A 30-year-old man with a history of IV drug use was admitted to this hospital because of fever, myalgias, polyarthritis, and rash. Results of liver-function tests were notable for mildly elevated hepatic aminotransferase levels and a normal bilirubin level.

A 77-year-old woman sought neurosurgical and neurologic consultation because of a long history of left thoracic pain, for which no cause or effective treatment had been found. Review of imaging studies revealed multiple perineurial cysts in the thoracic spine.

A 16-year-old girl was admitted to the hospital because of trauma and extensive burns sustained in a car accident. She had traumatic brain injury, crush injuries to the limbs, and inhalation injury. Management decisions were made.

A 56-year-old man presented with recurrent bone pain, stress fractures, and hypophosphatemia. A tumor of the jaw had been resected in the past, with resolution of symptoms. Studies of the jaw revealed no recurrent tumor. Diagnostic tests were performed.

A 65-year-old woman was admitted to the day-surgery unit of this hospital for release of a trigger finger of the left ring finger. A carpal-tunnel release was performed. After the procedure, the surgeon realized he had performed the wrong operation.

A 48-year-old man was seen at this hospital because of cough and pain and a lytic lesion in the scapula. He had been well until 2.5 months earlier, when a cough and scapular pain developed; a chest radiograph reportedly revealed pneumonia and a lytic lesion in the scapula. An excisional biopsy of the scapular lesion showed granulomatous osteomyelitis; all cultures were negative. Computed tomography of the chest revealed reticulonodular infiltrates and cystic lesions in the upper lungs. A diagnostic procedure was performed.

A 26-year-old man experienced the sudden onset of back pain. Magnetic resonance imaging disclosed a pathologic fracture of the T9 vertebral body. A chest radiograph and computed tomography of the chest showed a mass in the upper lobe of the left lung, with involvement of the hilar and mediastinal structures. Diagnostic testing was performed, and a management decision was made.

A 55-year-old man was sculling when his boat collided with an eight-person shell; the prow of the larger boat entered his lower back and exited through his abdomen, throwing him into the water. He was taken to this hospital, where the trauma surgery team took over his care. Members of the team discuss the problems of traumatic abdominal and orthopedic injuries and the role of trauma systems.

A woman who had recently fractured her ankle said she had chest pain and then collapsed at home. She had no palpable pulse but was resuscitated and taken to the hospital; additional episodes of pulseless electrical activity occurred. An electrocardiogram showed a rate of 56, atrioventricular dissociation, and a right bundle-branch block. A bedside echocardiogram showed no pericardial tamponade. Despite aggressive resuscitation, her blood pressure and oxygen saturation remained low. A therapeutic procedure was performed.