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Image challenge
Elderly patient with mass on the right arm of sudden onset
  1. Antonio J Martín-Jiménez,
  2. Miguel Ángel Cornejo-Saucedo,
  3. Daniel García-Gil
  1. Unidad de Gestión Clínica de Medicina Interna y Urgencias, Hospital del SAS San Carlos, Cádiz, Spain
  1. Correspondence to Dr Antonio J Martín-Jiménez; antoniomartinjimenez{at}hotmail.es

https://doi.org/10.1136/emermed-2018-207977

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    Clinical introduction

    An 83-year-old man with hypertension, type 2 diabetes, hypercholesterolaemia, stage 3 chronic kidney disease and bronchial asthma was admitted to the hospital for community-acquired pneumonia. The patient’s home medications were candesartan, gliclazide, metformin, simvastatin and a combination of inhaled fluticasone and salmeterol; in the hospital, he was treated with intravenous levofloxacin and ceftriaxone. Although his pneumonia improved, on day 4 he experienced sudden pain and swelling in the anterior region of the right arm (figure 1).

    Figure 1

    Deformity in the anterior mid-upper arm.

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    Footnotes

    • Contributors DGG planned the study. MACS and AJMJ did the clinical history, treated the patient and collected the images. DGG critically revised the manuscript and reviewed the bibliography. AJMJ wrote the manuscript and submitted the study.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; internally peer reviewed.