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Clinical Problem-Solving
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Volume 359:628-634 August 7, 2008 Number 6
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Beware of First Impressions
Oluwaseun O. Falade, M.D., M.P.H., Emmanuel S. Antonarakis, M.D., Daniel R. Kaul, M.D., Sanjay Saint, M.D., M.P.H., and Patrick A. Murphy, M.D.

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In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information, sharing his or her reasoning with the reader (regular type). The authors' commentary follows.

A 64-year-old Filipino man presented to a Baltimore hospital with a 4-month history of worsening midback pain, progressive leg weakness, and intermittent bladder and bowel incontinence. He had no fever or pulmonary symptoms. Magnetic resonance imaging (MRI) of the thoracic spine revealed hypointense T1-weighted and hyperintense T2-weighted bone marrow signal involving vertebral bodies T2, T3, and T4 (findings that were . . . [Full Text of this Article]

Commentary


Source Information

From the Department of Medicine (O.O.F., E.S.A.) and the Division of Infectious Diseases (P.A.M.), Johns Hopkins Bayview Medical Center, Johns Hopkins School of Medicine, Baltimore; the Division of Infectious Diseases (D.R.K.) and the Division of General Medicine (S.S.), University of Michigan Medical School, Ann Arbor; and the Department of Veterans Affairs Health Services Research and Development Center of Excellence, Ann Arbor, MI (S.S.).

Address reprint requests to Dr. Antonarakis at the Johns Hopkins Bayview Medical Center, Department of Medicine, B-1 North, 4940 Eastern Ave., Baltimore, MD 21224, or at eantona1@jhmi.edu.



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