doctorjunaid3924]

More cases

[@hhuk8698]

This is uncommon in our state.

[@wowhimin]

IDK. Look at the CT scan. "Mediastinal and hilar lymphadenopathy" seems to be too simple to describe those mediastinal and hilar lesions, to my eyes. They are not that nodular, they are rather diffusely infiltrative. And those lesions are obliterating normal mediastinal fat planes. It could be just "lymphadenitis", but I would probably suspect more than just simple "lymphadenopathy" if I see this kind of lesions. For example, I would probably include fibrosing mediastinitis (possible complication of various causes including histiplasmosis, IgG4-related disease, and tuberculosis) as my DDx, although it is a less likely diagnosis considering its low incidence.